Timoteo's Statment of Intent

In thinking, keep to the simple.

In conflict, be fair and generous.

In governing, don’t try to control.

In work, do what you enjoy.

In family life, be completely present.

~ Tao Te Ching

The purpose of this statement is to briefly introduce myself as both a macro social worker and social scientist; as well, to offer those reasons why I believe that I am an exceptional candidate for admittance to the University of Denver, Graduate School of Social Work PhD program. It is my intention to conduct research on social work management with a focus on capacity-building strategies in the field of HIV prevention that 1) strengthens organizational infrastructure for HIV prevention; 2) develop and adapt individual, group and community level interventions specific for Latino HIV prevention and; 3) strengthen community access points and increase utilization of HIV prevention services. The dearth of epidemiologic, behavioral, social science, evaluation, and particularly, intervention research focusing on HIV prevention, care and treatment needs of Latino, especially Latino men who have sex with men, is disconcerting. Ultimately, the aim of my research is to contribute to the elimination of racial and ethnic health disparities and to improve the health of all Americans.

Modern society has become increasing complex in the United States, resulting in notable stress on the psychological well being of its citizens[1]. My own development was shaped in a historical context filled with foreign and domestic crises, a threat of nuclear annihilation and ecological devastation, military conflict, terrorism, and an ongoing war on drugs that has led to a deterioration of privacy. I have witnessed tremendous social change including a sexual revolution, the civil rights movement, massive protests and rapid advancement in technology. I have experienced the change of our postwar economy giving way to globalization. As a child, I could not appreciate how this historical backdrop would color my development. At the time, I centered on surviving physical, emotional, psychological, and spiritual trauma[2] as well as being born into the pressures that accompany economic hardship^[3]. Applying for this PhD program is not just an academic exercise for me; it is a commitment to see quality of life raised for those born in the lower echelons of power. Therefore, in this statement of intent, I will cover how my experiences define my expectations and aspirations and how I plan to achieve the challenging goal to earn a Doctorate of Philosophy in Social Work.

I am a fourth generation Mexican-American, who self-identifies as Chicano. Like many Chicanos, I dropped out of high school when I was in the eleventh grade. Among Hispanic subcultures, Mexican-Americans have the highest percentage (32.1%) of people with less than a ninth grade education, compared to other Hispanic subpopulations. We also have the lowest proportion of high school graduates, (50.6%) with an even lower number who receive an associate (4%) or bachelor’s (7.6%), consequently only two percent have master’s degrees, and barley one percent have either professional or doctorate[4]. The Denver Public School System did a poor job preparing me for life; I am deaf in my left ear resulting in central auditory processing disorder which was never diagnosed. I was seen as a poor student and was still in remedial courses when I left school to work and help my family make ends meet. Beginning at the age of twelve, I worked forty hours a week during the summer and part-time during the school year doing manual labor. I quickly realized that I was doomed to low pay and a broken back if I did not find another way to earn my livelihood. My military service offered the opportunity to build confidence and discipline. Against the odds, I earned my high school diploma and eventually found my way into a community college, where I was committed to my studies. Eventually I transferred to Fort Lewis College (FLC) where I completed my undergraduate work with honors in psychology and a double minor in sociology and philosophy. While at FLC, I recognized what I learned in the class room I concurrently applied in my extra curricular activates, which included my election to the Student Senate and vice presidency of the then Gay Lesbian Bisexual Transgender club. What I enjoyed most was tutoring for the Program for Academic Advancement, helping students become independent learners, with a short term goal to improve the student’s grades. It was a matter of time before I discovered that my experience and education made me exceptionally qualified to serve in my community as a social worker.

Graduate School: Boston College

My formal education continued at Boston College, founded by the Society of Jesus in 1863, one of twenty-eight Jesuit colleges and universities in the United States. The Graduate School of Social Work provides an innovative curriculum that is sharply focused to meet the needs of a changing society, and remains an international leader in shaping the education of professional Social Workers. I successfully participated in a rigorous training program in Community Organizing Policy Planning & Administration (COPPA). Our faculty of gifted practitioners, skilled researchers and excellent teachers equipped me with the knowledge and skills necessary for planning, implementing, and managing human services through participatory strategies that involve individuals, groups, and organizations. I was fortunate to study with the chair of our department professor Demetrius S. Iatridis, an expert in privatization, social development, critical theory, and social policy[5]. Another special mention would be assistant professor Marcie Pitt-Catsouphes who is exceptional in program planning and evaluation, community, work and family issues. But it was Professor Vincent J. Lynch who teaches the course Social Work Response to the AIDS Epidemic and coordinates the Annual National Conference on Social Work and HIV/AIDS, founded in 1988, that helped me organize my research and give it new direction.

Field placement offered me intensive "hands on" opportunities to develop my professional social work identity. My first year was with The Home for Little Wanders, a nationally renowned, private, non-profit child and family service agency providing services to more than 10,000 children and families each year through 30 different programs. While I was working as a milieu counselor in a residential program, I arranged for my first year field placement to simultaneously take place with the executive team as they prepared for an audit by the Council of Accreditation a year after the merger with Boston Children's Services (BCS) and The New England Home for Little Wanderers (NEHLW). In this position, I was able to examine the relationship between executive management who provides the organizational structure that sets the parameters in which front-line staff provides direct services. It is my hypothesis that quality of care will suffer when management establishes an administration that promotes a provider driven model as opposed to one that is client driven. Under a provider driven model, clients are known by the system and acted on in ways that meet the needs of the provider as opposed to seeing clients as subjects who know and act in their own best interest. Instead of collaborating with clients to develop their strengths, the provider sees problems to be identified and pathology to be managed. Consequently, they set up a system of pariah care that is financially driven as opposed to increasing autonomy and resilience of their clients.

In my thirty plus years of working in nonprofit agencies, as a volunteer or front-line staff person, it has been my experience that few agencies could successfully manage a sustainable organization that also provides quality service. Family Service Association of Greater Fall River is one of those few agencies, which is where I served in my second year field placement. Under the leadership of Donald J. Emond, ACSW, LICSW who is the President and Chief Executive Officer since 1963, the agency has demonstrated their commitment to provide a wide array of high quality programs and services designed to strengthen and support individuals and families and to address the social service needs of a very diverse and changing community. Mr. Emond made it possible for me to enjoy a rich experience that allowed me to take risks and learn about organizational structure and the business of providing counseling and care programs that services more than 17,000 persons a year. During my internship I was given full access to the agency including their client file management and financial administration systems. As part of my learning contract I organized a continuing education diversity training program that brought in local experts to present information on a wide range of topics that included Cambodian and Portuguese culture, public housing, poverty, the sandwich generation, demographic changes, post traumatic counseling and my presentation on the Diversity of the Latino Community. I was the executive team’s facilitator during their strategic planning session and wrote a paper on succession leadership^[6]. I was also the project manager for two different assignments. The first project was the development of a grant to the Massachusetts Workforce Training Fund designed to increase the number of certified nursing assists. The other project was the quality assurance evaluation of Adult Family Care, which is a program designed for people who do not need the continuous 24-hour skilled care of a nursing home or other institutions. It is for those who would rather reside with another individual or family. I will always hold a special place in my heart for Mr. Emond, who showed me acceptances, positive regard and sincere interest in my professional development.

While attending Boston College it was always my intention to return and practice macro social work here in Colorado. As part of my effort to create social change, I noticed that social work management is largely unrecognized as a significant force in shaping the social programs of our time^[7]. Yet, we perform a vital role in developing, implementing, managing, and evaluating social programs^[8]. It is commonplace today to hear social work managers describe their environment as turbulent both in the ecological and institutional components^[9]. That is, the availability and distribution of tangible resources as well as the normative framework for legitimizing social service, which are changing rapidly and will continue to do so well into this new century. I believe that these changes amount to nothing less than a paradigm shift in the expectations placed on social work managers for a greater and wider range of management skills and competencies^[10].

There are five active forces in our environment which are perpetuating these changes. First, the industry is grappling with an overall decrease in the availability of resources while the demand for service increases. The gradual decline of funds from the federal government since the early 1980s exacerbates this imbalance between supply and demand. Second, social problems are becoming more complex and intractable, making them more difficult to remedy with current social service technologies. As the gap between the rich and the poor continues to widen, these social problems will become more pronounced. Third, the emphasis on accountability for demonstrating the relationship between services and outcomes (both cost, and quality) is increasing. The ability to show cost-effectiveness of services will be critical to sustaining future funding. Forth, advanced social and information technologies to address the forces have yet to be mobilized. It may already be too late to overcome the lag in technological acumen^[11]. To be successful in this environment will be no small challenge, the demands of leadership today require a great deal of skill in balancing the demands from different stakeholders including, investors, customers, employee’s communities and government agencies. This will require an innovative approach to the many demands of leadership and organizational development.

PRACTICAL APPLICATION

My work at Southern Colorado AIDS Project has reinforced the belief that we can no long rely on paraprofessionals to serve as case managers, high-level professional case management services are needed, and research supports the value of professional intervention that effectively integrate clinical and environmental approaches requiring Master’s or Doctoral level education and advance training in interpersonal relations and psychopathology. Individuals with bachelor’s degree may successfully perform case management role if supported and supervised by a highly trained clinician or direct service delivery specialist with a master’s degree.[12] While many case management programs currently ask for little more than a bachelor’s degree this typically limits their authority, credibility and increases the demand for closer supervision.[13] Given the complexity of the case management role, higher levels of education should lead to better services and greater ability to deal with complex fragmented service delivery systems.[14] Then we can be assured that case management will carry out the duties that include: assessing the needs of the patient and family; identifying resources; assisting patient in obtaining network services; coordinate care; negotiate savings for patients and clients; assess appropriateness and medical necessity of care; investigate and develop alternatives; coordinate discharge planning; assist the patient in understanding their condition; assist patient/family in appropriate medical care decisions; represent the client, as a qualified and objective third party; assess quality of care; provide network assistance; provide physician advisor assistance; participate in nationwide coverage and on-site visits.

I applied the principals of the case management model in my capacity-building effort as the HIV/AIDS Regional Resource Coordinator, but instead of serving individuals, my client load was made up of more than thirty different community-based organizations (CBO) across a six state region. In the context of my work with the Regional Resource Network I provided technical assistance in a variety of areas from program development and evolution to community mobilization, marketing and leadership growth, all designed to increase the ability of CBO’s to provide higher quality of care for minority clients. Capacity building is one of the most fashionable, yet least understood terms in the nonprofit sector today. The working definition I applied when referring to capacity-building, meant the development, fostering and support of resources and relationships for HIV/AIDS prevention at individual, organizational, inter-organizational and systems levels. The contemporary view of capacity-building goes beyond the conventional perception of training. The central concerns of management – to manage change, to resolve conflict, to manage institutional pluralism, to enhance coordination, to foster communication, and to ensure that data and information are shared - require a broad and holistic view of capacity development. One of the key requirements in this regard is to recognize that the social whole is more than the sum of its individual components.

AIDS is a difficult topic for policy making and capacity building activates because HIV primarily affect socially disdained groups of people and is associated with sexual- and drug-related behavior, special health policy formation regarding it is intensely political. Nowhere was this more evident then in the review of the scientific literature. It was discovered that research lags far behind the reality of the impact of HIV disease on African American, Asian/Island Pacific, Native Americans and Latino populations. Despite rhetoric about the changing face of AIDS, if the literature is assumed to represent attention to newly and highly affected population, development of culturally responsive services is exceedingly slow. Despite considerable discussion in AIDS service organizations about the particular needs of lesbian and gay HIV-infected people of color, there was not an extensive qualitative or quantitative body of research about those needs in social work, psychology, counseling, sociology, sexology, minority and multicultural studies, social policy, public health and medicine, or health and AIDS education. With out robust, rational research it will be difficult to influence policy makers and advocate for the necessary funding to adequately counter the transmission of HIV in minority communities.

The HIV/AIDS epidemic among Latinos in the United Sates is as complicated as Latinos are diverse. While race and ethnicity alone are not risk factors of HIV infection there are underlining social and economic conditions that may increase the risk of infection in communities of color. Disease prevalence and health outcomes are shaped by factors of social inequality. Race, class and experience of homophobia powerfully shape and organize sexual activity and sexual risk in the lives of men and women of color. Another major obstacle in understanding the impact of social discrimination on health is that most public health models of preventable disease - as well as the majority of public funded prevention programs and practice - continue to locate the source of health risks within the realm of individual behavior. In the case of sexual transmission of HIV, for example, misbehavior is seen to results from deficits in individuals’ level of information and knowledge, in their misguided assessments of risk, in their perceptions of personal vulnerability, or in their ultimate lack of motivation or lack of personal intention to practice safer sex. It is vital to challenge the assumptions of such models of individual risk by locating “risk" within the social context of groups and communities whose disease vulnerability is intrinsically linked to a history of sexual and racial discrimination and poverty.

SCOPE OF RESEARCH

As a social scientist, one that balances theoretical knowledge with the wisdom of experience, my unorthodox techniques clearly emphasize that I am not a traditional student. My approach is rooted in critical social science, which offers an alternative to positivism and interpretive social science. Thus, I am in agreement with Kincheloe and McLaren who stated that the goal of research is to empower.

“Critical research can be best understood in the context of the empowerment of individuals. Inquiry that aspires to the name critical must be connected to an attempt to confront the injustice of a particular society or sphere within the society. Research thus becomes a transformative endeavor unembarrassed by the label ‘political’ and unafraid to consummate a relationship with an emancipatory consciousness.”[15]

I see this model built on the foundation that people do not passively discover reality instead we actively use language to construct a conception of what is “real” through social interaction^[16]. It is my intention to conduct research that builds on the recommendations provided by the National Alliance of State and Territorial AIDS Directors^[17] in addressing HIV/AIDS policy including:

1. Work to improve access to prevention, care and the treatment services for Latinos regardless of their immigration or citizen’s status. Create, fund, and sustain services tailored to monolingual Spanish speaking and migrant/immigrant Latinos without regard to citizenship status. Create and support HIV prevention and care services to Latinos in and transition from correctional settings.

a. Support basic HIV/AIDS education efforts targeting Latinos. Information about HIV/AIDS including modes of exposure, strategies for preventing HIV infection, the natural history of the disease, the importance of early detection and early treatment, and current treatment approach should be broadly disseminated and constantly updated that is specific to local service areas.

b. Create public information and awareness campaigns that educate Latinos about their rights and entitlements as well as the availability and location of services locally.

c. Build and support local community-based capacity, especially with regard to a cross referral system that established a Latino AIDS health network with other wrap-around social services.

d. Establish and uphold higher standards for culturally competent care and support culturally competent training.

2. Research strategies that develop and support Latino leadership and mentorship programs.

a. Acknowledge and seek out the contributions and council of Latino leaders regarding critical public health issues and decision’s affecting Latino communities.

b. Developed Latino leadership and expertise inside of health departments at the state and local levels, within community-based agencies, faith-based community as well as informal leaders and local heroes.

c. Build and support advocacy capacity in Latino communities on policy issues.

3. Contribute to research on Capacity-Building and Social Work Management for the applied field of practice in HIV/AIDS Prevention among minority populations by focusing on four key capacity building strategies:

a. Strengthen organizational infrastructure for HIV Prevention;

b. Strengthen behavior interventions for HIV Prevention;

c. Strengthen Community Access points and

d. Increase utilization of HIV Prevention Services.

EDUCATIONAL & PROFESSIONAL DEVELOPMENT

Someone once told me, “When it’s time to go for your PhD, don’t try to be a superstar; select a manageable research project, get the piece of paper and get the hell out!” While I have no illusion that I will ever be an academic superstar, anyone who knows me well, knows that I never take the easy way. I have struggled long and hard for this opportunity and while I ache that it was in my nature to conform and submit, it is my constant struggle against the unjust use of authority that fuels my passion. As both a professional social worker and a critical social scientist I know that I am uniquely qualified to contribute to research in HIV prevention among people of color. What I need, to be accepted by a strong confident and capable mentor, who will guide my learning and help me to help my community counter the horrific threat of HIV. Because I see and experience the effects of the systems I attempt to study, I have a difficult time isolating variables and objectifying my subject. I have a knack for seeing complexity and interrelatedness where others see borders. In this program, I hope to learn how to develop a manageable research project and the “how to” of getting published; as well to use those skills to build a career in research and teaching.

CLOSING STATMENT

Johann Wolfgang von Goethe reminds us that “Thinking is easy, acting is difficult, and to put one's thoughts into action is the most difficult thing in the world.” Given the opportunity, I know that I will be an outstanding student in your program, and will represent Denver University in a proud and professional manner that exemplifies the outstanding education your Graduate School of Social Work has to offer. In the role of activist and social critic I hope to influence the shift from exclusively intraspychic to social ecological models of problems; and an exploration of new models of service deliver with an emphasis on prevention, collaboration, use of indigenous resources, cultural diversity and empowerment. As a social interventionist my goal will be to limit deviance; to resolve social conflict; to facilitate knowledge and enhance skills; to ameliorate psychological problems; to prevent and treat illness; and to promote cultural, spiritual and intellectual life. Please allow me to learn the necessary skills required to share my research with colleagues and contribute to a growing body of knowledge but more important to transmit the information directly to the people, to give them the necessary skills to meet the demands of a rapidly changing society and in essence return POWER TO THE PEOPLE!

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[1] Cushman, P (1990) Why the Self is Empty: Toward a Historically Situated Psychology American Psychologist 45, 5 599-611

[2] Herman, J. (1997) Trauma and Recovery: The aftermath of violence – from domestic abuse to political terror. Basic Books; New York

[3] Sennett R. & Cobb, J. (1972) The Hidden Injuries of Class W. W. Norton & Company New York NY

[4] Ramirez, R. R. & de la Cruz, G. P. (Issued June 2003) The Hispanic Population in the United States: March 2002 U. S. Census Department www.census.gov/prod/2003pubs/p20-545.pdf

[5] Iatridis, D. (1994) Social Policy: Institutional Context of Social Development and Human Services. Brooks/Cole Publishing Company. Pacific Grove, CA

[6] Dyck, B. Mauws, M. Starke, F. A., Mischke, G. (2002) Passing the baton the importance of sequence, timing, technique and communication in executive succession. Journal of Business Venturing. 17 pp. 143-162.

[7] Patti, R., Poertner, J., & Rapp, C. A. (Eds.) (1988) Managing for service effectiveness in social welfare organizations. New York: Haworth

[8] Austin, M. J. (1981) Supervisory management for the human services. Englewood, Cliffs, NJ: Prentice Hall.

[9] Hasenfeld, Y. (Ed.). (1992) Human services as complex organizations. Newbury Park, CA: Sage.

[10] Menefee, D. T., & Thompson, J. J. (1994) Identifying and comparing competencies for social work management: A practice driven approach. Administration in Social Work, 18(3), 1-25

[11] Patti, R. J. (2000) The handbook of Social Welfare Management Thousand Oaks, CA: Sage Publications, Inc.

[12] Weil, M. & Karls, , J. M. & associates (Eds.), 1985). Case management and human service practice. San Francisco:Jossey-Bass

[13] Raiff, N. R. & Shore, B. K. (1993) Advanced case management: New strategies for the nineties. Newbury Park, CA: Sage.

[14] Haw, m. A. (1995). State-of-the-art education for case management in long-term care. Journal of Case Management, 4(3), 85-94.

[15] Zkincheloe, J. L. and McLaren, P. L. (1994) Rethinking critical theory and qualitative research. In Handbook of Qualitative Research, edited by N. Denzin and Y. Lincoln, pp. 138-157. Thousand Oaks, Ca: Sage

[16] Searle, J. R. (1995) The Construction of Social Reality The Free Press New York, NY

[17] Ayala, G. (No Date) Addressing HIV/AIDS…Latino Perspectives and Policy Recommendations. National Alliance of State and Territorial AIDS Directors available at http://www.nastad.org/pdf/latinodoc.pdf