Social Welfare Policies and Services

Introduction on learning outcomes

- Definitions adn basic concepts in social welfare policy
- Relationship between social work ethics and policy
- Approaches to social work and social welfare policy practice

Module 1 - Policy

Social Work Policy and relation to social work

- How will policy play a role in the profession or impacts the community?

Defining Social welfare

"The institutions in modern industrial socieities that promote economic and social
interdependence and deals with the problems of dependence"

Implication:
- Recognizes the human need of interdependence and an institutional means of social control
- Means to redistribute societal resources status and power and reproduce prevailing social,
economic and political relationships

Influnced by and reflects the Evolving historical framing of

- Societal priorities: Addressing the problems
- Views of individual and social responsibility : How much societal supprot is there or individual
to meet their needs
- Views of human nature and human need: What is need?
- Views on the nature of change: What is change and how can it impact

Policy : Guide or Plan For decision making

(a) Public Policy: Any Action taken by Government; A general term for decisions laws and
regulations put forth by governing bodies

(b) Social welfare policy: Action taken by govenrmnet that deals with benefits to vulnerable
populations and universal services
- Frameworks that inform, limit or advance social work practices and the Goal of social justice

Socail welfare are programs, services, institutions that deal with and support well being
- Policies are providing these needs through programs

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Characteristics of policy

1. Socially Constructed
- Policy responses and social problems have been created by humans
- continue to be held in place by consent or failure to change them

2. Reified
- We treat them like they exist outside of human creation
- Seem necessary and unavoidable

Eg Poverty: Poverty will always be there. Can we use policy to Eradicate poverty?

But we can make change:

- It is important to know of biases
- develop critical consciousness : transforming social policies that are unjust
- Develop awareness

Social Justice

"An equitable distribution of resources enabling all members of society to eb psychologically

and physically safe and secure; a soceity where individuals famillity and groups are able to
achieve a balance of Self determination and interdependence"
- Process and Outcome

Connection between Social work and Welfare Policy

- Social Welfare Policys are Means to effect Social Change : We can facilitate the change
- Reciprocal relations: PRactice affects policy and vise versa
- knowledge of personal experiene of people affected by policies
- Social workers are viewed as experts who can provide insight and explain rationale of social
programs and policies: Testify before people
- Advocacy aas professional requirements facilitates need for social welfare policy analysis

"Social work policy as the mutual representaiton of clients or causes in a forums

attemping to systematically influence dicision making in an unjust or unresponsive system"
- we need to be aware of the policies
- Garner support for the areas that are impacting the marginalized or under-representted
populations

Social Welfare Policy and American Exceptionalism

- We need to consider the legacy of discrimination in our society

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- Social problems in America = historical values + economic ideology/ structure + legacy of
discrimination
- inadequate social policies in US shaped by dominant conservative ideologies

Conservative:
- Desire to uphold traditional attitudes and values while being cautious about change.
- Often passed down through generations , shared by large numbers of people
- Makes sweeping change harder to accomplish

Historical Values in the US

2 core themes:

1. Individual

- Individualism: Individuals should meet their own needs. No need for government support
- Independence

2. Work

- Protestant work ethic : high value on work. Working hard enough will achieve material
success.
Work harder for equal opportunity and playing field. Does not acknowledge structural
inequality
- Self Reliance
- Upward Mobility
- Equal Opportunity

Values, Privilege and Social welfare Policy

- Dissemination of dominant values through social welfare policy allow those in pwoer to
maintain privileged status
- Those in power control dominant values and control policy: Control narratives around these
values. Therefore, Social welfare policy maintains status quo

Note: America has limited radical political tradition to critique/ challenge Status Quo or
propose socially just alternatives

We focus on political principals that aim to alter social structures though revolutionary means
and change value systems in ways:

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- incremental approach: Small changes to the social structure and systems rather than broad
changes.

Recurring themes in Social Welfare Policy

1. Universality vs Selectivity
- 2 branches of policy:

(A) Universality: Everyone is eligible for benefits

(b) Selectivity: needs based criteria for benefits

2. Social Insurance v. Public Assistance

- Social insurance programs that are broad in scope (Universality)
- Public Assistance: Selectivity based programs where benefits are needs based

3. "Deserving" Vs "Undeserving" Poor

- Indivuals in need are viewed as deserving in need or underserving in need : Affects the way we
structure policy

4. Social welfare policy and Social Control

- Is Policy aimed at meeting the needs in the society and supportinng their self sufficiency
- Or are there control: Guidelines to meet ot recieve benefits .

Social Justice and Policy: Challenges and Opportunities

1. Complex systems
- Unintended Consequences : Individual Incentive structure

2. Multiple Goals
- Efficiency? Productivity? Control?

3. Conflicting perspectives/ interests of parties involved

All of these challenges are opportunities to engage in social welfare policy and advocate for
policies that are socially just
- how micro, macro and mezzo systems are connected: Unique perspective to understand
complex systems and engage in discussion in an informed way.
- Focus on dialogue and challenge opinions and discussion, to work together to advocate for the
client.

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Overview of the NASW
- SW is a profession grounded by ethics
- Different countries have its own ethics s

commonalities across multiple codes:

- Empowering individuals and communitiei
- Advocating social justice
- Promoting democratic participation

NASW code of ethcis

- Revised in 2017
- Reaffirmed commitment to influencing policy and social change
- Mission of SW is to enhance well being and help all people to meet their basic needs
- SW focused on the impact of hte environement and other macro level forces, eg policy
- Advocacy, social and political action, policy development and implementation are just as vital
as direct practice to the fields commitment to social justice and change

Ethical Obligations

1. Promote the General Welfare of society and development of people, Communities and their
environments

2. Advocate for societal change that leads to the fulfillment of basic human needs, promotes
social justice

Ethical obligation: Public participation

- Facilitate informed participation by the public by shaping social policies and institutions
Eg community education, Voting , Engaging policy makers

- Provide professional services in public emergencies to the greatest extent possible

Eg Natural disasters, public health crisis

Ethical Obligation: Social and Political Action

- Engage in social and political action that promotes equal access to opportunities for all people
to meet their basic human needs and develop fully
- Understand the impact of the political arean on practice and advocate for changes in policy

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and legislations to improve social conditions and promote social justice
- Expand choice for the opportunity for all peopele , particularly the vulnerable, oppressed,
exploited and those living in poverty

- Promote conditions taht encourage respect for cultural and social diversity within the US and
globally
Eg Promoting policies and practices that:
- Demostrate respect for differences
- Support the expansion of cultural knowledge and resource
- Advocate for programs and institutions that demostrate cultural competeence
- Safeguard the rights and confirm equity and social justice for all

- Act to prevent and eliminate domination of, exploitation of and the discrimination againt any
person, Group or class on the basis of identity ( Sex, Gender)

IFSW Code of ethics

International Federation of Social WOrkers (IFSW) is a global social work organization that
promotes social justice, human rights, social development and international collaboration

- Sets General principals for practice

- The mission of SW is to:
(a) Promote Social change
(b) Solve problems in human relationship
(c) Empower and liberate people to enhance well being

- Socail work intervenes to assist people with interacting with their environments
- The principals of HR and Social Jutice is paramount to SW

Social workers have an ethical obligation to challenge unjust policies and practices
- This obligaiton is defined as an ethinical responsibility to promote social justice

Promoting Social Justice

- Challenge "negative discrimination" on the basis of identity
negative Discrimination: Synomous with "discrimination"
Contrasts with "postive discrimination" whcih is used to refer to "affirmative action"

IFSW Obligations

- Obligation to ensure that resources under their control are distributed equitably

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- oblgation to respect the ethnic and cultural diversity of the communities in which they
practice.
- Obligations to inform employers , policy makers, politicians and the general public of
Inadequate resources, policies and practices
Resources, policies and practices taht are distributed in an oppressive, unfair or harmful way
- Obligation to work alongside other social workers:
Challenge social exclusion
challenge stigmatization or subjugation
Work towards an inclusive society

interview with Abigial

1. Role of NASW in social policy
- Creating services that help members, and help those who are vulnerable
- Creating services and products: Such as training, enhance skill sets to the practitioners
- Lobbist to Lobby for policies that help to lobby for access to care. ( Employment, resources,
healthcare). Meeting with policy makers.
- More voice throughout the State. Assessing the bills put forth, to fully understand them

2. How to involve
- Ulink for students
- Professional practices to bring social workers together
- Commitment to the profession as a society.
- Delegate Assembly to revise code of ethics.
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Module 2: Approaches to policy, critical questions

Learning Objectives
- Understand basic pproaches for social welfare provision
- Explore underlying values in Social wfare policy
- How the underlying values impact and shaped policy
-Descrime the Social work and social justice lense
- Key themes in social welfare policy through social work lens
- WHy social workers should care about policy

Definition of Social Welfare policy

- Set of choices
- Not a Neutral or objective activiy but shaped by people, history, context and vlaues

A social Welfare policy is :

- response to societal issues and conditions

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- policy created by groups that brings values, assumptions and perspective into developing
policy
- SWP reflects choices about how best to provide help and to whom given limited resource
- Shaped by visions about what and how Govenments should provide support
- SWP often change over time, as opinions, context and values change.

7 Frameworks to understand Social Welfare Policies

1. Deservingness (Poors Laws)

- Assumes that certain types of individuals are more worthy of help than others
- Dates back to the English Poor Laws (U.S)
Eg policies for the able bodied vs Vulnerable people (elderly)

2. Last Resort (application process)

- Assumes assistance is used only as a last resort
- Eg Application for Social Welfare programs.

Eg for State Department website requires applicants for food stamps to fill up: income, rent,
social security numbers etc.
- Long process that believes that barriers for assistance will enable people to find help
elsewhere

3. Paternalism (Behavioural requirements)

- Practice of controlling individual/group in the way Father controls a child
- Assumes Benevolent control: But it restricts freedom of choice

Eg Work Requirements/ Behaviour requirements for asssistance

- Limits recipients freedom by demanding they find work in the name of finding whats best for
them
- Assumption that job= productivity

4. Market-Based (Work Requirements)

- Social welfare policy shoud not interfere with the functioning of the labour market
Eg Giving out Cold hard cash will create distortions in the market and incentivizing people not
to work

5. Insurance (Social Security)

- Assumes certain events will happen to large groups and not because of what they have done

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Eg many people will become elderly.
- Social Security Serves as insurance against old age and allow people to leave the labour market
at the time they are unable to work

6. Opportunity/Empowerment (War on poverty)

- Eg Lyndon Johnson War on Poverty programs: Engage communities to come out with solutions
to end poverty

7. Prevention (Early Education)

- Assumes the best way to prevent problems is to address them in the first place

Eg Early Education programs are a good example.

Research shows that children are less likely to be poor by giving them a head start to the future

Other Dimensions to organize approaches

Characterized by
1. Institutional Universal
- Presumes needs are expected: Eg market failures, recession. Not because of their fault
- Takes a preventive approach: Help them before they fail/crisis
- Stresses security than meeting basic needs

2. Residual narrow
- Peoples needs are cause of bad choices/ personal self failures
Eg job loss: Assumes they made a bad decision not showing up to work on time
- Help is provided as a last resort ( application is hard)
- Meets a very specific need Eg foodstamps for only food

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These constructs operate on a continuum
- Some programs may not be completely universal: But serve many more people than
Narrow Criteria. Eg Many over 65 get social security benefits (Universal in scope) compared
Head start program (Serves Under age of 5 with specific income )
- Some Programs may not employ a last resort framework but are not preventative types

Intersection of these constructs?

- Social welfare programs will not fit nicely into the intersections
- But they are a tool for thinking about the assumptions for driving social welfare policies

Values, theories and Critical Questions in SWP in a US context

- Approaches are often based on underlying values and basic critical questions that have driven
social welfare policy developments

1. Who is human, who counts?:

- Some Policies exclude others. They do not count.
Eg The first case for child abuse is not from human based laws but protection for animals
only through that that count children as humans deserving protection

2. Who deserves Policy Assistance or support?

- Voting Laws: Once crimes have been committed, the person is not a voting citizen.
Human but not deserving of status

3. Who is going to act. To what extent the Gov should do or can do?
- Are we giving people things? Context to struggle for things or leaving them unhelped
- IS there a time and place for people to change who they are: Job of policy from being
impoverished or uneducated?
- Role of Gov or Role of Policy to make people better off (eg good education, housing)

4. How can the individual change Status?

- Any way to move or change the status of the individual?

Theories Informing Social Policy in the US

Historical Theories:

1. Feudal Period: Status based on where we live

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Characterized by a belief that people could not change their status. Support when offered was
charity-based, primarily from the Church

- Notion that people were born into positions and remained in the positions.
Eg as worker, nobility, tradescraft people.
- Support by Religion and Government at the time and many believed that was true

Belief System that the Humanity and responsibility of systems are based on
the location and where we were born

Exceptions for charity: People who were visibily no longer work (Young Orphans,
Elderly, Visibly Disabled)
- Need to prove inability to work in order to warrent help by churches or the hierarchy

Phenomenum that interfered with the system

1. Bubonic plague
- Affected Europe and killed a third of population
- Resulting in short of workers prior to the industrial revolution: Manufacturing processes were
employed and created

Effect to social policy:

- There is a need for people to move into cities to support the Industrial Revolution.
- Needed Manpower for work
- Thus, Elizabeth Poor Laws emerged.

Elizabethan Poor Law of 1601

Developed framework of “worthy” and “unworthy” poor. Focused on work, the ability to work,
and the government’s role to promote work

- Representation by 4 Institutions in Law

(a) Alms Houses: Poor who were "Deserving", Visible reason not to work
- State Stood behind, Church stood behind offering services through them
- They are Sufficiently unpleasant that people will not try to get into them, unless necessary

(B) Work Houses: People who "would not work" yet Able Bodied
- Forced Work to receive food, clothing and shelter

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- Marginally less pleasant than Alms houses

(c). Jail/Prison:
- Punishing people who were intractable in workhouses
- Or caught violating Work only Rules (begging, leaving employment)

(d). System to deal with children

- Children who needed to be trained to work, often picked up on the streets for begging.
- Made to undergo Forced Apprenticeships
- Designed to make them work ready.

Encapsulated in these institutions:

- Who is human and deserve help: People who work
- What is Responsibility of State: Avenue to work and insistance of work
- Can people change their status: No

Seeds of Institutions are bred through these

- Todays social welfare policies have a similar structure that divide the "deserving poor" from
the "undeserving poor".
- Enforcement of Work as the ends to means
- When and whether how people can negotiate better wrok

2. Enlightenment Period: French revolution, American Revolution

Focused on citizenship and a new emphasis on rights. Early development of systems for child
welfare

- Changed public thinking about these issues

- Importance of Citizens
- Importance of Children and Development
- Importance of Rights and Responsibilitys

Encapsulated in Laws and Institutions different from the Feudal period

- Development of Organizations of Workers: Guilds, Workshops, Communes
- Rise of Unions
- Rise of Education: Right for all children
- Rise of Policies: Child welfare laws, Family Law, Protection in Institutions

2 Current Theories:

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1. Marxism

Focused on collective organization and action.

Framework developed out of the shift from workers owning tools of production to factory
owners

- Arouse out of Karl Marx assessement of what industrialization has done to the status of
workers, what workers needed to do to respond to that

As Industrialization happened,
- Sustainences and Craftmanship Declined.
- Workers loss control of the "means of production" (Tools and Craftsmanship, including the
result of their labour such as the product)
- Factory workers do not own the tools, nor the product of make.

The Crux of the problems: Workers became dependent on the factory:

- The Solutions was Worker Coalition that leads to revolution

Unions Emerged :
- Negotiation for changes on behalf of worker: Changing Status

Social work link: Programs and Polices were a means to get people to work

2. Social Darwinism

A framework that centers competition. Those who win should receive the most benefits from the
system

- Emerged after Marxism

Borrow the idea of the "survival of the fittest" Could be applied to human society:
- the context for competition is the economy
- People compete for survival in the economy, the fittests survive
- It was a good thing; People Rise to the top in economic competition

Rising to the top; becoming the Factory owner was warranted power, deserved power

Social work link: Programs and Polices That Ease the competition that support the
marginalized

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Weakens the fabric of society
- Believes that Government should do as little to interfere with free market competition

Applying Theory through College tution

- A burden on Students. What happened and Why

In the mid 1900s: A student can pay the entire tuition with a Min wage job
- Many students are able to complete Debt free
- Today, it is hard to do so, and many students go into debt.
Through the lenses of Marxism and Dawinism, we get 2 different answers

State Instutions: Developed from that an educated public is good for society.
Every children could get a college education.
- Many Colleges were supported by Taxes post WWII.

What happened? Through the lenses, there is critiques whether it was appropriate
for the public to support the education.
- It became less of a public good but rather an investment
- At the same time, rising costs of education significantly and regularly:
1. University and College were spending more money, Research & Administration bloat
2. Public Universities supported by taxes decreased

The costs of education for a student has gone up like the cost of living over the decades (normal)
However the costs to students has gone up significantly due to the reduction of taxes share (not
normal)
- Higher education has become an investment (through debt)

A more marxist frame: individual rights and ability to be educated need to be supported
publically (laws, contract, invidiauls ability to be enlightened)

Socially Dwarnistic frame: Access to education is a competition, some will fall out, thats how
society works.

4 Social Work and Social Justice Policy Frames

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1. Empowerment and Stengths based approach
- Help people to use the strengths they have to make the best of their lives

2. Equity Diversity and Inclusion

- Basic Rigths that all people deserve regardless of where they are from. Policy ensures that
they are humans with Basic right

3. Human dignity and Human Rights

- Fight Discrimination and ensure that the most marginalized are prioritized for support over the
more privileged
- priority to the oppressed/ marginalized

4. Interconnections and complexity

- No one lens can solve the problems

A Just Policy Framework

Finn argues for a just policy framework that combines a set of questions to consider
when thinking about social welfare policy

- Who is helped? Who has access?

- What are the implications of the policy? on individuals? on Communities
- Does it promote economic and social equalities? does it challenge systems of privilege?
Eg a tax reform. Eg Same Sex marriage- give equal rights
- Does it honor human dignity and worth?
- Does it see connections to address root causes of issues?

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Application

Eg Food Subsidy- Strength Based

Eg Advocating for safe water: Human Rights
Eg Promotion of Education: Root Cause treatment
Eg Child warefare policy: Promotion of Equity to bring to a level playing field.

Skills Needed for Just Policy Practice

Many Skills needed:

- Reflexive: awareness of own experience and backgrounds, examineing our biases and
assumptions
- Explore multiple perspective and sides
- Examine power : who benefits, who does not
- Critical thinking about possibilities, empowerment and opportunitiy
- Explore root causes and impacts

Reflection on Skills and Lens

- Do we have the skills needed? Do we use them?
- How can we become more conscious over the skills in our own policy work?

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Module 3: Structures in Policy in the USA

Introduction
- Many levels of Government impact the different areas of social policy
- The interaction may affect each other

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Constitutional COmpromises
- The first american Gov was the Articles of Confederation
- Delegates end up scraping them and create a constitution. They had their own agendas-
relating to compromise.
- The Articles could not Government; no president nor Judicial branchs.
- The Government is able to accomplish one thig - States moving wests.
- They forbid Slavery.

The New Jersey Plan: Ensure that the Every State had equal representation

Difficult to count Slaves: Art 1 Section 2

(3/5 of each free person)
- Embedded Slavery into the constitution.

Federalist: Loved the Constitution, Strong Gov will pay debts

Anti Federalists: They didnt want a big Gov, Prefer Smaller State Governments.

Compromise : Basis of the Government

The 3 Branches of Government - Seperation of Powers, Checks and Balance

Seperation of Powers
- Executive : Executive branch executes the Law, with the Gov. Power found in the oath.
- Legislative: Makes Laws
- Judiciary: Interpret the Law
One supereme Court, Other Courts

Checks and Balance

- Each has the power to limit and check the other powers
- Each of them can investigate the executive branches.
- Congress can impeach judges.
- Congress can propose change of Laws.
- The Courts have the ability to invalidate Laws and Executive Orders

The powers came from the Fedualist Powers

- The devices are able to provide safeguards against a tyrannical Government.

Legislative Branch

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- 2 House: House and Senate.
- HOuses of representatives (Senate): Impeaches, Decides Elections.
- All bills about taxes starts in house
- Senate Ractifies treaties
- Senate confirms people, including judges.

Senate: > 30 Yo.

- Deliberative
- insulated from public opinion
- Representative acts as trustee

House:
- Directly impacted by voters
- Closest to the people
- Work on Taxes

Judiciary System
- Trial Courts
- Mootness: Not allowed in Court.

Executive System
- Formal System
- Chosen by Electorial College: Framework protecting against popular vote
- Powers: Ensure the laws are carried out.

1. Commander in Chief
- Keeping Citizen safe.

2. Making Treaties
- Receive ambassador: Legitimize States

3. State of Union address

- To set policy agendas.

4. Veto Laws, Convene congress, Appoint Judges

Expressed Powers : Formal Powers

- Sending powers

Informal Powers

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- Negotiate Executive Agreements: No need to be ratified.
Eg GATT, NAFTA
- Attempt to settle agendas, giving it to Congress to Pass.

Executive Orders
- To Circumvent the Legislative process
- Not Durable as the Law pass through formal methods

Executive Priveledge
- To keep information secret
- Overcame by Court Order.

How the Bill Becomes a Law

- A Bill is referred to the House, Sent to a Committe for Debate
- The Senate Version of Bill is Sent to the House. It move to the Rules Committee.
- The Second House Willl Attempt to change the bill and is resent to pass in the house.

There are many areas that Bills can die (Vetogates)

Social Policy
- Deals with Social Security and healthcare

Separation from Social and Economic Policy

-

- Some attempt to help the poor.

- The Great Depression changed the way Americans Feel about the Government and how they
feel about poverty. They felt it was the Governments job

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How should the Gov Help?
- Social Security (new Deal program):
- Provide monthly payments to 65 years and older
- 7.65% Going into a pot over 65
- Wealth is redistributed from the young to the old.

medicare
- third party payer support for health.

non contributory welfare Program

-Eg Free School Lunches, Federal Housing Assistance, Supplemental Nutrition Program (SNAP)

In Economic Downturns, Welfare needy recipients rose again.

Education
- People are able to obtain good high paying jobs
- Reduce dependency
- Social Policy is education!

Introduction to Budgets in the Development of Social Policy

1. Revenues
- Money collected by Federal Gov to Fund itself and Services
- Almost Half Comes from income Taxes, 10% around Corporate Taxes

2. Expenditures
- money that the Gov uses to fund the services and programs

Mandatory Expenditure: Programs and Functions which are automatically funded absent
changes in law
- Concern that it is the large amount of the Budget (Eg healthcare and social security benefits )

Discretionary Expenditure: Congress authroization needed. Congress may or may not use the
budget.
- No entitlement to receive benefits

3. Authorizations

4. Budget Resolutions

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Ongoing challenges around the Federal Budget

1. Deficits and Debts

- The federal Gov is often in debt; carrying a deficit.
- Controversial

2. Federal Gov can pay for the Deficit

- Bonds.
- Federal Debts is rising; fewer US citizens are holding these bonds.

3. Continuing Resolutions
- They are Stopgap funding mechanisms that keep the Gov funded at low levels.
- No new spending bills etc

4. Government Shutdown
- If the budget is not passed, the Gov may shutdown
- Social Workers need to be concerned. The Federal budget funds many of these programs for
clients. Real Hardship can result.

THe Role of Non Profits and foundations

- making Recommendations
- Providing Funding to raise important issues
- Represent all types of people in the community
- Eg support for Literacy program: wait list in the program. Bringing the different
organizations together in Sync to support the poor.
- Principals of Social work impact the systems. It is important to bring them to play in the way
we ask questions and see the different connections between non profits and SW.
- Note of the Framing of proposals
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Module 4: The History of Social work and social welfare policy

A brief overview of US social Work Early History

- Social work has transformed history in ways that changed lives in communities

Importance of Learning from History

- Serves as a "Warning Device": Alert us to past injustices, challenges. History often repeats
itself

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- Serves as a building block for new ideas: We can generate ideas to move forward
- Understanding role of Power: How power is used to control and oppress people, How power
can be harnesed for change such as masss movements for civil rights
- inspires us to act: Change is possible and people can do and work for change

The work of Social work is that of prehistorical foundations

Influences and early roots of US social welfare

- Often conformed to who is worthy of help and who conformed to their Values and Beliefs
- Those who werent unworthy were less worthy of help.
- Policy were crafted that excluded them.

People were discriminated against due to religion , Racial, other characteristics

We need to take a critical lens to see how they were rooted in assumptions, biases.
- Many of the US policies were also built upon the Judeo- Christian Religious Roots.

Influences for US social Work: 4 Foundations to the US social Welfare System

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1. Mutual Aid
- People taking care of their own
- Started with the rise of Community institutions (Churches, community concept)
- In terms of who these institutions were built for (eg people who worked hard or shared a
common religion)

2. Registration of the Poverty

- The Creation of the Elizabethen Poor Laws that recognized the Poverty
- Seen as the foundation for early social welfare policy
- Set of codes about who is worthy of help (women, children). C
- Categories of people who is less deserving of help

3. Creation of institutions
- Put people who needed help/ support ( many demed as needing to be reformed )
- Rise of Prisions, Mental asylums and orphanages.
- Seen at that time to create more harm: Many poor and unskilled mentally ill people ended up
in these area
- Built on the way to regulate morals and agency.

4. Emergence of Rights
- Poeple start to fight for their rights and reforms
- Movements for Women, African Americans.

Social work emerge in the 19th/20th century as a result of changing conditions

Movement to social rights come as a Response to the challenges facing families due to
industrialization, urban movements as people moved from farming to agregaian societies

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Issues that emerge:
- Issues of OVerrosding and housing, Poverty, Hunger, Unsafe working conditions
- Few organized social services to address needs
- Unsafe working conditions

There were few social services to address the needs. Social Workers aim to relieve issues,
provide proactive solutions and change injustices

Major influenes in Creation of Social Work

1. Charity oRganizations SOcieties

2. Settlement Houses movements

Both came from Europe as strategies to provide social welfare and support to address the needs
and issues coming from the post industrial society

1. The Charity Organization Societies in US (COS Model)

- Launched in 1877
- Goal was to provide direct relief and aid to address individual issues and provide charity.
Based on an idea of applied scientific principals to diagnose individual needs to help. Mostly
they were white women who helped

Women known as "Friendly Visitors" grew rapidly.

- More Organized conferences to help these friendly visitors and the idea to train them became
the basis of social work

- Early Schools Develop: New York School of Philosophy. Objective to train these visitors and is
one of the oldest models

Mary Richmond: She furthered the COS model. The work is to support the systemic approach in
casework.
- Casework is the foundational text to help friendly visitors assess individual experiences.
- Precusor of Case management and key values

Critiques of the COS Practices

- Focus on the individual and not the system: Work one on one, rather than systemic issues
- Many argue that COS is about fixing individauls
- Focused on Biases: White individuals, western european immigrants with little support to
african americans or others of colour
- Perpetuated a sense that the best way to create change was through individual work

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2. Settlement House Movements in US
- Created community/ neighbourhood organizations with the aim to address neds, organize for
changes, provide programs and support immigrants and the poor, Rather than the individual
- Focused on societal issues of poverty (Sanitation, employment, education, arts, recreation)
- Work to improve community through participatory approaches: Working directly with
residents to come out with community driven solutions
- Famous settlers: Hull house (Chicago), Henry Street (New york), University settlement houses
etc

Continues today and seen as the basis for community based practices
- Jane adams is often seen as the development of the settlement house movement esp with
Hall house in chicago

Critiques of the Settlement house movemement

- Led largely by white wealthy women, Practices informed by that perspective and with implicit
biases and assumptions
- Sense that effor was sometimes more about assimilation and to "Americanize" immigrants
- Immigrant culture was sometimes seen as different and less valued
- Moral assumptions about what communities need
- Excluded most african Americans and native americans

African American Settlement Houses

- Many African Americans an Native Americns who came to urban cities were excluded from
settlement houses
- Experienced Racism by workers and settlement houses were seen as forms of social control
rather than support
- Rise of African American Settlement HOuses to support needs (Eg White Rose Mission, NYC)

Influence of Settlement House Movements

Early Leaders: jane Addams, Ellen Gates Starr, Florence Kelley, Lilian Wald, Julia Lathrop,
- Influenced development of Univeristy of Chicago School of Social Service administration and
rise of new forms of social work schools
- Influence develoment of federal organizations : Eg US children Bureau
- Still exists in many communities today

Connection to Modern Social Work

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COS: Case work, individual treatment, Planniing, Person in Environment Context perspectives
SH: Group Work , Community Organiztaion, Root Cause practices

Critiques about US Social Work History

- Challenge to Decolonize Social work History: Many are seen through a white perspective
- Calls to decenter white woman narratives : Stop focusing on only the role of white women
- Expereince role of Global influences
- Examine and lift up indigenous social welfare practices and those of other communities
- Recognize the trauma, oppression, racism, exclusion present in Early social work and
embedded in foundations of social work, welfare history. How do they continue to impact the
practices today

From what lenses is this about, whose voices were included, what perspective would you add?

Timelines in Social Work

1. Founding of Social Work

The Creation of Socail Work led to the Childrens bureau, Labour protections, comprehensive
social insurance, political and voting rights, social justice, inclusion, engagement, participation,
community networks

1840- 1920:
1848: First womens rights convention
1890: Womens Suffrage Association

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1860- 1890: United States Immigration Peaks (14M immigrants)
1861: Beginning of the Civil War due to contrasting ideologies relating to slavery
1862: Homestead Act : Providing incentives for individauls to move west by providing land
1870-1910: Rise of Industrialization. Growing industries in manufacturing, transport, electiricity.
LEd to urban crowding, unsantation, rise im employment.
1882 - 1910: Charity organization society (COS) Formed. "Friendly Visitors" provided social
services in the homes of the urban poor. Many realized the root of poverty was not morals but
multidimensional factors.
1889: Hull House (Settlement house) provides housing, education, lifeskills and social
opportunities to immigrants and those of lower socio-economic status in Chicago
1889: Ellen Starr toured Toynbee hall and became a social reformer that fought in the womens
movement to reform child labour laws
1896: Edward Devine: Became General Secretary of the COS and advocate for a bill for the
Childrens Bureau
1899: Jane Addams: Founded Hull House and social services agencies
1900: Lilian Wald: Provided decent healthcare to residents and founded Henry Street
Settlement house. Championed Public health nursing, housing reform, suffrage and world peace
1900: Mary Richmond: Became the General Secrety of the COS Beleived in the Chldrens
beaureu, help established a network of Social workers. Improved Record Keeping, Casework
and implemented new social works programs for social workers.
1904; Sophonisba Breckinridge: Established the operations of Jane Addams Hull house and
founded the Womens trade union league and chicago chapter of NAACP

2. Social work and the Progressive Era (20th Century - Mid 1920s)

This era is the Early Foundations of Social Work, at a tiem of activism and reform to address the
growing needs facing post civil war US. COS and SH contineud to influence the social welfare.
Rising concens of worker rights and beginnings of the labour movemnet, along with the SH roles
has contributed to the development of federal agencies promoting individual needs and
changing societal conditions

1899: Florence Kelley: Defending the righs of children and working women, worked iwth Lilian
Wald
1904: National Children labour committe: Edgar Gardner created the National Child labour
committee to expose working conditions and work on labour reform;

27
1908: Janie Porter: Creation of the Locust Street SOcial Settlement in 1890. Modlled on Hull
house in chicago.
1909: Ida B Wells: She led an Lyching Crusade and became a Suffragist, Sociologist and Feminist.
1912: Establishment of the childrens bureau, Child welfare policies came about
1914- 1918: WWI
1916: Keating- Owen Child Labour Act Prohigbiting sales of items manufactured by children
under 14.
1916: Jeannette Rankin: First women to vote against WWI, WWII. Worked in the Womens
Suffrage movement.
1918: Social Work involvement in the Veteran Affairs, training courses to treat WWI veterans in
PTSD
1920: Passing of the 19th Amendment granting women rights to vote
1921: Grace Abbott: Director of the Childrens bureau.
1920: Sheppard Towner Act: First Legislation on infant and maternal Health. Petitioned by
Social Workers on the act. Ferrying out the causes of infant mortality, educational literature on
ensuring kids are healthy n safe.

3. Social work and the New Deal

The US was in the boom of the Roaring 20s. However a rise in income inequality and
unregulated banks contributed to hte Stock Market Crash and Great Depression. There was
huge unemployment, poverty and societal unrest. Enviornmental issues led to draught and
impact agriculture.

A new set of policies (New deal by Franklin D Roosevelt) help d

eveloped the foundations of the US social Welfare system. There was the First Federal
Emergeny Releif Adminstration. Many Policies focused on labour regulations, support for
umemployed, minimum wage laws, end of child labour, passage of the Social Security Act of
1935.
PRovided employment through and led to the building of the national infrastructure.
- Wagner Act: Workers right to organize
- Social Security Act : Age old pension scheme, unemployment insurance, health insurance for
people, financial insurancce for widows

African Americans werent covered by the Social Security Program initially.

1929-1939: Stock market crash Leding to the great depression. Left many unemployed and
facing poverty.

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1933: Bertha Capen: Founders of Radical Social work and Unionization.
1933- 1936: The ne deal signed into law by Frank D Roosevelt
1934: Indian Reorganizations act thqt recognize the Self Governing Rights of Native Americans
1935: Harry hopkinns: American social worker and directed the programs of the Work PRogress
administration
1955: Social Security Act is passed ofr older adults, disabled, women and children
1938: Edith Abbott: Founded the Bureau of Public Welfare in 1926
1938: Fair Labour Standards Act (FLSA) created fair labour standareds, including minimum
wage, 8 hour work day and prohibit dangerous work for children under 18.

4. Social Work and the Post War Era

Social Work as a profession had to reat to the changing environment post war. There were
a serie of services needed to meet the needs of families and returning soldiers.

GI Bill (Servicemne Readjustment Act of 1944) Provided support for housing loans, educational
accss and local services. Many African Americans soldiers were excluded from receiving these
benefits. Many AA were unale to attend the white colleges.
Some Social workers were active in the emerging civil rights movement and fighting practicess
such as the GI bill, while others are only focused on clinical work.

Mental Health ACt (1946) supports and brings the focus to mental health. THis highlights issues
of mental health and provided funds for local communities to develop care centres.

1944; Baby Boom

1944: GI Bill: Support fo housing loans, educaiton access, local services.
1946: National Mental Helath Act: Makes Mental health a federal priority. Redirected focus
from institutionalization to Evaluation and Treatment.
1946: Thyra J edwards: SOical workers and reestablish thet first chilcare program in rome to
assist Holocaust Survivors.
1953: US Department of Health, Education and Welfare is found. HEW serves as a cabinet
department to protect and promote wellbeing, safety and education of American Citizens.
1955: NASW formed
1955- 1965: Beginning ofthe deinstitutionalization movement : Institutions housing mentally ill
were shut down paving the way for community model of mental health standard.

5. SOcial Work and the Emergence of Rights

The 1960s and 70s were a time for Civil Rights and Change in US society.
Individuals and groups who were organziaing saw movement in theier rights for political, socia

29
and economic rights. The Civil Rights movement and rise of social movements aimed at
expanding these rights and raise awareness for social justice happended.
Some Gatherings/organizings were:

Civil Rights movement

Black panthers
Brown Berets
American Indian Movement
Stonewall Riots and rise of LGBT
Peace movements
Fights for passage of equal rights
Figt for ethinic studies programs

The Great society (War on pvoerty) were a seet of policy efforts to ddress some issues suchas
Economic opportunities act 964
Amendments to social security
Passage of medicare nad mediaid
Civil Rights act of 1964
Voting Acts of 1965
Older American acts of 1965

1961: Whitney Young JR: Civil rights leader at racial integration and AA economic
empowerment
1961: Wlbur cohen: Worked fro social security, diretor of the dvision of research and statistics
at UM. Established Medicaid and Medicare within SOcial Security
1963: March on Washinton, NASW members and Americans (200,000) marched for civil rights
and social justice.
1963: Community mental health act
1964: Civil Rights bill is enacted
1965: medicare and Mediaid is established. Social Security amendment provided insurance for
older adults over 65
1968: Feminist movement : Centred around changing policy to equalize and empower women
across th eworld. Centred on policy reform on issues suchy as maternal leave, domestic
violence, reproductive rights, womens suffrage. Divided into 3 waves: 19/20th , 1960s, early
21st century
1968: American indian Movement (AIM):Movement tackled social jsutice liek police
harassmeent and racism against american natives.
1969: Stonewall Riots: Police conducts raid against LGBT Community in Greenwich vilage
1970: LGBTQ Movements: Legalization of Same Sex marriage in US
1970: Jack Rothman: Highlighted the importance of community organizing, poltical advocacy

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and social action as components of social work
1978: Indian Child welfare act (ICWA) : mandated that Native Children in child welfare remain
with the native parents.

6. The Push and pull of individuals, Gov and Society

Form the 1980s to present, push and pull between supports for individuals and retraction of
supports. These periods were areas that provided a "safety net" were eliminated. The focus in
anti-poverty programs returns to the individual as the root cause of poverty (rather than
societal issues) . Focus on the importance of work

1996 Wlefare Reform( Perosnal Responsibiltiy and work opoortunity reconciliation act ) created
TANF which focus on : Moving people to employment, time limited benefits, state flexibility in
provision of aid, personal responsibility. IT has not helped to redcue poverty.

2000s: More policies to regulate banks, provide funds for new job training were developed but
struggeld to be passed. Poverty, unemployment, healthcare, and services remain to be critical
issues for social work.
Rise in the Elderly population also meant focus on poverty and healthcare for elders may not be
able to support the baby boomers who were now elderly.
- Gains in the Social movements such as Marriage equality, Womens march, FIght for
immigration rights, Rise of youth voices for gun violence.

1981: Reagonmics: Focus on supply side economics. Tax disproportionality hurt low income
people, including food stamps recipients etc.
1982: Passage of the National Voter Registration acts. Prohibits States from removing registered
voters from voter rolls unless certain criteria met
1990: American with Disabilities Act (ADA): Provided those with physical and mental disabilities
from Discrimination
1992: Housing First Model created to provide housing to those needy as quickly
1996: TANF Block Grant : Temporary assistance for needy family grant provided cash assistance
for families under the 1996 Personality Responsibility and work opportunity reconciliation act
1999: Wrold Trand Organization Globalizaiton protests: Raise awareness to the Economic,
societal and environmental impacts of globalization.
2010: Affordable Care act signed into law: Assessibilty of health insurance. IT should provide
assess to every person.
2012: DACA: Deferred action for childhood arrivals. Provide rermits for young people since
earlier efforts for the DREAM Acts has filled. Scheduled to expire.

31
2014: Black lives mattters emerges in teh wake of the murder trial. Call to the belief of Black live
matters and police violence.
2015: Mariage equality act makes same sex marriages legal in all 50 States
2016: Anti Islamophobia movemnets
2017: Womens march: push for human rights, women rights naad reporudctive justice.
2018: March for our lives: Marching aganst gun violence and calls for stricter gun control policy.

The History of Racial Housing

- There were racial segregation between the whites and the blacks
- communities that were racially divided were considered bad.
- Geographical segregation of racial groups is reciprocal with economic segregation
- the areas that have the most concentrated minority were also the highest poverty rates

Social Work Grand Challenges

- We need social change that can be measured and changed.
- Focus Great minds, build and share new knowledge and foster wider collaborations through
science.
- 12 Grand Challenges that employs new tools that are already in place.
- provide innovative well being, stronger social fabric and a just society.
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SWP 5.0: Poverty and Income inequality

Understanding Poverty

Time, Place and Cultural Meanings

- Poverty takes on different meanings based on time place and context.
- Different Economic circumstances: Poverty in western democracies is different than poverty
in central america
- Different Timings: Poverty in 1818 is different from 2018
Rural Areas In 1818 vs the current time period where standards of living are higher

Conceptual Definitions: Thinking of Poverty in different ways

1. Low Levels of income

- Income is easy to measure
- Commonly used

2. INability to meet basic needs (Experience of material hardship)

- Unable to buy food,housing

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3. Inabiltiy to fully participate in society
- A more multidimensional way to define poverty
- Poverty can keep people marginalized and exclude them from society
- Eg segregated environment. Social Exclusion.

Common Measures
- Income below some threshold (absolute measure) Eg below a dollar amt
- Income below some mark relative to the rest of the country

Absolute measures
- World bank: Less that 1.90/day
- US Census bureau: Anyone whose annual inocme less than 24858 (in 2017 for 2 adults and
children). Anyone above the number is not poor

Where did the number come from?

Historical roots of US Poverty Measurement

- Measure is based on the amount of money needed to purchase low cost diet, with food
assumed to comprise 1/3 of the Families budgets
- Income= all before tax, cash based income earned or collected by members of the household-
Fmailies falling below the threshold amount is poor
- Thresholds vary by household size and presence of children
- Thresholds are updated each year for increases in costs of living

3 Criticisms of the US measure

1. The Poverty threshold does not vary by geography.
A family in New york city (High costs of living faces the same threshold as a family in rural areas
with low cost of living )

Exception: Alaska and Hawaii where food has to be imported and since this is a food based
measure, the original construction took that into account

2. Does not Reflect changes over time in composition of household budgets .

It assums that famiies spend 1/3 of the income on food.
Currently, family spends more on housing costs. Does not take into account.

3. Not all forms of benefits are counted into the account

benefits that is cash is counted, whereas something like an income voucher is not counted

33
Thus, this underestimates the income and thus an overestimate on the number of families in
poverty

Census Bureau Supplimentary measures

- The census bureau has taken some suggestions into account and have a variable poverty level
where some urban areas have a higher threshold than rural areas.

Relative Measures of Poverty

- Income range from 0 to 100.

- The median household has $50
- The shape of the graph shows most households are around the median income.

Countries which use a relative measure

- looks at the median income
- Sets a poverty threshold at some percentage of the median income.
- All people below 16.50 is poor .

Comparison with absolute measure

- Both have a form of numerical measurement that define poverty levels
- However, Relative measure bears relationship to the median income of the country.

Relative measures can account for changes in standard of living

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- In the following year, everyone in the country has more money.
- The graph shifts to the right. Now incomes range from 15 to 100 dollars
- Now the median income shifts , and thus the poverty level increases
- Using absolute measures, the poverty number shrinks. However with the relative threshold,
the poverty level increases with the median

Relative measure assumes that in a given country, some set of people wiill be worst off than
others - Social Exclusion

Absolute measures simply update on the changes in cost of living, not in the overall economic
well being of the country as a whole

Income Inequality
- Gap between those with the most income and the least income
- Usually measured in reference to income and/or wealth (Assets the person has )

35
- Two country has different income ranges.
- Even though income is higher overall in the second country, there is slightly
more inequality but not to a significant degree

- There is lesser divergence in the black line: less inequality

The tighter the range, the less inequality there is

Income distribution in the US

36
it is a pretty skewed Income distribution
- There are very few people in the high income bracket.
- We can measure the 10th percentile in income, 90th percentile in income and so on

Anti Poverty and Income Redistribution policies

- The US combat poverty through provision of money for household and state programs.
- Inequality does not seem to be viewed as an issue for everyone. Some others view it as a
problem.
- Variable Taxes (Lower rates for lower income) helps in redistribution of income levels
That those with lower income keeps more.
- Higher income pay less taxes : higher income inequality

Cash and in kind programs

- Serves as a safety net so household can meet their basic needs
- Cash Assistance
- In kind: Supplemental Nutrition Assistance Programs (SNAP, Food Stamps) ,
Housing Assistance.

Debates of Policy

1. Incentives and Disincentives

- Policy Makers are worried about safety net programs being a disincentive to work

Eg Cash provision means that there is no incentive to work.

Mixed Research on this issue. The Programs are not Generous by any means

- SHould policy be Open Ended or Time limited

Food stamps are open ended while other programs are time limited (eg 15 mths)

37
Idea is to incentivise a certain behaviour such as work and self sufficiency

2. State and local level flexibility vs federal control

- How much Authority should state and local level authorities be given to run the programs

Discussions: Giving States money to run medicaid. They are given their own rules
For States: States know the local population the best and know what they should do to serve
citizens
Against States: To give equitable treatment for all states, there should be federal control

- Block Grant Vs Federal: Block Grant means that The money may run out while Federal money
is guaranteed

1996 Welfare Reform as a case study:

1996 Welfare Reform: Prior to 1996 there is a welfare program part of the Social Security Act
serving single mother. In the 80s,90s, there were talks about the program:
- Open ended way of giving assistance that women were staying on welfare for extended
periods of time.
- States should know best and allowed to experiment
- Reforms replaced the aid to temporary assistance programs: It has a time limit up to 5 years
- The program also has work requirements : Be employed, Looking for a job
- It has Fixed Funding: A Block Grant, when the money is gone it is gone. There is evidence that
some states restrict assess to the program

This is a startling example on how concerns about how grants are distributed play out in a real
way that affect families

Earned income tax credit (EITC)

- A combination of Traditional anti poverty tax polices and incentives that are embedded in
social welfare
- Cash in the form of tax refund to qualify families who have low moderate earning

38
- The amount of Credit Received is increasing as income increases
- The amt of credit is capped to no more than 3400 dollars
- At certain earnings, the credit is phased out and eligibility ends.
- This reflects the concern on the dependency of policy welfare programs
- serves as the nations antipoverty program.
- It redistributes some income

The complexity of poverty and the struggle for the American dream
- Development of the Low Wage Labour market: Lots of people paid low wages. Is social
isolation theory still hold today?
- There are parts which are still issues: if people have access to jobs, they would get better pay
and thus better lives.
- There was no public safety nets, folks were under lots of dept. Systems are not working for
families of colour.
-Policies are often used to oppress others.
- There are many ways that reparations can be achieved: Better wages, giving workers more
power.
- Listening to others stories is important. Statistics and Gov reports is impt.

Combating inequality with asset development

- Solving poverty through Assets: Racial Welath gap.
Does having education reduces poverty?
- How do we create opportunity and equality through education? This does not be the case.
Dept occurs.
- Financial inclusion: maing people have acedss to child savings accounts
etc

Child savings accounts: They are to conceptualize how to think about monetary matters.

39
iT affects all children across their timelines in all areas. They are bank accounts , that are for
investment.

- Research found that savings in Maine was successful.

- However, can the Poor save? they do save. They save small amounts of money
- For CSAs, they can mitigate hardship. It reduces the negative effects of hardships.
Social development, enrollment, diversified portfolios etc.

Access to opportunity is important

--------------------------------------------------------------------------------------
Module 6: Issues of access

Health and mental healht policy: Frameworks

- Should the federal government be involved in providing health insurance?
- Historically, there is limited involvemnt. Many obtain insurance through employers.
- Some argue that private insurance is more efficient and less costly

What is healthcare reform

- It is a term to describe major health policy creation or change
- Denots govenrnment role in the administraiton and delivery of healthcare

Universal healthcare vs Single payer healthcare

Organized healthcare: A combination of private and employer healthcare

SIngle payer healthcare: Provision of healthcare thorugh the Government

40
Healthcare reform - 100 Years of tensions
- Franklin Roselvelt was thinking medical healthcare in the New Deal Program
- They felt if they included, the entire agenda will fail, thus they didnt include it.
- There is limited federal healthcare in the US.

Reform in Action
- What is the program infrastructure?

Core Federal Health Policies

1. 1965: Medicare and Mediaid

- Medicare provides coverage for aged 65 and above and some with illness.
- They are a paid into program that all taxpayers support automatically.
- Medicaid is a public program- individuals need to show their need. 68 Million people are
served by medicaid

2. 1997 State Children Health Insurance Program

- Subsidized private health insurance for the uninsured, low income children. Parents make
copayments based on family ssize and income
- Financedd jointly by federal and state government
- Benefits adminstered at state level: State determine eligibility requirements, program design,
befits package and payment levels for coverage.
- they help close a gap for those who dont qualify for Medicaid and are unable to obtian
insurance.

3. Patient protection and Affordable care act (ACA)

41
- insurance reform ,
- Deliverance reform

Provides Coverage for individuals with pre-existing conditions

Expanded coverage for Young Adults on Parents plans
No lifetime or annual benefits
No co pays for preventive care
Recissions banned - taking away copays for insurance.

PPACA Delivery reform

1. Creation and implementation of healthcare exchanges

- Uninsured and Self Employed cna purchase insurance through State Based Exchanges and
Subsidies

2. Medicaid Expansion
- Increase the eligibility criteria to 138% of the Federal Poverty Level
- Undocumented immigrants are unavailable for the plans.
3. Individual Mandate

4. Employer Mandate

PPACA Finance Reform:

- Medicare Payroll Tax: Taxing Middle income Families
- Excise Tax on Cadillac Private Insurance Plans
- Indoor Tanning Service Tax : Tax on indoor tanning

Impact on Premiums

42
- The premium increases continually.

- Access to insurance across racial groups is high (healthcare Disparities)

Current Debates

1 Tax Cuts and Jobs Acts of 2017 repealed ppaca mandate

- Potential Consequences: Costs increases with insurance coverage
- Higher number of older users of ACA

2. Senator Bernie Sanders proposed Medicare for all

- Take the model to distribute across all socities beyond those lower than 65

Federal health policies for underserved populations

1. Federal health Centres
- Local Cnetres for Helath needs. Created Via Economic Opportunities act 1984

2. Rural health Clinics

- Creation of clinics in rural locations to obtain care services

3. Indian health Services

- Provided for tribal lands for the underrepresented.

Mental health Policy

- quest for parity or equal ocverage for mental health needs

1. rise of specialized treatment

- Historically, those with mental health needs seen as having mental issues and were a source

43
off concern,
- Individuals were housed in the homes of relatives in the public expense.
- The rise fo specialized psychiatric treatement arose.
- Dorathy identified many abuses and advocate for state institutions for mental health needs.
- institutionalization first became a good way for providing for those with mental health needs

2. Deinstitution and hte rise of community mental health services

- The communty mental health act of 1963 altered the delivery of mental health service : It
authorized federal grants for established public or non profit mental health centres
- Came in repsonse that mental healht needs can be treatedd more effectively and less costsly.

- Deinstitutionalization is a slow process and there are works ongoing.

Mayview State Hospital

- Went through a large deinstitution and creation in the late 1970s

Quest for Parity

- Mental heallth Parity and Addciction Equity act of 2008: parity is the equity which providers
treate phsycial helath needs vs mental:
- For a long time, physical health benefits were accessible than mental health needs.
- Prohibitive for individuals to acess ental helath needs
The act helped to improve parity between mental and physical health

PPACA 2010
- It expaneded on the requirements of mental parity.
- All plans covered behavioural treatment and services

2016 cenres for medicare and medicaid

- The changes in the 2008 will also apply to medicaid and CHIP
- Greater consistency for individuals receiving helath insurance via the programs.

Expanding Excess
- Through first hand experience and practice, clients can be referred for mental health issues.
- Issues such as travel, costs are current issues that affects people
- Group CBT Exercises can be adapted.
- There are areas to help address mental health needs: Using community health workers.
people wwho shared the lived experiences of those who are in the care.
Deliver support and intervention
- Really understand the link between practice, policy and research. Understand the policy
landscape and how do they impact the services that we can use. Ensure Triangulation.

44
be mindful and think about hte linkages.

Substance abuse and Opiod Addiction

- 3 types of opiod: Natural Opimum. Semi-Synthetic Opiod, Synthetic Opiod.
There are more Synthetic opiods now
- In 1996, oxycontin is approved and marketed as less addictive drug. Overtime, people
developed withdrawal symptoms.
- Now, Opiods are impacting whites and semi aged.

Policies: CARA (Comprehensive Recovery Act)

- 5 point strategic plan and is guiding the policy creation.
1. improve access to drugs that reverse
2 improve treatment and access
3. Better health surveillance
4. Cutting edge research on pain and addiction
5. Advancing practices for pain management

The local level is vital to help the citizens in the smaller level
- They need federal dollars too
- Communication between the federal, state and local governments is important.

Prevention and Education platform

- Prevention in noloxone access, an antidote that reverse overdoses
- Educating schools

Issues
- There need to be treatment and continued addiction kicking strategy.

Social Workers role

- Policy fomulation, State policy
- individual, Microlevel, Treating through MI, Group therapy, CBT, affecting it in the local and
federal level.

Access to Services in Transgender and binary genders

Definition of the community

- Every individual has a label. But various cultures are outside of the binary model eg
international culture, American natives
- Thus they are people who do not fall within the category of cisgender (Expectation of the
gender at birth). Some prefer to dress in a musculine sense of self, etc.

45
Non Binary: Agender, Gender Queer, Genderless, vs cisgender

Policy issues
- Country to country issues , states to states, city to city
- Some countries do not recognize them , while other countries recognize. Majority countries
fall somewhere in between.
- In the US, it is state specific. Some states are against employment discrimination, bathroom
bills, housing insurance policy, registering for FASA aid, obtaining services for the opposite
gender

problems in the world

- Changing sex boxes or gender marker box is problematic and state by state, such as on the
birth certificate.
- A non binary may not want to choose either options.
- A transperson have lots of issues to change the name, as the judge can shut down the name
change. Its a big undertaking for a legal name change.
- Transpeople may be moving states in between hte process of name change.
Moving State may affect copay insurance (hormones medicine)

Potential policy solutions

- Perhaps, there needs to be considering therapy or Gender transition care that allow for sex
change.
- How can someone change their birth certificate.
- Testify that there should be change.

Access to Services - Disabilities

- Language is shifting.

The ADA is a federal act that came out in 1930.

- However it has no teeth, only enforced thorugh lawsuit.
- People cannot benefit financially in any way. They cannot get any benefits from that.
- There is no money to support ADA

Universal Design: How canwe make it better instead of later changing it.
- It benefits all.
- Having someone who is a sign interpreter?
- Creating opportunities for disabled folk?
- Welcome warm inclusive communities.
- Funding policies Pro-activly
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46
Module 7: Policies and Services for Children and Families

Introduction to Policies

4 Era:
1. Progressive Era (1897-1920)
2. New Deal (1933- 1938)
3. Great society/ Civil Rights Era (1963 1938)
4. Welfare Reform (1996-Current)

Emergence of the Social work profession

- Emerged with the SW precedign Progressie Era
- Formation of Settlement Houses, doing community organizing, founded the settlement house
profession.

Progressive Era

1. US Children Bureau in 1912:

- Establish as service delivery system for children youth and families
- Association for Organizing Family SW was established
- Children Welfare league of america was established in 1920.
- Womens Full Suffrage, 19th amendment.

Progressive Era:
Shepard Towner Maternity and Infancy Act (1921)
- First effort for a maternal and child health infrastructure
- Laid the groundwork for future collaborations between state and federal governments
to address maternal and child health .

New Deal Era

response to the great depression

1. Social Security Act of 1935

- Establish a strong federal Gov Responsibilty welfare of US citizens
- Aid to Dependent children (ADC), Later AFDC : Provided to widowed women, women pensions
- Social Security : One of the largest fedral entitlement benefit: included retired workers and
spouses, children, Retired individuals
- Unemployment benefits. : Recognize the depression as a key issue

2. Title V under the Childrens bureau

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- provided maternal and child health services that was provided for by th3 Sheppard Towner act
- Services for the cripples children program enabled states to locate and provide medical and
other services for handicapped children
- Children welfare services enabled services for homeless, dependent and neglected children

Universal Programs
- Social Sercurity act also established Universal programs and Selected programs
- Universal: Individuals do not need to meet specific criteria (eg income levels )
Eg Social Security
- Selected : means tested (have to meet certain requirements: Eg below the federal poverty line)
or age, single household.

entitlement/ non entitlement programs

- entitlement: legal guarantee or right to benefit (eg social security)
- non entitlement: Depends on if funds avaliable, state requirements, No legal guarantee

Post new Deal Era

1. National School Lunch Act

- Access to adequate diet in School

Great Society Programs

-Relate to the reforsm across a different domain

1. Food stamp Acts of 1964

- Became Supplementary Nutrition Assistance Program (SNAP) in 2008
- Offers nutrition assistance to low income individuals and families
- Means tested entitlement
- Largest progoram in the domestic hunger safety net
- 15% of Us population receive food thorugh the program.

2. head start program of 1965

- Started as a summer school program to prepare low income children for elementary school
- Eraly head start was established in 1994 to serve children of birth to 3

3. medicare and Medicaid

- Established in the great society era
- Address the gap in health needs of low income families.

4. Civil Rights reform

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- Civil rights act of 1964 forbade job discrimination and segregations of public accomodations,
including housing discrimination
- Voting rights of 1965 assured minorities had the right to vote
- Immigration and nationality servicess fo 1965 abolished the national origin quotas in
immigration law.

Child Wefare policies and programs: Child abuse and treatment act in 1964
- Etablished the national cenytre on child abuse and neglect
- Required States to Strengthen Child Maltreatment laws in the ara of state definitions and
reporting laws: Collect data on child neglect and the programs
- Established federal minimum definition of child abuse: what it is defined in the US

2. Adoption assistance n child welfare act of 1980

- Reinforced the importance of services within the home , reduce children moving inot the
foster care settings
- established the development of case planning and 6 mths reviews for children in the child
welfare system

basic procedures to protect children in the child welfare system, beneficial to them in the long
run

3. Family Medical leave act of 1993 (FMLA)

- Provide up to 12 weeks of protected unpaidleave during the 12 month period for hte birth and
care of child or family member or individual own health condtion
- Gender neutral language
- Women make up 80 % of those who take leaves under FMLA

Welfare Reform Era

1. Personal responsibilit and work opportunity budget reconciliation act (PRWORA) of 1996
- Eliminated AFDC : Welfare requirements eliminated AFDC
- Elimiated entitlement to welfare
- Established work requirenets
- Established block grants from the adminstration

Women had to look for jobs, or educational activities to obtain welfare

post welfare reforme

1. SCHIP

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- Title XXI of the SSA established the State chiled health insurance program (SCHIP) in 1977
- SCHIP was passed to address the uninsured children who coluld not receive medicaid because
they were uneligible

Popular program and not too controversial

2. Home Visitation prograsm

- Federatl funding established throuh maternal infant and early childhood home visiting
program (MIECHV) of 2008
- Allow at risk pregnant women and families resources and skills to raise children who are
healthy and ready to learn
- Miechv funds numerous evidence based programs inlcuding the nurse family partnership
program

It Address the child abuse system

Juvenile Justice and Child Welfare

- Juvile delinquency is normal for kids : Risk taking, adolocent behaviours
- Most crimes are in property crimes, theif. less are in murder, violent crimes
- Foundation of the juvinile justice system is that adolescents are less culpable than adults
- Crimes is decreasing, Overall the trends is decreasing

issues facing the juvinile justice sysstem

1. What to do after a crime is committed

- Should they go through which court system?
- Secure confinement
- Representation of American African youths?
- Who is eligible in the Juviniel justice system

In certain states, some can be as young as 17 to be treated as a adult

- What are kids in issues with? Poverty? Limited employment opportunities for parents?
- Systematic processes that put poor families at disproportionately high risks at coming in
contact with risk factors
- Greater surveillance in neighbourhoods?

could there be policy issues?

- Police discretion? or warn them as a adolescent?
- Sentencing grids that limtis judicial discretion on the terms of a sentence

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Some stretegies limit discretion

Development data and sharing are linked

- To see how Vulnerable populations move through the systems, and hwo one experience
impact another system
- Policy implemented in an allied system will support and build bridges
- Using information to guide policy and planning

Complexity of policy issues: thinking about issues and policies

- Were there turning points that the state can be involved in other ways?
- What are some opportunities early on that can impact individuals and children abuse

Policies impacting early childhood

- Federal budget impact policies in the community.
-Early Childhood issues: Access to healthcare, homevisiting for children, Cash assistance for
families

Childcare is an issue
- Rise in Childcare cost: interconnected to what works in early childhood, kindergarden
readiness gap.
- High quality childcare can reduce the gap; opitimum teacher child ratio.
- Childcare should be an integral part of education at large.

Federal funding for childcare subsidies: Geared to low income families who need childcare.
- Our resources are not fully addressing the issues that are needed to resolve.
- Putting in more public resources for the welfare system

Type of issue/ policy:

- Childcare subsidy; how to increase subsidy amount
- How can we support early childcare providers? Eg supporting their growth and profession,
subsidies?
- How can we make sure that we are not forgetting our young children when talking about policy
issues

Issues Facing Seniors

- The older population is growing rapidly.
- Older people (65 and older) will double by 2020
- Increase life expectancy is the primary trend. Among the older population, hispanics
will more than double. Blacks will grow from 9 -12%
- There will be a diverse population.

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Issues facing the population
1. Long term care
- Using bathroom, bathing.
- 50% of the older people will need about 2 years of long term care .
- Long term care is expansive
- Nursing home/ Assisted living is costly about 4500 per month

Care givers is a tiring job

There needs to be ways to address the needs of the long term care population

2. Poverty
- Older people may face poverty.
- They are struggling with paying household bills, and meeting needs.
- Poverty among hispanics and blacks are 3 times higher than whites
- Women poverty is an issue as they live longer

Policy perspective
- Class Act from the Obama adminisstration helps in Long Term Care Acts.
- But it lacks a mandatory area, which was killed.
- Currently social security is the income for the majority . Strengthen social security for those
whoare in poverty.

Issues facing China

- Pace of Aging is much faster. Eg older population growth from 7 - 14 percent took 26 years
- A quarter of population is aged by 2050
- The issues they are facing: Long Term Care
- In the chinese culture, there is the norm of falial piety. But the structure is changing,
the burden of care is high on the adult children. There is the big issue
- Poverty: Poverty for the rural area is serious. This is because rural youths have migrated into
the city, lack of young people
- Many pension system and healthcare is only available for urban old, thus the rural elderly is
particularly vulnerable.

Solutions/Strategies that can address the issues:

- Long Term Care policy Needed. Social insurance programme is needed.
- Social Security has to be manditory solution
- Medicare and Medicaid has to be strenghtened. We need to protect and strengthen these
programs and give assurance to the vulnerable groups such as women and the ethinic Groups .
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