Introduction
The mantra of an aging American society is pervasive. As a society, however, we have failed to prepare for these vast demographic changes, particularly with regard to preparing an elder competent workforce or developing a comprehensive and systematic approach for providing coordinated health care and social services across the 30-odd years of older adulthood, for which many Americans can now expect to live.
The facts are simple: life expectancy in the US in 2001 increased to 79.8 for women and 74.4 for men - a jump of almost 10 more years of life since 1960. Strikingly, Americans who succeed at reaching age 65 can expect to live an additional 18 years, and if they reach 85, they are likely to live another 6.5 years! (Federal Agency on Aging-related Statistics, 2004). With increased longevity, the result of many factors such as improved public health and medical care, older adults may live many independent and productive years beyond their retirement from remunerative employment. Indeed, the recognized distinctions between "young-old" (65-74), "old" (75-84) and "old-old" (85+) signal an understanding that the needs of older (i.e. retired) individuals are not uniform. Today's older adults live with medical conditions-such as heart disease, hypertension, and cancer-that would have been fatal just a generation ago. Indeed, over 57% of Medicare recipients have 5 or more chronic conditions (CMS).
All this is true now. And, the oldest of the baby boom cohort are about to turn 65. The trends described above are predicted to be magnified as large groups of baby boomers age, retire and live longer than any previous generation. How can we prepare for this when the American health and service delivery systems are characterized as fragmented and "numbingly complex"?
The Social Work Leadership Institute (SWLI), at the New York Academy of Medicine, believes that professional social workers, with their legacy of community organization and casework, should be key players in planning for the future. The Census Bureau projects that demand for social workers will outstrip supply, especially social workers trained to serve the elderly. The Practicum Partnership Program (PPP), funded by the John A. Hartford Foundation and led by SWLI, addresses one facet of this need by developing incentives for students to become specialists in the field of aging. It is recognized, however, that this and other social work initiatives cannot be sustained merely by keeping pace with the need. A group of national experts in aging and social work education, representing leadership across the social work profession, formed the National Leadership Coalition to recruit, retain, and sustain social work professional who elect aging as their expertise.
Social Work Leadership Institute, New York Academy of Medicine
The Social Work Leadership Institute (SWLI) at NYAM was established to ensure that older adults have an opportunity to stay in charge of their own lives by training and advocating for an elder-competent social work labor force. The Institute cultivates leaders in the field of social work and acts as a central agent in enhancing multidisciplinary partnerships to succeed. The first SWLI initiative, the Practicum Partnership Program (PPP), is a national educational initiative to enhance field practicum experiences tied more closely with didactic coursework, in master's level schools of social work. The PPP is composed of five essential components: university-community partnerships, competency-driven education, integrated rotations across multiple populations and disciplines, expanded roles for field instructors, and especially, focused recruitment of students to the field of aging. The SWLI provides oversight, selection, training and technical assistance to PPP sites to insure long term sustainability. From 2000-2004, the PPP was pilot-tested in six sites across the country (11 MSW programs and over 100 community agencies), and demonstrated positive results for students and schools alike. For example, the PPP cultivated relationships between universities and local aging organizations, with the number of aging field placements increasing to 43% at these sites. In addition, over 400 social work leaders with aging expertise have been trained in PPP sites, with nearly eighty percent of PPP graduates working in the field of aging one to two years out of school. Because of these successes, the John A. Hartford Foundation continues to partner with SWLI at NYAM and is now funding 60 graduate social work programs to adopt PPP's for MSW programs over the next eight years. The aim is to continuously support increasing numbers of graduate students who specialize in aging, and develop new sites for aging-related fieldwork to become a permanent foundation of social work education.
SWLI's other major initiative is known as the Center for Aging Policy (CAP). The Center, a collaborative effort with NYAM's Department of Health Policy, aims to build upon the work of the NLC, by advancing public policy initiatives that support health and social services for older adults and recruit and retain a qualified elder-competent workforce. Among its key objectives, CAP is developing a long range policy agenda - to be adopted by relevant national and regional organizations— that ensures that the social work profession becomes an integral player in meeting the needs of our aging population. The Center is the repository of two informational clearinghouses that serve the social work community, and consumers, as it crafts successful policy initiatives. The first clearinghouse includes a searchable database on public policies and programs at the national on state levels, as well as information in emerging policies relevant to CAP's mission. The second clearinghouse focuses upon the available evidence on social work practices and intervention that are demonstrated effective. This "evidence-based" clearinghouse includes a searchable database for uncovering pertinent scholarly and grey literature information on effective care for older adults. Together the public policy and evidence-based clearinghouses create a foundation for the development of comprehensive and targeted communication plans for consumers, practitioners and policy-makers, pursing initiatives that serve social workers and their aging clients, an important vehicle for policy change. Funded through Atlantic Philanthropies, the CAP's activities are intended to help promote the social work profession into the policy arena.
Additional SWLI projects include a partnership with NASW's Center for Workforce Studies and the development of an online training course on geriatric social work competencies. SWLI also collaborates with NADD to foster leadership development and trainings.
Future
Sustainability is critical for the long-term success of any public policy or educational initiative, and SWLI is cognitive of the challenges to individual schools and service programs in maintaining momentum in accomplishing its goals. Creating a cadre of committed social work leaders is one element in mounting a rigorous and successful campaign for strengthening the profession. SWLI is dedicated to creating this critical mass of social work leaders for change at the organizational, local and national levels.
