Appendix G.docx
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- Solicitation number
- RFSQ-BHS-FY25-0066
- Issued by
- Santa Clara County, California
About this file
This is a Cultural Competence Form for the County of Santa Clara Behavioral Health Services Department in response to RFSQ-BHS-FY25-0066 regarding Children, Youth, and Family System of Care Services. Offerors are required to demonstrate their ability to apply cultural, gender, and language-specific competencies to the services provided under this solicitation. The form requires respondents to identify their staffing capabilities across multiple cultural groups, including African American/African Ancestry, Latinx, Native American/Indigenous People, Asian American, and Pacific Islander populations, as well as LGBTQ+ staff capacity. Offerors must indicate whether these competencies are included in their staffing work plan or identify partner agencies, including other Behavioral Health Services Department contracted agencies, that have arrangements to respond to referrals for populations not directly served by the offeror's staff.
Language accessibility is a critical component of this requirement, with offerors required to identify staff capacity in Spanish, Vietnamese, Mandarin/Cantonese, Farsi, Tagalog, Russian, and other languages as applicable. At minimum, services must be made available in the seven threshold languages specified: Spanish, Vietnamese, Mandarin, Tagalog, Cantonese, Farsi, and Russian. Offerors that lack in-house language capacity must document arrangements with partner agencies to ensure service delivery in these languages to meet the County's cultural competence standards for the Children, Youth, and Family System of Care Services program.
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Text version
APPENDIX G
County of Santa Clara – Behavioral Health Services Department RFSQ-BHS-FY25-0066: Children, Youth, and Family System of Care Services
CULTURAL COMPETENCE FORM
Offeror Name:
Program Category:
Identify the Offeror’s ability to apply cultural, gender, and language specific competencies to the RFSQ services provided by checking all that apply and/or provide the name of Agency that you have an arrangement with to respond to these referrals.
| Cultural, Gender, and/or Language Competence |
| Have staff |
1 2 Name of any agency, including BHSD contracted agencies, with which you have an arrangement to respond to these referrals.
| Included in staffing work plan |
| Not included in staffing work plan (Explain below) |
African American/African Ancestry Staff
Latinx[footnoteRef:1] Staff [1: Latino/Latina/Latinx]
Native American/Indigenous People Staff
Asian American Staff
Pacific Islander Staff
Other cultural competencies:
LGBTQ+ Staff
Spanish
Vietnamese
Mandarin/Cantonese
Farsi
Tagalog
Russian
Other Language(s)[footnoteRef:2]: [2: At minimum, services shall be made available in the seven (7) threshold languages (Spanish, Vietnamese, Mandarin, Tagalog, Cantonese, Farsi and Russian).]
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