NETTING, F.E., KETTNER, MP., McMURTRY, S.: Social Work Macro Practice. Longman, New York & London, 1993 I Ail Introduction to Macro Practice in Social Work Overview What Is Macro Practice? Macro Practice in Context Three Case Examples Case Example 1: Child Protective Services Case Example 1- Frail Elderly Case Management Case Example 3: Displaced Homemaker Services Surviving the Dilemmas Why Macro Practice? Summary References WHAT IS MACRO PRACTICE? Macro practice is professionally directed intervention designed to bring about planned change in organizations and communities. Macro practice, as all social work practice, is built on theoretical foundations, proceeds within die framework of a practice model, and operates within the boundaries of professional values and ethics. Macro-level activities engage the practitioner in organizational, community, and policy arenas. These activides go beyond individual and group Interventions but are often based on needs, problems, issues, and concerns identified in micro activities. Organizational activities include, but are not limited to, supervision of professional and paraprofessional staff, working with committees, participating in 4 VALUES AND HISTORICAL PERSPECTIVES budgeting, writing proposals, and developing programs. Community activities engage the practitioner in negotiating and bargaining with diverse groups, encouraging consumer participation in decision malting, establishing and carrying out interagency agreements, conducting needs assessments, and advocating for client needs in a variety of community systems. Policy-related activities include coalition building, lobbying, testifying, tracking legislative developments that directly affect clients, and carrying out other efforts designed to affect legal or regulatory frameworks. Typically', macro social workers occupy positionsln social agencies and are involved in the agency's functioning. The agency may be a funding source, a planning organization, or a direct service provider, or it may perform multiple functions. The unifying concern of macro workers is how the agency relates to its environment and the forces that shape that environment. These forces include changing needs, shifting demographics, interest group politics, legislative influences, funding patterns, and a host of other factors. The macro worker, therefore, must understand the community within which an organization operates and the policies that: affect the service deliver)' system within that community (Meenaghan 1987). Although most practitioners will work within organizations and have some understanding of communities, it is clear that not all committee and task force work is macro practice, and not all people who serve on committees and task forces are doing macro social work practice. Macro practice is carried out by people operating in a sanctioned professional capacity, following a soundly based set of procedures, and focusing on planned change. Social work practice is broadly defined and allows for intervention at the micro (individual, group, or family) level, and at the macro (organization and community) level. Given this division of labor, some professional roles require that the social worker be involved full-time in macro practice. These professional roles are often referred to by such titles as planner, community organizer, manager, or administrator. The direct service worker or clinical social worker, however, also bears responsibility for initiating change in organizations and communities. The direct service worker is often the first to recognize patterns indicating the need for change. If one or two clients present a particular problem, the logical response is to deal with them as individuals. However, as more persons present die same situation, it quickly becomes evident that something Is awry within the systems in which these clients are interacting. It then becomes incumbent upon the social worker to help identify the system(s) in need of change and the type of change needed. The nature of the system(s) in need of change may lead to communitywide intervention or intervention in a single organization. Given these statements, practitioners may begin to feel overwhelmed. Is it not enough to do good clinical work? Is it not enough to listen to a client and offer options? Professional practice focusing only on an Individual's intrapsychic concerns does not fit die definition of social work. Being a social worker requires seeing the client as part of multiple, overlapping systems that comprise the person's social and physical environment. If the social worker is not willing to engage in some macro-practice types of activities relating to these environments, then he or she is not practicing social work. I 1 / AW INTRODUCTION TO MACRO PRACTICE IN SOCIAL WORK 5 j Similarly, social workers who concentrate in macro practice must understand i micro practice, which may be defined as intervention directed primarily at the | individual or group level. Without this understanding, macro practice may be i carried out in the absence of an adequate grounding in the nature of client needs. ■\ MBA and MSW administrators would act similarly in all situations, and cost :'s alone—rather than an understanding of client need balanced with cost—would [ drive community planning. The interconnectedness of micro and macro roles ■) are the heart of social work practice. In short, it is as important for social workers In preparation for writing this text, we talked with a number of our former | students who are now practicing social workers, some of whom work directly with clients and some of whom are planners, managers, or administrators. We "j asked thera what they would say to current students about the differences between | their expectations of social work practice when tiiey were students and their actual !i experiences over the past few years. One student responded: "As a student, I .f have this very vivid memory of being idealistic. I liked social work's emphasis :i on serving clients as the primary focus of attention, and I thought that would it carry over to my'professional practice. Instead, I find that my professional life is G VALUES AND HISTORICAL PERSPECTIVES 1 / AN INTRODUCTION TO.M/SCPÖ PRACTICE IN SOCIAL WORK 7 dominated by two things: fellow employees and money..In malting decisions, 3 we find that we have to deal much more with staff egos than with client needs; ■ j| And the 'bottom line' mentality that pushes budget Issues into every discussion j and decision has been a real disappointment." -\ A second student said: "What makes this profession .worthwhile for me is i that there is a core of very committed people who really live up to the ideals 5 of the profession. They're very talented people who could make a lot more money *j elsewhere, but they believe in what they're doing, and it is always a pleasure k to work with diem. Our biggest frustration has been that diere are so many people (like state legislators, for example) who wield so much power over this profession, I but who have no understanding of what social problems and human needs are | all about. Even though professionals may have spent the better part of their careers H trying to understand how to deal with people In need, their opinions and | perspectives are often not accepted or respected." ;| A social worker recently employed by a community-based agency on an Indian ;jj reservation shared his experience: "Culture is so important to the work we do. I =| constantly have to ask indigenous people for advice so that I do not make >jj assumptions about the people widi whom I work. The concept.of community and what it means to this tribe, even rhe value of the land as a part of their tradition, ^ is so crucial. It is much more complex than I had assumed when I was in school." -t Another former student reinforced the importance of community: "I guess '■} I never realized how porous agency boundaries are. We have board members 1 coming in and out and we see clients. But the thing that has surprised me is how £ much I'need to know about the community—people's values, where funding comes from, how to; assess community needs. Even though I do direct practice, " I am constantly pulled onto task forces and committees that have to deal with " the broader community issues." . J Concerns about limited public resources combined with overwork were j expressed by a program specialist in foster care: "A big problem is the workload— / the sheer size of people's job responsibilities. The state can't or won't provide the money to Iceep workloads at reasonable levels. It never occurred to me the frustration there would be in working with policies you can't change because you don't have any input at those levels. Our organization has two separate parts—volunteers and professional staff—and there's often no clear definition of who does what. It's very difficult to know which issues should be brought to the board and which ones should be settled by staff." Despite these problems, though, tiiis same person quickly added, "A real positive is the feeling you are having a role in helping people. Seeing progress on the part of individual clients is one of the main things that keeps you going. It's also very reinforcing to have the opportunity to be an advocate for kids." - Another former student was disappointed about the impact of limited resources on practice and employee morale: "It really wears you down after awhile when everything Is decided in terms of money. Furniture in our waiting room is falling apart, the place needs to be painted, there are so many things we should do [o improve our efficiency and effectiveness, but we can't because we can't afford them. Just once I'd like to have the resources to really do things right, the way they can in big corporations." However, lest we begin to beUeve'iha^^ sector does not have Its own limitations, the clinical director C^a^p^yat^ adoption agency had this to say: "Unlike a lot of social workere|:IM^P^:}^M^^^■^^^^f:'y, and bu5ine5s considerations always have to be facfore&tin^ have a fairly small operation, and 1 think the agency, directo^Is^cesg(0nstcS.n^yj,c6ncerns about how clients are treated, but I've still had t6.gke;usjpfij^ arise between malting a profit and serving clients,; Our/agency^ adoptions, and I've been very surprised by the Ignarancd*Md'!ppM adoption even among other social workers/A lot of!rh'e^&^ their values on women about how they should 'always'Re'ep;their child, and they usually do this without knowing anything about/pne.;paser"'" A child protective services worker said: "It's really hard 46 describe. Within a few days last year in my caseload there was a death of a cliild,-another of my ldds was abandoned In our waiting room, and there were'Uireats'pE.violence against our staff from people who think we just indiscriminately tgke.childreriiaway From their parents. I often think of going into other lines of work, butthere are lots of intangible rewards in social work, and other professions have their.headaches; too." The director of a social services unit in a hospital talked about another client group, the elderly: "I have been here long enough to see the advent of diagnostic-related categories. This is. the Medicare system's way of maldng-sure'dldcrpatients are discharged efficiendy, and if they are not, the hospital hasto pickup the tab. Social workers graduate from MSW programs ready to counsel patients in the hospital and they are sorely disappointed. What we have to do 15 work fast; counseling Is done 'on the run,' and we are pushed and prodded by everyone from admissions to discharge planning to move these folks along. Many of these older persons don't have people who can help them when they are discharged and they are really vulnerable to being placed in a nursing home. It is-as if policies and procedures make our decisions—where is the patient involved?." On a final note, a direct practice student who recently graduated rnade this statement: "This may sound negative, but it is not meant to bc.'! My.education in social work taught me how little I know. I feel as if I have fust scratched the surface. Learning is a long ongoing process. I work in a head injury center and what I learned from having had exposure to macro-practice roles is that you have to know the organization in which you work, particularly the philosophy behind what happens there. This Is more Important than I ever imagined." These quotations tell their own stories. Many of the issues facing social workers in their daily practice are not only client problems but problems in agencies or communities that affect the worker's ability to serve their clients. We thank our former students for helping us raise these issues. i THREE CASE EXAMPLES J Other aspects of social work macro practice that need to be understood by the I student and the beginning practitioner can best be Illustrated by case examples. I We selected the following because they contain similar themes but focus on i different target population groups: children, the aged, and women. 16 VALUES AND HISTORICAL PERSPECTIVES Much of the work done by functional noncapitulators is what we,refer to as macro practice, and is carried out with widely'varying degrees of skill. The purpose of this text is to present a theoretical base and a practice model designed to assist the professional social worker in bringing about change in organizations and communities. We encourage its readers to become functional noncapitulators within the organizations and communities in which they will work. WHY MACRO PRACTICE? The beginning student will find that most social work literature reinforces the importance of practitioners' macro-level responsibilities. Why is this such an important issue? The answer has a great deal to do with the mission and history of the profession, and the development of a value base which has become the cornerstone of professional social work practice. Although Chapter 2 will focus on historical development, understanding the professional mission of social work is essential to recognizing why macro practice is important. In a provocative argument, Specht (1990) challenges social work's contemporary interest in the "popular psychotherapies." [They have] diverted social work from its original vision, a vision of the perfectibility of society, the building of the "city beautiful," the "new society," and the "new Frontier." There is a yet unfulfilled mission for Social work that might be resuscitated, ft is a mission to deal with the enormous social problems under which our society staggers- the social isolation of our aged, the anomie experienced by our youths, the neglect and abuse of children, homelessness, drug addiction, and AIDS. Our mission must be to build a meaning, a purpose, and a sense of obligation for the community, not one by one. It is only by creating a community that we establish a basis for commitment, obligation, and social support. "We must build communities that are excited about their child-care systems, that find it exhilarating to care for the mentally ill and the frail aged. (pp. 354-56) Earlier in this chapter we presented three case examples of what included seemingly unresolvable dilemmas. Yet, the lists of questions and concerns expressed by the three social work practitioners reflect their attempts to bold on to the mission described by Specht. This mission is built on a set of values. Barker (1987) defines values as "the customs, standards of contact and principles considered desirable by a culture, a group of people, or an individual" (p. 171). He goes on to explain that in 1982, social workers, as a professional group, stated some of the overriding values for their practice. These values were published in the NASW Standards for the Classification of Social Work Practice. They were: Commitment to the primary importance of the individual In society, Respect for the confidentiality of relationships with clients. Commitment to social change to meet socially recognized needs, ■1 t I I -A -31 i M 1 / AN INTRODUCTION TO MACRO PRACTICE IN SOCIAL WORK 17 Willingness to keep personal feelings and needs separate from professional reladonships, Willingness to transmit knowledge and skills to others, Respect and appreciation for individual and group differences, Commitment to develop clients' ability to help, themselves, Willingness to persist in efforts on behalf of clients despite frustration. Commitment to social justice and the economic, physical, and mental well-being of all in society, and Commitment to a high standard of personal and professional conduct. (Barker 19B7, 171) These values do not cover the entire NASW Code of Ethics, but they do provide a general orientation to the positions taken by the profession on die larger Issues relating to responsible and conscientious professional behavior. In all social' work practice, there is clearly an expectation that the social worker will, when "the situation calls for it, become involved beyond the simple needs of a "case" or client and initiate change at the organizational or community level. In many ways it is this commitment to the understanding and changing of larger systems that separates social work from other professional disciplines. Few other professions have adopted the same "systems perspective." Thus, while a committee or a task force might be made up of many disciplines, the professional social worker who is doing macro practice is operating from a knowledge and value base that includes a number of considerations: Informed Approach. First, the macro practitioner approaches the need for change with an understanding and expectation that decisions will be based on as complete a set of data and information as time and resources allow. Informed decision making is pursued in a systematic and scholarly manner, utilizing the best available theoretical, research-based, and practice-based knowledge. Consumer Input and Participation. Although it may be more time-consuming and take more energy to include clients in change processes, the social worker must always look for client input. Finding new and meaningful ways to facilitate citizen participation in organizational and community arenas is an ongoing challenge for the dedicated professional. Fit of Problem to Solution, Based on a Thorough Analysis. Defining the problem to be changed requires integrating what clients have to say with scholarly research and practice results. This analytical process is dynamic and interactive, often causing the change agent to rcframe the original problem statement. But once the problem statement is agreed upon, social workers must ascertain that their interventions make sense in relation to the problem at hand. Interventions often require a creative imagination that goes beyond traditional approaches. Goal Directed. Goals are broadly defined aims toward which practitioners guide their efforts. They are usually long term and sometimes idealistic. tell'- teigi' ..:ta^Bf- 18 VALUES AND HISTORICAL PERSPECTIVES However, goals provide a vision shared by clients and colleagues—a hope of what can be—and they assist the practitioner in maintaining a focus. Outcome Oriented. Outcomes are defined as quality of life changes in clients' lives, based on the interventions planned by social work practitioners. Outcomes can be determined by professionals, based on what they think clients would want, but the best test of an outcome is whether or not the clients themselves really see it as meaningful and valuable. Social workers have the opportunity to facilitate change. Based on a set of values, macro social work practice progresses in an informed manner, incorporating clients into the dynamic process, designing interventions to meet well-analyzed problems. Broad goals and specific outcomes provide the focused direction. SUMMARY / AN INTRODUCTION TO MACRO PRACTICE IN:SOCIAb^^R!^^ REFERENCES Barker, R. I. (1987) The social work dictionary. Silver Spring, MD: National Ass'ociaÜrän □f Social Workers. Meenaghan, T. M. (1987) Macro practice; Current trends and issues. Encyclopedia bfsocial work (18di ed., 2: 82-B9). Silver Spring, MD; National Association of Social Workers. Sherman, W. R., and S. Wenocur. (1983) Empowering,public welfare workers through mutual support. Social Work, 28(5): 375-79. Specht, H. (1990) Social work and popular psycho therapies. Social Service Revieiu 64(3)-345-57. In this chapter we have tried to provide the basic foundations on which students can build an understanding of social work macro practice. We defined macro practice as professionally directed intervention designed to bring about planned change in organizations and communities, and we began a discussion of the circumstances leading to the need for planned change. To do this, we used comments from former students who are now practicing social workers. These comments illustrate how the circumstances that are often most troubling to social workers are not only the concerns of their clients but also the management of their organization or the resources available widiin their community. These points were reinforced through three case vignettes showing how policies, program structures, resource deficits, and other macro-related criteria have much to do with social workers' abilities to be effective in their jobs. One way that social workers sometimes respond to these realities is to give up fighting against them. This is done through capitulation, withdrawal, self-martyrdom, or other approaches, all of which reduce the worker's professional effectiveness. However, social workers who are skilled in macro pracdee have another opdon, that offunctional noncapiiiilation, in which they use their understanding of macro systems to bring about needed changes in these systems. These skills are not, and should not be, limited to those who are working in traditional macro-practice roles such as aclministratian or planning. Instead, they are critical for all social workers to [enow, including those engaged mostly in micro practice. Parts II, III, and IV of this textbook will provide a macro-practice model to iide social workers in undertaking change processes. But first, Chapters 2 and will provide more detailed historical and values perspectives for macro practice social, work. ■i 30 VALUES AMD HISTORICAL PERSPECTIVES f$ Americans and the political order" (pp. 272-74). Other programs were less I successful and in some cases resulted in harsh criticisms of social workers and j| their efforts. Within the field itself, however, accomplishments such as those of ;| the CAP agencies helped to reestablish the importance of macro-practice rales, -vif. Reflecting .this trend, the Council on Social Work Education (CSWE), in 1962, :rf recognized community organization as a method of social work practice ^f, comparable to group work and case work. In 1963,. the Office of Juvenile j Delinquency and Youth Development of the U.S. Department of Health, ; Education, and Welfare funded CSWE to develop curriculum for training community organizers. Between 1965 and 1969, the number of schools of social -'A work providing training in community organization rose by 37 percent, eventually : 4' including virtually every school in the country (Garvin & Cox 1987). Community ||: organization thus emerged as a legitimate part of social work practice. || MACRO PRACTICE IN ORGANIZATIONS h Communities are macro systems in which all social workers interact arid for which -s-practice models have evolved. However, communities are comprised of networks -.J of organizations, and it is these organizations that usually hold the direct respon- 4 r sibility for carrying out basic community functions. As such, organizations are ;*\ : a second type of macro system with which social workers must be familiar. With 3 . respect to human service organizations, one important consideration is historical . patterns of shifting emphasis between centralization and decentralization of agencies and services. England's Elizabethan Poor Law of 1601, the first written law establishing -5 a governmental system of services for the poor, adopted a decentralized approach > to providing services. Under this law, assistance to the poor was a local function JJ-(as was taxation to pay for the assistance), and responsibility for service provision rested with an individual "overseer of the poor." This model was retained more :[. or less intact in the American colonies, and until the 1800s, relief efforts for die a needy remained primarily local and small In scale. The reformist movement of the early nineteenth century began a slow transition to larger-scale services in the form of state-run asylums for dependent ff children, the mentally ill, and others. Later, as population, urban concentration, \ and service needs increased, so did the diversity of both public and private ->j programs. Eventually, it became apparent that some sort of coordinating mechanism was needed for these various efforts. As Trattner (1989) notes: The situation in Massachusetts was typical. In 1859, the commonwealth had three state mental institutions, a reform school for boys, an industrial school for girls, a hospital, and three almshouses for the state or nonresident poor. In addition, ) four private charitable institutions—schools for the blind, the deaf and dumb, 7 the feeble-minded, and an eye and ear infirmary—received state aid. Each of ■ { these was managed by its own board of trustees. So uncoordinated a system not only increased the cost of operation, but it did not provide for a channel of ■• 2 i THE HISTORICAL ROOTS OF MACRO PRACTICE 21 '; h communication between institutions; a reform in one, then, might not be implemented in the others. The situation obviously called far some method of state supervision, (p. 81} The result was the creation of what became icnown-as the State Boards of Charities, first.in.Massachusetts in 1863, then in another fifteen states by the mid-1890s. .. These boards represented die first real involvement of state governments in . centralized coordination of welfare services, and they helped to establish standards for the administration'of human service organizations. For roughly the next sixty-five years, much of the development of human .^service organizations took place in the private sector. The formation of the COS .agencies and settlement houses was a partial recognition of the advantages of : establishing standard service practices within the framework of a strong organisational base. Efforts toward developing more comprehensive public agency ^involvement unsocial welfare services occurred during the Progressive movement ,:in the early.1900s. One example was, the creation of the first state public welfare ^department in Illinois in 1917. Still, the focus remained very much on decen-■Uralized serviceprovision. There was relatively little growth among human service ..-organizations in the public sector. . „ It was not until the Great Depression that public organizations for the .'provision of human services were established on a large scale, The New Deal ■'programs created an infrastructure; of organizations at the Federal level that became rboth the foundations of the welfare state and the First large, governmental human ..service bureaucracies. In addition,, a key function of these agencies was to distribute relief funds to various states, and this in turn helped to spur the creation -of.state-level public welfare organizations. Some programs, such as the Federal emergency Relief Administration (FERA) and the Work Projects Administration - TWPA) were established to respond directly to Depression-era problems and thus were relatively short-lived. Others, such as the Social Security Administration, formed the institutional basis of ongoing federal social welfare programs, and .■they continue to play major roles. With the creation in 195(5 of the Department of Health, Education, and Welfare (now the Department of Health and Human Services), most of these agencies were combined into a single, cabinet-level organization through which governmental social welfare programs were centralized; Since its early development, professional social work practice has been conducted within some type of organizational base. However, these organizations varied over time, and the skills needed for effective practice within them also changed. For example, in the early years of social work education, attention toward models of practice in social work organizations focused primarily on preparing a limited number of macro practitioners to assume roles as administrators of small agencies, usually In the private sector. The goal was to provide skills such as fund raising, working with voluntary boards, and supervising direct-■ service workers. With the growth of large public bureaucracies and nationwide networks of affiliated agencies in the private sector, the size and complexity of human service organizations changed. The role of macro practitioners within these organizations l-J- vJr~ cJ'-i_J ' i—1 «—«......I- i • .1 * i 32 VALUES AND HISTOHICAL PERSPECTIVES -'3$: L.t 2 / THE HISTORICAL ROOTS OF MACRO PRACTICE 33 ■"^ ■ ' ' " was also forced to change. For example, trends such as the increased size of humnn. ||!,.'. ;.,^e examine these same trends in terms of their influence on contemporary service organizations, their increased complexity and diversity of services, and ■?]§'■' developments In the field. changes in standard budgetary policies forced administrators to seek new skills- Lewis (1978) calls particular attention to the growth of concern for fiscal. >■ accountability that first became a dominant issue In the late 1960s. He argues - -'.Broad Social Conditions diat these concerns forced social work administrators to shiftfrom being "problem solvers" to being "managers." Implicit in this shift was a change in administrative i;j!>v--, -jhe combined effect of population growth, urbanizadon, industrialization, and orientation, moving away from external considerations of how best to deal with "if* '-/^changes in institutional structures have created communities that are very different specific social problems and toward internal considerations of budgetary com- JM".': '0,today than during the early years of the profession. Though these changes have pliance and operational efficiency. Considerable concern was expressed that if social 5§ -/fostered improvements in areas such as health, income, transportation, and others, work administrators did not acquire these skills, leadership of human service agencies if./v^nDt all aspects of die transformation have been positive. Warren (1978) calls would pass to persons from other disciplines who did possess such training. J|| attention to these concerns, noting that "discerning Americans have come to the Concern has also arisen that administrative decisions in human service l§X::-:^uriea5y realization that all is not right with their community living, that undesirable-agencies have become overwhelmed by managerial concerns and no longer reflect ^/situations appear with growing frequency or intensity and chat these are not the the consideration of client needs. In response, Patd (1987) and others have called •'^'adventitious difficulty of one community or another so much as the parts of a for the development of an effectiveness-driven model of administrative practice VSi V/general pattern of community living" (p. 14). Warren calls this the community in which the achievement of desirable outcomes for clients becomes the primary ■^'■■jtprdblem, and as an element of the contemporary society, it is an important criterion for decision malting. The intent of this model is to view administrative .^ippncern for macro practitioners. pracdce in social work as a unique blend of managerial skills combined with broader l:/// One aspect of this problem has to do with the consequences of urbanization. knowledge of social problems and the means of addressing these problems. ^Though Uiey offer many benefits, large, complex cldes also breed large, complex Finally, just as views of the role of human service administrators have ijif .^ip/oblems, and the very size and complexity of a community can interfere with changed, so too have notions about Che organizations in which they work. Since ^.'solving these problems. One casualty of metropolitan growth, for example, is most social workers now operate within the context of some type of organization, ^//^ sense of solidarity within the community. Small-town shared views of the , their understanding of that organization may have much to do with the ability ^|:_\ a "cauiuion good may, in large cities, devolve into narrow parochialism based on to do their Job well. W:1 ^"units such as a single apartment building, an area of gang turf, or family and ethnic ■ For example, in a classic work entitled "The Good Bureaucrat," Robert ||; ^fgrpup affiUations. The greater the number of these cornmunities wi7/jm commu-Pruger (1973} made the point that social workers have two major roles. The helper ^/^.^Ities, the more difficult it is to identify and serve the interests of die whole, role defines their activities as a social worker who assists clients widi various ;p|50/^i Closely tied to these consequences of urbanization is the loss of geographic problems. The organizational role defines the responsibilities the worker has for ^relevance of many communities. In small-town America, communities were completing forms, making reports, attending meetings, and other organizational 3jffi*^$Wl&T defined In terms of residents' physical proximity, as well as commonalities tasks. These roles may compete, and the clash between them may lead to a/|||;_-V-£/5udi as topography, soil conditions, water supply, and odier circumstances of worker's inability to meet either satisfactorily. For example, a worker may have /y^proxiinity. People lived in the same place they worked, frequently remained there so many forms to fill out that he or she has little time for listening to detailed- ;J6," ^'throughout their lives, and shared with their neighbors both fortune and mis-client problems. Pruger argues that a third role, the bureaucratic role, is possible,.^r^^fortune (droughts, floods, good and bad harvests, and so forth). In contrast, many in which the worker develops skills In mediating the conflicts between the other W; ^..^des are now so immense that residents in one area may share little with those two roles, learning to meet organizational demands without sacrificing profes-/^".;.;:iiiri another in terms of their economic base, political environment, lifestyle, or slonal skill. This Is what the functional noncapitulator, discussed in Chapter 1, ;^--.;^;^eh' climate and terrain. Because geographic, legislative, and social boundaries has to do in order to survive in a demanding environment. In subsequent chapters, ||;. } >/often intermingle and evolve, it may be difficult even to define the boundaries we will discuss how Pruger's model of the good bureaucrat fits well within me^&p--J^p^a given community. larger framework of the modern macro practitioner. As residents' identification with local connections has ebbed, the.importance- '^'i^M^textracominunity affiliations has greatly expanded. These affiliations define •'-^;fjpe;reIationships between community organizations and related organizations CONTEMPORARY TRENDS -'i?4-^l'tside me community. For example, an auto plant may be essential to ...the- ';||^',L^£cpnoruy of a particular community, but its^most Important ties may not be. to : At the beginning of this chapter, we discussed major historical trends affectmfri^^^community but to die home office of its corporation in another city far away the development of the social work profession. These were: (I) broad socialr-#fr'.^|-ilecision to close the plant might come entirely from the home office,(yet it, . } . ^■GDn^tions, (2) Ideological conflicts, and (3) oppressed populations. In this section. JpSjMl ^ community that would bear the most severe consequences of this decision 34 VALUES AND HISTORICAL PERSPECTIVES Loss of control over such decisions.renders the community extremely vulnerable yet an excessive concern for external affiliations may blind community members"' to critical local needs. In addition to community issues, contemporary developments in the organizational structure of human services are also important to consider. One parallel between communities and organizations is that both have continued to grow and. become more complex. In the organizational realm, this has given rise to the bureaucratization of service systems. The term bureaucracy has taken on a, number of mostly negative connotations which,, as we shall discuss in Chapter 6 .. may or may not always be accurate. Here we refer to bureaucratization as the-{ growth in size and structural complexity of human service organizations. This 1 has been especially true in public agencies, which have generally continued to ' expand since the New Deal. Bureaucratic organization is a means of structuring tasks and relationships.;; . among organizational members in order to maximize operational efficiency. In ■ many ways, this model has made possible the development of modern organi-| 'zations, and its advent coincides with the vast increase in productive capacity! associated with the Industrial Revolution. The problem with bureaucracies is that; they often become as machineiiite as the tools they employ, and the result can : be a rigid and dehumanizing style of operation. This style usually grows more > pronounced as the organization gets larger, and vast governmental human service agencies have become some of the most notorious examples of the negative-aspects' of bureaucratic structure. Partly in response to this problem, privatization became a significant trend. during the last two'decades. Although the term can be used in many ways, we define privatization as ' 'the deciding, financing, or providing of human services by the private sector to clients for whom the public sector is responsible" (Netting et al. 1990). The trend may be more accurately termed reprivatization because of its focus on returning to the private sector for responding to human need. Beginning in ttie 1960s, recognition of the limitations of government bureaucracies prompted growth in purchase of service contracting. Public agencies paid for services but they were provided to their clients by private organizations. Between 1973 and 1984, for example, nonprofit purchase of service contracts grew from $262.9 million to S664.1 million (Kettner & Martin 1987). Decision-making and financing functions remained governmental responsibilities, whereas the function of providing services shifted to the private sector. Tins arrangement was probably well accepted in many communities, since going to a local nonprofit agency to receive services Is often less stigmatizing for clients. However, other trends accompanying the move toward privatization complicated the community service delivery system. During the early 1980s, conservative views toward human services, combined with an economic slowdown, led to decreased public funding and decentralization of decision malting. This meant that many nonprofit agencies, which had pre-viously grown larger on public dollars, were suddenly faced with stiff competition for very limited resources. For example, facing a shortage of patients, hospitals began diversifying into service areas other than primary health care (i.e., substance 2 / THE HISTORICAL ROOTS OF MACRO PRACTICE 35 abuse centers, home health, etc.). .For-profit organizations began moving into human service provision, seeking cUents who could pay for their own services. The effect of this trend on community human servic'e.systemshasbeen most acute in the provision of services to low-income.clients.. Formerly,:many of these clients were served by nonprofit agencies either through contracts with public agencies or through excess revenues from clients who were able to pay. Now, ^ government funds are more scarce and.paying clients are. often siphoned off by Jiospitals and for-profit providers. Many nonprofit agencies no,-longer have resources to pay for services to poor clients and there is increasing, competition I between nonprofits for the funds that are available (McMurtry et al. 1991). *' A final trend is die advent of computerization. Society is moving toward a f tnodel in whicJiiriformation and sendees rather than manufactured goods are the '"most important commodities. As this takes place, communities will change. Heavy industries will diminish in importance and even the traditional character of the -''^vgrkplace will be altered, such as by workers remaining home, and carrying out *%ieir tasks on computers. Moreover, the ability to tie into national and international .Computer networks will further enhance the importance of extra-community ties. ■ Social workers' roles will inevitably be affected by these changes. For jexample, Ginsberg (1988) discusses how computer technology has facilitated ^storage of vast numbers of client records by large public and private human service 1 organizations. He cites government researchers who challenge social workers to use computer technology, noting that "social workers .- \i write reports and progress notes ■ii pull and read numerous files !;■.'■ take case histories and develop diagnoses tap into local area resource networks keep in touch with,professional developments provide factors and figures to contribute to agency accountability process." (Parker et al. 19S7, cited in Ginsberg 1988, 71) Still, other writers argue that these changes pose grave dangers for the profession. For example, Fabricant (1985) asserts that the computer revolution ■as simply another manifestation of. an ongoing process of "desldlling" social ■'^workers. One example he offers is the role of workers who determine eligibility W benefits such as AFDC and food stamps. These positions are often filled by poorly trained and poorly paid clerical employees who simply input data into "^computers, and these computers determine clients' eligibility. The point is that ■* if social workers cannot learn to adapt to and control new technologies (as well ^-as other social trends we have discussed) they risk being controlled by them. ■■'■rv- Ideological Conflicts ^As with the discussion of broad social conditions, Warren's (1978) notions of .^rthe community problem also provide a starting point for addressing contemporary ^ideological trends. One issue concerns community members' increasing difficulty öB THE COMMUNITY AS THE TARGET OF CHANGE 4 / UNDERSTANDING COMMUNITIES AMD COMMUNITY SOCIAL PROBLEMS 69 „ jABlE * 1 TilB Commun"y En'counter Framework understand something as complexes a community, much less propose ways to-' change it? _ _ . First, it should be made clear that there is no single accepted, orderly, systemadc'j^ ifi^—--- method that allows one to understand all the dements that go into malting up a ^,1, ^jdanhfying tha Target Population community. Understanding, for die macro practitioner, means gathering as mucft^lW--data and information as possible in a narrowly focused area of Interest or concern-^"^1 and malting die best Informed decisions the information will allow. There are three reasons why macro practitioners need a systematic approach. Si g to conceptualizing a community and its social problems. First, the person in 3^ Task : Determining Community Characteristics ■'Recognizing Differences 1. Understand characteristics of target-population members 2. Identify community boundaries 3. Profile social problems 4. Understand dominant values 5. Idenlify formal and covert mechanisms of oppression 6. Idenlify evidence □[ discrimination 7. Recognize locations of power B. Determine resource availability 9. Identify patterns of resource control and service delivery environment view is critical to professional social work practice. The community^ in which one lives has a lot to do with who that person is, the problems he orM j$ r^l^ntifying structure she faces, and die resources available to deal with these problems. Professlonal*|^*^' social work prescriptions may not be feasible or realistic without an understanding5^ £ 3 of these community Influences. The framework presented here for understanding — community Is designed to assist in concepmalizing the environment within whkftiflMw^ clients experience hope and draw strength, as well as lace oppression and frustration^^^ ~# Second, community-level macro change requires an understanding of rhert; ^ history and development of a community as well as an analysis of its current statug Without this knowledge, the practitioner has a limited grasp of the breaddi and^^^pulation is defined as those individuals, families, and/or groups who are depdi of values, attitudes, and traditions, and their significance in either main^^^^geriencing a problem or need, and for whose benefit some type of community taining the status quo or allowing for change. " iv^lpjiange is being considered. ^ifjirst selecting a target population, and that the community be understood from ^üjc perspective of the concerns and needs of that population. The target Third, communities constantly change. Individuals and groups move mtqs: power, economic structures change, sources of funding change, and citizens ralesi change. A framework for understanding community can be helpful in recogniziagjr and interpreting these changes. A FRAMEWORK FOR CONCEPTUALIZING COMMUNITY The choice of a particular target population is a choice of values. In every ^^^inniunicy there are multiple groups with varying needs. Therefore, the social "'•$orlcer must realize that In focusing on one target population, he or she is "'.fying' a choice to examine the community from a specific perspective. It JL'Be important, then, to go back and look at.the community again from ^l-feheigerspective of more than one target population so that a richer understand-:can develop. For example, existing reports on community Issues and lobulations may predetermine what target group the practitioner will serve, with ^f^ilmlted opportunity to familiarize oneself with other community needs rcphcerns. ||Wesuggest that a community be analyzed and understood from this limited {ij^pective because (1) practically speaking, people who become involved in ij^ramunity change are generally people with full-time jobs, and it is not unusual ^macro-level intervention responsibilities are added to those jobs; and (2) there i||j^limit to the amount of information that can be used in macro-level inter-^£Sdpp5. In short, we don't disagree with those who suggest that, in the ideal, ^l^VGiything possible should be known and understood about a community. We IgliJI^irapiy-suggesting that, with limited time and resources, responsible change ^^^rts can be initiated by narrowing the parameters of community analysis. Identifying a population in need can, in itself, be complex. None of us is ffc^itftr.of only one community. Community can be defined In terms of ethnicity M Yggi the Latino community), religion (e.g., the Jewish community), commitment ^t$|&J£ositibn (e.g., the pro-choice community), profession (e.g., the social work A first step toward understanding community is creating a framework that w help In comparing elements in one community to elements in another. SornK communities are larger than others, some have different etiinic makeups, som^ are wealthier than others. In searching for a framework to help understand community, we turn Warren (1978). In his classic, The Community hi America, Warren proposes tha; communities can be better understood if selected community variables an. analyzed. Based on these variables, we have identified nine tasks that comprise; a four-step framework to be used in conceptualizing and understandings community. In subsequent chapters, we will present mediods for planning change^ based on this understanding. This framework is shown in Table 4.1. Focus A: Identifying Target Populations ~^[f^si$&i$A*L-:*r' ' ---'■-•a-'----1-----------------J " 1-----------1 -■=>-■---------" " " Many approaches to community analysis propose that the community. Hp^^M^p^unity), avocational interest (e.g., recreational and sports enthusiasts), and understood in its totality to the greatest extent possible before intervention; ^l^^^^pnyrother designations. Each of us, in fact, would be more realistically defined planned. We propose, instead, that the definition of community be narrow?^^^^^^part of many different communities at once. 70 THE COMMUNITY AS THE TARGET OF CHANGE *J [0$J 4 * UNDERSTANDING COMMUNITIES AND COMMUNITY SOCIAL PROBLEMS We recognize that there are differences in urban and rural communities and; that this approach may be difficult in a rural community where members of the" target population are geographically dispersed. We also caution the reader nof:1 to assume that the target population can be disengaged or isolated from the larger community, even though one may focus on the target population in order td; manage this complex undertaking. In fact, members of the target population may' already feel isolated from the larger community. Certainly, we do not wane to reinforce this Isolationism. Brager, et al. (1987), view communities as being composed of people who have relationships that are systematic, interactive, and interdependent. These relationships are based on shared history, mutual expectations, predictable roles, values, norms, and patterns of status differentiation. These relationships are part of what constitutes individual identity; these relationships may be neutral or positive or negative; they may involve low to high degrees'of reciprocity and alienation, (p. 33) Viewed graphically, a community would look like a series of overlapping circles:' As an individual, any person from a community, pictured graphically, might look. -like a circle subdivided into many different reference groups, as illustrated in-^ ■Figure 4.1. By beginning with a papulation in need, we are suggesting that a person attempting to understand a community first identify the population of focus. This 1 begins a narrowing-down process. Inidal definitions of population can be broad with the understanding that the mare precise the definition selected, the more]U feasible a full understanding of the community context for this population For example, issues surrounding alcoholism prompt a concern for macro* level change,.the population of focus for a particular community analysis could be "people with alcohol problems who live in Riverdale County" or "ethnic s minority women alcoholics who have been convicted of driving while' intoxicated^ within the past two years In Riverdale Count)'." One is more inclusive, the other more focused. It is probably advisable, at this early stage, that a broader definition * be adopted, with an understanding that it will become more precise as a clearer^ understanding of needed change emerges. Once a population has been identified and the definition appropriately narrowed, all other dimensions of the community are explored arid examined^ from the perspective of that population. For each dimension to be explored, we will identify a task intended to bring focus to the collection of data andj information. We will next focus on questions about the population. Finally,* 71 FIGURE 4.1 The Individual'within tlie Community we will propose some questions about a community that will aid In understand-^j^u ing each dimension, and in comparing it to other communities. Although thisg| framework contains a number of tasks, the process of analyzing any comfnu"' nity requires the social worker to go back and forth, returning to refine previous j-tasks as new information is gathered. The social worker is urged to use the framework as an interactive guide rather than a rigid formula for approach ing community. t. Jtosb Is Understand Characteristics, of Target-Population Members. ^Questions to be asked: What is known about the history of the target population in this community? ■ How many persons comprise the target population and what are their characteristics? How do persons in the target population perceive their needs? How do persons in the target population perceive their community and its responsiveness to their needs? ;In their book on community organization, Brager, et al. (1937), remind us that: "Demographic differences [do not] exhaust the variations among subgroups of ■the poor. Although attitudinal differences arc more difficult to define and identify, ja wide diversity of world views exists even within demogrnphicatly homogenous (»fei m. í- iff* 72 THE COMMUNITY AS THE TARGET OF CHANGE ' UNDERSTANDING COMMUNITIES AND COMMUNITY SOCIAL PROBLEMS 73. populations. Thus, some poor are mote alienated than others, some more upwardly aspiring, and some angrier. Where they fail on these dimensions has a bearing on how rhcy will respond to particular efforts to involve them in organizing projects, (p. 60) It is precisely these shades of difference about the target population that the macro practitioner is attempting to understand. The study usually begins with an examination of available demographic data. Basic to any understanding is analysis of socioeconomic status, age, race, and gender by census tract. It is important to identify areas of poverty and high need, and to determine whether the target population is heavily concentrated in these areas or spread across an entire county. In addition to gathering statistics, it is also important to talk with people who understand its history, as perceived by the target population. Bellah, et al. (1985), explain why this Is important: A community Is a group of people who are socially interdependent, who participate together in discussion and decision-making, and who share certain practices that both define the community and arc nurtured by it. Such a community is not quickly formed. It almost always has a history and so is also a community of memory, defined in part by its past and its memory of its past, (p. 313) Examining the characteristics of the target population and Identifying where chey are located, together with gathering information from the perspective of people in the target population, completes the first step in the community encounter. The following questions can be helpful in collecting and using data and information: 1. 2. 3- What are the key demographic characteristics of the target population, and how do they compare to the demographic profile of the various-political subdivisions (e.g. city, county, state, whichever is relevant)' within which the community is located? Key demographic characteristics should include at least socioeconomic status variables, race, gender, and', age, by census tract. Generally, how do people in this target population (and others close to them) perceive their concerns, problems, issues, and/or needs? Do diey; tend to see them in terms of a need for empowerment and freedom from oppression? In terms of access to opportunity and removal of barriers?-In terms of a need for resources, protection, or services? Generally how do people in this target population perceive the conunu-. nity's responsiveness to their concerns, problems, issues, and/or needs?' Focus B: Determining Community Characteristics Size is an important characteristic of a community, and can be assessed in a number of ways. Size can be calculated in terras of the amount of space covered, by' the number of people living within its boundaries, or both. It is an important characteristic for the macro practitioner because geographical boundaries established for macro-level Interventions can range from neighborhood to county and even larger. Clearly the size of the community as defined will affect die nature of the macro-level analysis, and ultimately the intervention. Task 2: Identify Community Boundaries. Questions to be asked: • What are the geographical boundaries within which intervention on behalf of die target population will occur? • Where are members of the target population located within the geographical boundaries? • What physical barriers exist for the target population? ■ How compatible are jurisdictional boundaries of health and human service programs that serve the target population? Space is the distance or area covered by a community. It is one dimension of a community's size. Focusing on space allows the practitioner to establish manageable boundaries. If resources are available to focus on the entire city or county, then these may be appropriate boundaries in diat instance. If, however, the effort is to be undertaken by a small cornmirtee of volunteers who have limited time and resources available, then one may decide to focus the encounter on a limited part of the city where there appears to be die greatest need for intervention. Establishing boundaries for macro-level intervention, therefore, is initially done by focusing on a target population and, secondly, is further refined by selecting a geographical boundary. For most macro-level interventions we recommend beginning one's understanding of community by limiting boundaries to county or its equivalent, and focusing down from that level to more limited boundaries if appropriate. This Is in no way intended to indicate that intervention at state, regional, or national levels is not appropriate. It is simply to recognize that, for the vast majority of interventions, a level of county or smaller will be .most relevant. Figure 4.2 illustrates the boundary-setting process. Knowing that one cannot address all target population needs within large arenas, the encounter focuses on the target population witliin a manageable portion of the broader community. This becomes die focus of the macro-level intervention. A community may be a small section of the inner city or a fairly large expanse encompassing scattered farms In a rural area. For example, community as space is applicable to barrios in which groups of Hispanic people reside within a larger -metropolitan area. Spacial concepts of community are also relevant in less population-dense areas but may be more difficult to determine. This was painted out by a Navajo social worker who explained how difficult it was to determine ■spacial boundaries on a reservation. There were no street systems, property information or signs indicating county lines, or well-defined human service areas. Another characteristic important in understanding community as space is ijurisdictional units established by various government agencies for planning and go THE COMMUNITY AS THE TARGET OF CHANGE requires (1) focused arid precise data collection, (2) analysis of historical trends^ and (3) a thorough understanding of. qualitative elements that reflect humaa|| experiences, interactions, and relationships. ...^ REFERENCES Barker, R. L. (1987) The social work dictionary. Silver Spring, MD: National Association^ of Social Workers. Belenky, M. F., B. M. Clinchy, N. R. Goldberger, and J. M. Tarule. (1086) Women's way^M of knowing. New York: Basic Boolcs. Bellah, R.' N-, R. Madsen, W. M. Sullivan, A. Swldler, and 5. M. Tipton. (1985) Hab |f APPENDIX |§|?ramework for Conceptualizing Community fSpGCUS A: IDENTIFYING TARGET POPULATIONS the heart: Individualism and commitment in American life. New York: Harper Sc. Row&M^ fäfc^'i? Barrcra, M-, C. Munoz, and C. Ornelas. (3 972) The barrio as an internal colony. UrbaiS^ pffJf^ Affairs Annual Review, 6: 480-98. t&ivW'1'- MD: National Association of Social Workers, Burke, E. M. (1963) Citizen participation strategies. Journal of the American Institute of:{§^^if0ask 2: Planners, 3*(5): 293- -'M Choldin, H. M. (1985) Cities and suburbs. New York: McGraw-Hill. :M ^fg^'v Cross, T. L., B.J. Bazron, K. W. Dennis, and M. R. Isaacs. (1989) Towards a culturally com- J!| |§|f;£ petent system of care. Washington, DC: Georgetown University Child Development Center'^ «||p\;v( Fellin, P. (1987) The community and the social worker. Itasca, IL: Peacock. -'.::s| GMigan, C. (1982) In a different voice. Cambridge, MS: Harvard University Press. ;;'|| |||piV Jansson, B. S. (1988) The reluctant welfare state.- A history of American social welfare}^ How do persons in the target population perceive their needs? How do persons in the target population perceive their community and Its responsiveness to their needs? ITOCUS B: DETERMINING COMMUNITY CHARACTERISTICS Identify Community Boundaries policies. Belmont, CA: Wadsworth. , |l||jp|;i Kettner, P. M.,J. M. Daley, and A. W. Nichols. (1985) Initiating change in organizations'-^ &J|;!-and communities. Monterey, CA: Brooks/Cole. ■ fej^fe'. King, 5. W. and R. 5. Mayers. (1984) A course syllabus on developing self-help groups^ p^^^ among minority elderly "-1 r —•- ™ - -->- - — *■----—^^n-m^^rrh ■ mental health and in, Publication supported---------------------. .„™,_.. „1...... ------™ Margolis, R. J. (1990) Risking old age in America. Boulder, CO: Westview Press. -:§jz W*W>-Meenaghan, T., R. O. Washington, and R. M. Ryan. (1982) Macro practice in the humaiij%^M^t\ services. New York: Free Press." ■■■ Rabin, D. L. and P. Stockton. (1987) Long-term care for the elderly: A factbook. Oxford England: Oxford University Press: Specht, H. (1936) Social support, social networks, social exchange, and social work practice. Social Service Review, ff0(2): 218-40. ^l»ask 4: Understand Dominant Values r' -rfii--' - Tannen, D. (1990) Vau just don't understand. New York: William Morrow. Waring, M. (1988) If women counted. San Francisco: Harper & Row. Warren, R. L. (1978) The community in America (3rd ed.). Chicago: Rand McNalty- §B^ask l; Understand Characteristics ■s^of Target-Population Members ■ ■ . i»..t!, ... jjow many persons comprise the target population and what are their characteristics? • What is known about the history of the target population in this community? What are the geographical boundaries within which intervention on behalf of the target population will occur? Where are members of the target population located within the geographical boundaries? What physical barriers exist for the target population? How compatible are jurisdictional boundaries of health and human service programs that serve the target population? 3: Profile Social Problems What are the major social problems affecting the target population within this community? Are there subgroups of the target population that are experiencing major social problems? What data is available on the identified social problems and how is available data used within the community? Who collects the data, and is this an ongoing process? TIP ff m What cultural values, traditions, or beliefs are important to the target population? What are the predominant values that affect the target population within the community? What groups and individuals espouse these values and who opposes them? What are the value conflicts surrounding the target population? 92 THE COMMUNITY AS THE TARGET OF CHANGE FOCUS C: RECOGNIZING DIFFERENCES Task 5= Identify Formal and Covert Mechanisms of Oppression iKlCHAPTER 5 » What differences are observed among members of the target population? " What differences are observed between members of the target population nnd^jfWf' . other groups within the community? "^I^^i • How are target population differences viewed by the larger community? J-;|^v;V' • In what way is the target population oppressed because of these differencesFvVi^^;' • What target population strengths can be Identified and how might tiiesc strengths contribute to empowerment? ; •■p!^> ' System Task 6: Identify Evidence of Discrimination ■ Are there barriers that inhibit the target population From becoming fully integrated into the community? ■ What forms of discrimination are experienced by the target population within the community? At FOCUS Dr IDENTIFYING STRUCTURE Task 7= Recognize Locations of Power community that serves the target population? 7^^^v|:-' • What type of community power structure influences the service delivery ■■'icM'MSi network designed for the target population? ■ ''-'i^i^^vK:' Task 8: Determine Resource Availability ^M^ls^'i ■ What are the existing community agencies and groups currently seen as ma|dr|'i[i£-||'|.S'i. service providers to the target population? l^^-V*^* " What are the major funding sources for services to the target population? " 1 ~ ■ What nonmonetary resources are needed and available? Task 9: Identify Patterns of Resource Control and Service Delivery IP within the community? How is resource distribution to the target population influenced by extra-community Forces? Overview Introduction A Framework for Analyzing Community Human Service Systems Focus A: Understanding Need ■\',tC Task 1: Identify the Target Population Task 2: Define a Continuum of Need Task 3: Assess Target Population Needs Task 4-, Identify Collective Community Needs Focus B: Identifying Auspice or Sponsoring Organizations Task 5= Examine Informal Service-Delivery Units Task 6: Examine Mediating Service-Delivery Units Task 7: Examine Formal Service-Delivery Units Focus C: Determining Systemic Competence Task 8: Determine Linkages Between Units Summary References Appendix: •:Wjl^*RODUCTION • What groups and associations advocate for and provide assistance to the tarBefs|||^v.' population? ^f^any situation where an assessment is called for, whether it be an assessment • How is resource distribution to the target population influenced by Interactiqf^j t~ff$£an.individual, a family, or an entire community, it is helpful to use a framework. ;^^;%an individual, a family, or an entire community, it ^p^jframework aids in Identifying each of the variables to be examined, just as was iSs&Hnpe in prevjous chapter. Few such analytical frameworks are available for l|Sfl^esSmB local community human service systems. In this chapter, we will propose 93 94 THE COMMUNITY AS THE TARGET OF CHANGE 5 / UNDERSTANDING A COMMUNITY HUMAN SERVICE SYSTEM 95 a conceptual approach intended.to permit a student or practitioner to exanaitig|^|bj|i:ABLE 5.1 Framework (or Assessing Community Human Service Systems a constellation of services within a given locale to determine adequacy of exisHti^pfis^Se*— _„. resources to deal with current or projected levels of need. While we will use the term human service system to describe the focus i'f^lpl1!?^ Uni the assessment, we caution students and practitioners not to place too mucH^^f^" emphasis or credence in the term "system." There is rarely a master plan. Hurna'nf^a||fe._' service systems are generally made up of loosely related or unrelated ^ient-servin|^|^|'fl(B" programs operating under a variety of auspices, rather than clearly planned par^lffe^lk Taslis Understanding Need Identifying Auspice or Sponsoring Organizations that come together into a comprehensive whole. We wiLl attempt to presenbafiiH^'v! framework for assessing the extent to which this network of existing resources^pl|||S- Determining Systemic Competence is capable of meeting need. -^p^lisfr" 7. Identify the large! population 2. Define a continuum oi need 3. Assess target population needs 4. Identify colleclive communlly needs 5. Examine informal service-delivery unifs 6. Examine mediating service-delivery units 7. Examine formal service-delivery units 8. Determine linkages between units- A FRAMEWORK FOR ANALYZING COMMUNITY HUMAN SERVICE SYSTEMS lent of a community s existing human service system$£*%4si£i • -i ,,, , . , T ^ 1 ."^Isiiffi'ime.services wii : (1) that an entire human service system m most co'fai^fe^p. . ,. analvze as a whole, and dierefore services must be asspswi^f^^?!^ie e 1V " ■.r'^ip^'are"common to that culture' (p. 2). Because the characteristics of community '-'i&^i^fSesidents vary, there may be subgroups diat require special attention. For example, ^i*rP%f community has a high proportion of retirees, one can expect that many of will address the needs of older people. If services are not available, stem may not be adequately addressing community needs. We approach the assessment with several assumpdons munities is top complex to analyze as a whole, and dierefore services must be assessed^fe'^SC „ , , c . _ . . , c , . ^ 3 ■ ■ ^or ^ 0 discussion, consider the following seven target populations. for a specified target population, (2) that a commumty s human service system shoi3a$i-,=.^^''. c i ■ * i ■ j e >• j 1 , , , , . , : . . . . , 1. , -iEMJhFThey are frequendy used for planmng purposes, and funding rends to be clustered be assessed and evaluated in relation to the extent to which it meets the needs\ol^jjL^|^und these cate ories-its people, and (3) that the needs of the people in a community should be ^amin^^|^p|v!0un C a eS n ■ not only in terms of individual need, but also in terms of collective need. Ti^Mp^f5' Following these assumptions, we propose a framework for analyzing and^p^ffp^:; Children evaluating a community's human service system. The tasks that comprise thl5^fe|^£- Youth framework are shown in Table 5.1. ■■ '■'^i^S^"" Families Older adults Focus A: Understanding Need Task 1: Identify the Target Population. Questions to be asked: Adults Developmentally challenged Physically challenged What target populations are identified within the community, and how are they categorized? What target population will be the focus of this assessment? i^to'^^^Ohviously, these groups are neither exhaustive nor mutually exclusive. In addition, ^pMiftHey do not specify the many subgroups that fall within each category. For What priority is given to the needs of the target population in this »if|^amPle' * the tarSet population is children, it is important to recognize that , , V'>:ftsM3%feechildren come from families of all socioeconomic statuses, racial and ethnic community? ... "?^a|p|p$rauPs> and locations withm a commumty. Deing in a target population are consumers■o^MMW0 Although we have identified seven categories of people who may have provided are designed to meet their needs^g^^fdhrnmon characteristics and needs, individual communities will have their own nize that people's needs are always changiflg^Rl^^^firutions of target populations. How does the community categorize client People who are identified as being in a target population are consumers, services, and ideally the services However, it is important to recognize ^ ^ This requires a human service system that has Hexbility to respond to changiriM^pignoups for planning purposes? Local and regional planning agencies, United Ways, needs: Gonzalez, et al. (19910, remind us that even cultural identity changes. "Od^^^^qmmunity councils, and associations of agencies often produce agreed-upon can always expect to find both change and diversity within any conimuiUtyv^^^^^lassificatiori schemes for data collection and planning purposes. Regardless of fact, even a community that appears to represent one culture or cultural firo"|i^p^iistInB categories, It is ultimately the task of the individual or group conducting will actually be quite mixed, demonstrating a range of behaviors and beliefs th^^|^^the community assessment to define the target population. n r 98 THE COMMUNITY AS THE TARGET OF CHANGE TABLE 5.2 Community Service Identification Widows Aged S5+ Living Alone in West Kingston Type of Need Services Typically Designed to Meet Need Services Available In This Community 5 / UNDERSTANDING A COMMUNITY HUMAN SERVICE SYSTEM 99 foe community; (4) key informant surveys that focus on knowledgeable and Influential community residents; (5) secondary data analysis of existing statistics ^0n the target population; (6) review of social indicators such as income or Self-actualization NeBds Esteem Needs Social Needs Safety and Security Needs Survival Needs Education Programs Volunteer Opportunities Support Groups Psychosocial Counseling Mental Health Centers Recreational and Social Groups Senior Centers Home Visitors Emergency Response System Adult Family Homes Congregate Care Facilities Senior Housing Continuing Care Retirement Communltles-Wellness Clinics Telephone Contact Home Delivered Meals Senior Discounts Mobile Meals Transportation Horn em alter HomB Health Personal Care Medical Care Available at Kingston Senior Csnta Two support groups Mental health CBntBr has limited--'' services One senior center No emergency system Three unlicensed homes One congregate facility No senior housing No retirement community Public health department hon wellness clinic Church runs telephone reassurance program Limited delivered meals program Twenty mobile meels slots No bus system, one senior van-available One licensed homemaker progranre^^jflhod No home health provider ! ^t^js* Two licensed personal care agannlBs^^fS?™! One community hospital and-ones:-.^fesjl'-13"1 " DCcupational levels of the target population; (7) administrative or managerial jgcDJ'rf review; and (8) review of information from other agencies (Meenaghan %tal 1982). t ?W ( preferred approach in assessing need for a particular papulation is to >_jm$e. existing data. Original data collection is expensive and time-consuming, and ^js usually beyond the scope of the macro practitioner unless a particular change effort has widespread community and financial backing. Table 5-3 summarizes f^L [he advantages and disadvantages using each approach'. • s * ideally, the macro practitioner would like to know (1) the number of people _a 4Tijn me t,5rBet population who are experiencing each problem, and (2) the number r *"1j"of people that can be served using existing resources. The first number minus A ^a'fjie.second number presents the community's unmet need. Unmet need, inade-u ^jjjqusitely met need, or inappropriately met need are frequently the focus of macro-* ~~ 'Jievel change efforts. ^1 ' "With special population groups that require multiple services, classification .schemes are often based on the concept of a continuum of care. A continuum Needs Assessment Methods: Advantages and Disadvantages nursing home Description Advantages Disadvantages such as art and language (cultural); for learning from the past (historical); for-die;-* use of power (political); for viewing the past, present and future through action^ words and movement (creative/spiritual); and for explanations that connect whatf™, happens in one's world through investigation and experimentation (intellectual) ..■'."■a Task 3: Assess Target Population Needs. Question to be asked: fifsBCQnrJary fvica ai$rovider ^UfVBys Mt yafqrmant i.'.Tiiaurväys ita ^analysis " "What are feasible and appropriate ways in which to find out how many people are In need in each of the areas identified as relevant toj this target population? ^few^dloatDrs Eight general methods of approaching a needs assessment have been discussed 1 jN&jard in the literature. They include (1) general population surveys, which consist of? J Km^Ibw interviews with a sample of community residents; (2) target population surveys^ l^jJiaUDn that interview members of a select group; (3) service provider surveys, wlucij^-; i^yfSP.0ttler interview those groups and organizations that serve the target population widil%ijf| —). fancies Interviews with community residents Interviews with e sbIbcI group Interviews with providers that service target population Interviews with knowledgeable/influential rBsidBnts Analyzing existing data Reviews ol data such as incomB, age, occupation Review administrative/ managerial documentation Review any other data from courtly, slate, local agencies Provides broad overview of needs Obtains data directly from largBt Gives perspective from those who serve the target group Provides a community leaders' perspective Data Is already collected and usually accessible □eta Is available and provides broad overview □f community Provides insights into major issues and concerns May provide nBW Information not available elsewhere Requires great time and expense Often difficult to locate survey respondents, Is time-consuming and costly Providers may be professionally biased Community leaders may represent power structure, but may not represent target Analysis is restricted by what data was collected Indicators do not provide detailed information Is subjective and may be difficult to access May be difficult to locate I li > r Í. V Í 1 Í" 100 THE COMMUNITY AS THE TARGET OF CHANGE TABLE 5.4 Continuum of Long-Term Care Services by Category In-home Services Outreach Information and Referral Comprehensive Geriatric Assessment Emergency Response System Companionship/Friendly Visiting Telephone Reassurance Caregiver Respite Services Homemsker and Chore Services Household Repair Services Personal Care-Home Delivered Meals Home Health ln-HamB High Technology Therapy Hospice ji5 / UNDERSTANDING A COMMUNITY HUMAN SERVICE SYSTEM 101 |y .. What we have discussed thus far is really individual need experienced by many people. When one person is hungry, it is an individual problem. When .t-.;'huttdreds of people are hungry and the community is not prepared to feed them, j- ..It becomes a social problem. When needs clearly outstrip resources, it is a iV-comraunitywide problem and may require a human service response. More food panics, more homeless shelters, and more employment training services may be heeded. It is important to note, however, that just because social workers believe Go mm unity-based Services Case Management Adult Care Homes Transportation Shared Housing Senior Centers Congregate Housing Senior Discount Programs Wellness and Health Promotion Clinics Recreational Activities Geriatric Assessment Clinics Caregiver Support Groups Physician Services Self-help Groups Adult Day Care Counseling Mental Health Clinics Foster Homes Outpatient Clinics institutional Services Alcohol and Drug Treatment Swing Beds Rehabilitation Skilled Nursing Care Psychiatric Care Extended Care of care consists of a broad menu Df services from which items can be selected; to address the specific needs of certain individuals or groups. Conceivably, eacli> menu will vary based on what is needed for the target population served. Table 5:.4i provides one method of classifying continuum of care services for those persons? requiring long-term care. .,' Task 4: Identify Collective Community Needs. Questions to be asked: , ■ Are there needs in this community that require something other than a human service response? » What data supports the existence of these needs? a How are these needs expressed by the people of this community? While understanding need and examining community responses to each level? are important steps in concepmalizing a hierarchy, this is not enough. Need is an, elusive, complex concept that must be understood from a variety of perspectives;f At the simplest level are needs experienced by individuals that require some} rype of response: a hungry person needs food; an unemployed person needs a |ob. If there are resources to meet these needs, the needy person is matched.up; with the resources and the need is met. Ii:.:.that a community should respond to a problem does not mean that this belief |fv?will be shared by everyone in that community. pyr There is yet another perspective on need that should be understood by.the f';.'. pacro practitioner. It Is a need that requires something other than a human service ^v'vresponse. It may even require some fundamental redesign of structures and :|^vsystems. As discussed in the previous chapter, structure and power are important ^/variables for community analysis. When a whole community suffers from inferior ^.Housing, transportation, or schools, or from an inadequate economic base, these ;!^Lproblems may be more than simply individual problems on a large scale. They ;feskould be understood as collective needs. It is an assumption in the social work field that communities need adequately err:functioning basic systems to achieve at least a minimally acceptable quality of i^llfe. They need an economic base that will produce Jobs and income. They need |-;^ffordable housing, adequate transportation, sound community health practices, ■K^pmtectian from disease, good quality and relevant education for their children, ^protection "from harm and violence, and freedom to pursue obligations and ;'|;r-7ihterests without fear. When these conditions are absent, a service response (more '{"■'iffnoney, more resources of any kind) may provide temporary relief without: dealing M'wlth fundamental structural problems. li'W' The long-term need may be for collective empowerment, a collective sense of ir'^aignity, full participation in decisions that affect die lives of people in the community-, :^:self-direction, and self-control. Assessing collective need requires an understanding . §^p£ the history and development of the community, an ability to compare economic fv:-.data and social problem data to other surrounding communities, and a sensitivity f£i!tb. the needs and aspirations of those who live in the community. Collective need ^[bay also need to be addressed at another level such as die state legislature or U.S. p.Cbngress. The focus can remain on the local community where actions can be takenf jk;But the point of intervention may be outside the community. ■ When collective need for empowerment, participation, control and odier such : ^factors Is identified or expressed, the role of the macro practitioner is different from . |^;-:rtie role taken when the need is for a human service response. These roles will be .I^Jscussed in Part TV (Chapters S through 10). ^Eocus B: Identifying Auspice ||pr Sponsoring Organizations assessing and understanding a communicy's human service system, it is important ,7&|frexamine die sponsoring unit or organization. Table 5.5 Identifies the types of &*Wiit5 that should be considered when assessing service provision in a community. 1Ü2 THE COMMUNITY AS THE TARGET OF CHANGE 5 I UNDERSTANDING A COMMUNITY HUMAN SERVICE SYSTEM 103 TABLE 5.5 .Units Within the Health and Human Service Delivery System Informal Units Household Units Neighborhood/Groups Mediating Units SBlf-hBlp Groups Voluntary Associations Formal Units Nonprofit Agencies Public Agencies For-profit Agencies These units, taken together, comprise the total health and human service; delivery system within the community, each operating interdependendy. A given, community, depending on availability of resources, may emphasize the provisions of services through one set of units more than another. For example, in a resource-'-: poor community, reliance on informal units may be a necessity until publicly? funded formal services can be obtained. However, in all communities, elements ofn informal, mediating, and formal service units will be found. The astute practitioners will carefully assess all avenues of service delivery for the target population Tosh 5: Examine Informal Service-Delivery Units. Questions to be asked What informal units would typically assist the target population within a local community? What importance does the household unit have to the target population within this communlry? What importance do natural support systems or social networks have *P to the target population witiiin this conimunity? What informal units are actively engaged in service delivery to the target population within this community? Are race, ethnicity, or gender factors in the provision of Informal services and support? equivalent to the household, but in recent decades more and more people have -jjved together in dwelling units without being related, malting household a mare ^broadly useful term" (Smith 1991, 138)j Service provision in this unit generally 'takes die form of caregiving and tends ro fall heavily on women in our society, ffhe potential for caregiver burden or strain suggests that mutual support provided -by the informal system may require assistance from others within the community. ..Respite services are often needed in the interest of sustaining the physical and -jiiental well-being of the caregiver. --)■:? In assessing the extent of service provided in household units witiiin a given ^community, one should look for indicators of what is happening within private dwellings for the target population. For example, are identified caregivers within ,the community overburdened? Is there an.identified need for respite services for :caregivers of die physically disabled, developmentally disabled, elderly, and/or wi&young children? Are requests fDr live-ins and shared housing increasing? Answers ^-.^to-'diese and related questions will aid in the process of assessing the domestic .flweUmg as a service-delivery unit. m:- Of particular concern is identifying the importance of the household unit iplfor the target population. For. example, if the target population consists of frail ^widows living alone, the household unit does not contain others who can assist. tefcJSot only are caregivers not available, but formerly active older women may i€»|uddenly find themselves atone after years of providing care to children and [^nouses. On the other hand, target populations such as inner-city children, who sp&ioften live in crowded households where privacy is limited and tension is high, ^ynay.draw support from siblings, peers, and parents. Respite for single mothers ^anay be difficult to locate; poverty may have reduced opportunities and life pchaices. Yet the household unit can be a critical source of support for these children, ^fragile as it may be. Recognizing the household unit as a source of community JsErength and developing services to support this unit can produce a double benefit strengtiienihg families and reducing the need for other support services. ^ natural Support Systems and Social Networks. Often, an unstructured, informal ^agproach to mutual support will evolve as natural or social support systems develop. ^Most people are part of social networks, but this in itself does not constitute a natural | Ij^tjpport system. A natural support system, according to Mclntyre (1986), exists when •Resources have actually been exchanged. ^|§1|-:'The existence of natural support systems have been recognized for years. ^ J^vpcent studies and an emphasis on informal support have prompted a more intense L-^-sysaniination, particularly among minority and aging populations (Specht 1986). [ hr Because networks do not have established boundaries and depend upon Informal units are those that are not publicly incorporated as legal entities. | faction between informal individuals and groups, they are likely to extend to deliver health and human services. Often, these units have not been recDgnizeci If,^ n(j ^ communjty Mucual SUppoc[ taste may be provided by for tiieir importance in the service delivery system, whereas they In fact perform fJ^^gnmhicaUy dispersed, as well as geographically close, network members, a vast assortment of mutual support tasks. They include the household unit and r Bispersecd networks will depend upon linkages such as transportation systems natural support systems and social networks. ^ a£"Q telephones, and may, therefore, be vulnerable in times of crisis. Balgopal a iff 0988) explains the-importance of social networks; Household Units. The household unit consists of those persons who resiae £ ^ within a common dwelling, whether they consider themselves fairillies, slgnificanf ^-1 Socal networks such as kin, friends, neighbors, and coworkers are suppor-others, friends, partners, or roommates. "The concept of the family is roughly dve environmental resources that function as important instruments of help, 1D4 THE COMMUNITY AS THE TARGET OF CHANGE especially during times of crisis. Social networks provide emotional resources and strength for meeting the need of human retatedness, recognidon, and affirmation. They also serve as mutual aid systems for the exchange oF resources such as money, emotional support, housing, and child care. Well-developed social networks often consciously and purposefully serve as helpers to families in crisis, making it unnecessary for these families to resort to institutionalized services through publicly and privately supported health and welfare agencies. The concept of a family's social network emphasizes the idea of the family with multiple affiliations, some of which overlap and some of which do not, as well as the idea of the family as an active selector, manipulator, and creator of its environment, (p. 18) m 5 / UNDERSTANDING A COMMUNITY HUMAN SERVICE SYSTEM 105 icators of the extent of informal■ ----.----------7.------, "* ~ m °). •ighborhood associations, child^te^mmUmtjr Er°UpS 35 n«Bhborhood associations or local churches m wichln suction are aU Indicators of n^K"?^ category- Slmilar co se^helP ^ups, voluntary associations vary in their ';>[,. ■ Depending on the target population identified, self-help groups rasy be more pforless important. For example, groups that already have access to the service ^■system and its resources may find them less necessary, while populations that '}?ÍČĽ struggling to have their needs recognized may find them extremely helpful - f -'jn supporting their efforts. .! '^p\toluntary Association. Voluntary associations often serve as a bridge between ;;:|^vihĽ informal and formal components of a human service system. Voluntary -fi'íílV-lažsociation is defined as "a structured group whose members have united for ^l^-chí purpose of advancing an interest or achieving some social purpose. Theirs Within the local community there are Indicators of the extent ofinfbnnS^ * ^ tOWard * ChOBen form °f '50ciai betterment'" (Van Til 1988, 8). neighborhood groups and support systems. Nei care exchanges, and neighbor-to-neighbor interaction---„ ------„t ..J5i-.-- ^ extent of support available within this unit. -'#1^ of formalization Since they are membership groups, a dues structure will The significance of natural support systems and social networks will d^§Mea b*in PIace' Therefo«> *eir boundaries become more clearly defined than □n the target population. Networks that advocate for and provide ongoing supporcÄf^"^ BCOapa ln CermS of those who are P*^ members and those who are not. for the target population should be identified as a part of die human service systems?VoIuntary ^ociatlons have several characteristics. Members share a sense ■ ■.j«;gia;pf community, which provides a collective identity. Social status may be enhanced '.•SJ^^by membership; social control may be exercised over members. A function of Task 6: Examine Mediating Service-Delivery Units. Questions to be askeu|||J(|icas50ciation may be to enhance the well-being of its members in a supportive ''".^-ip&iflaDner. If the association is strong, it may serve as a powerful force to non- • What mediating units would typically assist the target population .iS»gSerabers. This influence may be positive or negative (Williams & Williams 1984). within a local community? Ar^feíóŕ example, associations such as the Ku, Klux Klan are powerful yet destructive • What self-help groups are available to the target population within ^/ifpffarces within certain communities. this community? Voluntary associations are a study in inclusiveness as well as exclusiveness. • what voluntary associations have members from, or take an interest ''^t^iaaa and Williams (1984) discuss the importance of the black church in the in, the target population within this community? ';£§|§jfveiopment and growth of mutual aid societies. Historically, many mainstream ' " _,. , . . , . . . ,. l , i-rífeáetivltíes beyond the church were closed to blades who migrated to urban centers. ■ What mediating units are actively engaged in service delivery to the -í-feí-'iioi ■ . v , ■■!._,,,, ,- ■ , b . ii ;väí Blacks organized voluntary associations in the church in such forms as sick and us communitrv? ■t'e^íí.' r , . . ,c, , . , '^#?,>DUrial societies, economic self-help groups, mission societies, and various secret ...í^|áhd fraternal orders" (Williams & Williams 1984, 21). Voluntary associations oHiffejvlthin the black church became an adaptive mechanism to deal with discrimi- target population within this community? Self-help Groups. Self-help groups are one of the fastest growing elements community support. They have been formed to deal with a variety of personal^pvt haifon. Numerous studies report higher participation rates of blades in voluntary and social problems and needs including bereavement and loss, depression,^^associations than for any other groups (Florin etal. 1986). In fact, ethnic minorities, parenting, and many other issues. A number of self-help groups (probably tke-|pv:]abians and gays, and other oppressed groups may generally use informal and best known being Alcoholics Anonymous) have formed national and internationali;M^itiediating units to a larger degree than other populations. Neighborhood groups, chapters and are recognized vehicles of service delivery. ^;§^lf-help groups, and voluntary associations serve as means of mutual support, as Hutcheson and Dominguez (1986) acknowledge the importance of cmni^gs^^place for clarifying perspectives, and as a focal point for action. In some cases Self-help groups are often viewed as being compatible with a feminist^^jnacro practitioner identify voluntary associations. Churches, unions, and perspective as well. Such groups are directed at widows, women who have been^-fei professional groups are all potential sources of support for the target population, exploited or abused, and caregivers. Mutual support provided through self-helpwjl.^iFhey may not be listed in human service directories, yet they may be the first groups may assist in protecting the mental and physical health of caregiverSi.-^R^sburce to which some people turn when in need. 106 THE COMMUNITY AS THE TARGET OF CHANGE Task 7.- Examine Formal Service-Delivery Units. Questions to beaskedt ■ What nonprofit agencies deliver services to the target population within this community?" • What public agencies deliver services to the rarget population within this community? • What for-profit agencies deliver services to the target population within this community? " Are there differences in service delivery across formal units that appear to be based on race or ethnicity, gender, affectional preference, disability, or age? In this section, we are concerned with formal vehicles of health and humane service delivery. Although these service,providers are interconnected in numerous-. ways, we shall examine them according to three types of auspice: Nonprofit (voluntary) Public (governmental) ,-i For-profit (commercial) Nonprofit Agencies. As voluntary associations become more formalized, they may.; become incorporated as nonprofit agencies, recognized as publicly chartered tax--free organizations (Van Til 1988). There are many types of nonprofit agencies, but^ here we will focus on nonprofit human service agencies, defined by Kramer (1981)? as: "those [organizations] that are essentially bureaucratic in structure, governed bran elected volunteer board of directors, [and] employing professional or volunteer staff to provide a continuing human service to a clientele in the community" (p. 9) -■ Nonprofit agencies are formal vehicles of health and human service delivery. They are often viewed traditionally within local communities as the agency of^. choice—a voluntary initiative that targets a specialized clientele. This traditional^ view is based on the early welfare system in this country which arose from n ^ profusion of agencies sponsored by various religious and secular groups. ' Today, health services represents 51 percent of the operating expenditures within the nonprofit sector (Hodgkinson & Weitzman 1989, 22). Health services*, primarily includes hospitals, nursing and personal-care facilities, and outpatient^ care and allied services. The 1982 Census of Service Industries indicated that there were 52,571 nonprofit human service organizations in the United States (U.S.,-Department of Commerce 1984). Although expenditures within this sector hadg risen until the early 1980s, federal budget cuts caused some declines in growth S / UNDERSTANDING A COMMUNITY HUMAN SERVICE SYSTEM 107 ■ regard to race or gender, diere is a growing trend toward agencies designed to serve [h,e special needs of ethnic minority communities and families, women who are victims of discxirninadon and/or violence, and other groups underserved by more ..traditional agencies. The macro practitioner should identify which nonprofit agencies • serve die target population and whether they have particular service emphases. public Agencies. The public sector consists of federal, state, regional, county nnd city government entities. When the mutual support function is performed ■ by government, it is referred to as social welfare. The United States social welfare system has been described as a "patchwork quilt" which "does not represent >a coordinated, comprehensive, integrated, and nonredundaat series of social ■welfare services; instead, it is a helter-skelter mix of programs and policies that defy a systematic understanding of the welfare state" (Karger & Stoesz 1990, 167). By the time federal programs are operatidnalized withln.the local community, -they have usually gone through several levels of bureaucracy. Depending on the ■ structure, which will vary by program type, there may be several extracommunity levels through which dollars have flowed. There may be regional as well as state 'mandates, rules, regulations, and procedures that instruct local providers regarding r-what they can and cannot do. Local decision malting and autonomy will vary ^depending on the policies that drive a particular program. In short, extracom-;inanity sources have a definite influence on the local delivery of public services. In assessing a community's human service system, it is important to gain 3cnowledge about policies and programs that affect the target population. For -example, working with the elderly means that one must be familiar with the Older ^Americans Act. Familiarity with the Older Americans Act tells us that there is a ^designated state unit on aging in every state and a network of area agencies on .■aging (AAAs). Every state must have a three- to five-year plan for services to the s^elderly, and each AAA must have a more localized plan. Therefore, every t community within the United States will be included in a plan that addresses the Heeds of the elderly. Experience suggests that this does not mean that every ^.community meets the needs of their elderly members. Resources will be limited, a&and actually carrying out the plan will include the use of Older Americans Act j>doIlir5, in partnership with other public and private initiatives. In addition, many ^communities have waiting lists for services, and state corrmutments to carrying □ut the objectives of the federal legislation vary. If one's target papulation is single mothers receiving Aid to Families with Dependent Children (AFDC), the social worker will need to know that states vary in what income is counted against benefits received. States also establish their |^.pwn needs standard for families in that state. Therefore, although AFDC is a large Tgublic assistance program developed at the federal level, state-level decisions Many agencies reacted to budget cuts by increasing their revenues from dues ft ^influence the benefits farnihes receive. To be effective, the social worker will need fees and charges (Hodgkinson & Weitzman 1986, 111). Therefore, nonprofit - J' °"J J " * J' ?~" agencies often charge fees and have expanded over the years through the infusion of government funds. Nonprofit agencies provide many different services within local communities ^ While all nonprofit agencies using government funding serve cheats without ^ iai understand how federal and state governments interact and how community ^attitudes toward AFDC recipients influence clients. 5^- In assessing the distribution of public resources across an entire community, ^"including the funding of social service programs, it is important once again to ^samine community practices from the perspective of special populations t' I- 1' t......t lJT~-_._F 108 THE COMMUNITY AS THE TARGET GF CHANGE Voluntary associations often serve as advocates for their members and have had. varying degrees of success in influencing the allocation of resources. In many communities the elderly have been highly successful in these efforts, but attention-to the needs of children varies. Ethnic minority groups have exercised increasing political power over the last few decades, but still find, in many" communities, diat their interests and needs are considered a. low priority. Lesbian and gay groups have increasingly taken up causes such as funding for AIDS research, and have, participated in the political arena to influence allocation of resources, but they.; still face widespread dlscriraination. Understanding the political system within the community is a challenge, in the United States, jurisdiction over health and human service programs is^, "distributed across municipal, county, state, and federal governments, in addition, to specialized governmental units such as school districts, housing authorities, , and regional and metropolitan governments" (Brager et al. 1987, 20). Assessing the public sector requires stamina. Not only are there federal; statutes, regulations, administrative rules, and funding formulae to contend with; but there are state and local laws and funding procedures to identify. Professional ■ colleagues, however, can provide perspectives on types of services and whether government is truly addressing the needs of the target population. For example, for macro practitioners working in a public housing development, social workers., in other developments will be helpful in interpreting how regulations assist as.; well as constrain tiieir efforts. Locating colleagues in similar settings is important to developing a professional support system to aid in coping with public policies,,; procedures, and rules. For-profit Agencies. In the past, the for-profit or commercial sector assumed/ a lesser role in providing mutual support within the community than either the nonprofit or public sector. However, this does not discount the role corporate, foundations have played In funding programs that benefit local communities or the many corporations that have provided employee benefits addressing healthj human service, and retirement needs. Indeed, a growing number of social workers? are involved in the corporate workplace through employee assistance programs* (EAP5). These programs have developed as corporations realize that productive employees are tiiose who are supported in all aspects of their lives (Abramovitz & Epstein 1983). In an aging society, some large corporations have created elder-care support networks for employees caring for aged parents. In the last decade, the actual delivery of health and human services has been, increasingly carried out by for-profit corporations. For example, the majority of ■nursing homes are now for-profit organizations (Margolis 1990, 154). According to Gronbjerg (1987), the entry of proprietary or for-profit organizations into any given service area is marked by a cooling effect on the relationship between die-public and nonprofit sectors. Because proprietary organizations tend to dominate within the economy, patterns of interaction shift. These shifting patterns were first noticed in the health care arena, when proprietary hospitals began competing with traditional nonprofit providers. 5 / UNDERSTANDING A COMMUNITY HUMAN SERVICE SYSTEM 109 -■;-;|V:: 'Marmor, et al. (1987), explain this shift in terms of a life-cycle model involving :«fetfthese steps: A new service is developed by nonprofits; ' Ofei'i* '• Crie service is broadly accepted; '.M|'::-;v'use m tne Proprietary sector Increases; "'tSl^fr''- policymakers become concerned about those unable to pay for this service. 'First, a new service is developed dirough technical or social innovation. Typically, .'these efforts are initiated by nonprofits because new services are normally .expensive and require subsidization from private or public sources. Second, once ■■the service is well-recefved, broad acceptance follows. Third, interest from the .proprietary sector is sparked and proprietary organizations enter the arena, ^competing with the nonprofit providers. In efforts to keep up with the -competition, nonprofit providers begin behaving much like their for-profit compe- ' yitors. Last, policymakers become concerned about those persons who cannot j'pay for the service because both for-profit and nonprofit organizations are ^competing for those who can pay. If the service is important enough, the public' 'sector will finance the poor and uninsured, "which In mm tends to reduce die .Importance of charitable provision of care by private nonprofit agencies" (p. 229). Inevitably, some consumers fall into the gaps—not being able to purchase the service ^themselves, but not qualifying under die strict eligibility criteria set for public subsidy. ^This life-cycle model reflects patterns identified in the health care field, as proprietary {corporations have begun competing with nonprofits in die community. Public financing of health care through private mechanisms was only the beginning.. Stoesz (1988) tells us more: By the 1980s, human service corporations had established prominence in child care, ambulatory health care, substance abuse and psychiatric care, home care, and life care. Increasingly, proprietary firms obtained funds for facilities through commercial loans or sales of stock and met ongoing costs by charging fees to individuals, companies, and nongovernmental third parties. Insofar as resources for human service corporations were not provided by the state, firms were free to function independently of the government, (pp. 54-5) life i^..., As profit-making corporations bid for public contracts, competition with £fSnonprofit organizations increases. Ten years ago our discussion of the health and human service systems would have focused almost entirely on die government >;;^and nonprofit sectors and their partnership. Today, as we approach the twenry-^t;:;;flrst century, the term mixed economy, including government, nonprofit, and ^-for-profit services Is clearly a more accurate description. Given the complexity of die formal service delivery system, the purpose of p^,mis assessment is to gain a better understanding of what organizations are ^providing services to the target population In this community. Having a general r.^I'ldea of what nonprofit, public, and for-profit agencies are available leads to an p^pcaminatioa of how they work together. 110 THE COMMUNITY AS THE TARGET OF CHANGE Focus C: Deteraiiňiňg Systemic Competence Knowing what agencies are available does not go -far enough. It is important for.-die macro practitioner to know whether or not those, agencies actually work, together so that target groups do not fall through^gaps in the service-delivery: system. The nextptfo task/ in the assessment process thus examine the linkages that are evident to the practitioner and require a judgment as to whether these interacting units truly comprise a system that Is responsive to multiple needs,: Task- 8: Determine Linkages Between Units. Questions to be asked: • How are the various types of service units generally connected within a community? ■ What are the established linkages between units that serve the target ■ population within this community? ■ Where are linkages between service units obviously needed, but not '\ currently established? " Are the interests of ethnic minorities and women represented in the ■ ' network established through linkages between units? If there are multiple agencies with overlapping relationships and numerous: types of services, Is there a glue that holds the community delivery system together? Certainly there may be competition among units, but there will also, be connections. Just as the individual is embedded in a social network, so are the group and organizational units within the community. These relational patterns may change over time. Tobin et al. (19B6), identify five levels of interaction between human service agencies within the community. Table 5.6 provides an overview of their interactional'types. B -i'iis. Communication. Communication can be formal or informal. Information and; referral exemplifies formal communication that occurs between units on a daily, basis. Communication designed to increase interagency Information and understanding may be enhanced through the use of brochures, pamphlets and media. Informal "communication occurs between units as groups meet to discuss community issues or staff members talk about their programs at conferences. Although communication Is assumed, breakdowns in the delivery,system often occur because this process of sharing information between units is not nurtured. Frequently, written agreements are developed as a reminder of the importance of constant communication as staff changes within organizations and newgroups are formed within the community. Cooperation. Cooperation occurs when units within the conimuniry agree to work toward similar goals. A local private child day-care center may work closely with a public human service agency. Both want to provide supports for single --3 5 / UNDERSTANDING A COMMUNITY HUMAN SERVICE SYSTEM 111 TABLE 5.6 Five Levels of Interaction Leading Id Improved Programming ['Level of Interaction Type of Interaction \'. ' communication Verbal, written, or other forms of communication limited to sharing -_' Information or ideas between organizations. Includes consultation. -;■ •cooperation Two or .more separate organizations plan and implement- Independent programs, but all work toward similar, nenconfflctlng goals. The organizations share information but ect.on It Indepen-:V-; . dently. Organizations advertise for each other and !ry lo avoid . unnecessary duplication of services, ■iwl.Coordination Two or more separate organizations work together to plan programs and ensurB that they Interact smoothly and avoid conflict, waste, and unnecessary duplication of services. Organizations share Information, advertise for each other, and make referrals to each other. Collaboration Two Dr more separate organizations join logether to provide a single program or service. Each organization maintains Its own Identity but resources are jointly shared. Confederation _ Two or more organizations merge to provide programs or services. None of the participating organizations maintains a separate identity or separate resources. ^Kiince: Enabling Iha Elderly: by Sheldon S. Tabin, Jamas W. Ellor, and Susan Anderson-nay. Chan 9.7 Five Levels at Interaction Leading la Improved Programming, p. 149, Stala University a[ New Yark Press, 19B6. l^^mothers with young children, yet these units provide different resources. Social Plfeworkers at die day-care center meet with staff at the human service agency once jj':.a month to discuss common concerns and to maintain a sense of continuity for p^:-;mothers who are clients of both agencies. If the target population is single mothers, r-ii^jhe practitioner needs to know diat tiiese linkages are established. ■J|J8.y; Corporate volunteerism represents a cooperative linkage between die for-;]|^£.proLlt and nonprofit sectors. The Levi Strauss'Company provides an example. ppf$3n communities throughout the United States in which Levi Strauss factories are j^-fpeated, there are community Involvement teams. In one southeastern city, the i^j^ company encouraged its employees to become actively involved with a raulti--^Scounty nonprofit home aide service for the elderly and physically handicapped. Il^/Hlmployees donated time to painting and repairing the homes of alder shut-ins, ^j^-as'well as providing friendly visits to the agency's clients. If the target population '^i'J5 °Jder widows, the social worker needs to know that the corporate sector is i'^;.:Willing to address client needs. The concept of corporate volunteerism is manifested in a number of ways, business may subsidize their employees by giving them release time to do |§E0rOmmunity service work. Other companies will loan employees to human service indigencies for a specified period of time so that die expertise required for a project L^jcan be provided at no cost to the agency. As employees near retirement, the for-ItjSjiPfofit sector often provides preretirement training in which postrcrirement p^yolunteer opportunities are presented. In tills way, the for-profit sector actually misperforms a recruitment function for the nonprofit service delivery system. 112 THE COMMUNITY AS THE TARGET OF CHANGE 5 / UNDERSTANDING A COMMUNITY HUMAN SERVICE SYSTEM 113 The interchange between the for-profit and nonprofit sectors also occurs 'S itF-A^JsioCtf odiitioas, public agencies, and interested individuals have joined forces to work the form of corporate cash and in-kind contributions. Computer roanufactufeR^M^iJ^ard a common goal—health care For all citizens. In coming together, a new may donate hardware to a local service agency, assisting in computerizing it&^Jp^oiuntary association Is formed. Even though the diverse members of this coalition information system. Restaurants may donate food to homeless shelters. A locai^gpf^pcesent various interests across community units, their collaboration on health for-profit nursing home may open Its doors to older community residents whn:;$^fconcerns provides a strong and focused network for change. In some corn-live alone in a large metropolitan area during a time of anxiety over a crime wav^^^'^u'riities,' agencies created to serve the needs of a special population collaborate In this community, what cooperative efforts exist between service units withini^||pfo/assess neea*. ta examine the fit between needs and services, and to present different sectors diat focus on the target population's needs? Are ethnicicy, gender/^fe?^\united front and a stronger voice In pursuing funding for programs. Dr affectional preference factors that need to be taken into consideration ia;.;^^i^i Albrecht and Brewer (1990) call for change agents within communities to assessing service system interactions? Are any of these interests left out when thcyyi^d^iipv'e beyond coalition building, which is often temporary, and toward building should be Included? . ■T^g|^f|iiance5. The. "concept of alliance as a new level of commitment that is longer- ";-y||i^ia^aing, deeper, and built upon more trusting political relationships" requires Coordination. Coordination, implies a concerted effort to work together. Often^^p|sidng questions such as.- ' 'Who sets the agenda? What axe the power differentials? separate units will draft agreements, outlining ways in which coordination will Qccur;/;^Mf^f.^atr different skills do we bring to the table? What different visions of social In a continuum of care system that attempts to address the needs of sucfi^S^^^aiiBe do we have? And what different leadership styles do we use and do we populations as older persons, those with disabilities, or AIDS victims within ^^p^^^PAf^' (P- ^ community, coordination Is necessary. As consumers exit the acute care hospital'-^^^cfM Jn ^s community, what coalitions are focused on target population needs? ■ discharge planners work to develop a care plan. This requires knowledge of and^l^^^w, active are coalitions in advocating for change? Are there Joint ventures (new Depending UU Ull. II- y u i-ii uwuluul^ h_ui-i iv-n^iu ut i-^^^i_Lvu^^it^^3-g?;_ for recovery, this service plan may make the difference between returning ham&^^^^Q7}fidBration. Units within the community may actually merge, often when or convalescing in a long-term care facility. Extensive coordination is required;%®c^be:pr both units becomes unable to function autonomously. A horizontal merger The growth of case management within local communities reflects the nee'd^^^SGeurs, for example, when two mental health centers consolidate into a single for interunit oversight as consumers receive services from multiple units. Gase^i^^g^ganization. A vertical merger occurs when a hospital absorbs a home health management programs attempt to provide a coordination function so that service^^^gjbvide'r. A conglomerate merger occurs when units within the community form delivery flows across Informal and formal providers of care. Where there are caseif0g^^|5nfedera£ion of multiple smaller units under a large umbrella agency. These managers serving the target population it is useful to learn how they view th.^|^^^^"tipns are generally limited to nongovernmental agencies, relationships between service units that serve the target population and wtiert|||pjg|/Agency interaction inevitably involves competition and conflict. Change they see gaps. : '"''A^|^lf?°ts leam to cope with competition and conflict on a regular basis. These types t'%||^^^iiiteraction5 will be discussed in Part III. Collaboration. Collaboration implies the concept of a Joint venture. Joihi^^^^ ventures are agreements in which two or more units within the community a8re?v^^|||^ to set up a new program or service. This usually occurs when no one separateJ-^^|JjVtMARY unit within the community is able or willing to establish the new venture aloii^^^^^f For example, a local senior citizens center identified the need for repalr^||^|§jj-i:liia chapter, we have endeavored to present a means for assessing a services for many of its participants. Because older persons tend to own oldec^^^pmmunity's human service system. The assessment process begins with the homes, repairs were often needed. The center did not have the resources to begiii^^f^^inition of a target population, whose needs must then be conceptualized in this program alone, but by working with a community action agency within the^^^fcrarchy according to their urgency. Following this, the human service response community, a home repair service was sponsored jointly by the center and-th_^^pfcxplored and collective needs are considered. Sources of help are then agency. Eventually, the home repair service became a separate unit, incorparated<^^^.g(tiressed, including informal sources such as households and social networks as a nonprofit organization i^P^^tl'inediating sources such as self-help groups and voluntary associations. Formal services inrlm providers, and both important ways across these Coalition building is another form of collaboration. A coalition is a loosely-||;^Wirces of services include nonprofit, public, and for-profit developed association of constituent groups and organizations, each of whose pwnarrJ^^JJ|nature and orientation of services may differ in importa identification is outside the coalition. For example, state coalitions have been romied.^^^ices. Determining the competence of these systems in combining to meet as part of the National Health Care Campaign. Community organizations, vohiniary^|||gjia3 in an effective way Is the final consideration. L;_Vi U_JI APPENDIX 5 / UNDERSTANDING A COMMUNITY HUMAN SERVICE SYSTEM 117 Framework för Ana Human Service Systems lVZirifi COmmUllitV '^SlPf-4 What informal units are a '■"^•^Jfe^i''. population within this cm LeULlo --■$&t^J£$\i£-.. irp rnre. ethnirirv. nr oci FOCUS A: UNDERSTANDING NEED Task 1: Identify the Target Population ■ What target populations are identified within the community, and how are they categorized? ■ What target population will be the focus of this assessment? • What priority is given to the needs of the target population in this community? Task 2: Define a Continuum of Need ctlvely engaged in service delivery to the target community? ■.'m^^S^i- Are race, ethnicity, or gender factors in the provision of informal services ' ft'rM'tBiiHi'kl'*' '■■j&m&$£x-- ■ and support? -mm. 6: Examine Mediating Service-Delivery Units What mediating units would typically assist the target papulation within a -■.■Sfet^v:'' local community? .'-.'^P^^^f,?1 What self-help groups are available to the target population within this 'rM&e?3^~ cornmunity? ■ What voluntary associations have members from, or take an interest in, the 't-'SV- ■ target population within this community? ''^jafll^ • What mediating units are actively engaged in service delivery to the target population within this community? ■^/Ifask 1- Examine Formal,Service-Delivery Units How can target papulation needs he conceptualized so that a determination i.M'S5gj; can be made about the extent to which they are (or are not) being met? ■ What nonprofit agencies deliver services to the target population within this ■ 'i^sM^T': .'■ community? .,-i=..sl*....... _ ------L"---^ncies deliver services to the target population -within this Task 3; Assess Target Population Needs • What are feasible and appropriate ways in which to find out how many people are in need In each of the areas identified as relevant to this target population? Task 4: Identify Collective Community Needs agencies deliver services to the target population within this communiry? '^||P^'' " ^re mere differences in service delivery across formal units that appear to be -.:-,feVblr4i-'; based on race or ethnicity, gender, affectional preference, disability, or age? ■ Are there needs in this community that require something other than a human^^QCus c. DETERMINING SYSTEMIC COMPETENCE service response? • What data supports the existence of these needs? • How are these needs expressed by the people of this community? FOCUS B: IDENTIFYING AUSPICE OR SPONSORING ORGANIZATIONS Task 5= Examine Informal Service-Delivery Units • What Informal units would typically assist the target population within'a locai-V community? - What importance does the household unit have to the target population £ within tills communiry? " What Importance do natural support and social networks have to the target population within this community? {ffefiisk 8: Determine Linkages between Units •^fe,^;; • How are the various types of service units generally connected within a community? • What are the established linkages between units that serve the target t'1"-^ ' population within this community? - • Where are linkages between service units obviously needed, but not currently established? ■S-'r?-' " Are the interests of ethnic minorities and women represented in the network ,established through linkages between units? APPENDIX Framework for Analyzing a Human Service Organization FOCUS A: IDENTIFYING THE AGENCY'S TASK ENVIRONMENT Task 1: Identify Funding Sources " What are the agency's funding sources? • How much and what percentage of funds are received from each source? " Which funds are earmarked for certain programs or services and which are flexible? ,. Task 2: Identify Sources of Noncash. Revenues ■ Docs the organization use volunteers? ttyes, how many and for what purposes? ■ What material resources (e.g., food, ciothing, physical facilities, etc.) docs the organization receive? • What tax benefits does die organization receive? *• How Important are noncash revenues to the organization's operation? Task 3: Identify Clients and Client Sources ." What client groups does this organization serve? • How many unduplicared clients are served by each program? • How are client needs determined? " Within each client group, how. many.(or what percentage) are able to pay? Contract eligible? Unable to pay (low-pay or no-pay)? • What percentage of clients are ethnic/racial minorides, women, gays or lesbians, or members of other oppressed groups? • Haw and by whom (I.e., self, family, provider) are clients referred to this organization? ■ How and to which agencies does this organization refer clients? Task 4: Identify Other Constituents • What state and federal regulatory bodies oversee programs provided by this organization? " What agencies contract with this organization for service delivery? m '■-jo: 7 / PRACTICE IN HUMAN SERVICE ORGANIZATIONS 193 • What professional associations, labor unions, or accrediting bodies influence agency operations? • Is this organization affiliated with or sponsored by religious, ethnic, or fraternal bodies? ■ How does this organization define its "public," and what groups are parr of this definition? ffyoCÜS B: RECOGNIZING THE DYNAMICS WßjOV AGENCY/ENVIRONMENT RELATIONS ftirask 5: Observe Relationships with Clients It w • Has this organization targeted new or different clients within the last five years? ■ What is the organization's domain (specifically, what types of clients does the organization serve)? ■ Are these clients ones who bring resources to the agency or for whose services resources must be obtained elsewhere? ■ Does the organization claim a larger domain than it serves, and are significant numbers of clients turned away? ■ What types of clients does the organization refuse (e.g., are most of these the poorest or most troubled clients; are most of these minorities as opposed to nonminorities)? What happens to these clients? S^Task 6: Observe Relationships with Resource Sources fie'-'"1-" 1^ How good are the relationships between funding sources and organizational leaders? How does the organizadon use and work with volunteers? How good arc the relationships between important external various constituencies and organizational members? What types of changes have recently affected the organization, particularly in the area of access to resources? IJTask 7: Observe Relationships with Competitors ■ What other agencies provide the same services to the same clientele as this organization? • Are there mechanisms for interagency cooperation and are they used? • With whom does the organization compete? • With whom does the organization cooperate? Are these relationships formal or informal (eg-, is the organization part oF a coaiidon or an alliance)? 194 THE ORGANIZATION AS THE TARGET OF CHANGE FOCUS C: ANALYZING THE ORGANIZATION Task 8: Identify Corporate Authority and Mission • Is the organization operating in a manner that is consistent with its mission and authority? ■ To what extent is the mission supported by staff who perform different roles within the organization? " Are policies and procedures consistent with mission and authority? . Task 9: Understand Organizational Structure ■ What'is'the organizing theme for the basic organizational structure (e.g., bureaucratic, organized around programs, organized around professional disciplines, alternative or nontraditiohal, etc.)? . ° Is this die mast logical structure? Is it consistent with and supportive of the mission? ■ Are staff clear about reporting lines and accountability? " Is supervision logical and capable of performing expected functions? Is there an informal organization (people who carry authority because they are respected by staff, and thus exert influence outside those in formally designated positions)? ■ Are there clear distinctions between staff and line functions? Task 10: Understand Administration, Management, and Leadership • How Is the workplace organized and work allocated? ■ Is appropriate authority assigned along with responsibility? . ... ■ How close is supervision and what, exactly, is supervised? Is it tasks, or is it functions, or is it the employee, depending on need? . ■ How are people treated in the workplace, including the very lowest level employees? " Do employees feel valued at every level? Do they believe they are making a contribution to the success of the organization? ■ How are decisions made? Is information solicited from those affected? Is it used? Are there individuals or units within the organization that are left out of decision making? If so, why? • How Is conflict handled? Task 11: Recognize the Organization's Culture • How would one begin to describe the organization's culture? • What are the organization's artifacts and creations? • What are the organization's stated values and what is actually valued within the organization? 7 / PRACTICE IN HUMAN SERVICE ORGANIZATION' How do leaders within the organization influence organizational values and assumptions? What are the taken-for-granted patterns within this organization? Is behavior consistent with culture? Arc there minorities or others who feel left out of the accepted Drganiza_ - If/'c tlonal culture? M: teiitask 12: Assess the Organization's Programs and Services m ■■-.Jriffc:' 195 I ft What programs are offered? What services are offered within each pro ^mJ Are the services consistent with the goals and objectives of the Prograrn? Is there a common understanding among management and line staff Witr,jn each program about problems to be addressed, populations to be served services to be provided, and outcomes lo be achieved? Are staffing patterns appropriate to the services to be provided? Are ariy siaff over or under qualified? Are workload expectations reasonable given cvn(,rrn tions for achievement with each client and within each service and program? Is consideration given to cultural and racial understanding of workers and clients? What data is collected on clients and how is it used? What evaluative information is expected from the evaluation plan? Is there a plan to gather information about clients and the extent of improvement at [ue p0jn[ of termination and In a follow-up survey or interview? Is there an effDr[ [D determine level of client satisfaction with services? What do the findings reveal to date? |,T"'for direct benefits, and distinguishing between, primary and secondary bene-•^^flciaries. The decision will have an important impact on the change effort. If /^^■"students who want a good education in a drug free environment" are identified as primary beneficiaries, then the intervention may well be directed toward &|tigbter security and stricter discipline. If, on the other hand, primary beneficiaries ":are described as "students who use drugs and are unable to maximize their ^educational opportunities due to impairment," then the intervention may be ^'directed toward treatment. However the primary beneficiaries are defined, the remaining groups should Pjiibe identified and listed as secondary beneficiaries. Secondary beneficiaries may ;bbe important and may need to be called upon when the change effort needs public -||§!;suppart. "We will refer to this group, as the support system. 'Task 4.- Identify the Support System. The support system refers to that ""Segment of the community or organization who have an interest in the success &Df the proposed change and who may receive secondary benefits. This group is ijexpected to be involved In supporting and advocating for the change if they are tneeded. The boundaries for macro-level changes tend to he defined in a way that P^:me primary focus is on a segment of a community or organization. Total com-Mnunities as defined by political boundaries (entire towns, cities, counties) or total ^organizations are rarely the focus of a change effort. The support system is defined largely by the target population (or client ^system) and the problem. People have an interest in certain populations and '[problems for a variety of reasons: a loved one is afflicted with the problem, their ^employment brings them into close contact, their church or service organization §has selected this population for assistance. They are sometimes described by the related concern or issue, such as the "mental health community," or the "foster care community." These are the people the change agent will count on to become .|jj.vfinvolved if decision makers need to be persuaded that the change is necessary. Cplngure 9.1 Illustrates the relationship between initiator, change agent, client ■fend support systems. „s*L=,t Initiator, change agent, and client systems can be seen as incorporated within fithe boundaries of the support system in that they all have an interest in addressing ■the need for change. Initiator, client, and change agent systems may overlap, or ..jP^Jnay represent separate and distinct constituencies. i -i rash 5-- Identify the Controlling System. The controlling system is defined $jj£as that group of individuals with the formally delegated authority and the power to approve and order the implementation of the proposed change. Macro-level ^ —^ ftfw*,K5& t^BHfffr JlOBEB^i I € 1 I E D 228 MACRO CHANGE 9 / DEVELOPING AN INTERVENTION STRATEGY 229 Initiator System Client SystBm Change Agent System FIGURE 9,1 Relationship of Systems change Invariably involves approval by some formally designated authority. If the change Involves a public agency or publicly funded or regulated services, control may rest with a body of elected officials. If the change involves a private agency, control may rest with a board of directors. These bodies are significant-to acceptance and implementation of the change effort, and their positions att-die proposed- change must be known and considered. Task 6: Identify the Host and Implementing Systems. The host system-is the organization or group responsible for implementation of the change. "Within.; the host system.is a smaller group who will have day-to-day responsibility for' carrying out the change. We refer to this as the implementing system. Imple*.. menrers are employed by or volunteer for the host system. In most instances of-macro-level change the host system will be an organization that will be expected to implement a policy change, a new program, or a project. The listing of systems in Table 9.2 identifies controlling, host, and implementing systems la a school system and in a law enforcement system. The change agent should be careful not to assume that the positions of the-controlling system, host system, and implementing system are identical. It is not unusual for those involved in the execution of policy to disagree with the policymakers TABLE 9.2 Examples of Controlling, Host, and Implementing Systems Controlling Host Implementing School School Board A particular school and Teachers In the school System ils principal Involved In the change Law Enforcement City Council Police Chief and department Police Dftlcers Involved In System the change and vice versa. Each system should be assessed separately. Figure 9.2 depicts the typical relationships of the controlling, host, and implementing systems. Task 7: Identify the Target System. The target system is the individual, group, structure, policy, or practice that needs to be changed for the primary beneficiaries to achieve the desired benefits. The target system is a complex concept that cannot always be defined in clear and simple terms. Often what needs to be changed may include philosophy, values, attitudes, practices, and policies as well as die provision of services. Another complicating factor is that many change efforts must address multiple targets. For example, in addressing the high school's drug problem it may be necessary to educate the faculty and staff about what is happening before they are willing to allow the change to occur. They are targeted for change first. Next, it may be necessary to target the school board to gain their approval to intervene. Finally, having gained the approval and support of teachers and school board members, the intervention, focusing on the "real" target group—high school students using drugs—can be implemented. Two questions need to be answered in defining the target system: (1) what change (or series of changes) needs to take place in order for the primary beneficiaries to achieve the desired benefits? and (2) what individuals or groups need to agree to die change (or series of changes)? We have defined these . Individuals or groups as controlling, host, and Implementing systems. The target system may lie within the boundaries Df any or all of these systems, or it may lie entirely outside of any of them. Target could include, for example, selected school board members, a principal and assistant principals, or a subgroup of teachers, or the target system could be a selected group of students. Task 8: Identify the Action System. As all other systems are being defined and participants selected, an action system is being formed. The action system is made up of those individuals from other systems who have an active role in FIGURE 9.2 Relationships between Controlling, Host, and Implementing Systems Controlling System Host System Implementing System 230 MACRO CHANGE 9 / DEVELOPING AN INTERVENTION STRATEGY 231 planning the change and moving it toward implementation. Clearly there is a good deal of overlap here with the change agent system, earlier defined as the professional change.agent, sanctioning organization, and sometimes a core planning group; "While the change agent system forms the core of the action system, other actors also have important roles in providing input into decision malting. The action system should include, whenever possible, representatives from all other systems, including those systems in need of change, if the relationship is not. excessively adversarial. For example, if the social problem under consideration.is the unmet needs of the homeless, the concern might first be raised by a person who passes by a Few old men sleeping in doorways ever)' day on her way from the bus to her place of work (initiator). She Finds that several other employees at her place of work have the same concern and raises the issue co the city council (controlling system), where it is assigned to the City Department of Human Services (change agenrsystem and host system). The social worker (change agent and possibly implememer) forms a task force which includes those who brought the issue to-, the council. As the condition is researched and analyzed, more people are added to the task force. Professionals who work with the homeless (support system) would be 'asked to join, as would some current or former homeless people (client system)'and someone from the city's political or administrative structure who understands the potentialities and hmitations of the city's participation (controlling system). When all the significant participants have been identified, this group ■ would become the central decision-malting body in the change effort and would be defined as the action system. Systems in Interaction. In examining these systems in interaction, it is impor-. tant to remember that we distinguish among them and define them separately for conceptual purposes only. In actual practice, all systems could be within one organization, and it is highly "probable that many systems will overlap. The interrelationships of all systems is depicted in Figure 9.3. FIGURE 9.3 Systems In IntBracllan ACTION SYSTEM One side of the diagram includes those systems proposing and favoring change. The larger system is the support system, and includes all systems favoring change. Contained within the support system we find the initiator, client, and change agent systems, all with possible varying degrees of overlap. On the other side of the diagram we find those systems identified as in need of change. The controlling, host, and implementing systems are represented by concentric circles in that each subsystem is typically contained within the span of control of the next larger system. The target system may lie within any of these systems or even outside all three. The action system may overlap any or all of these systems. An example illustrating all systems within one organization would be a situation in which an organizational change is proposed. For example, a human service agency may have a special program for "crack babies" and their mothers (the client system) which includes detoxification, rehabilitation, counseling, and . parent training. After six months, a supervisor (initiator system and change agent system) notices that die case managers (implernenting system) have been practicing ''creaming,'' providing the bulk of services to the most highly motivated clients and ignoring the needs of the least motivated. In this example, tiiis practice of "creaming" would be the target—that which is to be changed. The supervisor calls the problem to the attention of the executive director (representing the host system) and the executive director raises it with the board (the controlling system), and recommends that incentives (the proposed change) be developed for case managers to work with less motivated clients. A task force (action system) made Afe up of the supervisor, a case manager, a board member, administrator, and an ex-client now volunteering for the agency examine the problems and possibilities of directing more service to unmotivated clients. All this has taken place witiiin the boundaries of a single organization with essentially no input from extraorganizational sources. This illustrates the nature of the shifting boundaries of S3'Stems, while demonstrating the value of retaining conceptual clarity in defining the systems. Even though the terms controlling, • host, and implementing may never be used, it is important that the change agent understand the domain, authority, and power of each, and keep roles, responsibilities, and expectations for each clear and distinct. Focus B: Examining System Readiness for Change As the change process unfolds, each of the systems defined above should be assessed for its readiness to support the proposed change. An assessment of readiness should include consideration of an openness to change in general, commitment to the proposed change, availability of resources to implement the proposed change, and the degree of outside resistance to theproposed change. These considerations will most likely be assessed differently for different systems. However, it is \.]k.eiy that there will be some similarities among those systems promoting change (initiator, change agent, client, support, and action systems) and among those with whom they are hoping to bring about change (controlling, host, implementing, and target). 240 MACRO CHANGE 9 / DEVELOPING AN INTERVENTION STRATEGY 241 etiology, interpersonal and political .factors, or resource considerations. Each should be examined for its potential driving or restraining effects on the change effort. Figure 9.6 illustrates examples of support from facts and perspectives. Using this format, action system participants next initiate a discussion session focused on making the "go/no-go" decision. An option, of course, is to gather more facts or to postpone the decision to a more opportune time. Additional fact gathering, if absolutely necessary, is considered advisable only if It Is highly focused and time-limited. If, however, fact gathering is proposed as a delaying tactic or intended simply to avoid maldng a difficult decision, it should be recogr nized for what it is and rejected. It should also be recognized that this may be the point where some participants will believe the proposed change to be unattainable and will decide to drop out, while others may choose to pursue the effort. Here again, It should be emphasized that the professional person acting as change agent must make as rational, non-emotional a decision as possible. Necessary changes that have a good chance of success should be supported. Causes that are likely to be defeated as currendy conceptualized should be tabled until they are more fully developed Df the timing is better. Focus G: Setting Goals and. Objectives Goals are brief, one sentence or phrase, general statements of expected outcomes (e.g:>T-o reduce the number of dropouts in the Jefferson district). Objectives spell out the details for each goal in measurable terms, including expected outcomes-and the processes to achieve them: Activities, are lists of tasks that must be undertaken and completed in order to achieve each objective. If the decision is made to proceed, the Final step before selecting tactics is to ■ establish a set of goals, objectives, and activities for the change. Goals and objectives are intended to act as a beacon to aid in keeping the change effort on trade Activities-specify precisely what is to be done, by whom, and within what time frame. Setting goals and objectives is probably as much art as it is science. The purpose is to take what can be a very large and complex undertaking and to break It up into manageable subsets. Each subset has its own set of goals, objectives, and activities. FIGURE 9.6 Support tram Facta and Perspectives on trie Problems of Homeless Teens □riving/Supporting Forces Restraining/Opposing Farces 1. Teen homelessness is Increasing by 20 percent per year 2. Homeless teana have been drawn Into drug trafficking, prostitution and many property crimes 3. Media have increased coverage of the problem; the public increasingly favors some action 1. Rssourcos are already inadequate to meet existing needs of homeless families. 2. No federal or state funding is available;-hamelsssness Is considered a IocbI problem 3. Suburban cities are not willing to contribute needed support; malar urban city council feels it should be considered a regional problem ti.v if--I- . ■ Iii-/ •ať I m fr m. ■t" f m M. >-fi'-' -fic-'. - ■S'.'i;- I SS' ■3j- \% It- % 1 The process begins with re-examining the change effort and organizing it Into categories or sections. This takes some practice and requires knowledge of the subject area, which is why problem analysis is so important in macro-level change. The problem, as analyzed and conceptualized In the problem analysis phase, becomes a theme that is repeated throughout the change episode. The following examples illustrate how one might go about this first step of breaking a large and complex change effort into subsections or categories. They are built on the assumption that the preceding community or organizational analysis and the problem analysis work have been completed. Example 1 The proposed change is a three-year project to reduce teen pregnancy and enable at-risk teens to graduate from high school. Project Subcategories 1. Building self-esteem 2. Providing health, hygiene, and sex education 3- Providing academic support 4. Providing financial support In the example, we have depicted a four-part program designed to achieve the purpose as stated above. In bodi examples, each of the four areas listed above would have its own set of goals, objecdves, and activities. Example 2 The proposed change Is a policy change diat provides for financial incentives for programs demonstrating measurable improvement with alcohot-abusing clients. Project Subcategories 1. Developing valid and reliable indicators 2. Developing the fiscal incentive package 3. Developing quality assurance measure By dividing the change effort into subcategories, each part of the effort can proceed toward achieving its own set of goals and objectives in a way that is more concentrated and focused than if all objectives and activities were organized under a single goal. The exception to this principle of subdividing is when the change effort is so clear and simple that It does not require subcategories. For example, a project to conduct a client satisfaction survey might be a project that requires only a single set of goals, objectives, and activities. It Is often true, however, that simple, unopposed change efforts come about without complications, and 242 MACRO CHANGE 3 / DEVELOPING AN INTERVENTION STRATEGY 243 do not require the type of change process described in this book. If one follows die steps recommended in this book, it is Ukeiy that one is dealing with relatively complex change. Once the subcategories are selected, a set of goals, objectives, and activities should be developed for each. They should always be thought of as a set or package, not as items that stand alone, even though they are occasionally used alone. Task 21; Identify Goals. A goal is a general statement of expected outcomes or a desired future state (Kettner et al. 1985). It need not be observable or measurable. It Is simply a statement of hopes or expectations, stated in a positive and general enough way to get agreement and support. Continuing with the above examples, the following goat statements would be appropriate. Teen Pregnancy Project ■.Goal I- To.improve client self-esteem. Goal 2: To increase client knowledge of health, hygiene, and coqtraceptlon. • 'Goal 3: To strengthen client academic abilities. • Goal 4: To increase client financial resources. Measuring Client Outcomes ' Goal 1: To develop indicators of client change. Goal 2: To develop fiscal incentives to promote client improvement. Goal'3: To develop methods for assuring service quality. . ... Task 22: Formulate Outcome and Process Objectives. Once a goal statement is written, the next step is to specify objectives. Objectives are intended to move the change effort toward the goal. They are highly specific and measurable. There are two types: (1) outcome objectives, and (2) process objectives. One outcome objective is written for each goal, and specifies the results or outcomes to be achieved. One or more process objectives then specify the process to be followed in order to achieve the result. When the outcome objective and all Its related process objectives are completed and written out, it should be evident that the process objectives, when completed, will lead to achievement of the, outcome objective, and that the outcome objective, when accomplished, will move the effort toward the goal. A complete objective, whether outcome pr process, has four parts: (1) a time frame, (2) a target, (3) a result, and (4) a criterion for measuring or documenting the result (Kettner et al. 1985). In the following pages, examples will be given of both outcome and process objectives. The time frame is stated in terms of the month, day, and year by which the result will be achieved. In situations where a project's start date is unknown, the time frame may be specified in terms of time elapsed from the beginning of the project (e.g., "within three months of the beginning of the project, ■ ■It " '*5-':. ■ "te * 'as*r w ft or "by the end of the first year"). Once a start date is known, it is wise to go back and fill in actual dates, since objectives are often also used as monitoring tools. The second part of an objective, the target, specifies the individuals or focal point for which the objective is written. Outcome objectives are focused on a quality of life change and will identify the individuals for whom the change is intended. Process objectives may have an object (such as a program or a department) as a target, instead of a population. Statements should be as precise as current knowledge will allow. A drug treatment program, for example, might specify "twenty-four cocaine addicts at least eighteen years of age and currently employed" as its target. A process objective might specify "the counseling program" or the "performance evaluation system" as Its target or focal point. For reasons stated in earlier chapters in this text, the more precise the target, the greater the likelihood of a successful intervention. As an example, the teen pregnancy program mentioned above will be used to illustrate how outcome and process objectives fit together to form a plan of action. The following diagram illustrates partial objectives, including a time frame and a target. 'I n m m .■Ef ■ft ■.m M .Ä Outcome objective: [ time frame ] By June 30, 19XX, [ target ] at least fifty teens considered to be at risk of pregnancy . . . Process objective: [ time frame ] By February 1, 19XX, . . . will he developed for 1 [ target, ] a group of teens considered to tie at risk of pregnancy . . . In this illustration, the target is the same. The reason will become evident as the objectives are developed further. The third part of an objective is a phrase that specifies the expected outcome or result to be achieved when all activities are completed. This phrase differs depending'on whether the objective is an outcome or a process objective. An outcome objective focuses on a quality of life change for the target population. Outcome objectives refer to such factors as improved knowledge and skill, improved relationships with spouse, reduction of alcohol abuse and other such changes. Process objectives focus on the result expected at the completion of the process. Results might include such objects as a report, a plan, or a new data collection form. Continuing with the example of the outcome and process objectives used above, we add the following outcome and result. 244 MACRO CHANGE Outcome objective.- [ time frame } By June 30, 19XX, [ target ] . at least fifty teens considered to be at risk of pregnancy ... [ outcome ] will Increase their knowledge of health, hygiene, and contraception . . . Process objective: [ time frame j By February 1, 19XX, [ result ] a training curriculum on health, hygiene, and contraception will be developed [ target ] for teens considered to be at risk of pregnancy . . . The final part of an objective is the criterion which will be used to determine whether or not the objective has been achieved. Objectives must be precise and measurable, yet sometimes the result to be achieved seems vague and elusive. Some programs, for example, are designed to Improve self-esteem. The question, is, how does one know whether or not self-esteem has been improved? The criterion specified In the objective insures that only one standard will be used. If improving self-esteem is the result, then it must be measured by a standardized, test designed to measure self-esteem. The criterion for an outcome objective usually begins with the phrase, " . . , as measured by . . ." Increased self-esteem might be measured by the Index of Self-Esteem (Hudson, 1982). Process objectives generally produce products or achieve milestones hi a process, and use a different type of criterion to measure the result. In most cases, process objectives will use the phrase, ". . .as documented by . . ." indicating some formal product or. result that will be accepted as documentation that the process objective has been completed. Continuing examples of outcome and process objectives on the teen pregnancy project follow. Outcome objective.- [ time frame ] By June 30, J9XX, -■'••[. target ] at least fifty teens considered to be at risk of pregnancy . . . [ outcome will increase their knowledge of health, hygiene and contraception . . [ criterion ] as measured by a prercst/posttest developed for the course. K~ § --[It;- - I j;» : i 1' Ti£p-. 1 & *^ I" m I I 9 / DEVELOPING AN INTERVENTION STRATEGY 245 Process objective.- [ time frame ] ' By February 1. 19XX, [ result ] a training curriculum on health, hygiene, and contraception will be developed [ target J for teens considered to be at risk of pregnancy . . . [ criterion | as documented by receipt of a completed training package. When all four parts—time frame, target, result, and criterion—have been written, the objective is complete. The foregoing examples are reproduced in Table 9.4 to reinforce the understanding of the differences between outcome and process objectives. Typically a set of goals and objectives will include one goal, one outcome objective, and several process objectives. For example, In the program outlined la Table 9.4, die following might be the focus of goals and objectives. Goal To increase knowledge about health and pregnancy for teens at risk. Outcome Objective By June 30, 19XX, to increase knowledge of health, hygiene, and contraception for fifty teens considered to be at risk of pregnancy as measured by a pretcst/posttest developed for the course. Some possible process objectives: 1. Develop training curriculum 2. Develop and reproduce training materials 3. Recruit fifty teens at risk of pregnancy 4. Secure a suitable training location 5- Hire trainers 6. Implement the program 7. Evaluate the program 1 Task 23: Plan Activities. The final step in Focus G is to itemize activities. Activities represent the highest level of detail Incorporated into the plan. Each activity represents a step which, when accomplished, moves the project closer to achievement of a process objective. Activities should specify the work to be done, the person responsible, and a time frame. The Gantt chart, originated early in the century by management pioneer Henry L. Gantt, has proved to be a useful format for setting up activities. A Gantt chart is made up of columns and rows. 246 MACRO CHANGE 9 / DEVELOPING AN INTERVENTION STRATEGY 247 TABLE 9.4 Sample Outcome and Process Objectives Outcome Process Time Frame Targel autcomer'Rosult Criterion By June 30, 13XX 50 teens considered to be at risk of pregnancy will increase their knowledge ol health, hyg\ane, and contraception as measured by a pretBStVpostlest developed for the course. By February 1, 19XX for teBns considered to be at risk af pregnancy a training curriculum on health, hygiene, and contraception will be developed as documented by receipt of a completed training package. Each row represents an activity, and columns are used to identify activity number, person responsible, and the beginning and ending month. Illustrated below is an example of a Gantt chart applied to one of the process objectives for the pregnancy prevention program. The Gantt chart in Figure 9.7 depicts a training project beginning July 1, phasing in each activity' sequentially over the next seven months, and delivering the completed training package as promised on February 1, The horizontal lines, across the columns indicate the approximate anticipated beginning and ending. times for those activities. The 1 in the February column next, to activity number 7 indicates that the completed training package is due on that specific date. In preparing an action plan for a macro-level change, each subsection of the. intervention should include a set of goals, objectives, and activities. "When these are developed at an acceptable level of precision, with responsibilities and time- FIGURE 9.7 A Gantt Chart Process Objective: By February 1, 19XX, to develop a training curriculum on health, hygiene, and contraception for teens at risk at pregnancy, as documented by receipt □f a completed training package. Activity Number Activity Person Responsible Time Frame J FMAMJ JASOND 1. Develop course □bjectives. J. Smith 2. Prepare content outline J. Smith/ modules on bealih, hygiene, L. Black and contraceplion. 3. Select teaching methods L. Black for each module. 4. Prepare workbooks and C. Rich handouts for each module. 5. Print up workbooks and B. Wood handouts. 6. Develop pretest/posltest. J. Smith 7. Deliver complete training J. Smllh package. frames clearly specified, the action plan is complete. The last steps in macro-level change involve the selection of tactics and the development of a written plan. These final steps are discussed in the next chapter. REFERENCES Brngcr, G., and S. Holloway. (1978) Changing human service organizations: Politics and practice. New York: Free Press. Brager, G-, H. Specht, and J. L. Torczyner. (1987) Community organising. New York: Columbia University Press. Hudson. w". w*. (1982) Tlje clinical measurement package. Homcwood, TL: Dorsey Press. Katz, D,, and It, L. Kahn. (1?66) The social psychology of organisations. New York: John WUey & Sons. ' Kettner, P; M., J. M. Daley, and A. W. Nichols. (1935) Initiating change in organizations and communities. Monterey, CA.- BrboksyCole. Lewin, IC (1951) Field theory in social science. New York: Harper & How. Tropman.J. E., andj. L. Erlich. (1987) Introduction to strategies. In F. M. Cox.J. L. Erllch, J. Kothman, and J, E. Tropman, eds.. Strategies of community organisation (2nd ed., pp.'257-69). Itasca, IL: F. E. Peacock, von Bertaianfry, L. (1950) An outline of general system theory. The British journal for the Philosophy of Science, 1(2): 493-522. 10 I SELECTING APPROPRIATE TACTICS 249 CHAPTER 10 Selecting Appropriate Tactics Overview Introduction. Focus A: Selecting Appropriate Tactics Collaboration Implementation Capacity Building Campaign Education Persuasion Mass Media Appeal Contest Bargaining and Negotiation Large Group or Community Action Class Action Lawsuits Considerations in Selecting Tactics Objectives Controlling and Host Systems Primary Client Resources Professional Ethics Pocus B: Preparing a Written Plan Conclusion References Appendices INTRODUCTION Chapter 9 addressed strategy, which refers to the development of a written plan directed at bringing about the proposed change. Deciding on a strategy can be a time-consuming and detailed process. Although many may agree that a problem exists, getting agreement on just how the situation should be changed is seldom easy. Special efforts must be concentrated on tactics designed to get the change accepted. Tactic selection tests the professional judgment of the change agent, particularly in how to approach the target system. Certain tactics can raise ethical dilemmas. Selecting tactics calls for mature, professional judgment in community and organizational change. Social workers should be open to the possibility that practices in many of the arenas in which they operate are well entrenched and there will be a natural tendency to resist. The fact that agency missions are stated in inspiring words does not mean that ail agencies carry out those missions. Practitioners must be aware that they are a part of legitimized systems tiiat often contribute to the oppression experienced by the client group they are trying to serve. Selecting appropriate tactics requires one to think critically and to carefully analyze the target system. FOCUS A: SELECTING APPROPRIATE TACTICS The choice of tactics is a critical decision point in planned change. Tactics have been defined as "any slcillful method used to gain an end" (Brager et al. 1987, 288). "Whereas strategy is the long-range Uniting of activities to achieve the desired goal, tactics are reflected in day-to-day behaviors (Brager & Holloway 1978). As the change agent engages in tactical behavior, it is important not to fose sight' of the goal toward which these behaviors are directed. Brager, et al. (1987), identify four essential properties of tactics used by professional change agents: "(1) they are planned ... (2) they are used to evoke specific responses ... (3) they involve interaction wida others . . . and (4) they are goal-oriented" (p. 288). In addition, it is our contention that a fifth property must be in place in professional social work change efforts: (5) the tactic will do no harm to members of the client system and, whenever possible, members of that system will be involved in tactical decision malting. Change almost always involves influencing the allocation of scarce resources—authority, status, power, goods, services, or money. Decisions about tactics, therefore, must take into consideration whether the resources are being allocated willingly or whether someone must be persuaded to make the allocation. If there is agreement on the part of the action and target systems that the proposed change is acceptable and that resources will be allocated, a collaborative approach can be adopted. If there is agreement that the proposed change is acceptable but a reluctance or refusal to allocate resources, or if there is disagreement about the 24a 250 MACRO CHANGE 10 / SELECTING APPROPRIATE TACTICS 251 need for the proposed change, then a more coercive approach may be necessary if the change effort.is to proceed. For example, a change effort may focus on the inability of physically disabled people to get around the city and travel to needed service providers. A thorough srrj&y^bcuments the problem, and a dial-a-ride transportation service Is proposed. 'The planning commission and city council graciously accept the report, agree on the need, arid thank the Transportation for the Disabled Task Force. Three city council members favor funding, three are opposed, and one is undecided. If-the undecided council member can be persuaded to favor funding, then collaborative tactics can be adopted. If, however, he or she decides to oppose handing or if a compromise would undermine the change effort, then tactics designed to coerce support must be adopted. For collaborative approaches to. be adopted,, there" must be agreement on both the proposed change and the allocation ol^needed resources. In the social work literature, tactics have been divided into three broad categories; cdUaboration, campaign, and contest (Brager & Holloway 1978; Brager et al. T?87). In this chapter, we use these terms to describe the relationship between the action and target systems. Collaboration implies a worldng relationship where the two systems agree that change must occur, whereas contest tactiGs"'indicate disagreement between the two systems. Campaign tactics are used when the target must be convinced of the importance of the change, but when communication is still possible between the two systems. The effectiveness of the "campaign" may determine whetiier collaboration or contest follows. Contest tactics are used when-neither of Che other two are possible any longer. Change efforts that begin with one set of tactics may progress to other sets, depending on the evolving relationship between the action and target systems. The continuum along which these tactical categories fail is as follows: Collaboration Campaign Contest Although we categorize these relationships, success may hinge on the change agent's ability to keep the action and target systems in a state of continual interaction. It is possible that'what begins as a collaborative relationship will move to conflict when new issues arise during the change process, it is equally likely "'that the relationship will vasrillate between various gradations of communication, with both systems uncertain about the other, even when compromise can be reached. In short, these relationships ebb and flow, sometimes unpredictably, given the political situation, and sometimes all too predictably, given the change agent's prior experience with the target system. Our concern is that the social worker never take the relationship between the action and target system for granted. To assume that the target is immovable before communication has been attempted demonstrates poor use of professional judgment. To assume that the target will embrace the cause once the facts are known is naive. Assumptions have little place in assessing the relationship between ' the action and the target system. We believe that regardless of what types of tactics. axe used, communication should be maintained with the target system if at all possible. If communication ceases, it should be because the target system refuses to continue interaction. Within each of the three categories are tactics that are typically used. The framework in Table 10.1 guides our discussion. Some of the following conceptualization-is. drawn from previous literature (Brager & Holloway 1978; Brager et al. 1987). In some areas, we offer slightly different perspectives and add new ' tactics.- Throughout the following discussion, we attempt to provide an analytical framework to guide an action system in selecting the most appropriate mix of tactics. Collaboration p Implementation. Collaborative approaches include instances when the target and action systems agree that change is needed. Under collaboration, we place (1) implementation and (2) capacity building tactics. Implementation tactics are used when the action and target systems work together cooperatively. When these systems agree that change is needed and allocation of resources is supported by critical decision makers, the change simply needs to be implemented. Implementation will most likely involve some problem solving, but it is hot expected that adversarial relationships will be'a concern in these type of collaborative efforts. Capacity Building. Capacity building includes the tactics of participation and empowerment. Participation refers to those activities that involve members of the client system in the change effort. Empowerment is the process of "helping TABLE 10.1 Tactical Behaviors Relationship of Action and Target Systems Tactics Collaboration Targsl system agrees (or Is easily convinced to agree) with action system that change Is needed and supports aliocalion of resources Campaign Target Bystern is willing lo communicate with action system, but there is Utile consensus that change Is needed; or target system supparls change but not allocation of resources Contest Target system opposes change and/or allocation of resources and is not open to further communication about opposition 1. Implementation 2. Capacity building a. Participation b. Empowerment 3. Education 4. Persuasion a. Coo'platton b. Lobbying 5. Mass media appeal 6. Bargaining and negotiation 7. Large-group or community aclion a. Legal (e.g., demonstrations) b. Illegal (e.g., civil disobedience) 8. Class action (awsult 252 MACRO CHANGE 10 / SELECTING APPROPRIATE TACTICS 253 a group or community to achieve political influence or relevant legal authority" (Barker 1987, 49). For example, a problem may be defined as exclusion of a neighborhood from decisions that affect them. The focus of the intervention is on building a capacity for greater self-direction and self-control—that is, actually teaching people how to get involved in the decision-making processes in their communities and taking greater control over the decisions that affect their lives. This approach often emerges in situations where disenfranchised communities become targets for development, freeways, airport expansion, and other such encroachments. Through professionally assisted change efforts, perhaps led by a neighborhood social service organization {change agent system), neighborhood resident (client system), and city council (controlling system and perhaps target system) agree that community citizens should have a greater voice in developments that affect their community. The focus of the change or intervention, however, is not on the target system (city council/planning commission) but on educating, training, and preparing community citizens for a fuller participation in decisions that affect their communities. Tactics would include education, training, and actual participation in civic organizations and activities. Empowerment involves enabling people to become aware of their rights, and teaching them' how- to exercise those rights so that they become better able to take control over factor's that affect their lives. Mobilizing the efforts of self-help groups and voluntary associations identified in Chapter 5 as well as the client system's informal support structure may be used to assist In guiding the target 5VStem toward consensus with the change effort. Campaign Campaign implies a group effort to convince target system members that a cause is just or a change is needed, and that resources should be allocated. Campaign' tactics require.a good deal of skill on the part of the change agent and action system. Lack of consensus rules out collaboration, yet a firm disagreement has not been established. Under this heading we include the use of education, persuasion, and mass media appeals designed to Influence public opinion. Education. Educational tactics can be an Integral part of campaigns. Therefore, we use educational tactics, to describe those interactions in which the action system presents perceptions, attitudes, opinions, data, and information about the proposed change with die intent of convincing the target system to think or to act*'differently. The objective is to inform. The assumption is that mare and better information will lead to a change in behavior. It is a difficult tactic to use because.--opponents of the change can also be expected to inform decision makers armed: with different sets of data and information, and there is seldom an absolute "truth" in dealing widi complex organizational and community problems. In many cases where education fails to produce the desired result or falls short of having the desired impact, the change agent turns to persuasion. Persuasion. Persuasion refers to the art of convincing others to accept and | support one's point of view or perspective on an issue. Social workers must J- frequently use persuasive tactics in addition to collaboration because their causes ■S; are not always embraced by decision makers, who often must be convinced £ through persuasion that the change is worth pursuing. This means that the change f;>-_ agent must understand the motives and reasoning of the target system in order ■zl; to Identify what incentives can be used to negotiate an agreement. lp. Skillful communication requires that the action system must carefully select its leadership from those persons who have the ability to persuade. Persons who jr. are seen as nonthreatenlng to the target system and who can articulate "the reasoning behind the planned change are particularly useful. For example, in a change effort, particular actors may be perceived as unreasonable, as trouble-;.f. makers, or as chronic complainers by members of the controlling system. It is i-r not in the best interest of the client system for those persons to be the only V spokespeople for the change. Clients themselves can also be powerful spokes-iy persons, providing information and a viewpoint that persuades people of the I,;' need for change. @-; Framing the problem statement to make it more palatable to target system \'l members is a persuasive techniques This requires the ability to think as the target jp. thinks. For example, a social worker hired as a long-term care ombudsperson was working closely with a coalition of advocates for nursing-home reform to end abuse in long-term care facilities. Nursing-home administrators were very h upset over the nursing-home reform coalition and perceived them as not 'p understanding the difficulties with which they coped on a daily basis. They £j' sincerely wanted to provide quality care, but were frustrated by staff who were Si not properly trained to work with geriatric populations. By framing the problem ;£7 as a training problem designed to better prepare employees and reduce turnover, p-, the ombudsperson was able to persuade administrators to cooperate .with the action system. When the ombudsperson met with the local nursing home association, she acknowledged that she was aware that the administrators wanted pr to operate high-quality facilities. She also noted that recent studies revealed that ff high staff turnover rates often contributed to lack of continuity and lower patient care, sometimes leading to abuse. She explained that she and her colleagues would ^ be willing to develop training for nurses aides because they interacted most intimately with patients, yet were most vulnerable to high turnover. Essentially, jp; one of the contributing factors leading to abuse was being addressed, but it was %f( framed as reducing an administrative nightmare—high staff turnover, it; Cooptatlon is defined as minimizing anticipated opposition by absorbing or V-r including members'of the target-system in the action system. Once target system %: members are part of the planned change effort, it is likely that they will assume ;f|.; some ownership of the change process. Persuasion is used to coopt new persons ||; into the action system. This is valuable to the success of the change effort because Jr' It is important to include persons who are viewed as powerful by the target system, if-' These persons may be relatively neutral and may have little interest in obstructing |i£ the change effort. However, if they can be convinced to support the change effort (or even to allow their names to be used in publicity), their participation may 254 MACRO CHANGE sway others who respect their opinions. Cooptation is most effective as a tactic when opponents or neutral parties can be helped to recognize a self-interest in the proposed change. Cooptation can be formal or informal. Coopting individuals is called informal cooptation, whereas cooptingorganized groups is referred to as formal coaptation. Formal cooptation means that an entire group agrees to support a cause. Because their governing structure agrees that the change effort is worthwhile, the group may issue a statement to that effect. This formalizes the commitment, even though there are always members of any group who may, as individuals, disagree with the proposed change! Formal cooptation of a number of groups leads to-coalition building. A coalition is a loosely woven, ad hoc association of constituent groups, each of whose primary identification is outside the coalition (Haynes & Mlckelson 1986). For example, the purpose of the National Health Care Campaign Is to provide health care coverage to all American citizens. This change effort brings together hundreds of orgar:zations such as the National Association of Social "Workers and the American Public Health Association. On a state by state basis, health care campaign chapters are forming. Interested change agents have encouraged local groups to join in the efforts—forming a. coalition dedicated to the stated goal. The diversity of the coalition contributes to a powerful alliance of individuals and-groups,, that vasctllate between collaboration and campaign tactics as they attempt'to address health care needs. Lobbying is a form of persuasion that addresses policy change under the domain of the controlling system. The action system will have to determine if it is necessary to change agency policy, to amend current legislation or to develop new legislation in .order to .achieve their goal. Haynes and Mickelson (1986) delineate three essential concepts for social work/lobbyists to consider. First, one should always be factual and honest. Trying to second guess or stretching the facts to support one's position Is devastating to one's professional reputation as well as to the change effort's credibility. Second, any presentation should be straightforward and supported by the available data. The problem identification and analysis process discussed in Chapter 8 will assist the change agent In organizing the rationale for change. Third, any discussion should include the two - critical concerns of decision makers—cost and social impact of what is proposed. If the cost is high, the social worker is advised to calculate the costs of allowing the identified problem to remain unresolved. Mass Media Appeal. Mass media appeal refers to the development and release of newsworthy stories to-the print and electronic media for the purpose of •influencing public opinion. This tactic-is used to pressure decision makers into a favorable-resolution to the identified problem. The expectation is that if the proposed change can be presented to the public in a positive way and decision makers' refusal to support the proposed change can be presented as obstructionist or somehow negative, then decision makers will feel pressured to change.their position. Where decision makers are high-profile people like elected representees who depend on a positive public perception, this can be an effective tactic. Use $' 1D / SELECTING APPROPRIATE TACTICS 255 t |. of mass media depends on news reporters' agreement that the proposed change jr. is a newsworthy story, and assurance that one's cause will be presented accurately & Use of any media must always include consideration of clients' rights to privacy, f • £ Contest ■ii ' . . ■ ■ " ' |; Under the heading of contest we include the use of bargaining and negotiating, |- the use of large group or community action, or class action lawsuits. Large groups •|;. in community action can be further divided into legal and illegal tactics. Contest ii. tactics are used in situations where: (1) the target system cannot be persuaded I ■ by the action system, (2) the target system refuses to communicate witii the action ifi system, or (3) it is perceived that only lipservice is being given to the proposed |i change. Co.ntest tactics mean that the change effort becomes an open, public conflict as attempts are made to draw broad support and/or to pressure or even iii: force the target system into supporting or at least accepting the change. Once J1; this occurs, the action system must be prepared to face open confrontation and 'k to escalate its coercive techniques." Conflict is inevitable in social work practice. There will be times in the T experience of every macro practitioner when incredible resistance is encountered ({J. in addressing the needs of oppressed population groups. Social work as a fr profession developed in response to a basic societal conflict—the persistent j; anatagonism over individualism and the common good. Conflicts, over the rights of various population groups have spawned violent confrontations rooted in basic j value systems and beliefs. We believe that physical violence and terriorism can i not be condoned in any change efforts in a civilized society. Nonviolent con- j: frontation, however, including civil disobedience, is an option when there is a j, communication stalemate between the target and action systems. I Contest tactics will require widespread commitment and possible participa- |: tion from members of the support system. It is critical to the success of these ] tactics that the support system and its subsystems—initiator, client, and change % agent—are comfortable with contest tactics because there are risks that are not I present when using collaboration and campaign tactics. It is likely that the time j and energy necessary fór effective change will increase and relationships can I become disrupted. When collaborative and campaign tactics are employed, tactics I can move toward contest. However, once contest tactics are employed it is not ■| likely that one can return to collaborative or campaign tactics. Without a clear \ understanding of what contest tactics involve and without full commitment from í the support system, contest tactics are not advised. "!-'- 1 Bargaining and Negotiation. Bargaining and negotiation refer to those J. situations in which the action and target system confront one another with the |: reasons for their opposition. Bargaining and negotiation occur when there is a • recognized power differential between parties and a compromise needs to be made. These tactics are more formalized thanpersuasion, often involving a third- j~ party mediator. Members of the target system will typically agree to negotiate i when the following factors are in place: (1) there is some understanding of the 256 MACRO CHANGE 10 / SELECTING APPROPRIATE TACTICS 257 intentions and preferred outcomes of.the,action system, (2) there is a degree of urgency, (3) the relative importance and scope of the proposed change Is known, (4) there are resources that facilitate the exercise of power, and (5) they perceive the action system as having some legitimacy. In order to negotiate, both the action and the target systems must perceive that each has something, the other wants, otherwise there is no reason to come together (Brager et al. 1987). Bargaining and negotiation can result in a win-win situation, where both target and action systems are pleased wltii and fully support the outcome. The result can be a win-lose where one system is clearly die victor, or a lose-lose where both systems give something up and ate disappointed in the results. large Group or Community Action.. Large group or community action refers to die preparing, training, and organizing of large numbers of people who are willing to form a pressure group and advocate for change through various forms of such collective action as picketing, disruption of meetings, sit-ins, boycotting, and other pressure tactics. Peaceful demonstrations.are legal activities, often used by both groups at either extreme of an issue, to express their views. Civil disobedience activities intentionally, bfeak the law. When action system members deliberately engage in illegal activities, diey must be ready to accept the consequences of their actions. The change agent Is responsible for malting potential participants fully aware of these, risks before the decision is made to proceed. Class Action Lawsuits. Class action lawsuits refer to those Instances where an entity is sued for a perceived violation of the law and it is expected that the finding of the court will apply to an entire class of people. These tactics are often used with highly vulnerable populations such as the chronically mentally ill, the homeless, or children, where it Is unlikely that they, have the capacity or the resources to protect their own rights. Public interest.law organizations.may be resources'for the action system In developing class action tactics. Considerations in Selecting Tactics A few salient considerations need to be weighed in selecting the best tactic or mix of tactics. These considerations include: 1. What are the current objectives of the change effort? 2. "What is the perception (by those promoting change) of the controlling and host systems? 3. "What is the perception (by those promoting change) of the role of the client sjistem? "4. "What resources are needed and available for each tactic? 5.; What are the ethical dilemmas inherent in the range of tactical choices? Objectives. Objectives often tend to evolve as the change process moves along, and a rc-examination prior to selection of tactics is in order. For example, with the problem of domestic violence, the condition may have been brought to public. awareness by the perceived need for additional emergency shelter space for battered women. However, as the problem is analyzed and better understood,' the objectives.may shift toward consciousness raising for all women in the-community who are perceived to be at risk of violence. Thus strategy and tactics would move from advocating for service provision to educating for empowerment. Since tactics can change as objectives change, it is worthwhile to make one last check to Insure that all are clear and in agreement on current objectives. The following questions can be used to guide the action system's re-examination of the change objectives. I. What are the stated objectives of this change effort? :.. 2. Given what has been learned in the change process thus far, do the stated t objectives need to be revised? 3. Which best describes the intent of the current objectives? a. to solve a substantive problem or provide a needed service ■ 1*.. b. to increase self-direction or self-control of the client system ] c. to influence decision makers ; d. to. change public opinion p e. to shift power f. to mandate action. 4. Do members of the action system have any concerns about the intent of the current objectives that require further discussion? The range of objectives and likely accompanying tactics are indicated in >i. Tab„le 10.2. TABLE 10.2 Relationship of Current Objectives to Tactics ">':; .i ' Relationship ' of Target and ¥ Current Objective Action System Possible Tactics 1. Salving a substantive problem; Collaborative Implementation through Joint action providing a needed service 2. Self-direcHon; self-control Collaborative Capacity building through participation and empowerment 3. Influencing decision makers In disagreement Education, and persuasion through but wlth'open cooplation, lobbying, etc. f communication ;'l -r1 4. Changing public opinion In disagreement Educalfon, persuasion, mass 1 but with open communication media appeal, Adversarial Large group or .community action t 5. Shifting power Adversarial Large group or community action 6. Mandating action Adversarial Class action lawsuit