PLease see the doc. the instructions are there and I provided the reading where you will get the answer it is in a pdf file.
1 1 BECOMING A POLICY ADVOCATE IN EIGHT POLICY SECTORS In this chapter, you will learn to: 1. Engage social welfare policy whether you are micro or macro 2. Conceptualize policy practice 3. Understand how a multilevel policy advocacy framework was developed 4. Link the multilevel policy advocacy framework to eight policy sectors 5. Use this book as a road map for your student and professional career 6. Contrast micro, mezzo, and macro policy advocacy with clinical practice 7. Understand how the social workers’ code of ethics requires micro, mezzo, and macro policy advocacy 8. Use policy advocacy to help marginalized and vulnerable populations 9. Analyze a multilevel policy advocacy framework 10. Provide policy advocacy at three levels 11. Link three levels of advocacy for pregnant teens and teen mothers 12. Develop policy advocacy Red Flag Alerts at three levels LEARNING OBJECTIVES Social workers engage in humanitarian work in many kinds of social agencies. They work with people from all social classes, racial and ethnic groups, genders, ages, and nation- alities. They work with active and retired military personnel. They work with residents of urban, suburban, and rural areas. They work with people with myriad social problems. Copyright ©2020 by SAGE Publications, Inc. This work may not be reproduced or distributed in any form or by any means without express written permission of the publisher. Do no t c op y, po st, or di str ibu te 2 Social Welfare Policy and Advocacy They often encounter obstacles as they engage in their work such as adverse social poli- cies and difficult work environments that stem from insufficient funding, punitive policies, and heavy workloads. Their clients, too, are often impacted by hardships, such as poverty, mental illness, disability, excessive incarceration, deportation, and discrimination—and large numbers of them live in the lower 50% of the economic distribution. ENGAGE SOCIAL WELFARE POLICY WHETHER YOU ARE MICRO OR MACRO Because their clients are profoundly impacted by social policies that emanate from social agencies, communities, states, the federal government, and courts, social workers often engage in three kinds of policy advocacy: helping their clients navigate social policies in eight sectors that personally impact them (micro policy advocacy) reforming dysfunctional agency and community policies in eight sectors (mezzo policy advocacy) changing policies that emanate from local, state, and federal governments as well as courts (macro policy advocacy) After providing orienting materials about social policy in its first three chapters, this book provides in-depth discussion of micro policy advocacy in Chapter 4, mezzo policy advocacy in Chapter 5, and macro policy advocacy in Chapter 6. It applies the multilevel policy advocacy framework to health, gerontology, safety net, mental health, child and family, education, immigration, and criminal justice sectors in Chapters 7 through 14. Because you will probably work in one or more of these sectors and will often refer clients to programs in different sectors, this book provides a road map to your career. Social policy was widely viewed not as a practice discipline but as a descriptive and analytic discipline prior to the 1980s. Social work scholars described myriad policies at local, state, and federal levels. They evaluated many of these policies by engaging in policy analysis. They focused on government policies with little attention to agency policies or policies impacting communities. These activities have merit, but they failed to make social policy sufficiently relevant to many social work students. This book aims to open up social policy to all social workers including to ones in direct service, community organization, and administration. Three changes took place in social policy that expanded its relevance to all social workers: conceptualizing policy practice, developing a multilevel policy advocacy frame- work, and linking this framework to eight policy sectors. CONCEPTUALIZING POLICY PRACTICE The term policy practice first emerged in social work in 1984 to describe policy as a practice discipline (Jansson, 1984). Discussion of ways that social workers could participate in mak- ing social policies hardly existed in the profession’s scholarly literature prior to 1984. Rather, existing policy literature was mostly confined to defining social policy, studying the history Copyright ©2020 by SAGE Publications, Inc. This work may not be reproduced or distributed in any form or by any means without express written permission of the publisher. Do no t c op y, po st, or di str ibu te Chapter 1 ■ Becoming a Policy Advocate in Eight Policy Sectors 3 of policy, analyzing the philosophical underpinning of policy choices, and policy analysis. These topics are important, but do not sufficiently discuss how social workers work to change policies in different venues, such as agencies, communities, and government entities. Policy practice describes roles, tasks, skills, and strategies that policy practitioners need to read contexts as well as develop, propose, enact, implement, and evaluate policies in specific settings. It describes different styles of policy practice, such as ones that involve social action, rational deliberations, implementation of polices, or combinations of these and other styles. Emerging policy practice literature discusses how social workers read the context to identify constraints that can be surmounted or opportunities that they can seize. It discusses how to place issues on policy agendas, develop policy proposals, engage in policy analysis, enact policies, implement policies, and evaluate policies. It describes skills needed by policy prac- titioners, including analytic, ethical, political, and interactional ones. It describes different models of policy practice, such as ones that emphasize analytic skills (such as think tanks), political skills (such as campaigns to pressure public officials to enact specific policies), inter- actional skills (such as developing coalitions to develop and pressure public officials to enact a policy), and ethical skills (such as developing policies that advance social justice). This redefinition of policy as a practice discipline raised its stature in a profession oriented to practice, whether direct service or clinical practice, administrative practice, or practice of community organizers. It facilitated social workers’ engagement in policy practice in community-based agencies; community boards; government agencies at local, state, and federal levels; legislatures; and political campaigns. The Council of Social Work Education mandated that schools of social work include policy practice in their curricu- lums in the 1980s—a requirement that currently exists in its accreditation standards for schools of social work. A national organization of social work policy faculty, known as Influencing State Policy, was established in the 1980s to encourage the teaching, research, and practice of social policy. To clarify that important social policies are developed not just at the level of states but also at levels of local and federal governments, this organiza- tion changed its name to Influencing Social Policy (http://www.influencingsocialpolicy .org). It maintains a website and convenes an annual national conference where it awards prizes to the best policy advocacy projects of BSW, MSW, and doctoral students. Policy practice also includes involvement in political campaigns whether working on campaigns, running for office, or voting. Elected officials develop policies that shape and fund American social policies. Social workers need to work to improve these policies by placing pressure on elected officials, helping elect promising ones, or running for office themselves. The Nancy A. Humphreys Institute for Political Social Work at the School of Social Work at the University of Connecticut, for example, trains hundreds of social workers to work in campaigns, to run for political office, and to hold leadership positions in local, state, and federal governments. UNDERSTANDING HOW A MULTILEVEL POLICY ADVOCACY FRAMEWORK WAS DEVELOPED A multilevel policy advocacy framework was developed in a book that was published in April 2015 but copyrighted in 2016 that describes the policy advocacy of social workers no matter in which sector they are employed (Jansson, 2016). It includes micro policy Copyright ©2020 by SAGE Publications, Inc. This work may not be reproduced or distributed in any form or by any means without express written permission of the publisher. Do no t c op y, po st, or di str ibu te 4 Social Welfare Policy and Advocacy advocacy at the level of individuals and families, mezzo policy advocacy at the level of organizations and communities, and macro policy advocacy at the level of government agencies, legislative and executive branches of government, and political campaigns. This framework was developed in three stages. First, a review of 800 citations in health care literature identified seven core issues that frontline health professionals address in their professional work, including social workers, nurses, and medical residents: protecting patients’ ethical rights improving patients’ quality of care helping patients receive culturally competent health care helping patients receive preventive health care helping patients finance their health care helping patients obtain mental health services helping patients link their health care to their households and communities (Jansson, 2011) Second, empirical research was initiated to measure the extent frontline health pro- fessionals engage in micro, mezzo, and macro policy advocacy with respect to these seven core issues with a grant obtained from the federally funded Patient-Centered Outcomes Research Institute (PCORI). A research team surveyed 300 frontline health professionals in eight major hospitals to measure the extent they engaged in micro policy advocacy with respect to the seven core problems. These health professionals included 100 social workers, 100 nurses, and 100 medical residents. It also measured their involvement in mezzo policy advocacy because health literature frontline professionals and patients often navigate and contend with hospital policies as well as policies of community agencies. It also measured their involvement in macro policy advocacy to change policies of local, state, and federal agencies, courts, and accreditation bodies. The data obtained from the PCORI survey demonstrated that frontline professionals help patients at the micro policy advocacy level frequently as can be seen in Table 1.1 (Jansson, Nyamathi, Heidemann, Duan, & Kaplan, 2015a). They frequently help patients get their ethical rights honored; find evidence-based treatments; receive culturally respon- sive care; receive preventive treatments; finance their medical bills; obtain mental health services; and receive medical care linked to their households and neighborhoods. Third, with assistance from an expert panel, the research team identified four to seven manifestations of each of the core problems as can be seen in Table 1.1, in which they are numbered from 1 to 33 (Jansson et al., 2015a). The expert panel iden- tified five manifestations of Core Problem 1 (patients’ or clients’ rights), for example, such as whether patients need assistance in obtaining “informed consent to a medical intervention,” “accurate medical information,” protection of “confidentiality of (their) medical information,” “advance directives,” and “care from professionals with com- petence to make medical decisions” (see Items 1 through 5 in Table 1.1 where aster- isks signify half or more of the 300 respondents selected “sometimes,” “frequently,” or “always”). Copyright ©2020 by SAGE Publications, Inc. This work may not be reproduced or distributed in any form or by any means without express written permission of the publisher. Do no t c op y, po st, or di str ibu te Chapter 1 ■ Becoming a Policy Advocate in Eight Policy Sectors 5 Item Mean (SD) Never Seldom Sometimes Frequently Always Core Problem 1: Patients’ Rights 2.97 (0.99) 1. Informed consent to a medical intervention 2.81 (1.3) 61 66 68 67 33 *2. Accurate medical information 3.26 (1.18) 24 54 88 78 51 3. Confidential medical information 2.81 (1.31) 52 85 66 50 42 *4. Advance directives 2.95 (1.38) 62 52 71 60 50 *5. Competence to make medical decisions 3.0 (1.28) 45 60 83 63 44 Core Problem 2: Quality Care 2.49 (0.90) 6. Lack of evidence-based health care 2.3 (1.12) 88 87 71 41 8 7. Medical errors 2.22 (1.1) 88 104 64 27 12 8. Whether to take specific diagnostic tests 2.62 (1.17) 66 64 99 48 18 *9. Fragmented care 2.95 (1.21) 46 56 90 74 29 10. Non-beneficial treatment 2.37 (1.15) 81 86 81 31 16 Core Problem 3: Culturally Competent Care 2.87 (0.90) *11. Information in patients’ preferred language 3.3 (1.2) 24 58 68 95 50 *12. Communication with persons with limited literacy or health knowledge 3.38 (1.1) 16 46 90 95 48 13. Religious, spiritual, and cultural practices 2.68 (1.15) 49 82 103 35 26 14. Use of complementary and alternative medicine 2.12 (1.07) 105 91 68 22 9 Core Problem 4: Preventive Care 2.98 (1.02) 15. Wellness exams 2.28 (1.35) 120