When the clients can choose: Dilemmas of street-level workers in choice-based social services

How does the increased use of choice-based management strategiesin social services influence the behavior of street-level workers? In this article, we provide an analytical framework for understanding street-level logic in choicebased environments. We then turn to the case of home-nursing care in Israel to examine how choice plays out in street-level workers’ day-to-day practices. By relying on 34 interviews with social workers working in home-care agencies, we illustrate how street-level workers’ jobs have expanded beyond implementing public policy to include the “new job” of recruiting and retaining clients. The article show show a choice-based environment gives higher priority to clients’ preferences, while at the same time these preferences are subordinated to the economic interest of the providers. It also demonstrates how market pressures may push street-level workers to develop new practices and coping strategies that go beyond, but often also counter to, formal policy.