Children's Voice Article, November/December 2002
SIX TO ONE: The Evolution of Children's Services in Tennessee
By Kelley M. Blassingame
Everyone brings something to the table. Two heads are better than one. The more the merrier.
Life is full of optimistic clichés when in comes to mergers, but the hard truth is that merging different personalities, cultures, and philosophies is tough--even more so when six different personalities, cultures, and philosophies are involved. Yet the Tennessee Department of Children's Services (DCS)--a joining of six state agencies--is proof it can be done.
DCS was created in 1996 after six state agencies struggled separately for years to maintain effective, efficient services for children and families. Although the union was not exactly blissful at first, state officials agree it is now making faster strides and better meeting the needs of the Tennessee's children and families as a single department than it ever did as six.
"It was, in some respects, a shotgun wedding," says DCS Commissioner Page Walley. "Trying to combine cultures and very different approaches was difficult, and six years later it's still a challenge. But we've found ways to adjust, appreciate the diversity, and continue working toward common goals in a common direction."
Land of Confusion
Throughout the 1980s and early 1990s, the Tennessee Depart-ments of Education, Youth Development, Finance and Administration, Health, Mental Health and Retardation, and Human Services worked on independent paths to the same destination--positive placements, services, and outcomes for the state's children. Despite a common cause, however, there was little communication between the agencies.
"We recognized for years that having services divided was unproductive," Walley says. "Most times, the left hand didn't know what the right was doing. The system was set up for conflict."
Fran Priest, Executive Director of the Tennessee Association for Child Care, recalls those years, searching through various state departments to find adequate resources and supports and finding only confusion and discord. "People were trying hard to get a grasp on things, but confusion abounded," she says, noting each issue "sounded like someone else's problem" to each department. "Plus every department felt put upon as having to serve the children no one wants, so children kept getting shuffled around."
Officials recognized that losing children in the departmental shuffle was unacceptable and in the early 1990s attempted an initiative to keep everyone on the same page. Counties created teams known as ICAMs (Interdepartmental Committee on Assessment and Management) that met regularly to resolve issues of struggling children that seemed to straddle services provided by individual departments.
"It was an attempt to bring groups together to talk, and some were more effective than others to reorganize services faster," Priest says. "But most of the time, the people who were at the meetings were not decisionmakers, so the process stalled because those individuals had to go and seek permission to take action." Ultimately, she says, the project faded away because people could not commit the time and service consistently.
Further exacerbating problems from lack of communication were funding concerns. During the early 1990s, state administrators were viewed as paying little attention to child welfare issues. Priest recalls, "We were pretty low on the priority list for resources, and what few dollars were available, there was a competition among all the departments."
The state then created a "Children's Fund," a superfund of sorts that combined rather than compartmentalized all state dollars for child welfare, which, Priest says, made it easier to obtain federal money for programs.
More difficulties arose when the state legislature ordered all private children's services to be moved under the management of TennCare, the state Medicare system. (See "Riding the Winds of Change," Children's Voice, Spring 1997.) "It was a coordination nightmare, trying to get service without applying medical necessity," Priest remembers. "For example, in instances of residential care, TennCare leaned toward hospitalization rather than a residential treatment program."
After the care coordination debacles through TennCare, child welfare advocates began calling in earnest for a central department for children's services. A groundswell movement began with support from the legislature and the governor's office. Finally, in 1996, Governor Don Sundquist (R), established DCS by executive order, and a bill sponsored by Walley--a member of the state House of Representatives from 1990 to 2000--creating DCS was enacted that same year.
Despite the years of planning to conceive DCS, Tennessee officials found the reality to be much more challenging. The state cut the new department's budget by $20 million in its first year of operation.
"It was so hard, because we came in with such high hopes," says George Hattaway, DCS's first commissioner and now Southern Regional Government Affairs Associate for CWLA. Hattaway asked DCS service providers for help in trimming the budget to size. "You can't make good decisions without input from everyone, so I told them, 'I can do this, or you can help me do it in a way that we can still serve kids.'"
Apart from the budget squeeze, merging six agencies into one was far from a match made in heaven in DCS's early stages. "It's always tough when you're trying to change things, because change threatens people," Hattaway says. "Plus, because juvenile justice and child welfare naturally clash, the juvenile justice folks thought the child welfare folks were too soft, and the child welfare folks thought the juvenile justice folks were too harsh."
It didn't help matters that most of DCS's first leaders--including Hattaway, a former probation officer and state juvenile justice director--were from a juvenile justice background, which made the department's child welfare members feel slighted. Further, each agency had its own unique approach to helping children and families that didn't always mesh with the other five.
"It's taken a long time for the philosophy, values, and goals for the department to become truly united," Priest observes. And while she acknowledges the growing pains were difficult, she adds, "I'd rather have that conflict than go back to how things were before."
After two years operating as one agency, DCS discovered persistent concerns in finding swift, permanent adoptive placements for children in foster care. In 1998, Hattaway asked CWLA for help in evaluating and addressing the difficulties. "The problems were so overwhelming," he says, "and I knew we needed assistance, so we called the League to get a realistic picture about what was really going on, how bad it was, and how to fix it."
CWLA Vice President of Program Operations Bob McKeagney, who managed the League's consulting arm at the time, remembers being contacted initially to address adoption issues, yet finding much more than he or his staff bargained for when they arrived in Nashville. "We went in response to mounting pressure from the legislature regarding permanency," McKeagney says. "After we got there, we learned of the merging of functions and the major clash of cultures that was present, with child welfare staff feeling alienated and misunderstood by juvenile justice managers."
But the staff's philosophical differences paled in comparison with concerns about the department's operation. "Some felt the department wouldn't work at all and should go back to square one," McKeagney notes. Confident that DCS had no insurmountable issues, however, CWLA consultants got to work immediately, conducting nearly 1,200 interviews within the department and other state agencies, among citizen groups, and with parents, providers, family court judges, and child welfare attorneys to get a better picture of the issues DCS was facing. The consultant team gave candid, blunt feedback about what they discovered.
"The nature of the League's work is we don't mince words," says former CWLA consultant Carolyn Hill, who worked prominently on the Tennessee project. "We held very frank discussions [with the special committee DCS had assigned to the project] about the issues we saw. We found huge significant delays in the length of time kids waited in each phase of the adoption process. And training for foster and adoptive parents was really lacking."
Using CWLA's Standards of Excellence for Adoption Services as a starting point, consultants crafted a three-year plan to revamp the department's adoption processes. They found the state was placing only 31% of the children who needed adoption in a given year, due to delays in transfers, termination of parental rights, and shortage of adoptive families and DCS staff. In their final report, the consultants wrote that DCS needed to make "fundamental systemic change that will be pivotal in decreasing the average length of stay in foster care for all children and for preventing a backlog of children in the system needing permanency from recurring."
The consultant team recommended several changes to increase the number of permanent placements, including establishing clear guidelines about the appropriate role of kinship care in adoption; coordination among DCS, the courts, and related legal professionals; training DCS and contract staff to improve service delivery; and hosting a statewide adoption conference to highlight excellence in adoption practice. CWLA also made recommendations regarding family preservation, access to TennCare and mental health services, and staff training, among other areas.
The first area of concern CWLA touched upon, however, was the need to "aggressively address. . . and overcome widespread resentment and lack of confidence among frontline staff" (according to the League's final report). McKeagney observes that, ironically, working to improve the department's adoption and general operations helped ease tensions between its juvenile justice and child welfare staffs. "People became more engaged and started talking to people they'd had strained relationships with in the past. People started working together, and the greater interaction helped build consensus."
Four years later, CWLA continues its work with DCS, yet "on a series of things, rather than just one project," McKeagney says, adding, "It goes a lot smoother now that there is a well-integrated, shared vision."
By 1999, things were beginning to click for DCS. "We'd become one of the largest departments in state government and had become much more visible," Priest says. "But with that visibility came greater scrutiny, and that's when the lawsuit happened."
Children's Rights, a national nonprofit that advocates for children waiting in foster care systems, filed suit against Tennessee DCS, citing children's long waits for foster and adoptive placements. The ironic timing of the suit is not lost on Hattaway. "Just when we had secured funding to implement everything in [CWLA's] plan and were in the middle of reform--that's when we got the lawsuit."
Rather than sign on for a lengthy and costly legal fight, state officials opted for arbitration to settle the case. "The department essentially said, 'Yes, we're guilty,'" Priest says. "What resulted from the arbitration was a set of principles that would create permanency and stability for the state's kids, and no one could argue with that at all."
The case was settled in early 2000, and Hill believes the suit actually spurred much of the department's progress. "The settlement took their work to the next level," she says. "Several things, they would have achieved anyway, but the settlement helped to garner new resources that produced remarkable strides." Priest agrees. "The lawsuit will drive the department's actions for years to come. Yes, it means big change, but we've been dealing with big change for a while now."
Maintaining the department's momentum of progress is the main priority for DCS staff and state officials. "We were inert for so long," Priest says, "then all of a sudden it seemed like we were on a speeding train. But that's good, because if we stopped now, who knows if we could ever get going again."
DCS's efforts are focused on implementing the settlement provisions from the Children's Rights lawsuit, with the help of the Annie E. Casey Foundation, and on growing as a single organization. "Even though it was painful thing to go through at the time," Hattaway says, "I think Tennessee is really moving in the right direction now, with the support of the legislature and administration." Looking back on the struggles to create DCS, and the agency's rocky evolution, he credits DCS staff for bringing it to the point where Tennessee now serves as a model for other states that may be pursuing similar mergers.
"You can go to any state and see the same problems--a lack of proper funding, a lack of addressing issues, and the need to overcome a poor history. But it's never a lack of good people. We have some of the best staff in the country. We've been able to attract real advocates who wanted to change the system as much as [the leaders] did."
After two years at the helm of DCS, Walley says the department is sailing much smoother waters. Working three days a week in the office, Walley conducts what he calls "listening meetings" with local media, chambers of commerce, legislators, and advocates, noting that these meetings "build esteem externally" for the department.
Walley doesn't neglect the importance of building esteem internally, however. He also spends two days in the field meeting with frontline staff in various regions, taking note of "how we in the central office can make their work more fulfilling and less stressful."
Sitting in his Nashville office and looking back over more than a decade in DCS's evolution, Walley says the struggles have been worth the result. "The rewards are knowing where children are, what needs are out there, and knowing all the resources to address them are under one roof," he says. "It's all worth it to know we can help a child find a good, safe, and loving home. Nothing is more fulfilling than that."
A freelance writer and former CWLA Associate Editor, Kelley M. Blassingame works for a trade magazine in Washington, DC.
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