May/June 2014 Issue

Community Connectors — White House Recognizes Value of Social Workers
By Lindsey Getz
Social Work Today
Vol. 14 No. 3 P. 8

An unprecedented day for the field of social work took place in Washington, DC, this past September in the historic Eisenhower Executive Office Building. The White House briefing for social workers, “Addressing the Social Determinants of Health in a New Era: The Role of Social Work Education,” included four panels focusing on the importance of social workers as the Affordable Care Act (ACA) moves forward. Event leader Darla Spence Coffey, PhD, MSW, president of the Council on Social Work Education (CSWE), says the “door is open,” and social workers are being recognized for the critical role they can—and do—play in the health care sector.

“We, as social workers, are in an ideal position to educate on the Affordable Care Act,” Coffey says. “We’re already working with people who could use assistance because they may have never navigated the health insurance world before—they never had insurance.”

The navigation skill set certainly is not something new for social workers. “We’ve already done this; helping people navigate systems is what we do,” says James Herbert Williams, PhD, MSW, dean of Graduate School of Social Work at the University of Denver and president of the National Association of Deans and Directors of Schools of Social Work. “We’ve served as a guide, helping people navigate the welfare system, or worked with elders to navigate Medicare or Social Security. Advocating and educating is an essential part of who we are, and it will be no different with the Affordable Care Act.”

“I believe social workers have played, and will continue to play, a critical role in educating the public about the Affordable Care Act,” adds Marilyn Luptak, PhD, MSW, an associate professor and the chair of the Aging in Social Work Concentration at the University of Utah College of Social Work. “We are ideally suited for this role given our profession’s unique person in environment perspective, our long-time advocacy for vulnerable populations, and our ability to use plain language to help patients and families in health care settings understand complex health information. All of these factors are relevant as we work with consumers to help them understand and navigate the intricacies of the Affordable Care Act.”

Social workers also may play a role in clearing up some of the confusion that exists surrounding the act’s implementation, though Coffey points out it’s not always easy to clear up confusion that’s not of one’s own doing. “Even so, it is still a responsibility for social workers to be current with their knowledge of the act,” she adds. “People can become easily discouraged when things become confusing or difficult, but we can be ready to support them and offer the follow-through that may be needed.”

Contribution to Wellness
While navigating the changes that the ACA brings is a critical role for social workers, Coffey says it doesn’t stop there. “With the Affordable Care Act, there are going to be many more seeking out insurance and more navigating a health care system they may not be familiar with,” she says. “We need to think about how to deliver care differently. There are going to be roles for social workers to play when it comes to the delivery of care as well.”

The intermeshing of social work and the health care field is not new. Social workers always have been integral in health care delivery, Williams says. “But what’s happened with the shifting of managed care and changes to other positions within the health care segment is that social workers have had to rethink their roles,” he says. “At one point, social workers might have been primarily thought of in the discharge process. But I think with the onset of the Affordable Care Act, it has put social workers back into the total conversation.”

Going forward, this may mean social workers play an even more critical role on the front end of patient care. The tools always have been there and social workers certainly had the capabilities for preventive care, but the field may have pushed social workers more toward working with the “already sick.” Now that’s changing.
“The shift toward managed care and prevention is all about people living healthier lives so that they’re not high users of service,” Williams says. “Social workers can be effective in encouraging medication compliance or chronic disease management and helping people remain healthy and out of the hospital system.”

Richard P. Barth, PhD, MSW, dean of the University of Maryland School of Social Work, agrees that social workers definitely can play a key role in community wellness. “Even though they’re not physicians, social workers are playing a critical role in managing people’s health after illness or a hospital stay by doing follow-up and encouraging a medication regimen. They’ve demonstrated they can reduce readmission rates. I think there are a lot of opportunities for social workers in promoting wellness. They can encourage improved lifestyles by encouraging exercise or nutrition, or running smoking cessation programs at places like local churches, community centers, and more.”

Team Players in an Integrated System
During the White House briefing, Luptak addressed new expectations of health care under the ACA, while Anand Parekh, MD, MPH, deputy assistant secretary for health for the U.S. Department of Health and Human Services, emphasized the importance of linkages and connectors between the community and health care providers—and the value of social workers in making those connections. This connector role truly will be integral within the new health care model that makes use of an increasingly team-based approach.

“As a long-time geriatric social work practitioner and educator, I think it’s essential for social workers to take on leadership roles in the Affordable Care Act pilot projects and demonstrations aimed at improving coordination among primary care providers, specialists, and other providers, and helping adults manage their own care,” Luptak says. “Social workers have long understood that unmet social needs lead to worse health for Americans.”

At a recent Boston College Graduate School of Social Work forum, Massachusetts gubernatorial candidate Charles D. Baker, Jr., also made the case that social workers will be critical within the team-based approach to health care issues, which is valued in this new era. He says social workers already are trained for cross-disciplinary collaboration. “If everyone has a role and if everyone plays a role, good things happen,” he says.

But Williams says that, given this new model, further training is important. “Some social workers are already prepared for integration, but I believe more training and curriculum changes can even better prepare social workers to work successfully within the new team-based model of health care,” he says. “This integrative approach is a new way of thinking about health care and opens the door for changes to the social work curriculum and the way we talk about health care.”

Further training is just one way that social workers can help keep the door open now that this administration has made it clear that they believe in social workers’ ability to better assist within the new health care model. “The door has been opened to recognizing the value of the social worker,” Williams says. “As Dr. Coffey has said, we absolutely need to keep that door open.”

“I think some light bulbs have gone off, and the value of the social worker is getting attention,” Coffey adds. “But we, as a profession, now need to make sure we continue to communicate our value as we bring the goals of universal health care coverage to fruition. Knocking at the door is not enough. We can play a much more integral part in health care delivery, and we have the opportunity to now do that. Now that the door is open, let’s make sure we get in.”

— Lindsey Getz is a freelance writer based in Royersford, PA, and a frequent contributor to Social Work Today.