How Did The Affordable Care Act Affect The Field Of Human Services

November/December 2014 Consequence

The Affordable Intendance Act and Social Services: The Technological and Business Impact
By Lindsey Getz
Social Work Today
Vol. xiv No. 6 P. 26

Change is constant in life and perhaps nowhere is this more axiomatic than in health care with the implementation of the ACA. Read how social services volition need to adjust to the technological and business shifts this legislation will bring.

While we've already heard a lot about changes to hospitals and health networks, the signing of the Affordable Care Act (ACA) stands to have a significant concern and technological impact on the field of social piece of work as well. The implementation of electronic health records is already taking place inside health intendance and well-nigh believe those requirements will trickle down to the social services sector in the near future. That means social workers must become increasingly good at utilizing technology and implementing software. In addition, there is no uncertainty that the ACA will institute changes to the way that social workers do business organisation. Those already in the field must be prepared to adapt to changes in both business organisation and technology, while those responsible for education should consider pertinent changes to training.

The government has already demonstrated that it recognizes the value that social workers bring to the tabular array every bit the ACA finds its foothold. Concluding September the White House held a briefing for social workers that focused on the importance of their role as the ACA moves forward. Many believe the result, which was led by Darla Spence Coffey, PhD, MSW, president of the Council on Social Work Education, was one of the first times the role of the social worker was truly recognized for its contributions to the health care field as well as the possibilities it holds inside this new model. Simply the cardinal to success has a lot to do with how the field volition handle these business organization and technological changes.

"The door is open," Coffey said. "But we, as a profession, at present need to make sure nosotros continue to communicate our value as nosotros bring the goals of universal health intendance coverage to fruition."

Room for Growth
Many share the sentiment of standing the journey forrad and believe social workers can have a bully impact on the success of the ACA. But in that location is room for growth when it comes to applied science. "The social services have always lagged backside when it comes to the pace of technological alter and that's never been a problem," says Mike Meikle, CEO of the Hawkthorne Group and an It consultant with experience in the human services sector. "There hasn't been a requirement to keep up with engineering as the social services have always been more of a face-to-face field."

But Meikle says that the ACA stands to alter that. While social workers will still retain that core confront-to-face customer time, the field can wait to be faced with a requirement to maintain medical records and patient data electronically. "As wellness care is being pushed in that direction with electronic health records, access to health information exchanges, and other electronic communication, those requirements are going to trickle down to the social services space. If you're going to be integrating with the health care space and if y'all have a system that hasn't been upgraded in 20 years, y'all are going to have some problems."

All of this also equates to the field developing a greater agreement of available software packages as well as how to use them, Meikle says. For those unaccustomed to using software, this can feel like an overwhelming chore.

"One of the kickoff steps that social services offices tin take is to await around at what their peers are already utilizing," Meikle says. "Find a group that has already implemented a software package to manage their client base and exist prepared to ask a lot of questions. If y'all programme to integrate in any manner with the health care space, a greater understanding of utilizing engineering science to manage the exercise is a must. Large health care systems and hospitals just aren't going to want to connect with practices that are out of date and tin't offer their patients the same level of connectivity or service that they're already providing."

A Technological Future
In addition to adapting to software and systems changes, social workers can also expect that this new management will push them toward other uses of engineering. As the customer base expands and more individuals have wellness care coverage or require assistance with it, social workers may need to be proficient at other forms of electronic advice, adds Michael Reisch, PhD, MSW, Daniel Thurz Distinguished Professor of Social Justice at the University of Maryland School of Social Work. "In club to exist able to communicate more effectively with a diverse array of clients, constituents, and collaborating organizations, social workers will need to be comfortable using social media such as Facebook, Instagram, and Twitter."

And every bit more hospitals and health networks begin to look at and use telehealth practices, these applied science-based services may as well trickle down to the social services sector, suggests Meikle. The field of health care is already finding that at-risk populations take a lot to gain from telehealth, which is defined as the use of electronic information and telecommunications technologies to support long-altitude clinical health care, patient and professional health-related educational activity, public wellness, and wellness administration. Through video imaging and advice, those in rural areas tin can now gain access to more specialized medical care that their community hospitals might non offer.

"I do believe that social services volition too be pushed in this management," Meikle says. "After all, they're the ones typically working with the at-risk population groups. Existence able to communicate with clients who tin't travel the many miles to see you in person is only going to be an increasing need as the ACA comes into play. People are already looking to utilize technology to monitor their wellness. Social services is going to keep bumping into that until they finally get on board. It's but the way things are going."

Model of Integration
While the many technological changes that the ACA stands to have on the field may seem jarring, the changes to the fashion business is done volition probable be more than adaptable. Going forward, it's believed that at that place will be a greater connectedness between the medical field and the social services sector as the ACA promotes a model of community-based intendance. While the current health care model tends to separate concrete health from mental and behavioral health, this new model aims to bring them all together.

"Wellness has both a physical and mental component, also equally extenuating environmental factors, and social work has an impact on all of that," says James Herbert Williams, PhD, MSW, dean of the Graduate School of Social Piece of work at the University of Denver and past president of the National Association of Deans and Directors of Schools of Social Work. "That gives social workers the opportunity for an integral office within the medical profession."

In general, social workers are already a natural fit in the medical community. "A social worker is a not bad person to have around when someone has been diagnosed with a new condition," says Williams. "There are a lot of parts of the process that come later that diagnosis—even helping the patient sympathize the diagnosis—and social workers can excel at putting those pieces together and navigating the road ahead."

Social workers tin can also expect to put their teamwork skills to increasing employ in this new model. "Since the ACA also emphasizes an interdisciplinary approach I foresee social workers not only working with hospitals but joining efforts with churches, community groups, and local employers," says Reisch. "Social workers have skills that brand them incredibly useful in an integrative health intendance model. This idea of a one-stop-store kind of model where physical, mental, and behavioral wellness are all provided are a swell frontline opportunity for social workers. The idea is to get more than conditions identified early before they become serious."

Although working side by side with the medical community may feel new to many, Reisch says it's really not. "A century ago, social work and public wellness were similar twin sisters," Reisch says. "They've worked closely together before and it can be done again. They are philosophically compatible. And as the ACA encourages greater involvement of social workers in the health intendance arrangement, I think we'll meet social workers finding more than roles not only in traditional places such as hospitals but even broader than that as well."

The Navigator Role
In improver to learning new technologies and adapting to practice-related changes that come with this new wellness care model, a third expanse of modify will come as social workers assume the part of "patient navigator." This is probably the easiest change to adapt to; it's something social workers are already accustomed to doing.

"Social workers can provide patients back up equally they assist them to navigate the system," says Salome Raheim, PhD, ACSW, dean and a professor at the University of Connecticut Schoolhouse of Social Work. "This is something nosotros've already been doing equally social workers only the importance of patient navigation has really been elevated with the implementation of the ACA. Social workers can assist educate patients and brand them aware of what wellness plans be also as assist them with information on how to enroll in those plans."

It's certainly not a new skill gear up, agrees Williams. "We've already done this," he says. "Helping people navigate systems is what we exercise. We've served as a guide, helping people navigate the welfare system, or worked with elders to navigate Medicare or Social Security. Advocating and educating is an essential part of who we are and it will exist not dissimilar with the ACA."

The only thing that will be different is the system being navigated, adds Raheim. That'south why information technology's and then important that social workers brand an effort to stay upward-to-date on the latest information. "The central is that we brainwash ourselves," she says. "Social workers must be educated on the ACA whether we're working directly in health intendance or not."

Even if social workers are not direct employed in the wellness intendance field, information technology'due south probable that the populations they serve will be affected in some fashion by the ACA. Fifty-fifty helping patients navigate the process of becoming insured can be incredibly useful, peculiarly for those who never had coverage before. Social workers should wait to be able to assist with helping people sign up for care, understanding eligibility requirements, detailing what programs are available, assisting with Medicaid, or directing individuals to the health insurance exchanges. Patients may besides demand assistance navigating "patient portals," which are increasingly implemented by health care groups since the adoption of the ACA. A patient portal is defined equally a secure online website that gives patients user-friendly, 24-hour admission to personal wellness data from anywhere with an Cyberspace connection. This, of class, comes back to the engineering science event.

"As well considering the implementation of a patient portal organization for their own practice, at the very least, those in the social services field should know how to operate these systems if their clients are already using them," Meikle says.

Changes to Training
As developments in the health care system create new opportunities and potential for changes in the field of social piece of work, it only makes sense that they be addressed in a schoolhouse setting. The fashion in which social workers are trained also as some of the education provided in the core curriculum should be considered.

With the integration of the ACA, technological skills are a must and there is corking opportunity to incorporate more of this training for social workers at the educational level. While social workers may not directly be operating these systems information technology is probable that greater integration of behavioral and mental health services with health care in general will ultimately link the fields electronically. At the very to the lowest degree, social workers may be required to take a bones understanding of how these software systems piece of work.

There is also academic opportunity to discuss the implications of expanding technology use. "The increased utilize of figurer technology will not only require new skills and the modification of familiar skills, it will also create new potential upstanding dilemmas around such issues every bit confidentiality, informed consent, and the intersection of professional ethics and the constabulary," says Reisch.

Going forward, education volition play a key function not merely for students but for current social workers, adds Meikle. As the ACA brings technological modify, new training may be required. "New business and technological processes are to be expected," Meikle says. "Technology volition brand inroads into the social services space. The question is how to integrate them into business practices. That's where training is going to be important."

And even though social workers already bring many of the practice skills needed to work in this new system, there'due south yet room for teaching there every bit well. "We absolutely need to rethink the training of social workers so that they can piece of work in an integrative health intendance team," says Raheim. "While social workers accept e'er been squad players, this new model of integration is withal a big modify. We are at present talking about a full care continuum in which behavioral and concrete health are integrated. Do social workers have the knowledge to work in that setting? Some may, but more than training tin can be done to ameliorate prepare social workers for this new environs."

Marvin J. Southard, DSW, the director of the Los Angeles Canton Department of Mental Wellness, agrees. "Correct now the biggest problem the U.S. health system faces is the integration of main intendance with specialty care," he says. "Our profession is well-suited to figure out how care coordination ought to take place merely that requires us to deepen our skills of being effective in multiple systems."

Even social workers who at their core are skilled in squad-building take gotten used to working in a system where specialties are compartmentalized, says Southard. And even within the behavioral and mental health services areas (which are undoubtedly linked) the subsets have been quite split up. Simply social workers must be willing to step outside of the lines.

"I know that nigh mental health social workers historically stick to mental health and don't know much about substance abuse treatment," Southard says. "Merely they become manus in manus. Information technology has to be a cadre skill. Those in mental health must at least know the beginning treatment steps toward helping those with addiction issues."

As the field begins to work more closely with health care, social workers must also become more comfortable with medicine. "Social workers should have enough basic knowledge to be able to talk about testing for diabetes or exist able to coach a patient on improving their blood pressure or eating a healthier diet," Southard says. "Just as social workers who are currently more than involved in the physical health of patients need to understand mental health better. Overall, all of our subspecialties demand to branch out and at least know the start steps of assisting a patient with an consequence exterior of their specialty."

A New Horizon
While the ACA presents many potential opportunities for social workers to expand their function in the health care arrangement, there is work to be washed. The technological and business changes that the field faces are pregnant. "There are a lot of changes to many systems every bit a result of the ACA and it'southward a lot to grapple with," Meikle says. "The social services field really hasn't had a big business process disruption in its history but information technology'due south possible the ACA could be information technology. Only resisting these changes and the implementation of new engineering is futile as that's where the future is headed. The ball is already rolling that way. It's at present up to the field to take the necessary steps to keep upwards."

— Lindsey Getz is a freelance writer based in Royersford, PA, and a frequent contributor to Social Work Today.