Social workers will be needed in greater numbers as integrated care systems for Americans grow in coming years, said a panel of experts at a Capitol Hill briefing in June.
Integrated care is the systematic coordination of general and behavioral health care. According to the Substance Abuse and Mental Health Services Administration, integrating mental health, substance abuse and primary care services produces the best outcomes for clients and is the most effective approach to caring for people with multiple health care needs.
To help underscore this transition in health and mental health care delivery, the Action Network for Social Work Education and Research, or ANSWER, Coalition, in cooperation with the Congressional Social Work Caucus, compiled an expert panel for the Capitol Hill briefing “The Role of Social Work in Integrated Primary Care.”
“Person-centered care is second nature to social workers,” said Victoria Stanhope, associate professor of social work at New York University Silver School of Social Work and one of the panelists. “For social work, it’s always been about the relationship.”
“Person-centered care marks an important shift away from the medical model — acknowledging that people are experts in their own health care and that the treatment plans must be the result of shared decision-making,” she told attendees that included health care leaders and representatives from Congress.
As integrated care progresses, it’s vital that the client is active in her or his health care treatment plan, Stanhope said.
Working with other health professionals, social workers have the training to help clients navigate a cross culture of health systems. They also can address client disparities and instances of individual and/or institutional racism, she said.
“Social workers understand the complexity of people’s lives and how they are shaped by social environments,” Stanhope said. Because of this, they are qualified to be key in the health-reform shift from case management to care management.
Schools of social work across the U.S. are working to address the changes in health care reform, in curricula and field training, she added.
Another panelist at the briefing was Virna Little, senior vice president of psychosocial services and community affairs at the Institute for Family Health. She oversees the administration and delivery of behavioral health, community and grant-funded programs in 26 federally qualified health centers in New York.
Social workers are the professionals she said she can count on to be flexible in meeting the variety of services clients need in an integrated-care setting, from insurance enrollment to locating social services.
“Social workers get the macro and micro training,” Little said.
The Affordable Care Act encourages the growth of Health Homes, which incorporates community support systems and resources as well as coordination and integration of primary and behavioral health care. More social workers will be needed to work on Health Home teams, she said.
Social worker David Johnson is the director of Health Care Programs at WellPoint Insurance’s Government Business Division and leads the organization’s Health Homes initiative by building community collaborations to establish a holistic health service delivery model.
He offered a case vignette about a recent widow with diabetes. A primary care physical may focus on the widow’s physical ailments, but a social worker — working on a team approach with the client — can uncover the personal reasons the client is suffering new ailments.
In this case, the social worker discovers that the widow’s now-deceased husband used to oversee her medications, meals and even exercise.
“This is a different kind of approach,” Johnson said.
He urged attendees to address how health care policies can support or restrict coordinated care services. Removing limits on same-day health services and breaking down the separation of reimbursement streams for physical and behavioral health treatments are examples, Johnson said.
Alexander Ross is a senior adviser for Behavioral Health, Health Resources and Services Administration for the U.S. Dept. of Health and Human Services.
He said part of the HHS $9 billion annual budget is used to train the next generation of health care providers. Thanks to the ACA, social workers will be among the benefactors of new HHS incentives to increase the workforce in new health care models. Training for existing social workers will also be part of the plan, he said.
“Social workers for decades have foreshadowed the health care enterprise taking shape today,” Ross said. “The profession was the first to deliver team-based and patient-centered care.”
New initiatives are in the works to increase the number of social workers and other health professionals in home-visiting programs as well as behavioral health and substance-abuse programs across the U.S. There are also efforts to increase the number of MSWs and master-level psychologists in high-need populations, Ross said.
He noted that SAMHSA’s Human Resources and Services Administration Center for Integrated Health Solutions’ website, offers numerous resources for the development of integrated primary and behavioral health services.