Navigators and Assisters: Two Case Management Roles for Social Workers in the Affordable Care Act

Abstract

Social workers can help ensure successful implementation of the Patient Protection and Affordable Care Act (PPACA, hereafter ACA) (P.L. 111-148). This became clear to me as I attempted to find my way through the 2,400-page-long ACA, looking for the “low-hanging fruit”: places where there was evidence that social work would be effective and there was a natural fit because of social workers' specialized training and professional code of ethics. There are, in fact, many such places in the ACA, particularly where one encounters the terms “case management,” “care coordination,” and “care management”—terms that occur 39 times. With each such mention is an opportunity for social work to meet the ACA's goal of reducing costs by improving health through a set of activities that the social work profession calls “social work case management.” The National Association of Social Workers (1992) defines social work case management as “assess[ing] the needs of the client … and arrang[ing], coordinat[ing], monitor[ing], evaluat[ing], and advocat[ing] for services” to address the client's needs. Two characteristics set social work case management apart from other kinds of case management. First, social work has a dual focus on the person and the environment. Social work's biopsychosocial focus means that social workers are concerned with the interaction between the body, the mind, and the social system. Second, social workers carry out case management by using a strengths-based approach, which focuses on strengths rather than deficits and views the community as an “oasis of resources” (Etzel-Wise & Howley, 2006).