A major initiative to repair managed health care through the inclusion of social work services will begin this month. The New York City and New York State Chapters of NASW and Local 1199 of the National Health Care Union plan to reach tens of thousands of social workers, health care advocates and public and elected officials to inform them of the serious lack of essential social services in managed health care. Members of the social work coalition are expected to join in sponsoring this effort.

The lack of social work services, already a serious problem for many members of managed care plans, will be seriously exacerbated as New York State mandated Medicaid managed care brings more than a million Medicaid recipients into the system.

No provision has been made to replace in-patient hospital social workers as the system downsizes, nor have social workers and their services been built into the emerging and growing primary care services. In the next year, Medicaid recipients, large numbers of children and members of families with chronic illness will come into managed care. Social workers are essential to avoid chaos and excess cost as the new system develops. Although contracted companies will assist in enrollment, experience has shown very large numbers of those expected to select a managed care organization (M.C.O) do not, resulting in "auto selection" , which frequently separates people from their usual neighborhood services.

Without social services, consumers utilize health care providers more frequently, although their need may be for psychosocial services related to their health condition. This inbalance can be expected to incease costs and inefficiency. NASW is asserting that businesses and governments which purchase managed care for employees and covered groups must expect the inclusion of social services in their contracts with M.C.O's.

Social workers, in recognizing the social components of health care, build the networks of service between health care organizations and community based services required to maintain family health. These linkages have been damaged as hospitals have downsized and care has shifted to primary care organizations. Social work is essential to rebuilding and enhancing the health care delivery system.

The social work coalition initiative will increase public awareness of a growing gap in health care services so that policy can be changed to include the missing social services.