Montgomery, Al – Alabama’s Department of Human Resources (DHR) was sued in federal court in 1988 over its treatment of disabled children. Twelve years later, advocates sued Tennessee over its child welfare system. Both lawsuits led to settlement agreements in 1991 and 2001 respectively.
Plaintiffs in the Alabama lawsuit, R.C. v. Fuller, had a reformist defendant they rather liked, Paul Vincent. He was the Child Welfare Director of the Alabama DHR. Vincent’s boss was Bill Fuller, DHR Commissioner and the official defendant in the lawsuit. Child Welfare was Vincent’s domain and it was a real mess. He knew it, disability advocates knew it, family court judges knew it, and families and their children certainly knew it.
“There was about a year of discovery. The state resisted settling for quite awhile and then on the eve of trial they settled the case,” Vincent said. He said he never spoke with the plaintiffs about Alabama’s dysfunctional system until after the state agreed to a consent decree.
Instead of going to trial both sides negotiated a settlement and the state agreed to abide by its terms even after the judge dismissed the case, which can take several years. In Alabama’s case it took 18.
“The case ran for nearly 20 years….and we are now more than 10 year past the conclusion,” said James Tucker, Director of the Alabama Disabilities Advocacy Project, one of the plaintiffs who originally brought the lawsuit.
In Alabama, caseloads were too high, caseworkers were poorly trained, children were placed too far from their families, and they didn’t get to visit with them much.
“We brought kids into care that with adequate home and community-based services could have stayed with their families and once kids got into care, they moved too often,” Vincent said.
Tennessee’s child welfare system was just as bad. Tennessee is still failing to address many of the same systemic problems that Alabama faced.
“They were often put in unnecessarily restrictive placements which could be a long distance from their home, and they stayed too long. And the care they got while they were in the system was often inadequate,” Vincent said. Ditto Tennessee. (See https://tntribune.com/another-child-dies-in-dcs-foster-care/)
“When the lawsuit was filed in 1988, the state was so under-resourced that good social workers couldn’t do good social work,” Tucker said. If they were better supported, they could do the work they were trained to do.
Tucker said that after the settlement more of an effort was made to engage families and meet them where they were and provide services where they were needed. Vincent’s insider’s account is similar.
“The entire structure of the agency decided the best thing to get it implemented and exit court supervision was to enthusiastically implement it. And we did,” Vincent said.
One main reason why Alabama has done better than Tennessee in reforming its child welfare system is because the guiding principles adopted in their separate settlement agreements were so different. (See Tennessee 2001, A Matter of Principles @ https://nccpr.org/state-local-and-international-reports-and-presentations/
Alabama focused on keeping families together. Returning children to their families when they were taken into foster care was the primary goal of the newly reformed system. It was etched into the agreement in a number of ways.
Tennessee’s principles, by contrast, contained no such language and focused more on the state’s primary authority to make decisions in the child’s best interest. Essentially, Tennessee’s principles opposed family reunification in favor of state control over children most of whom they have continued to put in foster homes. Many studies concluded that is a wrong-headed approach. (See https://tntribune.com/dcs-needs-a-major-overhaul/)
Vincent said Alabama’s counties were excited about the consent decree. “Because they were woefully understaffed, didn’t have enough services, had a lot of turnover because the job was impossible and unfulfilling, and they saw it as an opportunity to make the system work. There was very little resistance to it except among some group home providers,” he said.
Outside consultants helped Vincent change the department by focusing on keeping kids in their homes. They decided to implement the settlement in stages.
“We thought it was a win for us. The department didn’t have much money with which to implement the settlement. We couldn’t have reformed the system with any depth so it gave the state time to experiment with some new strategies and gave us the money we did have to enrich a small group of counties to some depth instead of trying to spread it around to 77 counties.”
It was a risky strategy because at first some counties got short shrift. A national consultant would come in once a month to coach and teach small groups of social workers how to work with families better.
Vincent credited the plaintiffs with coming up with that approach. It was less expensive overall and proved to be quite effective because they could test their ideas on a smaller scale before rolling them out across the entire state.
“Counties got a lot of flexible money which had never happened before. The state held all the purse strings and so the state pushed a lot of money down to them so they could execute some unique contracts to do a lot of creative things that came out of these team plans that weren’t present before and wrap around services to kids, as the saying goes.
When we began with the money we had we decided we couldn’t retrain the work force–which had to be done. There had to be a comprehensive change in the way they viewed families and they way they treated families with kids and a higher level of skill. So we decided to at least make the workforce we had competent. Creating a training curriculum to match the settlement is useless if all you do is train new hires which is what many states do.”
Tennessee is one of those states. It turns over its entire cadre of caseworkers every 5 years with dismal results. DCS is a terrible place to work so people don’t stay. (See https://tntribune.com/dcs-internal-affairs-covered-up-dozens-of-complaints/)
“We retrained everyone in this 4-week curriculum mainly about being a social worker, not a bunch of rules. And in my opinion our workers changed their values and improved their skills a lot, so they were good practitioners so they could make really effective use of flexible dollars. That was one big element of the reform,” Vincent said.
Within four years, all DHR staffers were trained and counties had some flexibility to tailor their operations and spend money on what was most important in their districts.
“The state had a model of practice which was consistent with that really works with families compared to what there was before,” Vincent said.
Early on Alabama capitalized on Medicaid to finance a lot of mental health services and that helped fund the changes until the legislature got behind the new system and supplemented its budget. Afterwards, Medicaid continued to help finance the reforms in the consent decree.
“We had a very cooperative Medicaid agency that was happy to revise the state plan so we used Medicaid dollars to finance a number of services that helped get kids out of congregate care and foster homes and return them to their birth families,” he said.
Vincent didn’t know if the new strategy would work or how how influential it would become. “But it proved to be effective enough and push the change deep enough so a lot of the key elements of the settlement survived the attacks on it when the foes of the reform came into power,” he said.
Reform Stalls in Alabama
Fob James was elected governor of Alabama in 1994. James was a Reagan Republican, hostile to big government, particularly the federal government, where DHS got much of its operating funds for its new approach to child welfare.
Tennessee Governor Bill Lee is cut from the same cloth. He has steadfastly refused to expand Medicaid and the state remains an outlier in health policy. His approval ratings recently dropped ten points.
“He appointed a foe of the reform who operated a group home so at that point a number of us left the department,” Vincent said.
James wasted no time in sabotaging the reform effort. The state filed a petition in 1994 to exit the settlement agreement. Tucker’s group, the Alabama Disabilities Advocacy Project, wanted it to continue and convinced Senior U.S. District Judge Ira DeMent to deny the petition. He did. The state tried twice more, unsuccessfully in 2005 and again in 2007 when DeMent dismissed the case.
In short, James couldn’t get rid of the settlement agreement so instead he did a lot of backsliding. “There was some dismantling of the reform which just prolonged the settlement longer than it otherwise would have been,” Vincent said.
“It comes back to the classic notion that children need to be served and be consistently supported and when children are being parented by the government that does not happen,” Tucker said.
According to Tucker, in recent years some positive changes have not been sustained like reducing the number of placements in foster care, reducing multiple movements while in foster care, and keeping sibling together. “Some of those have been lost,” he said.
Tucker credits that state for helping more children get adopted. “But that is different than individual plans for children and their birth families. Family engagement between a child who is at risk coming into the system and their birth family, that engagement has deteriorated,” Tucker said.
“So it’s been a mixed bag since the conclusion of the case. The focus on family engagement and lack of resources that was at the heart of our consent decree is no longer the same,” he said.
“We have filed a new lawsuit about a very specific piece of the foster care system,” Tucker said. The case involves the several hundred disabled children who are warehoused in 19 Psychiatric Residential Treatment Facilities in Alabama. The Alabama Disabilities Advocacy Project sued in federal U.S. District Court in May 2021.
Two of the four teenage plaintiffs are African American. They want to be placed in the community but DHS has kept them locked up for years. The complaint alleges these children are placed in “highly restrictive facilities that isolate them from their families, friends, and communities”. Plaintiffs allege this isolation and segregation violates the American with Disabilities Act.