Ethics Alive! Money, Money, Money
by Allan Barsky, JD, MSW, PhD
When we think of money, we may envision dollars and cents. However, money includes more than bills and coins. Broadly speaking, money refers to any medium for exchange. When we buy something, we give the vendor or service provider money in exchange for the goods or services. In social work practice, clients may pay for services in various ways, for instance, through private health insurance, Medicare, Medicaid, or fee-for-service. Fee-for-service may be paid via cash, check, credit card, or digital transfers. In this article, we explore the ethics of using various means of exchange for social work services. You may be familiar with traditional forms of payment, but how familiar are you with the use of digital money or cryptocurrencies to pay for social work services?
What the Code Says
The National Association of Social Workers (NASW, 2021) Code of Ethics says relatively little about payment for services. Standard 1.13(a) says that social workers should ensure that fees are “fair, reasonable, and commensurate with the services performed.” It also says that workers should consider “the client’s ability to pay.” Standard 1.13(b) strongly discourages bartering for services because of the potential for conflicts of interest, exploitation, and boundary confusion. For instance, if I ask a client to clean my office in exchange for providing counseling services, the client may feel exploited or disrespected. If I am not happy with the client’s cleaning services, this could negatively affect our client-social worker relationship. Standard 1.13(b) permits bartering in limited circumstances—when it can be demonstrated that such arrangements are an accepted practice among professionals in the local community, considered to be essential for the provision of services, negotiated without coercion, and entered into at the client’s initiative and with the client’s informed consent.
When social workers do engage in bartering for services, they accept full responsibility for demonstrating that the arrangement will not be harmful to the client.
Cash Only
In terms of fee-for-service, the simplest form of payment is cash. When clients pay in cash, the social workers (or administrative staff) should provide them with a receipt to document that payment was received. Workers should also document payments in the organization’s accounting records.
From a client’s perspective, one advantage of cash is that there is a very limited paper trail or digital trail that they have received social work services. If they do not want their family, financial institutions, or others to know, they can simply hide or destroy the receipt. In addition, some clients may not have access to checking accounts, credit cards, or other forms of payment. For instance, they may not have a sufficient credit rating to obtain a credit card. Alternatively, they may want to avoid credit cards as a result of prior experiences with overspending and debt. Within some cultures, there may also be skepticism about keeping money in banks or other financial institutions.
One of the biggest downsides of cash transactions is security. Neither clients nor social workers may want to carry large sums of cash in case it is stolen or lost. Within social work organizations, it may also be easier to keep track of payments when they are made through checks, credit cards, bank transfers, or other means that provide automatic third-party documentation. Although some people have predicted that we are moving to a cashless society, cash continues to be an accepted form of payment.
Charge It
Credit card payments provide certain benefits to both clients and service providers. For clients, they do not need to have large sums of cash. Also, if they do not have ready funds available, they can charge social work fees to a credit card and have extra time to pay outstanding balances. Of course, when charges come due, clients may face high rates of interest and penalties for late payments.
For social workers, credit cards often make it easier to collect fees. Some organizations keep credit card numbers on file and charge clients as services are provided. This also saves time for social workers and their administrative staff.
In terms of confidentiality, financial organizations operate under relatively strict privacy protection laws. When clients share credit cards with spouses or intimate partners, they should be aware that any fees for social work services will appear on credit card statements.
From the social work provider’s perspective, one of the key downsides of credit card payment is the fee charged by credit card companies (typically 1.5 to 3.5% of the transaction amount). Some workers or agencies may encourage clients to use checks, debit cards, or other forms of transactions to avoid paying credit card fees. However, social workers should consider client self-determination, including the client’s preferred form of payment and how different payment forms incur different benefits, risks, or costs for the client. Some clients may prefer credit cards because they can obtain perks, such as points for travel or gifts.
Digital Payments
In addition to cash or credit cards, clients, workers, and their organizations may consider digital payment or digital transfer systems, such as PayPal, Facebook Money, Zelle, Venmo, Google Money, or TransferWise. One advantage of these systems is that both clients and service providers may be able to avoid transfer fees or credit card charges from their financial institutions (Leonhard, 2016).
When deciding whether or not to use such options, however, social workers and clients should consider potential risks. For instance, are these transfers as secure as payments made through other means? If a client wants to dispute a credit card charge, for instance, the client may contact the credit card company to investigate the dispute. If there has been an error in a credit card charge, the credit card company can reverse the charge. With some digital transfer programs, financial institutions take no responsibility for payments made in error. Although some digital transfers are free, others may incur extra charges.
Further, it is important for service providers and clients to understand whether their transactions are secure. Unauthorized access to accounts could lead to breaches of confidentiality, as well as fraudulent withdrawals or transfers. Some digital transfer systems were originally developed to facilitate transfers between friends or family members (peer-to-peer payments) and not for commercial payments (including payments for health and social services). As these systems continue to evolve, they may develop even better security and ease of use for commercial purposes.
Cryptocurrencies
Cryptocurrencies are digital forms of money independent from the traditional forms of paper and coin currency issued by most countries. The prefix crypto means secret or hidden. Examples of cryptocurrencies include Bitcoin, Etherium, and Tether.
To ensure secure transfer and storage, cryptocurrencies use a shared ledger technology called blockchain. Blockchain ensures that all transactions are transparent to the transferor and transferee. No information is hidden from them. Because there is no financial institution acting as the intermediary for transactions, transfers can be made in a secure manner without transaction fees by third party providers. Whereas financial institutions such as banks and credit card companies are highly regulated, cryptocurrencies are developed without government regulation or oversight.
One of the main risks involved in cryptocurrencies is that the values can fluctuate widely. Although some people have earned large profits as certain cryptocurrencies appreciated in value, others have lost significant wealth. Further, if the owners of a cryptocurrency lose their password, they may be unable to access their money. Note to self: Keep my cryptocurrency password in a safe place.
So, what does cryptocurrency have to do with social work? It is possible for clients to pay for their services through cryptocurrencies. Both the client and social worker (or the worker’s organization) would need to have the same type of cryptocurrency account. The client could simply transfer funds as a digital transaction. Such transactions could be made confidentially, making it difficult for others (including the Internal Revenue Service and courts) to track them.
Currently, it is unlikely that cryptocurrency is commonly used to pay for social work, health, or mental health services. I say unlikely because I was not able to find research on this matter, other than research that talks about the more common uses of cryptocurrency. Some people are using cryptocurrencies for investment purposes. Some use cryptocurrencies for large purchases across international borders. Because each cryptocurrency has its own value across the globe, buyers and vendors in different countries do not have to worry about exchange rates. Some people use cryptocurrencies to engage in illegal or questionable financial dealings (e.g., laundering money from trafficking). However, we should not assume that the primary uses of cryptocurrencies are unlawful or morally suspect.
Futurist Ethics
Although using cryptocurrencies to pay for social work services currently seems uncommon, we should pay attention to possible future uses. Futurist ethics suggests that we should not only consider ethical issues that we are currently facing, but also ethical issues that could arise in the future (Nissen, 2020). As social workers, it is important to understand digital payments and cryptocurrencies as they continue to develop. They could offer greater protections for ourselves and our clients, as well as greater efficiency in our transactions with clients.
They could also raise ethical issues in terms of professional and legal accountability. If financial transactions cannot be traced, then how can clients raise concerns about a social worker’s financial improprieties with licensing bodies, professional associations, or courts?
Cryptocurrencies also raise concerns about technological justice. To use cryptocurrencies, people require access to computers or similar devices. They also require technological and financial literacy. Even financial experts have difficulty predicting whether particular cryptocurrencies will rise or fall in value.
By having a greater understanding of cryptocurrencies, we can be part of the conversation about how they develop, how they are used, and how they are regulated (if at all). We can also be a voice for vulnerable groups in society to ensure that they are not excluded or disenfranchised as new forms of technology to facilitate financial transactions continue to develop. If we simply wait until these new technologies arise, it may be too late to influence development for the good of society and the people we serve.
As the saying goes, “The future is now.”
References
Leonhard, G. (2016). Technology vs. humanity: The coming clash between man and machine. Fast Future Publishing.
National Association of Social Workers. (2021). Code of ethics. https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English
Nissen, L. (2020). Social work education and practice in post-normal times: Using futures thinking to move the field and the world forward. Council on Social Work Education (Conference Presentation). https://drive.google.com/file/d/1eQh-27DnRdce4HrziMw_otN-XIQsRwzG/view
Allan Barsky, PhD, JD, MSW, is Professor of Social Work at Florida Atlantic University and author of Social Work Values and Ethics (Oxford University Press).
The views expressed in this article do not necessarily represent the views of any of the organizations to which the author is affiliated, or the views of The New Social Worker magazine or White Hat Communications.