Organizations often pay good money for diversity of equity training. However, the employees return to the same environments. They work with the same coworkers and use the same tools. Policies, practices, funding and service gaps have not changed. These are just some of the ways that structures of a system powerfully move individuals. Professionals can have a high level of commitment. However, systematic changes are needed to shift to a person and family-centered practices that are culturally responsive. This requires more than training. It requires ongoingconcerted effort and focus. It requires accountability. It requires that people for whom the system has not worked well, be represented and present at all levels of discussion and decision-making. This includes being part of the workforce that delivers services and sets policy.

• Just because it’s always been done that way doesn’t make it correct.
• Just because the form or record asks for this information in this way, doesn’t mean it’s harmless.
• Recognize that all tools and processes are built around the needs of the practitioner and systems unless they have been explicitly built to be person and family-centered.
• Developing solutions for communities without leadership and guidance from those communities is a perpetuation of the problem not a solution to the problem.
• Organizations need to reflect the racial, linguistic, and cultural backgrounds of people served as much as possible or people may avoid services.
• Services that take people away from their home and family, may not be acceptable.

Individual need to look beyond their own practices. They must insist that their organizations and the broader systems engage in a process of change. They need to support direct representation of members from underserved groups in all aspects of service delivery. They can documented and share issues that interfere with their ability to be culturally responsive. This can be used to consider changes at all levels of practice and policy.

During an assessment a professional is asking questions and filling out an electronic form. The form asked the person’s gender. It only provides two options: male or female. It will not move forward without an answer. When asked for a gender identity the person says they do not affiliate with one gender. They say they prefer to be recognized as non-binary in regards to gender. The assessor says: “I can’t move forward on the form if you don’t pick a gender.” There is some discussion in which the person tries to explain why they cannot select a single gender. The assessor says: “I understand but we have to do something or I can’t complete the assessment. Let’s just put down whatever is on your birth certificate.”

What implications do you see for this as far as person and family-centered practice? How does it affect the interaction today? How does it affect each person’s ability to work with professionals in the future or to receive quality person and family-centered services? What could be done differently from your view that might work better, if anything?