1. Gero-Ed Center, National Advisory Board Member JoAnn Damron-Rodriguez, PhD, LCSW University of California, Los Angeles Department of Social Welfare jdamron@ucla.edu Reality Check: Social Work Geriatric Workforce Issues Mini White House Conference on Aging July 2005 Prepared for distribution by the CSWE Gero-Ed Center

2. Reality Check: SOCIAL WORK JoAnn Damron-Rodriguez, PhD, LCSW University of California, Los Angeles Department of Social Welfare jdamron@ucla.edu Mini-Conference on Geriatric Healthcare Workforce Issues Bethesda, Maryland July 16, 2005

3. Geriatric Social Work: Addressing Key Issues of Older Persons and Their Families in Today’s Delivery System Consumer Direction (Choice, Quality and Satisfaction) Family Caregiving (Family Caregiver Acts) Community Care (HCBS, Olmstead Decision) Addressing Diversity (+ Ethnic Elders)

4. Evidence Supports Geriatric Social Worker’s Competence In and Effectiveness To: 1) Promote Self Determination through Older Person and Family Centered Solutions Social Work enhances the developmental, problem solving, and coping capacities of older people and their families. 2) Develop Linkages to Appropriate, Accessible and Acceptable Services Social work promotes the effective, coordinated, and humane operating of systems that provide resources and services to older people and their families. 3) Respect the Diversity of the Older Population Social work recognizes the need and strengths of persons who differ based on culture, race, class, gender, sexual orientation, disability.

5. Social Work with Diverse Older Populations The Value Added of Psychosocial Care

6. Barriers to Older Persons Receiving Psychosocial Care from Qualified Geriatric Social Workers Lack of Title Protection: Recognizing a SOCIAL WORKER States legally recognize four categories of social work professionals: Basic (BSW), Intermediate (MSW no experience), Advanced (MSW with two years clinical experience), and Clinical (MSW with state licensure) Some practitioners hold a social work title without a social work degree. Estimated number of current number of social workers :350,000; number self identifying as social workers: 782,000 Older persons do not recognize nor understand the role of social worker Lack of Reimbursement Mechanisms for SOCIAL WORK SERVICES No Medicare/Medicaid reimbursement for comprehensive assessment and care management OBRA 1987, BBA 1997 limit professional social work services in NH

7. The Need and Challenges of Preparing a Geriatric Social Work Force  By 2020, approximately 65,000 geriatric social workers needed  Approximately 5% of MSW graduates specialize in geriatrics  9% practicing social workers are specifically in field of aging and have the lowest annual income of all workers  Yet 76% social workers have older persons in their caseload and the majority report needing more geriatric knowledge  Social work labor force is aging and reducing in size- retention

8. Progress in Preparing A Geriatric Social Work Force  US Bureau of Health Professions 1995 National Agenda for Geriatric Education: Social Work leads in the success of recommendations  John A. Hartford Foundation Geriatric Social Work Initiative  CSWE Gero Ed Center- aging infused curricula  Practicum Partnership Program- age enriched field education  Evidence of SW effectiveness (Rizzo & Rowe Report, insert date):  Shortening lengths of stay and decreasing inappropriate use of emergency rooms  Overall healthcare better coordinated  Caregivers more able to cope  Greater satisfaction  Social work force more diverse than other health professions  State Level: CalSWEC Aging Initiative (Archstone Foundation)

9. Geriatric Social Work WHCoA Recommendations 1. Guarantee older adults have the benefits of geriatric social work services and psychosocial care through : Establishment of competitive and equitable reimbursement of services provided by a qualified social worker in the community, hospitals and nursing homes. Center for Medicare and Medicaid Services Reimbursement for psychosocial care including geriatric assessment, family caregiver assessment, clinical case management, counseling and other services aimed to increase older adults’ autonomy and quality of life. Center for Medicare and Medicaid Services

10. Geriatric Social Work WHCoA Recommendations 2. Recognize the professional role of geriatric social work in contributing to the quality of care for older persons though the following actions: Stipulate the professional qualifications of a social worker (BSW, MSW and licensure) for geriatric positions in all publicly reimbursed care both in nursing homes and the community. Center for Medicare and Medicaid Services, AOA Promote older persons recognition of the services provided by a professional geriatric social worker including elder advocacy, linkage to service, family enablement, and counseling. AARP, NASW

11. Geriatric Social Work WHCoA Recommendations 3. Attract and retain gerontological social workers through : Provide aging enriched field and classroom education in all Schools of Social Work. CSWE, Hartford Geriatric Social Work Initiative (PPP, CSWE GeroEd Center) and other Foundations Sponsor federal and private financial incentives, such as loan forgiveness, student stipends, senior practitioner fellowships, and continuing education for education in geriatrically enriched programs. HSRA, BHPr, AAA, do you want to specifically mention Medicaid here?

12. Geriatric Social Work RESOURCES and REFERENCES California Geriatric Education Center http://www.geronet.med.ucla.edu/centers /cgec/home.html CSWE Gero-Ed Center http://depts.washington.edu/geroctr Use this website www.Gero-EdCenter.org/ Hartford Geriatric Social Work Initiative http://www.gswi.org Institute for Geriatric Social Work http://ww.bu.edu/igsw/ National Association of Social Workers “Assuring the Sufficiency of a Frontline Workforce” www.naswdc.org The New York Academy of Medicine Practicum Partnership Program http://socialwork.nyam.org The Rizzo and Rowe Report on the Efficacy and Cost-Effectiveness of Social Work Services http://socialwork.nyam.org/pdf/Efficacy_ Final_Report.pdf Berkman, B., Dobrof, R., Harry, L., & Damron ‑ Rodriguez, J.A. (1997). White paper: Social work. In S.M. Klein (Ed.), A national agenda for geriatric education: White papers (pp. 53-85). New York: Springer Publishing Company. [Previously published as a monograph: U.S. Bureau of Health Professions.] Scharlach. A., Damron-Rodriguez, J.A., Robinson, B., & Feldman, R. (2000). Educating social workers for an aging society: A vision for the 21 st century. Journal of Social Work Education, 36(3), 521-538.

13. SOCIAL WORK A PROFESSION FOR ALL AGES