Suing the hand that (doesn’t) feed them: Nonprofit organizations and human rights

Do you ever have the experience of finding that someone else has been thinking something along the very same lines that you have, and you get excited? And then you find out that they were kidding?

Um, me neither?

So here’s my basic idea: there’s this whole industry, the social service sector, that gains its legitimacy and, indeed, its very existence, on the backs of the people it serves, really. It may sound ugly to say that, but it’s true. People (foundations, governments, individual donors) give us money because of what we say we’re going to do on behalf of, and for, our clients.

And sometimes we do. And sometimes we don’t.

And so, I’ve wondered for a long time, what if clients could sue social service providers for failing to provide the services/benefits/impact that they promise, implicitly or explicitly, to both donors and the clients themselves?

Now, I know, an attorney reading this will immediately point out that there’s no ground for a suit…

but that’s my whole point.

When what we’re providing is charity, the message we’re essentially sending to our clients is that they’re lucky to get what they get, and, if they don’t get what they were supposed to (because we don’t have a really good theory of change, or our methods are outdated, or our workers aren’t well-trained, or we’re cutting corners to cut costs), then, well, “social work isn’t an exact science”, or something like that.

If we used a more rights-based approach, perhaps not in the touchy-feely human rights sense (because I think that there are some legitimate concerns about that, as raised in the posts linked above), then in a more contractual one, then there would be, at least, an implied right to legal redress.

Because, really, in a way, that’s what we have in the human service arena–a compact between service providers and funders and clients, where only the clients lack a right to legal action if they don’t receive what it is that they were promised.

Sure, they can (and should!) sue if there’s actual malfeasance, unethical behavior, or real harm.

But what about the ‘softer’ harm that is leveled against people every day, in many small ways? The programs that are poorly designed, and the ones that come with far too many restrictions and requirements for anyone to succeed; the inexperienced staff who were hired to save money, or because of nepotism; the bigotry that, while perhaps never crossing a legal line, permeates so many organizations; the squandered resources, the missed opportunities, the slowly lost dreams?

I, for one, would love to see a class action suit, or at least the threat of one, against social service organizations who, despite perhaps being well-intentioned, have, perhaps unconsciously, settled into a lull of believing that those same good intentions are sufficient. Who buy into the idea that they’re saving the world just by showing up. Who think that ‘good enough’ really is. I’d love to see real accountability mean not just answering to those who write the checks, but those against whose lives those checks are leveraged, those who make the whole enterprise possible. Those who would, in an ideal world, really call the shots.

And I am not kidding.

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25 responses to “Suing the hand that (doesn’t) feed them: Nonprofit organizations and human rights

  1. I believe the threat of a class action suit against these agencies would be warranted. I have worked in the social work sector for 7 years of my life. I have never, once, worked for an agency that had been able to back up the promises that they have to the people served. It does not matter what the population. I believe that a lot of the broken promises come from the state, however this does not excuse the problem. This is not only true of non-profit organizations. The state of Kansas has made broken promises to the population we serve on a greater level they like to call Kancare. The newest promise is eliminating the under-served list in the IDD sector. This sounds great but how they will do it? The agencies here in Wichita are at max capacity and many of those on the under-served list are waiting for residential placement. With smaller agencies folding under the weight of the recession, larger agencies are already full. Unfortunately, this promise looks like another broken one for out population and the state is setting themselves up for failure.

    • And, then, there can result a culture of promises that no one expects to be kept, which makes them not really promises at all, and erodes the accountability we all–clients, workers, organizations–have a right to expect. Is there a movement to take action around KanCare? What do you think should be done? What is the role for social work?

  2. It is very interesting that the though of a class action suit against social service agencies was raised because there are many social services agencies that do not do what they should when serving clients. However, I believe the chances of such a thing happening would be slim. A lot of the clients I work with fail to advocate for themselves when they suspect something is wrong and even when they know it is wrong, it tends to be easier for most to bypass those things because they have so many other stressors to worry about. For example, a lot of families have trouble with getting interpreter services at the hospital, so important information is missed because the hospital failed to provide proper services to serve that family. I have had many families complain about it, but have done nothing and do not plan to even make a complaint. I believe that the best thing we can do within social agencies ourselves it to make sure that we as individuals are doing the right thing to properly serve clients and be an example to others in the workplace. However if a class action suit is ever filled against some agencies, I believe it would be a rude awakening.

    • Great example about interpreters! One of the first things that I talk about with a lot of the organizations I work with is their grievance/appeals process, to make sure that clients know how to navigate their rights. And that also takes, I believe, empowering workers, so that they feel comfortable helping clients to advocate for themselves. Powerless social workers aren’t in a position to empower anyone!

      On Sun, Feb 23, 2014 at 12:47 PM, Classroom to Capitol wrote:

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  3. Wow, you made a really good point! To think that if we don’t actually give what we are supposed to give under the social expectations could lead to a law suit is kind of scary but I do think that we would be more likely to own up to these expectations. I work with the mental health organization and I really try to “make a difference” in the lives of those I serve but ultimately, they are responsible to either apply my recommendations or not so we document these efforts. I would say it is about 50% of the families that truly follow thru. This is partly do to what I call social acceptance of what they feel is the right way to parent their child. Some parents do not understand how to apply new concepts of discipline such as discarding punishment to rewarding positive behaviors. If the parents decided to sue for my negligence, I could produce the documentation that shows that I did recommend different courses of actions that were not followed through. Many of these parents want someone to “fix” their children but I really try to empower them to incorporate different strategies in parenting. This sometimes gives them a feeling of making their own changes instead of me providing services. Thank goodness that your suggestion is not truly doable at this time. There would be more court cases that would cost more money and time that could be devoted to helping those in need.

    • I think, actually, Mary, that building a system that provided greater redress for grievances would improve work in nonprofit agencies–for clients, who might have a better chance of getting their needs met if workers felt that clients had recourse if not, and for workers, too, who would, I think, feel empowered to be part of a truly accountable system. The challenge is getting there, which would require culture shifts so that workers’ interests aren’t seen as in opposition to clients, and so that it’s not framed as adversarial, this idea of holding organizations accountable for delivering the outcomes they intend (which, I believe, would also result in greater attention to the environmental contexts that interfere with that success).

  4. I think a class action suit would be appropriate for agencies that try and take the “easy way out”! When organizations low ball, many are effected by not following through with the full extent, especially, when it comes to agencies that serve others/clients. So sure, they should be held accountable. I know there is more involved than good intentions. Often times funding or some kind of reimbursement is received because nothing is free. However, there are better more effective ways to save money and valuable resources when it comes to our clients and their rights! This is a touchy situation but I do feel that if we teach our clients to advocate well enough for them, we could very well see some suits in the feature regarding these little things. I really enjoyed this blog as it gives perspective and enlightens us and make us more aware and accountable for EVERY step we take when working with clients and making sure we document thoroughly and do everything to the tee when it comes to protecting ourselves (those that work in a social services agency) and our license.

    • Thanks so much for your comment, Jennie! Yes, I think it’s intended to be thought-provoking, more than anything–certainly lawsuits aren’t THE answer, but I want to see us shift the paradigm, so that we’re not falling into the trap of assuming that our clients should be ‘grateful’ for whatever we’re able to provide them, but instead setting high standards for what we can accomplish together! I really appreciate your comments.

  5. This world has become sue crazy lately. It is the easy way out to sue someone and get money. I don’t feel that there should be law suits out there for this for the main reason that most in this field are truly trying to help those in need. However, if there is a pattern of a group of people continuing to receive money to come up with a better way than that is when we need to be more aware of who we are giving the money too. I think that you are right there is no black and white in this perspective. But there needs to be some point of accountability. The clients that need help usually don’t advocate for themselves as others mentioned and it is the most vulnerable ones. Sad to see this and I wish that there was a easy way to say this is the answer but there isn’t

    • Good points, Lisa–I wish that it always worked out, that those organizations that have the greatest promise do receive most of the resources–a sort of ‘natural selection’ for nonprofits, but that doesn’t seem to be the case, too often. What I’m interested in is making sure that vulnerable clients have the same access to the levers that would redress their grievances as those more privileged, and I am not sure of many other ways to do that, beyond the legal system. What do you think?

      On Fri, Apr 25, 2014 at 9:57 PM, Classroom to Capitol wrote:

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  6. I know that there should be some justification in the system and I am not sure what it is. I struggle in the area of advocacy and never thought that I would like being an advocate. However, with my practicum I have learned that there is times that people need help standing up for themselves. I know that I am not the strongest in this area and would not be one that would have a clue on where to start. But I do think that there should be some why to oversee what and how things are spent for these projects.

  7. I would love to see something like this happen. At least to light a fire somewhere. With more and more budget cuts to mental health, I feel like we are getting more income focused instead of outcome focused. As direct service workers, we feel the pressure from upper management to provide more services. If a client does not need that, we should not be providing it and I don’t. When I first started working there, we celebrated successes like when a client no longer needed services. Now if a child is coming off the waiver program, I feel a lot of frustration from upper management. Our clients are meant to get the services they get to help them, not for maintenance of a budget for an agency. The budget is important in us being able to survive as an agency, but being client centered should be our core. They are the reason that we are even there and do have the right to get the best services that we can offer. Agencies should be held accountable for what they are doing with clients and making sure that we are fulfilling our mission.

  8. Stephanie McGuire

    I think this would be a positive thing in the fact that these agencies would be held accountable when they aren’t accomplishing what they set out to do. I love what Sasha said about with budget cuts to mental health services, the agencies are getting more income focused instead of outcome focused. I completely agree, and I think this is such an injustice to the population and clients that we serve. I can see both sides of this though when it comes to funding and staffing. By reducing some unnecessary costs to avoid layoffs I think that is a positive thing. At the hospital I work at the weekly Brown Bag luncheons at the hospital used to include lunch for the community members that came. As budgets were slashed across the board expenses like this were cut out to avoid having to lay off employees. But expenses for direct client services like therapy I don’t think that should be compromised, I’ve had clients before whose therapy sessions went from being bi-weekly to monthly or ever other month to cut back on costs. When clients are receiving the short end of the stick they should be able to advocate for themselves and receive better services..

  9. Kendra Swartz

    I think that the idea that agencies and organizations need to be held accountable for living up to their promises is correct, however, I’m not convinced that lawsuits are the way to do it. Part of my reason for this is, aside from the money that can get tied up into a lawsuit (for the people prosecuting as well as defending) which isn’t necessarily there, but the amount of time it takes. If it takes several years to go through with a lawsuit, then that’s several years before judgment is passed and change is required and enforced. While this might be a good way to do it for really major changes that are going strongly against agency or organizational culture and policy, I feel like changes like holding an agency accountable for what they promise is a smaller type of change. This has something to do with me buying into the idea that people choosing to work in a social work agency tend to be the kind of people who really are well-intentioned, and if they could be shown that they aren’t being as effective as they mean to be and perhaps shown a better way to create and enforce that accountability, they ought to be willing to do so under that initiative alone. It’s the same idea as micro loans and activism in other parts of the world being fueled by those from within– in a lot of ways they are the ones that know how things are done currently and the places where there is room to bring about change, and how to gather their allies and push when needed.

  10. I feel that I work for a really great agency that strives to do the best they can with what they have and puts customer service first. But I have heard of instances where there are gaps in customer service and for example, a client has been received a letter stating “Congratulations! You graduated services!” when they had not even seen their case manager in several weeks and had not worked toward accomplishing the goals set forth on the treatment plan. Why did this happen? I am not sure. But the client was offered a complaint form to ensure that the issue was addressed with administration.
    I’m sure that a lawsuit or threat of lawsuit would “set a fire” under any social work agency that was not following through with expectations, but I wonder if it would really create internal change or just force them to do something because they have to. I would like to challenge agencies to be better for the mere fact of having good integrity, character, and professionalism, but I know that hoping for change and getting it are two very different things.

  11. The concept of suing a social services agency has never crossed my mind until reading this. Wow. Consumers do it in numerous other sectors, right? What especially stood out to me was this: “the message we’re essentially sending to our clients is that they’re lucky to get what they get, and, if they don’t get what they were supposed to (because we don’t have a really good theory of change, or our methods are outdated, or our workers aren’t well-trained, or we’re cutting corners to cut costs), then, well, ‘social work isn’t an exact science’, or something like that.” Many times I have witnessed social workers (and those in similar professions) drone on and on about who is grateful and who is not. I mean, does it matter? Are we doing social work in exchange for “thank you”s? Does gratitude determine the worthiness of our clients? I don’t know if any lawsuits in this arena will ever occur, but either way, this blog is helping me to reevaluate my efficiency as a social worker. I sometimes fall into this trap of thinking that I’m just a mediocre social worker, but it’s okay, because at least I have good intentions and am doing work that a lot of people don’t want to do, right? Wrong. It’s not okay for me to settle. I really need to change my mindset and understand that effectively delivering services is just as important in this field than any other, if not more so.

    • Wow, Annie–yes. Yes, it’s destructive when we gauge our clients’ worthiness–or our own–by their gratitude. And, yes, it’s so dangerous when we think that ‘better than nothing’ is good enough. And when we judge ourselves by any standard other than absolute adherence to the Code of Ethics, and complete dedication to client success, as we define it together. Thank you so much for your comment.

  12. The first thing that I thought of after reading your post was “Someone should really sue Johnson County Mental Health because they have really dropped the ball over the last few years and it doesn’t seem to be getting any better.” But the more I thought about it I realized that the causes for the issues at Johnson County aren’t all the fault of Johnson County. Sure, it would be safe to say that bad management led to restructuring of the branches and the relocation of several key staff members – but what really drove Johnson County into such a quagmire was all of the budget cuts that occurred on the State level. When you walk through the Olathe branch there are empty offices everywhere – and they most likely are not from people who quit their jobs. It is more likely that the state cannot budget a position to fill that office.
    So who would we really sue?? The state?? They think they are doing great deeds in making budget cuts because they believe that they are saving the state money, right? There is one person we could sue for making all of the cuts in the first place – that would be our Governor. Good luck with that, as I write this he is no doubt thinking of more institutions that he can tweek to take more funding from.
    Needless to say, I can see the quality of services and the dedication of some of the staff decrease at Johnson County Mental Health, only I have nothing but respect for the work that they are still trying to do under the circumstances they have been given. Suing the governor would perhaps be like a big punch in the nose but it would get his attention.

    • So, a few thoughts here, Chris. First, yes, it’s absolutely essential to differentiate between the struggles of an anemic social safety net and the abdication of responsibility by that same system. The end result may be the same–inadequate help for those who need it–but the cause is obviously quite different, and so the response should be too. But, of course, suing the state isn’t unheard of at all; look at the debate over school finance today, which wouldn’t be at all what/where it is without litigation. The challenge is to determine the grounds on which to make a case, and, since there isn’t a constitutional obligation to provide mental health services, the way there is in public education, that’s much thinner ice. What civil rights case, around equal protection or maybe due process, might one be able to bring, in regards to essential mental health services in the state? How might the unspeakable tragedy of a death or suicide prompt legal action, less likely in its absence?

  13. For the last 33 years, I have worked in the legal field, from one-man law offices to mid-size law firms consisting of 30-40 lawyers. I have worked on the plaintiff’s side, as well as on the defense side. Now I work in the public sector. I used to think we lived in a sue-happy society and to some extent that is a true statement. However, wasn’t the idea of lawsuits to bring justice to the party seeking restitution? And, when justice prevails, a precedent is set to ensure that a repeat of the action does not occur or, at the very least, provide arguments for future infractions. I know that budget cuts for mental health services in my county has left many individuals without care and treatment. I know that if one of these individuals were my child, spouse or other relative, and a suicide resulted after they were turned away, I would sue with the hopes it would turn into a class-action lawsuit once people learn others experienced the same injustice. The best case scenario would be a win, not a monetary win because there is no value one can place on a loved one, but instead a win in that the public will most likely learn about the lawsuit. The worse case scenario is a loss in court, but I am sure the lawsuit will raise awareness through media coverage – so a loss is still a win.

    • Yes, Dorothy–there’s so much I love here. First, the recognition that litigation can and absolutely should be a tool we use to pursue social justice. That means that we can’t discard lawsuits just because we think that there are some that are unwarranted, or because we don’t want to entangle ourselves in the courts. We can’t afford to leave stones unturned that way. And, then, your example is a really powerful one–indeed, some of our strongest protections in the mental health arena (like the duty to warn and the right to mandated holds for treatment) came as a result of litigation, itself born of tragedy. If people hadn’t committed themselves to turning their families’ pain into something lasting for others, we wouldn’t have seen those changes. And, then, your point that even a loss in the courts can be a victory–not just in awareness, but maybe in legislation, too–reminds us why and how lawsuits can be valuable tools for social change. Thanks for your comment!

  14. Tina Wiltshire

    This may be crazy but I had never realized that people could not sue an agency for not receiving services or services they were promised. Going back to a previous example of the non-social work administrator in my practicum organization, he reviews eligibility screenings and determines if they qualify. There was one person that he felt did not need services and said we could not enroll him. My immediate thought was discrimination if he meets all of the eligibility criteria! There have been other instances that my immediate thought is this client has grounds for a lawsuit. I believe that social service agencies should be held accountable just as other businesses and organizations are. Just as Annie said, I too have heard people talking about how ungrateful clients are and if we aren’t held accountable for helping some and not helping others (or not helping as much) based on our own personal feelings, then this will continue and we will hold all power over our clients, which is something we are supposed to fighting against.

  15. To clarify, Tina, if there has been an actual contractual agreement that has then been violated, people often can sue. The issue is that, frequently in social services, there is no such right that’s conferred, because the attitude and, then, the expectation, is far more that people are lucky to be getting whatever help they do and, then, if they feel that that assistance has been less than truly helpful, there’s little they can do about it. The scarcity mentality that pervades so many social work organization just makes this worse–the attitude easily becomes, then, that organizations that are trying to make do with so little cannot possibly be expected to really do all of the good that people expect, rather than holding ourselves to a standard of excellence. Maybe more organizations need to use ‘clients’ bills of rights’, to really embed the idea that that clients should expect organizations to uphold their end of ‘the deal’?

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