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3. Neoliberalism at Work: Contemporary Scenarios of Governmental Reforms in Public Health and Social Work
- Temple University Press
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3 Neoliberalism at Work Contemporary Scenarios of Governmental Reforms in Public Health and Social Work S even months into my fieldwork in 1998, the CHA program began to receive federal welfare reform monies for operating support. As the health center began to take part in the nationwide reallocation of resources aimed at moving welfare recipients into the “world of work,” this new phase brought many changes to the CHA program, which had been in operation less than a year before it received this new grant. The Access Enterprise, as the county’s Welfare-to-Work (WtW) project was called, made CHA coordinators subject to new regimes of accountability. Funding requirements specified many features of the CHA program that had previously been left up to the agencies’ discretion, including the target population, what constituted “training ,” program duration, and other key features. WtW instituted new relationships with other agencies and changes in hierarchies of relationship among agencies. As each CHA program coordinator tried to position their CHAs to receive the maximum possible benefits from WtW (and there were some, if not many), they were accountable to a new model of “helping” based more in the logic of verification and enforcement (Cruikshank 1999; Bane and Ellwood 1994) than in community empowerment. While earlier welfare policies allowed more flexibility and discretion for case managers to determine their clients’ needs and issue resources, the logic of verification required caseworkers to generate paper trails in order to be able to defend their decisions in the face of the always-eventual audit (Power 1994; Carlen 2008). Finally, and most significantly, a new population, the so-called hardest-to-serve, was constituted and specified as appropriate (indeed, the only) candidates to be CHAs. New mechanisms of accounting tracked the progress of these “hardest to serve” welfare recipients through the CHA training and program , ideally culminating in their placement into full-time permanent employment. The WtW grant funded most of the original partners on the CHA project (TCHC, Helping the Black Family, and El Pueblo, all under the umbrella of Healthy Communities, Inc. [HCI]), but also introduced new “collaborators” in the citywide initiative. In 1998, the city of Thornton disbursed approximately $2.4 million in federal welfare reform funds to local agencies through a request for proposals. WtW in Alistair County was governed through a complex series of contracts and subcontracts flowing from the state through ever-smaller, more privatized units. WtW essentially amounted to an elaborate job training program, albeit one in which clients are “empowered” in part through the language of consumerism. Calling clients consumers, for example, supposedly returns the power of choice to those traditionally constructed as dependent on the state. Correspondingly, the point of sale is the company or organization that employs the welfare recipient. The Job Training Unit, a county agency already well funded to provide a range of job training programs, was the main contractor for the WtW program.1 The Job Training Unit then subcontracted with HCI, the umbrella agency for the CHA program. HCI’s partner agencies and sub-subcontractors—TCHC, Helping the Black Family, and the Brighton Square Community Health Coalition—were responsible for the day-to-day management of women on welfare. Staff members of these agencies felt that a qualitative change had taken place with the advent of WtW funding in the nature and meaning of their work. This chapter sketches the broad outlines of changes in government that help explain why an empowerment-based program such as the CHA program would apply for and receive WtW funds. After first tracing the contours of the new populations (the so-called hardest-to-serve and those merely “at risk” of welfare dependency) constructed by WtW, I explore a set of concepts that served as focal points for two different approaches to governing the poor. The concepts of empowerment, self-sufficiency, and participation were mobilized by both the WtW approach and the earlier community health approach to the CHA program, with at times divergent meanings and powerful consequences. In the analysis that follows, 1. In Massachusetts, WtW created a new bureaucracy parallel to the state’s own welfare offices. As part of politicians’ promises to “end welfare as we know it,” WtW was not administered through states’ existing public aid offices but rather through private industry councils (PICs), which distributed WtW funds through contracts and subcontracts with vendors such as HCI. Additional WtW case managers were funded at PICs as a supplement to existing caseworkers employed by the state welfare...