Appendix G.docx

This is a Cultural Competence Form (Appendix G) associated with a Request for Statements of Qualifications (RFSQ-BHS-FY24-0084) issued by the County of Santa Clara, California, Health System Behavioral Health Services Department for Program Evaluator Services. The form requires offerors to demonstrate their capacity to deliver culturally competent evaluation services by identifying available staff with relevant cultural, gender, and language competencies. Offerors must check applicable boxes indicating the availability of staff representing African American/African Ancestry, Latino/Latinx, Native American/Indigenous People, Asian American, Pacific Islander, LGBTQ+, and other cultural backgrounds. Additionally, offerors must specify language capabilities including Spanish, Vietnamese, Mandarin/Cantonese, Farsi, Tagalog, Russian, and other languages as applicable.

The form requires offerors to indicate whether identified cultural and language competencies are included in the staffing work plan or, if not included, to provide an explanation. Alternatively, offerors may identify partner agencies with which they have arrangements to respond to referrals requiring specific cultural or language competencies. The solicitation establishes a minimum threshold requirement that services must be made available in seven specified languages: Spanish, Vietnamese, Mandarin, Tagalog, Cantonese, Farsi, and Russian. This cultural competence assessment is a mandatory component of the qualification evaluation process for firms seeking to provide program evaluation services to Santa Clara County's Behavioral Health Services Department.