1199 and the Challenges for the Social Work Profession
(November/December 2003)
By David Kranz, Professional
and Technical Coordinator, 1199/SEIU
*David is the official 1199 representative on the Social Work
Alliance with NASW.
1199 is a statewide union of health care workers, representing well over 200,000
people in New York State. Among this membership are over 3,000 social workers
who work in a variety of health care settings including hospitals, nursing homes,
mental health agencies, community health centers, substance abuse facilities,
facilities for the mentally retarded, dialysis centers, children’s services,
and many others.
The problems facing social workers thus become our problems, problems we are
compelled to address. These problems have their roots in a society that has
unfortunately turned away from its commitment to the poor and the disadvantaged.
There is also less commitment to funding of health care, and market forces hold
ever greater sway in our health care system.
This has resulted in a number of negative consequences. Many agencies and neighborhood
health centers have suffered severe cuts in their funding. This in turn places
tremendous burdens on the social work staff, as they try to do more with less.
In addition, it becomes very difficult for us to maintain the contractual standards
when there’s no money to pay for it. This results in social workers, master
degreed professionals, being underpaid, leading to worsening short-staffing
and heavy caseloads. In addition, there is sometimes the unfortunate reaction
on the part of the administration of the agency or health center to deal with
these problems by imposing virtual quota systems on the social workers, with
threats of punitive action if the social workers don’t achieve a certain
number of billable cases each month. This of course just adds to the demoralization
of the staff.
Hospitals are under great pressure to discharge patients as quickly as possible,
to reduce their “length of stay.” This too results in heavy demands
on the social work staff. In addition, many hospitals have followed the misguided
advice of consultants in creating certain case management models that marginalize
the role of the social worker in discharge planning, and subsume everything
under an RN. In many hospitals we have seen the demise of social work departments,
with social workers reporting directly to nurses. This is a model that assumes
the issues involved in the discharge of a patient are primarily clinical, with
the issues that social workers deal with seen as peripheral.
What is the role of the Union in all of this? 1199 is the voice of the line
social workers at their workplace. In the agencies and health centers we have
fought to convince the administration to include the line social workers in
a positive way in looking for solutions to the difficult situation the agencies
find themselves in—not just threaten them if they don’t meet caseload
quotas. We have fought against models that minimize and de-professionalize the
role of the social worker. Politically, we work to increase the funding stream
for all settings.
We have found it invaluable to partner with NASW to help focus on the main priorities
of the profession. Last year working together we were finally able to win a
decent licensing law for New York social workers. This year we are working to
win loan forgiveness for social workers. In all of these endeavors, 1199’s
strength is that we bring the power of representing the whole health care profession
for the benefit of social work goals. This is a very rough time for all health
care settings. No one health care profession is powerful enough on its own to
achieve what needs to be done. The future, I believe, is in more union/professional
association partnering to achieve the best gains possible in these difficult
times.