Executive Directors of not-for-profit human service agencies are seeing some distinct changes in the way social work will have to be practiced in the light of recent cuts in budgets and programs on the City, State and Federal levels. As part of the Currents series on social work trends (see the January 1995 issue for the first article interviewing the deans of the City's schools of social work) the directors of five agencies were asked to talk about these changes; how their agencies would respond to change; the positive perspectives for social workers in their fields; what the profession as a whole needs to do to meet current challenges; and how NASW and agencies could work together.

All five directors -- Melba Butler of Harlem Dowling-Westside Center for Children and Families; Maria Elena Girone of the Puerto Rican Family Institute; Dr. Alan B. Siskind of the Jewish Board of Family and Children's Services; Nancy Wackstein of the Lenox Hill Neighborhood Association; and Nancy Weber of Visions/Services for the Blind and Visually Impaired -- agree that there are no simple solutions to the profound problems facing the profession. They advocate for educating decision makers by emphasizing success stories and pointing out areas of unmet needs; creating partnerships with clients, other not-for-profit agencies, and allied professions; and evolving in a changing world by refining skills to enhance effectiveness.

MELBA BUTLER, CSW, Executive Director, Harlem Dowling-West Side Center for Children and Family Services

On first blush and perhaps on second, the budgetary cuts imposed and/or anticipated from all levels of government, appear ominous and heinous. They are targeted at our most vulnerable populations, i.e., children, the poor, and the elderly. There is a clear and pervasive paradigm shift in the country's sense of obligation and responsibility to its most needy. Clearly there will be less resources allocated for traditional services that we as professional social workers view as supportive and helpful to those in need. As a consequence, there may also be shrinkage in employment opportunities for social workers and allied professionals. An intensified emphasis on outcomes and "cost-effectiveness" will result in services as diverse as mental health, income maintenance and foster care, becoming time-limited, i.e., "managed." As an executive director, responsible for both short and long term planning for my organization, I grimace with each new fall of the budgetary axe.

On the other hand, my work within a number of systems (child welfare, employment, services to the aging and education) and in tandem with other systems (judiciary, health, mental health, state and local government), has convinced me that we can do things better. We can provide more sustaining services, with greater impact, at less cost. Further, I am convinced that the bureaucratic systems designed to facilitate services are sluggish to change, self perpetuating and COSTLY.

As a profession, it is imperative that we confront those policies which are deleterious to the vulnerable populations that we serve. Yet, we must do so while concomitantly reevaluating current practices and acknowledging a diminished fiscal climate. An example of this is the proposed policy shift to place the babies of all unwed teenage mothers in orphanages -- a proposal which is both mean spirited and suggestive of displaced blame. However, fundamental opposition to the proposed policy does not obviate the need to accept failure in many of the strategies heretofore used to effect delayed parenting. Nor does it suggest that we desist with efforts to impact on timely and appropriate placement (foster and adoptive) for abused, abandoned or neglected children.

At Harlem Dowling West Side Center, we are responding to the policy and funding shifts in several ways:

1. Strengthening our Management Information Systems and Quality Assurance capabilities. Data about who we are serving, the types of services provided and service gaps, will enable the agency's management to ensure compliance with regulations and funders, analyze staff training needs, measure outcomes and maximize resources;

2. Training our professional staff in various outcome oriented interventions such as Homebuilders and the Antecedent Behavior Consequence (ABC) models;

3. Pursuing collaborative relationships and sharing resources with other organizations and providers;

4. Involving clients and staff in advocacy efforts with policy makers;

5. Chipping away at internal bureaucratic impediments to effective and efficient service delivery.

As professionals, we cannot afford to sit idly by while others who, lacking theoretical, analytical or experiential knowledge, impose sweeping changes in funding and programmatic approaches. Schools of social work must prepare students to conduct applied research and qualitative analysis, if we are to have adequate ammunition to debate with those who devalue social work interventions. Practitioners must be trained in cross system integration for effective case management, focused short term models of intervention and the role of practitioner as a social change agent. Further, emerging professionals will be insufficiently trained unless they are also taught to understand human development and psychodynamics but in the context of a changing political and social environment.

NASW and the schools of social work must assume leadership roles--insinuating our collective perspectives into policy setting process. While these institutions are still at risk of being dismissed as liberal "do-gooders', their broad based scope makes them less of a target for allegations of being self-serving.

MARIA ELENA GIRONE, MSW, Executive Director, The Puerto Rican Family Institute, Inc.

There is no question that the "blame the victim" attitude pervasive in the political arena will adversely impact the social work profession. We foresee that not for profit community based organizations, such as the Puerto Rican Family Institute and those we serve, will be most affected. Our focus by necessity will be to maintain and strengthen existing programs now at risk of being defunded. We must set aside our goal to develop specialized services, i.e. home based crisis intervention, intensive case management, family violence prevention, et. al., sorely needed by the special population we serve, mostly monolingual families and children, disenfranchised and living below poverty levels in devastated urban areas.

If we are indeed able to sustain our existing programs, the rate of growth and expansion is expected to stand still for the next several years. As a result, we anticipate being unable to provide competitive salaries to our professionals and less than adequate fringe benefits. Consequently, we will be unable to retain our MSWs who are bilingual/bicultural and be forced to lower our qualifications by relying on Bachelor level practitioners who require more extensive supervision and training. This also impacts on the quality care clients should receive. In essence, we will be expected to provide more services to a population with ever increasing needs using less financial and manpower resources.

In order to do more with less, the only avenue appears to be that of short term, crisis and concrete service oriented interventions. Preventive services, now essential to maintain families together as functioning units and to avert the cycle of removal to foster care or hospitalization must, by necessity, be set aside. In turn, we must rely on the various systems in the community to try to meet the needs of our clients. Community based organizations must strengthen their linkages with all other service providers in order to respond to this crisis. Caseloads will increase and, consequently, cases will have to have a rapid turnover rate. Thus, the way in which we conduct individual supervision will have to change, making group supervision a more viable option.

To better prepare themselves for future employment, social workers must diversify, enhancing their community organization and advocacy skills. Social work as a profession must become more pro-active and place its energies in lobbying. Building partnerships with the private sector should also be a priority. Most agencies are dependent on public funding, placing their ability to operate in greater jeopardy than ever before. Community empowerment is crucial, and this will only be attained through education, particularly in the political process. These would be organizational efforts in which NASW could take an active role in working with agencies.

ALAN B. SISKIND, Ph.D, Executive Vice President, Jewish Board of Family and Children's Services, Inc.

The Jewish Board of Family and Children's Services began more than a century ago as a charity organization. As we evolved, government contracts became a substantial source of support for much of our work. Today, we find ourselves competing in a market-driven environment where cost effectiveness, efficiency, and objective measures of success matter more than ever before.

Our challenge is to continue adapting to political and economic realities without forsaking our mission to serve the poor and disenfranchised. JBFCS is adapting creatively and is experiencing tremendous growth in services to people with AIDS, chronic mental illness, the developmentally disabled, the elderly and victims of domestic violence. We are finding ways to compete without losing the compassion that is central to our work, and without losing sight of the needs of the vulnerable populations we serve.

With managed care companies becoming an increasingly significant source of referrals, JBFCS is placing greater emphasis on providing rapid assessment and disposition, time-effective treatment in the most appropriate settings, and a comprehensive and accessible continuum of care. In order to fill service gaps, we are forging formal partnerships with other providers. Cooperative efforts have become more important than ever.

Social workers have often viewed managed care with suspicion, because it tends to limit the extent of our services to individual clients; we need also to look at the positive changes it could bring in the field. Some of those have to do with refocusing on whole populations, so we no longer provide long-term services to some while providing no services at all to others equally in need who remain on waiting lists. In the long run, the advent of capitated systems will allow us to do things we've wanted to do for a long time -- for instance, put more money into prevention to reduce the need for more expensive services later.

We can also find benefit in learning to perceive clients as consumers and expanding our definition of successful treatment. Clients come when they are hurting and often stop coming when they believe we've helped them. Intermittent use of service can be productive if need is defined by the client and respected by the social worker. We need to accept small wins.

Social workers today and in the 21st century need to be pragmatic, versatile and adaptable. They have to be able to meet the expectations of an increasingly market-driven service system and also be equipped to deal with an increasingly troubled client population. JBFCS clinicians report a significant increase in the prevalence of substance abuse, impulsivity and characterological issues among clients in all levels of care; social workers with education and experience in serving these kinds of clients and who have an enhanced ability to do rapid, competent assessments will have an advantage in a competitive job market.

Sadly, we have entered an era in which oversimplified sound-bites are presented as solutions to enormously complex social and economic issues. It is important for us not to apologize for what we do, and to continue working to improve the quality of life for millions of people. We need to advocate aggressively for those in need and challenge those who scapegoat clients and providers of social services. At the same time, we must accept our need to evolve in a constantly changing world and continue to refine our skills and effectiveness.

NANCY WACKSTEIN, MSW, Executive Director, Lenox Hill Neighborhood House

My response to the current political climate resonates on both a personal and professional level. When what you do for a living is fueled by a set of principles and underpinned by a belief system, the distinction between the personal and the professional sometimes seems arbitrary and artificial. I believe that social services are important, they are effective, and they contribute toward creating a more equitable and just society. So when the social work profession is attacked, when the clients we serve are demeaned and demonized, when the very value of social welfare is called into question, it's probably not surprising that I take it personally.

I've spent almost 20 years of my life working as an advocate for people in need. How could I not feel, the day after the November election, that all of a sudden I was out of step, a liberal dinosaur, an anachronism?

I can't think of a more difficult time to be working in our field. Even when Reagan was President and Koch was Mayor (when I thought things were difficult and we were without friends) there was not the same sense of resentment and

selfishness that now seems to characterize public policies towards poor and dependent

people. Nor in the 1980's had social work and social welfare lost credibility, among both Democrats and Republicans, as now seems to be the case.

And the fiscal realities on every level of government have never been so discoura-ging. At least in the 80's, the City and State had money, which helped to offset Federal reductions. Now, not only do the City, State and Federal governments all have tremendous budget deficits, but the political and electoral climate is such that they all have identified cutbacks in social services as the solution to their budget woes.

So the challenge for me, personally and professionally, is how to lead an agency -- to inspire others, to have a vision of hope, to communicate a sense of mission to staff --when you personally are feeling as if the rug has been pulled out from under you.

There are a couple of concrete responses I believe can be helpful. First, to hold on to some of the anger! In this situation, I think anger is a more productive response than the utter hopelessness which is its flip side. From anger comes action and effective advocacy.

Here at Lenox Hill Neighborhood House, a multi-service settlement house, we have begun to mobilize our constituencies--senior center members, Headstart and afterschool parents, Board of Directors, even fitness center members-- to begin writing letters and attending rallies to protest funding reductions. While this is not unique, what is unusual and significant is that even if their particular program has not had its budget cut (yet), we are beginning to help members and clients see that their future is intimately tied to others who live in their community.

Second, we must continue to focus on individual clients and their needs. It is easy to get caught up in the theoretical policy debates and the budget calculations, but the response to this climate and these budget reductions must be to do that which will preserve the service to clients.

And service to clients is intimately involved with staff. In a social service organization, the success and quality of programs is wholly based on the abilities of staff. We should eliminate pencils, toilet paper and the copy machine before we eliminate staff positions and the benefits we provide to staff. When it comes to serving clients, it is simply not true that we can "do more with less." No such thing in a settlement house where most of us already are short-staffed and doing without.

Third, it is imperative that agencies and institutions whose core mission is to help those in need, band together to fight the backlash. It doesn't matter if the agency focus is mental health, child care, health care, homelessness, senior services. Nor does it matter if it is a voluntary agency or a public sector one. Those on the other side are speaking with one voice, at least for now, and we must put aside our internal disagreements if we are to have any impact at all. We can't fight against each other for the paltry crumbs from the budget table.

At the risk of sounding like a discredited liberal, I do believe that in unity there is strength. For sure, without it, the people we care about will continue to be sacrificed.

NANCY D. WEBER, ACSW, Executive Director, VISIONS/Services for the Blind and Visually Impaired

As a result of current trends and recent elections, social work administrators and practitioners should take advantage of every opportunity to educate key decision makers in both the public and private sectors regarding the needs of our constituents. Through presentations at civic and fraternal organizations, testimony at public hearings, publishing articles in journals and newsletters, participation in State committees, and involvement in City task forces, I, along with the Board, the staff and the consumers of VISIONS, highlight our program successes, including positive experiences with state outcome-based funding, while we continue to point out areas of unmet needs.

We must take responsibility for contributing to the development of long range plans and policies which support, not dismantle, the partnership between not-for-profit agencies and government funders. We must make this environment an opportunity to communicate the complexity of the problems we address in our day-to-day practice. We must dissuade government from the temptation to support simplistic solutions.

We must energetically and enthusiastically explain and quantify the impact of our services and explain the value-added nature of our service delivery system. Government dollars usually pay for only a small portion of the expenses of providing services. In our efforts to best serve our clients, social workers often go well beyond the strict job tasks typically outlined in grant funded programs.

At VISIONS, the entire staff has become more comfortable with, and skilled at, goal setting; prioritizing job responsibilities; using performance evaluations as a service enhancer; flexible and enlarged roles; and use of teams for service delivery and problem solving.

As social workers in administration and practice, we must create partnerships: with our clients so they are empowered to influence public policy along with us; with other not-for-profit agencies so that we can address mutual areas of interest together; and with allied professionals who share our concerns for ethical and value based practice.

NASW's continued role in promoting and highlighting "best practices," promoting standards and a code of ethics, and offering a context for joint problem-solving and coalition building, will help shape and strengthen the influence of social workers in the current environment. NASW also provides an arena for mutual support through its committee structure. However, it takes a personal commitment of each member to be more active and effect change.

By keeping the client at the center of our focus, we can work together to ensure that the vulnerable populations who benefit from our expertise will not lose their needed entitlements, programs and services. We have strength in numbers, and we can use that strength to protect and enhance human services.