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Article

Financial Management  

Roger A. Lohmann

The management of finances in human service organizations has undergone a quiet revolution in the past three decades. This has included a complete and coordinated theory and practice of accounting, a still-incomplete theory and evolving set of practices in budgeting, and the accumulation of an expanding set of analytical tools and methods that reach well beyond what most human service organizations currently use. The new financial management paradigm is a model of the human service enterprise that is sufficiently robust and dynamic to encompass financial management practices in public, nonprofit, and private enterprises and to provide a platform for confronting privilege and challenging oppression.

Article

Privatization  

Andrew Dobelstein

Privatizing social services has taken a new turn as America enters the 21st century. Although it was once possible to separate private and public social services, the growing trend toward public–private partnerships has made such earlier distinctions meaningless since more and more private social services are supported with public money. There are advantages and disadvantages inherent in the mixing of public and private social services, but perhaps the greatest problem may be the support of a growing trend for all levels of government to dissociate themselves from their longstanding public social service responsibilities.

Article

Health Care Financing  

Candyce S. Berger

The U.S. health care system is a pluralistic, market-based approach that incorporates various public and private payers and providers. Passage of Medicare and Medicaid, combined with rapid advances in technology and an aging population, has contributed to rising health care costs that typically increase faster than general inflation. This entry will review health care financing, exploring where the money is spent, who pays for health care, what the reimbursement mechanisms for providers are, and some issues central to the discussion of reform of health care financing. To effectively advocate health care reform, social workers must understand health care financing.

Article

Contexts/Settings: Private/Independent Practice Settings  

Sandra A. Lopez

Private independent practice (known historically as private practice) is a growing segment of the social work profession. Social workers entering this context are providing a range of services, including clinical and nonclinical. Major considerations for establishing, maintaining, and marketing a successful and ethical private independent practice will be discussed. Existing tensions and challenges in the social work profession and in the field of social work education will be briefly examined. Future directions for private independent practice of social work will be explored.

Article

Corporate Settings  

David Stoesz and Catherine Born

For-profit health and human service corporations afford a range of employment opportunities for professional social workers, although organizational structures may not resemble those of nonprofit and government agencies, and these settings may present new professional challenges. Corporations have become prominent, in some cases dominant, providers in fields as disparate as hospital management and nursing home care, child and adult daycare, residential treatment, managed health care, welfare eligibility and job placement, child support, and corrections. For-profit expansion across the array of health and human services continues, which bodes well for social workers willing to consider corporations as a practice setting. Opponents of commercial human services worry that adverse client selection criteria may screen out the most troubled individuals and about possible corner-cutting in service delivery to meet fiscal targets. The general concern is that, in these firms, profit may trump program. Others strongly believe that the profit motive is simply incompatible with the human service mission. Proponents claim that benefits include management and cost efficiencies, nimbleness, ease and speed of innovation, and technological prowess. The emergence of new commercial entities such as benefit corporations that commit to creating social benefit, not just profit, are also touted. Arguments aside, the neoliberal social policy vector that emerged in the later decades of the 20th century encourages the outsourcing of public services. Thus, privatization in the form of corporate human services may continue to expand and almost certainly will continue to exert influence in health and human services policy, programming, and service delivery for the foreseeable future.

Article

Neoliberalism  

Jessica Toft

Neoliberalism is an international, transdisciplinary, and interdisciplinary concept with political, economic, and social dimensions. Neoliberalism is a governing rationality based on market logic that protects free markets by reducing business regulations, restricting citizen and resident welfare state protections, and increasing welfare state discipline. This entails three dimensions: First, neoliberalism consists of economic governing principles to benefit free markets both globally and domestically to the advantage of corporations and economic elites. Second, this includes concurrent state governing principles to limit welfare state protections and impose disciplinary governance so service users will be individually responsible and take up precarious work. A third component is neoliberal governmentality—the ways neoliberalism shapes society’s members through the state to govern themselves as compliant market actors. Neoliberalism is at its core a political reasoning, organizing society around principles of market rationality, from governance structure to social institutions to individual behavior in which individuals should behave as responsible and accountable market actors. Among its central tenets are that individuals should behave as independent responsible market actors; the social welfare state should be downsized and delegated to lower levels of government; and public welfare should be privatized, marketized, and commodified. While neoliberal policy design sets public provision parameters, its signature tool is to govern through state public administration. New public managerialism is a common example, as is managerialism more generally; they both borrow business management principles and apply them to the management of all aspects of social services. Because of its prescriptive nature, there is concern that neoliberalism dictates practice, threatening professional authority of social workers and challenging the implicit trust the public puts in professions. Writ large, there are concerns about democracy itself as neoliberalism works against the will of the people and collective responses to social problems. Resistance to neoliberalism is growing and early examples are provided.