Research Responds: Monitoring the Impact of Social Legislation
Ewalt, Patricia L., Social Work
A report by the Center on Budget and Policy Priorities (Golde, 1995; Mann & Cogan, 1995) discussed the federal "savings" anticipated from capping federal Medicaid payments. Savings in payments to the state of New York, for example, would be $20 billion over seven years, or 28 percent of what would otherwise have been spent. Savings in payments to the state of California would be approximately $16 billion, or 30 percent. Savings in the United States as a whole would total about $182 billion, or 23 percent, over seven years.
The experiment with human health embodied in these cuts is taking place without a basis for predicting the impact on individual health or state budgets. These fiscal rearrangements do nothing to increase health status or diminish fraud, so the so-called savings can come about only through a combination of reduced health care for individuals and increased costs to states. The effects of increased costs to states in reduced health, human services, and education opportunities are not yet fully known. For example, education is often pitted against health and human services in competition for tax dollars. Therefore, choices will be made about whether and who will receive health care, human services, or educational opportunities.
In this context of radical restructuring of dollars for human well-being, the social work profession is developing responses that could be beneficial to both the public and social workers. The first response is a call for research documenting the impact of the fiscal rearrangements on the U.S. population, and the second response is advocacy by the major social work practice and education organizations.
Documenting the Impact of Fiscal
The Institute for the Advancement of Social Work Research (IASWR) has issued a call for evaluations of the impact of federal budget reductions on the populations of the 50 states. IASWR, jointly sponsored by NASW, the Council on Social Work Education, the National Association of Deans and Directors of Schools of Social Work, the Baccalaureate Program Directors, and the Group for the Advancement of Doctoral Education, will coordinate this national evaluation effort. Social workers are encouraged to bring evaluative information to the attention of IASWR, which seeks to understand the nature of the changes about to take place and to inform legislators and the public about these changes.
Social Work Advocacy Coalition
Over the past two years, the four major social work education organizations and IASWR have joined with NASW to supplement its advocacy efforts. The advocacy coalition has already expanded the profession's capability to inform federal legislation and to influence implementation in executive-branch agencies such as those forming the National Institutes of Health (NIH).
Social work training and, to an even greater degree, social work research have in recent years received bipartisan support. Service provision is clearly a more contentious partisan issue. Yet the social work advocacy coalition has increased the discussion of this issue with Congress.
The September 15, 1995, report of the Senate Appropriations Committee on Labor, Health and Human Services, and Education contains numerous directives to the federal agencies favorable to social work and its clients; the directives use language on the research issues submitted by NASW in collaboration with IASWR. Some of the legislative directives to the agencies include the following:
* The Health Resources and Services Administration should expand support for the training of disadvantaged mental health professionals (especially people of color), including social workers. …