By Gerald Beallor, Co-chair, Health Care Policy and Practice Network
The social work profession is close to the realization of a desirable goal in ensuring quality services for hospital patients. The struggle to counteract the Governor's proposed deregulation of significant patient care provisions in the health code which has continued since last April, has led to an advance which will, when confirmed, assure social work standards in the delivery of social services.
Working in coalition with other organizations, NASW has been able to obtain a proposal, that although not perfect, is a significant advance over the regulations as they were at the time. The existing provision which mandates that hospitals (excluding rural hospitals) have a social service department is embedded in regulations which actually have no requirements for professional standards for practice or staff. The current regulations that require a social work department are of little or no protection because they do not call for any professional social work standards or staffing by social workers.
Following months of discussion with The State Department of Health, there is agreement that in order to safeguard patient care, professional social work standards are necessary. A new proposal, published in the December 13 issue of the New York State Register, calls for social services which reflect "generally accepted social work standards under the direction of an individual with a masters degree in social work". That person shall be responsible for directing the provision of social services which may include but not be limited to social work case management, staff supervision and implementation of measures to monitor and optimize patient outcomes. Also, this regulation will apply to all hospitals in the State. For the first time, the New York State Department of Health recognizes professional social work in hospitals and requires the direction of social services by a qualified professional social worker.
The proposed new regulation replaces the requirement for a social work department. The NASW leadership in New York recognizes that this is a necessary trade-off, since the new language will prove to be valuable in the coming months and years of fiscal constraints, managed care, and hospital system downsizing.
The new language will be brought before the Codes Committee on January 18 and the Hospital Review and Planning Council on February 1, both in Albany. Our effectiveness in obtaining this new regulation needs to be backed by communications to the Hospital Review and Planning Council and State legislators. It is important to make support known as soon as possible. Letters of support are needed to ensure a victory.
By remaining united, by maintaining close relationships, and with support from Local 1199 of Hospital Workers, The Society of Social Work Administrators in Health Care, The Deans Association of Schools of Social Work in New York State, and public minded legislators, the profession has been successful so far.