Angela Waltz is finding answers to some of her questions at the La Follette School.
The second-year public affairs student enrolled at the University of Wisconsin–Madison in 2005 and started work on a doctorate in social work. "I came to the School of Social Work with questions I wanted to answer related to my professional administrative work with older adults," Waltz says.
Waltz liked the practical component of the social work program. "I wanted to do something that was not just academic, I wanted to stay involved in the field," she says. The combination of community and field-based work was a good fit.
Then, when she was interning at a nursing home, she began to encounter policy issues that were affecting her clients. "Public policy wasn't working for them," Waltz says. "I started to want to know why, to learn more about public policy and how it relates to managing programs and dealing with clients."
When Waltz sat down to put together her preliminary exam for her doctorate, she realized the La Follette School's curriculum would help her explore her topic, how facilities for older adults can promote the philosophy of assisted living and still keep residents safe. "While writing my three-part paper for my prelim, I found I was trying to focus on individuals and realized that I really wanted to look at administrative issues," she says. "I had already been considering the La Follette program because I needed more exposure to management issues and policies, and in this case, the MPA program and my dissertation topic go hand in hand."
"The goal of assisted living is to promote residents' autonomy and choice and to facilitate their ability to age in place," Waltz says, "but finding the right balance between the need to ensure both autonomy and safety can be challenging for licensed facilities as residents become frailer and depend more on the organization for care. So, although facilities strive to honor resident autonomy, they are also obligated, from a regulatory perspective, to provide a certain level of protection and care for residents."
One answer, Waltz says, has been "negotiated risk agreements," a fairly new tool that some states require. When residents want to do something that presents a potential risk and is of concern to the care provider, such as refusing to use equipment that could prevent a fall or ignoring a physician-prescribed diet, the resident and facility staff collaborate to reach written agreements in which residents acknowledge they understand they are taking risks and accept the potential negative consequences of their choices. "The concern with this new tool," Waltz says, "is that facilities use the agreements appropriately, to provide residents with the least restrictive environment rather than as an attempt to waive liability for the provision of inadequate care."
Rather than taking a few public affairs courses as part of her social work curriculum, Waltz decided to apply and complete the entire Master of Public Affairs program and postpone her preliminary exam. As a project assistant, she is working on the School of Social Work's reaccreditation application. She also conducts an ongoing outcomes survey used to understand student and field supervisor perceptions of student preparedness for social work practice. The School of Social Work uses these data to identify program strengths and inform its ongoing improvement plan.
The public affairs courses have shown Waltz new ways of looking at administrative challenges. "The economic perspective on policies, the complexities involved in making decisions, on where to best focus resources, has been eye-opening," Waltz says.
Waltz appreciates how accessible the La Follette School faculty are. "Also, the atmosphere of the school promotes student collaboration, which really improves the learning process," she says. "I think it is wonderful to have a cohort that is really cohesive. We are all going through the same experiences at the same time at La Follette. I feel that I am being asked for so much, and I put a lot of effort into it because I am expected to be proficient, because of those high expectations. It's great. It's hard. I love it."