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if they don’t get what they were supposed to (because we don’t have a really good theory of change, or our methods are outdated, or our workers aren’t well-trained, or we’re cutting corners to cut costs), then, well, “social work isn’t an exact science”, or something like that.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

53 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:


  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:


  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’?

  16. You make many good points within this post. It is interesting to see the lack of resources that could potentially be provided but a social service agency that receives funding to give specific resources. In the United States, it seems that many people look at social services and the resources they provide as “civil rights” rather than as charities. Many people expect resources to come easily once contact with the agency has been made. However, each agency has different guidelines for the population they can help and the amount of resources they are able to provide. The requirements, paper work and other means of getting resources often make getting aid difficult and form circles. For example, in order to get childcare paid for, a parent would have to show proof of working at least 15 hours a week. However, it is not realistic for the parent to work without the childcare being paid for to begin with. I am not sure if this is an issue of individuals believing that access to resources by social service agencies is a right, or if it is an issue of creating available resources and funding within the country to begin with.

    • Hmm…I actually see the international comparison differently: in the U.S., nonprofit organizations play a much larger role in the provision of the social infrastructure than in many European countries, where the social contract–between government and its citizens–looms larger. The complexity of our system flows from its fragmentation, I think, which we wouldn’t see if there was a more centralized approach. At the same time, that devolution facilitates personalization and diversity of services, which can make it easier for people to find services that align more closely with their own preferences, so each approach has its advantages and disadvantages.

  17. Erica Rose-Hunter

    I have mixed thoughts on this idea. On one side I completely agree that there should be more than just the promise of rendering services to help clients. I have worked in areas in which unqualified staff were given the task to complete services to clients, and qualified ones didn’t because they are overworked and underpaid. Truthfully, most were not social workers, but you get the point. I do think there should be a legal binding commitment from agencies to do more than just attempt to provide the services that clients expect when choosing to receive their help. However, aren’t higher entities, such as the government, to blame for these situations? I personally think when you give these organizations so little funding, they are forced to go with the cheaper option. Let’s be honest, it is cheaper to hire a bachelor’s level worker to do certain work than it is to hire a MSW, or even higher, a LMSW or LCSW. I knew of a gentleman who was a caseworker with a BA in business administration. Doesn’t make much sense does it? But it was cheaper to have him. When the government gives funding they expect services rendered and salaries to come out of these budgets. Also, suing these companies only guarantees the “little man” will take the fall and reap the consequences. This will only put them at the level of the clients we serve with lack of resources, assets, and money. Just my thoughts.

    • Good questions, Erica, about where the accountability belongs, and how we trace the roots of the problems we observe in social services. The first step, I think, is to acknowledge that what many clients or would-be clients experience is, in fact, a ‘problem’–to suggest otherwise is to buy into the sort of ‘better than nothing’ rationale that is so corrosive. But, having acknowledged the unacceptability of the status quo, where do we locate responsibility for it? You make some really key points here, in terms of whether it’s nonprofit organizations who ‘owe’ clients a certain level of service or, instead, funders and other oversight entities that should ensure that they are both demanding specific levels of service and, at the same time, paying for them. Thanks for commenting!

  18. I do not believe that things should go as far as a class action suit in regards to agencies who are not living up to their full potential. I believe that the majority of agencies do truly strive to help their clients. However, it is true that most agencies do not fulfill the promises that they make to funders and the clients themselves. And it is also true that the clients are the ones suffering when these promises are not met. Would the threat of a class action suit change how agencies treat their clients? I believe it most definitely would. But is there a better way to push agencies to fulfill their promises? I believe yes. What these methods would be, I’m not completely sure of. The truth is that the agencies, and the people that make up those agencies, should not need to be asked to fulfill the promises that they make to their clients. It should be our desire as social workers to help our clients reach their full potential and provide to them the best services possible. However, when faced with an easy way out or an environmental constraint, it is human to give in. Yes, the threat of a class action suit would “light a fire” so to speak, but there must be a better approach.

    • Is the problem, do you think, that organizations are held to standards that are unreasonable? That funders expect too much, in other words, thereby setting organizations up to fail? Or are there other problems that lead to a breakdown in accountability? Where you see these gaps between expectations and outcomes, what would you like to see, in terms of a response?

      • Brittany Sheets

        I do believe that in many cases organizations are set up to fail. Agencies are almost forced to make promises that can not reasonably be kept, in order to get the funding that they need to provide services. I understand why funders ask so much of organizations, as they want to ensure that the money they provide is being put to good use. I think it comes to a point where funders expect too much and organizations try too little to fulfill their promises, both knowing that these actions have become “acceptable”.

      • I read a book chapter the other day, too, Brittany, from a philanthropic leader, about the danger of mistaking ‘outcomes’ for ‘progress’–getting so caught up, in other words, with measurable successes that we miss the bigger forest for those tree metrics, if that makes sense? As social workers attentive to the macro context, how can we be sure that we’re not letting others’ expectations dictate ‘accountability’, instead of a commitment to those we serve?

        On Sun, Feb 21, 2016 at 10:41 AM, Classroom to Capitol wrote:


  19. Jenny D'Achiardi

    I feel like the real purpose of this post is a call for action for the social service sector as a whole to recommit to making service effectiveness and accountability their number one priority. You were right on the money when you spoke about this mentality that clients “get what they are given” and should be grateful for it. It pervades not just social service organizations, but life in general. A prime example comes from the Great Recession when all I would hear was “I guess I am lucky to have a job” as the person worked under duress and did not complain. I am not sure if there is a regulatory board for social service agencies but I know in the legal world, defendants have a recourse of action when they feel that the defense they received was lacking – they go to the Office of the Disciplinary Administrator in Topeka, Kansas. If there were a similar board for clients and other social service agencies to give feedback about their fellow agencies, there might be more attention paid to how effectively services are delivered and how appropriately clients are treated. Obviously, agencies are limited in what they can give as far as resources and they cannot be faulted for that so it is unfair to judge them for things like amount of rental assistance they are able to disperse to a client when they only have a certain amount of money. However, the type of treatment a client receives is something that organizations should be held accountable for and the presence of a regulatory board or an internal auditing procedure might just be enough to motivate decision makers to make more client-centered decisions. I am curious as to how many social service agencies provide services and then have clients submit evaluations about their care? What does it say about how we feel about our clients when we do not ask their opinion about our services? Does the absence of such accountability measures reiterate the message that the relationship between practitioner and client is not in fact egalitarian but rather that of almsgiver and beggar? Time would be well spent assessing the answers to these questions in each of our agencies. I think that encouraging lawsuits would be an extreme measure that might distract from the real issues and not serve the best interests of the client as this type of litigation today has come to be associated more with greed than justice.

    • It is, of course, intentionally a bit extreme, to highlight the severity of our abdication of responsibility owed to those we serve…and to make us uncomfortable with the limits of what we find ‘acceptable’ approaches to seeking redress. How would you suggest, alternatively, inducing organizations to change this mentality and shifting the balance of power between those served and those serving? What levers do clients whose needs are not well met really have? How do we change the equation re: what people ‘deserve’ in the social service system?

  20. Brittaney Miller

    I loved the idea of this post. The idea of someone having to be held accountable for the failure to, not achieve success, but strive for success. Held accountable for mediocre! Too often I think that is what services provide to their clients. Also, as you mentioned that can fall on understaffed, or under qualified staff which occurs due to funding. My thought on that is an internal continued education committee that can ensure the staff is at least capable of providing clients with the best care possible and not “good enough”. I’m so glad you used that in your post because I see that attitude in a lot of social work settings that I have been exposed to. The workers are stressed, over worked and burned out so they do “good enough” work. But to a client, having a shelter to stay in for one night is not good enough, or a place to get one meal is not good enough. People do tend to believe that the worker should never work harder than the client. Shouldn’t we though? Especially in seeking change on behalf of the client. If we are working on behalf of someone who can’t, why wouldn’t we work harder than them? Advocacy for another human being shouldn’t be limited to what the worker believes to be sufficient, but should be measured in the terms of what the client’s needs are. Great input!

    • That’s a really good question, Brittaney. I think what is meant by ‘not working harder than the client’ is not doing things the client should be doing for him/herself…not carrying the load, in other words, in a way that suggests that the client is not fully invested in the change. But your point is a critical one; since workers come from a place of greater resources, greater support, and greater reserve, doesn’t it seem fair for us to put more into pulling off a change? I mean, if we don’t have something of real value to offer, beyond what the client could do entirely him/herself, why would we expect anyone to come to see us? I’m going to keep thinking about this, and how we balance empowerment and authentic assistance, in an aura of accountability. Thank you for sharing.

  21. Natalie Reeves

    This is one of the best things I’ve read. This is why I left a job in social work about a year ago. A job I loved, with clients I was invested in, in an organization that I had advanced in and loved as well. I was the perfect person for the job, I know that sounds conceited. However, I could not stand with an organization that inadvertently caused such injustice to the very people it was supposed to serve. I agree with you, we should be accountable! I also want to say charity implies I am doing you a favor but most of the clients that I worked with, they had a RIGHT to what was being “offered” them. I think it would be interesting to see how organizations and services would change if legal action by clients was a possibility. I think that recent changes in how the state of Kansas deals with PRTF placements even points to the fact that when there are consequences for not serving clients, services improve. Great post!

  22. Yes, Natalie–the point isn’t (as some have interpreted) that I want to see nonprofit employees go to jail or something. It’s that we need to shift the accounting in nonprofit service provision, so that there’s an assumption that clients are entitled to services–owed help, in other words–and that organizations and those who run them will be held accountable when they don’t receive that aid. We have to change the power structure and the incentives that attend to it, and we don’t get there without changing at least some of the rules!

  23. I definitely can understand where you are coming from. And, I know what you mean when you talk about those who have good intentions but aren’t actively pursuing ways to improve the services they provide or seeking to increase the efficacy of the treatment they provide. I think that there is accountability needed for those who are just looking to ‘get by’. But my question is, what if a social service agency got their grant cut that year and could only afford to hire one person for a position that is developing (because of an increase in demand for that service) into a two person position, and then they got sued? What would they do? Where would those who need those services go when that agency can no longer afford to provide services because they got sued? I can think of numerous instances where social workers fail to provide sufficient services, because of circumstances outside of their control– such as, a case worker being given too many case loads. I don’t think they should be punished for that. However, I also see your point, because I can think of many instances where those who provide services are doing their job just to get by. I think that social workers should be the ones pushing the limits to try and find the best, most effective treatments, interventions and other services. I think that they should be advancing their area of expertise and active in social policy, and I certainly believe they should provide the services they promise (and in the manner that they promise to provide them) to their clients!

    • It’s a great point, Julia, and a reason why the post is only partly serious. Obviously, there are huge problems with the idea that suing nonprofit providers is the answer, or with framing social service providers’ failures as, truly, ‘their’ failures, since that’s obviously often not the case. I think what I’m hoping for, really, is not more lawsuits but a shift in orientation, away from thinking that all nonprofit folks are doing the best they can–and, so, should be forever off the hook–toward expecting excellence and seeing access to services as a right, not a gift. I hope that our organizational cultures are fostering that…but I think it’s too seldom the case.

  24. Isaac Sanders

    As much as I love people being held accountable for their actions I also want to point out that we are working in a larger systemic context that may make it hard for nonprofit organizations to do what they say they want to do. For example, if an organization is promising free care to at risk youth in a community but their in a inaccessible area due to the lack of funds that they receive, that’s a dilemma. They can do outreach, they can figure out bussing programs, their is a lot of ways to address the problem but at the end of the day if you don’t have a grant or donors, how do things get paid for?

    Then the idea of nonprofits being sued does not sit right with me. Nonprofits have so little, by my understanding, and try to do a lot with that little. Sometimes their are gonna be people who fall through the holes, as many systems have that dilemma, but to sue for systemic problems has never gone over well in the larger systemic context for social problems and political problems alike.

    I’m not sure where I am at on this. I can feel some sarcasm within the post but I definitely agree. Accountability is important but at the cost of who and what exactly?

    • I totally get that, Isaac, and I appreciate it. Here’s what makes me push back, though–often, nonprofits tout what they supposedly provide, in the pursuit of dollars. They play up those promises and what they are capable of and then don’t want to be held accountable when they aren’t able to deliver on them, because they don’t have the resources. But who does get held ‘accountable’, though? People living in poverty, those struggling with addiction, people whose children are in custody…all of whom are lambasted for their failure to (fill in the blank: get a job, get sober, parent ‘well’), when there are ‘so many’ resources/opportunities/supports to theoretically help them do those things. I would feel a lot more comfortable saying, ‘of course we shouldn’t hold nonprofit organizations accountable when they are grappling with limited resources’ (because they are, totally), IF I saw them consistently talking publicly about what they can’t do, demanding public policies that better serve their clients, and reframing the experiences of their client populations in correctly systemic terms.
      Convincing at all?? (that part IS tongue-in-cheek; you are obviously entitled to your own opinion!!)

  25. I think that this would be a good idea based on the concept of respect for others. when you come to work for social service agencies, the entire idea is that you will be there serving the people and helping out the ones your service provides for. What is frustrating i think, as a non-profit employee, is when we say we can provide these certain services, and they end up still not being able to get them. You are left with an unsatisfied client and the most you can do is refer them out to some place that also claims they offer services they need. At that point, as a client, I would want something done on my end. But even then, legal aid doesn’t come free. So not only does this low-income individual need these resources that somehow they cannot receive, but the financials needed to sue anyone is well above what someone of low means can afford. Maybe that’s how they get them.

    • Great points, Lauren; yes, I think that barriers to entrance to the judicial system play a huge role in perpetuating the status quo, particularly in cases where there would likely be recourse, if people had a way to present their claims. To be clear, I’m not necessarily advocating wide-scale litigation, but rather trying to point out that those who come to our organizations have a legitimate right to expect that they will get what they came for, because we are usually the ones who are giving that impression. To me, that means that we have a corollary responsibility to do something when we can’t live up to that expectation.

  26. I have personally experienced the “rights-based approach” at Thalia House, where I am doing my foundation-level practicum. Thalia House is a non-profit, transitional living facility for women with eating disorders that are stepping down from inpatient treatment. I feel incredibly lucky to be working with such a generous organization, especially because it seems that the eating disorder community often gets forgotten and/or tossed aside. For example, we had a client who received treatment for over 1.5 years; her private insurance refused to cover her treatment after 60 days, so she applied for Medicaid in the hopes of getting funding for the rest of her much needed treatment. Our staff played what seemed to be the “cat and mouse” game with Medicaid, and the staff at Thalia never actually received any form of payment after all was said and done. In fact, this particular client owed close to $50,000 for all of the treatment that she had received. It should be noted that her parents were not in the financial position to pay for our facility (at a steep rate of $6,000/month just to reside there), so that was out of the question.

    The staff was kind enough to offer this client all of her needed individual, family, group, and nutrition therapy that she needed in order to recover from her eating disorder, and so she could develop the emotion regulation skills necessary to function in the real world. Our staff certainly employed the rights-based approach when treating this client because they gave her the services she needed with the knowledge that they probably would not get paid, and the organization would lose money. However, Thalia House has a mission to support women in their life-long journey for retaining recovery from an eating disorder, and they will achieve this by any means necessary.

    • How does the organization make this work financially, particularly given what we know and have discussed about the imperative to sustain the organization, and the difficulty that many nonprofit leaders face in making the budgets balance. What strategies do they employ, in other words, so that the constraints of tight budgets do not derail the treatment that clinicians want to provide?

      • Jennifer Hannon

        We have other clients that stay with us, so they were able to keep her because they have funding coming in from other clients. In addition, Thalia House also has a foundation affiliated with it, and they do fundraising to stay afloat. This is an isolated case and has not happened before and will not likely happen again, but the agency has made deals with families that are in a financial bind to make staying at the facility more feasible.

        From my experience thus far, meeting as a team once a week and being on the same page with treatment has helped the therapists provide the best care they can. This particular client was also not in a position to go home and be safe, so that was the primary concern over financial gain.

  27. That’s terrific that the systems in place within the organization allowed for decision-making that prioritized the client’s well-being. It sounds like you have had the opportunity to work closely with an organization that really places clients’ needs at the center.

  28. I think the idea of giving clients the ability to sue social service providers who fail to impact the clients in the way that they promised is very interesting; I had never actually considered this before. However, it makes sense; consumers in almost every other sector have the ability to do so. I believe this would be effective in bringing some accountability to these organizations that are funded based on their promises to help people. However, if this became possible, it would also require working with organizations to update their grievance policy and ensure that clients are aware of the grievance process and how to maneuver it. Shifting the culture in the social service sector to one of more accountability would not be easy, but I think it could be an important step in improving the quality of services being provided. Empowering clients to take action when they are not receiving quality services that meet their needs could help shift to a more outcome-based system. I really agreed with the statement “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, then well, “social work isn’t an exact science”, or something like that”. Expecting clients to be not only satisfied but grateful for whatever services they do receive, because it’s better than nothing, is simply not good enough. One possible issue would be ensuring that all clients, despite their power or vulnerability, had the same ability to pursue legal action.

    • Thank you for flagging the issue of grievance policies, Summer–really, while the post is intentionally provocative with the call to legal action, in many cases, if organizations were more explicit about how clients pursue remedies within the structures already available to them, we could open up promising avenues for improving outcome responsiveness. Thanks for weighing in on this.

  29. What an amazing, and eye opening perspective on non profit organizations. As I read this post I kept thinking to myself “have I upheld the promises I have made (on behalf of my agency) or agencies I have served in the past?” The answer would unfortunately be no. I love the non profit world, that’s why I am an aspiring social worker, but, I can see where the lack of accountability on the service providers end could make for a meaningful conversation about the rights of the people be serve. Other fields make sure they let the customer know if the services they are seeking aren’t met, with in reason, they can take legal action. This, in my opinion, should be the same for the clients in the non profit world. Giving the clients the option for guidance and support on how to seek justice in a situation where they felt the organization was lacking would need to be explicit and clear. It just seems right.

    • Thanks for this, Alexa; I honestly see efforts to intensify our collective accountability as a WAY to live our values and ‘love our profession’; insisting that organizations make good on the promises they make isn’t an attack on them; it’s a call–to all of us–to practice what we ‘preach’.

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