Our faculty members are offering fresh innovations and inventions as they see the changes and challenges posed to social work and social work education in the 21st century. The following articles reveal creative ideas by three faculty members, and many of their colleagues are working on other pioneering initiatives.
In the first article, Assistant Professor Luke Shaefer proposes a way to fill the gap of oral health access. Assistant Professor Brian Perron then takes a look at emerging technology and considers how social work can take advantage of it and, moreover, can’t ignore it. In the final article, Professor Barry Checkoway considers how to prepare students for community practice in a segregated and diverse society.
Closing the oral health access gap in Michigan: Is there a role for a mid-level dental provider?
Nearly one-third of U.S. citizens lack access to basic preventive and primary oral care services. As a result of my research on public health insurance for children in the United States, I began researching how dental care might be made more accessible to more individuals.
One proposal for addressing these barriers to oral health care is the introduction of a “mid-level dental provider” (MDP, also referred to as an “alternative dental provider”) position within the dental field. MDPs are generally permitted to perform basic preventive and basic restorative dental procedures under the direct, indirect, or general supervision of a dentist, with the goal of extending access to care to underserved populations.
MDPs now practice in a variety of capacities in more than 50 countries, including Great Britain, New Zealand, Australia, and Canada. Alaska and Minnesota are the only two U.S. states that have approved MDPs (Alaskan MDPs are limited to serving Alaska’s native population living in remote areas of the state). However, policymakers in a number of other states are seriously considering MDP proposals. In fact, MDP legislation has recently been introduced in Washington State, New Mexico, Kansas, and Vermont.
In a recent report prepared for the W.K. Kellogg Foundation, Professor Burton Edelstein of Columbia University concluded that a majority of dental procedures could be delegated to properly trained MDPs. Implementation of MDPs within the U.S. dental team framework holds the potential not only to increase access to care, but also to create new jobs and allow dentists to devote more time to advanced oral procedures, which they are best trained to address.
One cause for the oral health access gap is that Medicaid’s (and other public insurance programs’) reimbursement rates for dental care are low across the United States, leading few providers to participate. Also, dental providers are unevenly distributed geographically. MDPs might be more likely to live in areas that currently have few dental providers, and they could provide much of underserved groups’ necessary care at a lower cost than dentists.
Thus, I have been talking with policymakers, interested groups, and individuals about the role an MDP might play in Michigan. I believe this proposal deserves serious consideration by state policymakers.
Since beginning this effort during the fall of 2010, I have met with representatives from the W.K. Kellogg Foundation (which has a long-standing interest in MDPs), the Michigan Dental Association (which has some concerns about the proposal), the Michigan Oral Health Coalition, the Michigan Dental Hygienists Association, and faculty from the Schools of Dentistry at the University of Michigan and the University of Detroit Mercy. I have also met with numerous groups outside of the oral health community and am finding that lack of access to oral health care seriously impacts many of the families that U-M SSW alumni and other social workers serve.
In February, I hosted a meeting at U-M SSW (with funds generously made available by the Nokomis Foundation) for groups and individuals interested in this issue. Over 30 people attended, representing over 25 organizations and government agencies. As a result of this interest, I have decided to partner with the Nokomis Foundation again to host a miniconference late this summer (date still to be determined) titled “Concrete Proposals for Closing the Oral Health Access Gap in Michigan.” This conference will allow for some vigorous discussion on the role that mid-level providers might play in Michigan, as well as explore some alternative concrete solutions for addressing the oral health gap in the state.
—Luke Shaefer is assistant professor of social work.
All facts are drawn from: Shaefer, H. L., & Miller, M. (accepted, pending revisions). Mid-level dental practitioners: A policy proposal for improving access to oral health care services among underserved populations in the U.S. Journal of Health Care for the Poor and Underserved.
Why Social Workers should use Information and Communication Technologies
There is little doubt that technological advancements in information and communication technologies (ICTs) are leading to sweeping changes in societies across the planet. Facebook has more than 600 million members, while 4.6 billion people use mobile phones. Microsoft, Wikipedia, iPhone, Google, and Blackberry are household words. ICTs are truly revolutionizing social, political, and economic processes worldwide and hold significant promise to do the same for social work practice and education, particularly when closely aligned with social work ethics.
ICTs allow us to communicate through a wide range of tools, including email, SMS text messaging, cloud computing, and video chat. Hardware, such as laptops and smart phones, has given users of ICT tremendous flexibility in where and how they work. Information can now move across the planet virtually at light speed. Although ICTs and the growth of the Internet are not without problems, both will undoubtedly continue to shape social work education and the global community.
A variety of professions recognizes the importance of ICTs and considers them to be a key part of professional development. By contrast, the attention that the field of social work has given to ICTs in research, education, and practice does not match the efforts of other national and international organizations that view ICTs as critical to improving the lives of disadvantaged and disenfranchised persons. Still, some movement toward active recognition and integration of ICTs has occurred in social work. The Association of Social Work Boards and the National Association of Social Workers (NASW) have published a set of 10 standards regarding technology and social work practice as a guide for the profession’s incorporation of technology into its various missions. Similarly, the Council on Social Work Education has made calls for the integration of computer technology into social work education, but there are no explicit standards for integration or student learning.
We believe that ICTs are of critical importance to advancing the field of social work. Specifically, they provide efficient and effective ways to organize people and ideas, offer greater access to knowledge and education, and increase efficiency, flexibility, and collaboration in our work. Moreover, many aspects of the NASW Code of Ethics can be advanced through careful and thoughtful application of ICTs. Thus competencies and literacy with ICTs should be required learning outcomes in social work education and continuing education.
How can social workers align the burgeoning field of ICTs with social work values? Because of the truly overwhelming range of applications of ICTs, social workers can readily adapt such technology to complement many of social work’s core values. For instance, workers could be trained in relevant aspects of information security with ICTs to ensure client confidentiality when using electronic records. Social workers are also expected to make reasonable efforts to provide services even when clients have difficulties traveling to an office. ICTs can provide a range of options for clients who are difficult to reach. Similarly, ICTs such as email, conference calls, and distance education pave the way for workers to seek the advice and counsel of colleagues when necessary, advocate for clients within and outside of agencies, and seek continuing education and staff development, all vital social work values. Social workers are also expected to read and critically examine emerging knowledge in social work, another task made easier with ICTs. These are but a few examples of the ways in which ICTs can readily improve client care and outcomes.
The fields of social work education, research, and practice are surrounded by rapid development in ICTs. In order to ensure that social work practice upholds the standards and values of social work ethics, it is vital that social workers are competent and literate with ICTs. This will enable social workers at all levels of practice to help advance the lives of disenfranchised and disadvantaged persons through greater access to education, knowledge, and other resources.
—Brian Perron is assistant professor of social work.
This piece is adapted for Ongoing by former SSW doctoral student Chris Jarman from: Perron, B. E., Taylor, H. O., Glass, J., & Margerum-Leys, J. (2010). Information and communication technologies in social work. Advances in Social Work, 11(1), 67-81.
Strengthening Diversity
Many metropolitan areas (e.g., Chicago, New York, Jerusalem, Johannesburg) are changing in their racial and ethnic population patterns. Whereas once it was common to view these areas as “segregated,” today they are becoming “segregated and diverse.” As they do, how should we think about “challenging injustice,” “strengthening diversity,” and “creating change”?
For example, metropolitan Detroit is among the nation’s most segregated metropolitan areas according to the 2010 Census, but there also is diversity. The city is 80 percent African American and suburbs are 85 percent White, but there are smaller suburban areas that are increasing in people of African, Asian, Middle Eastern, and Latin American descent.
Young people in metropolitan Detroit are aware of segregation and its injustices. They want to reach out to and connect with those who are different from themselves, but because they attend segregated schools in segregated communities, they are limited in doing so.
In response, a team of faculty members has established Youth Dialogues on Race and Ethnicity in Metropolitan Detroit, a program that brings together young people of African, Asian, White European, Middle Eastern, and Latin American descent.
We work closely with several community collaborators, including Arab Community Center for Economic and Social Services, Alternatives for Girls, Youthville Detroit, Farmington Public Schools, Latin Americans for Social and Economic Development, Michigan Neighborhood Partnership, Peoples’ Community Services, Rosedale Park Baptist Church, and Southfield Community Foundation.
Young people participate in intergroup dialogues and establish new relationships with others across segregated boundaries, often for the first time. They join together for metropolitan tours, campus retreats, and community action projects of their own design. They develop courses in schools, conduct town meetings, and make presentations to city councils. At this writing, they are preparing to deliver 3,000 petitions, calling for changes in educational policies, to public officials in Lansing.
The youth participants also have written a book about growing up in segregation, presented a theater performance in school assemblies and community centers based on their stories, and participated in a PBS television series based on the Youth Dialogues program.
Our faculty and students work together in this program. Faculty members direct the program and incorporate its content into courses (such as a new course on Youth Empowerment), evaluate its effects, and publish the findings. MSW students are program planners and youth organizers through their field placements. PhD students participate too, and a dissertation is on the way.
This program is unique but only one of several school initiatives in metropolitan Detroit. Should “segregation and diversity” affect how we prepare students for professional practice, and, if so, how?
Towards a New Community Practice
With support from Dean Laura Lein, faculty members—Laura Lein, Larry Gant, Lorraine Gutierrez, Katie Richards-Schuster, Mike Spencer, and I—have formed a Community Organization Learning Community to discuss questions like these and some of the educational issues they raise. For example, we have:
- Expressed a goal of preparing students to strengthen “social justice” and “community change” for “diverse democracy,” all concepts that we know are fundamental and contested.
- Reviewed our core competencies in terms of culturally competent and intercultural methods to mobilize around issues, organize action groups, plan local programs, and develop community-based services.
- Established a Community Scholars Program as a signature program placing students with community agencies in Detroit neighborhoods and other areas nationwide—for example, the Mississippi Delta, Central Appalachia, and the San Francisco Bay Area.
- Encouraged faculty members to take intellectual leadership of community organization as a field of practice and subject of study. We are planning a national conference and a series of cuttingedge publications.
- Strengthened our partnerships in Detroit, Flint, and other cities through joint projects that build community capacity and contribute to our core educational mission.
- Created a Saturday Academy offering half-day and whole-day workshops on new practice skills in communities nationwide.
What About You?
What should a social work school do to prepare students for community practice in a society that is becoming more segregated and more diverse?
Questions like this are important to us, as social work educators and as stewards of the oldest and largest community organizations program in graduate education. We respect our tradition and appreciate its high standards.
But we also know that the future will be different from the past and will raise new questions for which there are no single answers. You, our alumni and friends, have experience and expertise, and we hope that you will share what you think. What do you think?
—Barry Checkoway is professor of social work and professor of urban and regional planning