week 8 milestone

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A Public Opinion and Policy Advocacy: Hospital Patient Dumping on Skid Row.

Social Problem

The social problem chosen is hospital patient dumping in the streets of Skid Row in Los Angeles where homeless individuals, particularly elderly and cognitively challenged people, are discharged from the hospital without safe post-hospital services. One such instance was of Carol Ann Reyes, a 62-year-old dementia patient who was left alone on a hospital sidewalk wearing a hospital gown (Jansson, 2008). This practice has a focus that is not on human dignity, but on institutional cost cutting.

The Impact of Public Opinion on the Political Strategies.

The extent to which patient dumping shapes public opinion influences politics' reactions to the issue. If there's enough outrage in the public, then legislators will be pressured to act in response to media attention in cases such as Reyes. At the same time, attitudes among the general public toward homelessness are negative, enabling politicians to respond with symbolic rather than structural changes (Rome & Hoechstetter, 2010). As Jansson (2008) points out, strategic reframing or reimagining patient dumping as a civil rights issue of EMTALA and not a problem with hospitals can help turn public opinion and force continued legislative action (Padgett et al., 2015). The more Skid Row is viewed as a racial justice issue, the more political accountability is increased, as people who live in Skid Row are disproportionately Black and Latino.

Policy Advocacy Approaches and Skills

Reframing, building coalitions and working legislatively are fundamental to good advocacy. A reframing of the problem in terms of patient rights and systemic racism expands the public base of support (Jansson, 2008). Coalition with legal aid programs, healthcare advocates, and community groups helps to increase political pressure (Rome & Hoechstetter, 2010). According Padgett et al. (2015), advocating for evidence-based policy briefs to lawmakers such as the one recommending mandatory discharge planning by social workers and referrals to transitional housing provided by Medicaid puts advocacy into policy action.

Social Justice Implications

This advocacy strategy is human rights and equity focused. Patient dumping is a symptom of classism, racism and the criminalization of poverty. Advocacy rooted in "non-abandonment" and "self-determination," two NASW values, will seek to combat systemic devaluation of unhoused people and to ensure that hospitals carry out their ethical and legal duty to all patients, including those without a place to sleep (National Association of Social Workers, 2021). Advocacy will be based on NASW Code of Ethics values of non-abandonment and self-determination and will seek to challenge systemic devaluation of unhoused people, and will call on hospitals to fulfill their ethical and legal obligations to all patients, including those who lack a place to sleep.

References

Jansson, B. S. (2008). Becoming an effective policy advocate. Thompson..

National Association of Social Workers. (2021). Code of Ethics. Socialworkers.org; National Association of Social Workers. https://www.socialworkers.org/about/ethics/code-of-ethics

Padgett, D., Henwood, B., & Tsemberis, S. (2015). Housing First. Housing First: Ending Homelessness, Transforming Systems, and Changing Lives. https://doi.org/10.1093/acprof:oso/9780199989805.001.0001

Rome, S., & Hoechstetter, S. (2010). Social Work and Civic Engagement: The Political Participation of Professional Social Workers. The Journal of Sociology & Social Welfare, 37(3). https://scholarworks.wmich.edu/jssw/vol37/iss3/7/