The challenges of health care reform for hospital social work in the United States.

This article examines the potential impact of the Patient Protection and Affordable Care Act (ACA) of 2010 on the practice of hospital social work in the United States and its implications for social work education and training. It briefly traces the history of hospital social work, outlines some contemporary issues in the health care field, particularly those that create persistent health disparities, summarizes the major provisions of the Act that have implications for social work practice, and discusses how social workers in hospital settings might respond effectively to the changes produced by the legislation.

Competitive allies: rural nurses' and social workers' perceptions of the social work role in the hospital setting.

The domain of social work in healthcare has not been clear, nor exclusive. Recently the social worker's role in hospital, particularly in rural hospitals, has been impacted by economic imperatives and legislative mandates. This article discusses the results of a study of rural hospital nurses' and social workers' perceptions of the domain of the medical social worker. Analyses of the profession identified as being best qualified to perform 15 generic hospital social service tasks revealed areas of clarity and collaboration. Implications include expanding the role and skills of medical social workers to include multi-systemic interventions and multi-disciplinary collaboration.

Advance directives: development, opposition, and criticism.

Since the PSDA became law on December 1, all Medicare and Medicaid health care providers are required to develop policies and procedures to comply with the law. The principles of autonomy and distributive justice are basic to the Act, and the social worker's vital role will continue to develop as the law is implemented.

The legal clinic: helping social workers master the legal environment in health care.

The social environment for all is becoming increasingly legalized. This fact is evidenced in the extensive entitlement regulations and ethical decision-making processes surrounding health care consumers and professional providers. The authors of this paper describe a program designed to educate social workers in an acute care hospital to the legal issues and considerations that influence decision-making and interventions in social work practice. The purpose of the paper is two-fold: to highlight the program planning process in establishing and institutionalizing a Legal Clinic for social work, and secondly to stress the significance of legal content in the knowledge base of social workers in health care settings.

Assessing the foreseeable risks in discharge planning: the challenge of discharging the brain-injured patient.

Hospital discharge planning is a challenging and complex task, which becomes increasingly difficult when the patient has suffered brain injury or cognitive impairment. The social worker is often in the conflicting roles of trying to serve the best interests of the patient as well as serving the institution in the discharge planning process. This paper is intended to be a practical guide to examine the issues involved in discharge planning from the perspective of the hospital's duties, with consideration being given to the potential risks to the patient.

Legal problems and principles in discharge planning: implications for social work.

While not immutable, legal principles are among the more sturdy and commanding guides of our professional behavior toward patients. By protecting privacy and autonomy inherent in the Patients Bill of Rights, legal principles shore up what is vulnerable and fearful in the patient's approach to making sense out of their plight.