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1 Program vs. Policy Walden University SOCW: 6351 Dr. Montrell Pryor

2 INTRODUCTION The field of social work is inherently intertwined with policy, as the interventions and outcomes of social workers are often shaped by the broader policy environment in which they operate (Camillapemberton Supporting social workers in 2021 ). In the case study of Joe, it highlights the complex interplay of federal, state, and local policies in shaping the social worker's ability to deliver services. He is a homeless individual who has been dually diagnosed with a dependence on prescription medications/opioids and major depressive disorder. Joe has also been incarcerated in the past for distributing drugs on his college campus. While some federal programs, like SNAP (food stamps), offered a safety net, others, like General Assistance and Medicaid, were inaccessible due to Joe's past conviction. This limited the social worker's resources and forced them to navigate a fragmented system of support with varying eligibility criteria. PROGRAMS The state policy excluding individuals with CDS convictions from General Assistance and Medicaid presented a significant challenge. The General Assistance program is a state program that provides cash benefits for food, clothing, shelter, and other essentials to adults ages 18 through 64, without minor dependents, who are temporarily disabled and who do not qualify for Social Security ( General assistance (GA 202 2023) ). This policy directly impacted the social worker's ability to address Joe's immediate needs for financial support and healthcare. Medicaid is a public health insurance program. It is free or low-cost health insurance for eligible low- income adults, children, pregnant women, elderly adults, and people with disabilities. It is the

3 largest health care program in the United States ( Maryland Department of Health Maryland Medicaid Administration ). Joe needed Medicaid to maintain his treatment at the Hope Center partial hospitalization program. Hope Center is the local community mental health center that operates a partial hospitalization program for clients with dual diagnoses (Walden, 2023), like Joe. The program provides intensive treatment services to help individuals manage their mental health conditions and substance use issues. Lastly, Narcotics Anonymous (NA) is a non-profit organization that provides peer support and recovery services for individuals struggling with substance use. Joe has an NA sponsor who provides him with guidance and support. Unable to rely on traditional benefits, the social worker explored alternative solutions, referring Joe to local programs like St. Dominic's New Direction Center and The Bridge Home (Walden, 2023). While the social worker primarily engaged with resources within the County Division of Social Services, they also considered and suggested resources from the community and Joe's existing support network. This demonstrates a holistic approach to assisting Joe in meeting his needs. The collaboration with Joe's mental health counselor was crucial in exploring options for maintaining his treatment without Medicaid. POLICIES Current state regulations deem individuals with a CDS distribution conviction is ineligible for GA benefits (Walden 2023). This policy prevented Joe from receiving GA assistance despite his need for housing and Medicaid. Federal regulations require states to provide Medicaid coverage to certain groups of individuals, including individuals with disabilities. This policy allowed Joe to remain eligible for Medicaid despite his CDS distribution conviction. Narcotics

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4 Anonymous (NA) itself is not directly driven by either federal or local policies. It operates as a non-profit, self-supporting organization with its own set of guidelines and principles. However, its existence and operation are influenced by various policies at both levels. For example, NA receives limited funding from the Substance Abuse and Mental Health Services Administration (SAMHSA), a federal agency. This funding supports initiatives like public awareness campaigns and training programs for volunteers. At the local level, local zoning laws may impact the availability of space for NA meetings and events. This policy may have influenced the availability of treatment options for Joe at the Hope Center. Local policy may dictate the availability and scope of substance use services in the community. This policy may have influenced the availability of support groups and treatment options for Joe through NA. IMPACT OF POLICIES The policies that I identified had a significant impact on the social worker's delivery of services to Joe. The state regulation excluding individuals with CDS convictions from General Assistance and Medicaid, the social worker's resources were limited. They could only offer Joe food stamps and a homeless shelter, which wouldn't fully address his needs. Federal regulations on Medicaid allowed Joe to remain eligible for Medicaid, which ensured that he had access to the healthcare services he needed. Local policies on mental health and substance use services may have influenced the availability and scope of treatment options for Joe. STATE OR LOCAL POLICY EXAMPLE

5 If Joe was being assisted in Washington, D.C. he would be recommended to apply to the Supplemental Security Income Program. Supplemental Security Income (SSI) is a federal monthly income benefit provided to individuals who are determined disabled by the Social Security Administration (SSA). Individuals, regardless of age, may be determined eligible for SSI payments ( Supplemental security income (SSI) program ). To be eligible for this program Joe must be 65 or older, have a disability, have limited income and be a U.S. citizen. This program can help Joe maintain income and take care of his basic needs. The Targeted Affordable Housing (TAH) program provides a permanent housing subsidy with case management (i.e. typically a quarterly check-in) to ensure housing stability. TAH is designed to assist individuals and families who are independent, but due to disability, age or other socio- economic factors require long-term subsidy to prevent homeless. Such individuals and families are appropriately engaged in community services and do not require intensive services to remain stably housed ( Targeted affordable housing for individuals and families 2022). Eligibility consists of being a resident of Washington, D.C. 1+ years of documented chronic homelessness, limited income earning potential and need for case management. This program can help Joe establish permanent housing and escape homelessness. AFFECT ON SERVICES Since Joe's mental health diagnosis may qualify him for disability benefits under the Americans with Disabilities Act (ADA) , a federal law, he has a chance of receiving SSI regardless of his past conviction. This is unlike General Assistance in the original case study, which excluded him due to state policy. SSI provides monthly income, addressing Joe's

6 immediate need for financial assistance. This income can help him cover basic necessities like food, housing, and healthcare, promoting stability and reducing his reliance on other resources. TAH provides permanent housing subsidies and case management ( Targeted affordable housing for individuals and families 2022), which can be crucial for Joe. This program addresses both his need for affordable housing and ongoing support to maintain stable housing. TAH eligibility requires documented chronic homelessness for at least one year. While Joe experienced homelessness, it's unclear if it meets this specific requirement. The social worker would need to assess Joe's situation and determine his eligibility.

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7 REFERENCES Camillapemberton. (2021, March 16). Supporting social workers in 2021 . Community Care. http://www.communitycare.co.uk/2021/03/16/supporting-social-workers-2021/ Document: The Case of Joe Download The Case of Joe (PDF) https://waldenu.instructure.com/courses/93262/pages/week-2-learning-resources? module_item_id=3194068 General assistance (GA) . GENERAL ASSISTANCE (GA). (n.d.). https://humanservices.hawaii.gov/bessd/ga/ Maryland Department of Health Maryland Medicaid Administration . Maryland.gov Enterprise Agency Template. (n.d.). https://health.maryland.gov/mmcp/pages/home.aspx Mental health parity . disb. (2022). https://disb.dc.gov/page/mental-health-parity Supplemental security income (SSI) program . Supplemental Security Income (SSI) Program. (n.d.). https://dhcf.dc.gov/service/supplemental-security-income-ssi-program Targeted affordable housing for individuals and families . dhs. (2022). https://dhs.dc.gov/page/targeted-affordable-housing-individuals-and-families

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