VA Social Worker Anna B. Raines, Pioneer of the Veterans Foster Care Program

Anna B. Raines was frustrated. As the lone psychiatric social worker between 1924 and 1944 at the Veterans Hospital in Tuskegee, Alabama, Raines operated without a proper office, resources, or staff while serving a population of some 600 patients. Raines was also responsible for Veterans in the 22 counties surrounding Tuskegee. Raines took her profession seriously and was often disheartened by what she perceived as administration’s indifference to her position. Raines’s personal papers convey a tale of struggle and document the numerous limits she faced as an early VA social worker.[1]  She nevertheless persevered and developed a prototype of a home-based foster care system for Veterans long before similar programs were implemented nationally.

A 1923 graduate of the Atlanta School of Social Work, Raines’s first position was with the Red Cross. Red Cross social workers were assigned to Veterans hospitals from the end of World War I until 1926 when the Veterans Bureau created an internal department of social work to address Veteran-specific issues. Raines was hired as the Chief of Social Work by the Tuskegee Hospital in November 1926. When the Red Cross social workers exited, they left Raines with over 2,000 active and inactive patient cases. In 1928, the first Director of Social Work for the Veterans Bureau, Irene Dalrymple Grant, traveled from the Central Office in Washington, D.C., to Alabama to help Raines sort through patient cases. [2]

Raines’s primary goal was to “return [Veterans] to their respective communities physically and socially benefitted to make adequate adjustment among their fellow citizens.” [3] As the only Government establishment to treat Black Veterans in the South, the Tuskegee VA Hospital was often overcrowded. Raines observed that while some patients did not require hospitalization, they stayed simply because they had nowhere to go. Veterans with psychiatric conditions were often misunderstood and shunned by their families. In other cases, Veterans could be incapacitated by physical or mental injuries, making them unable or unwilling to care for themselves. For others, illiteracy reduced their employment prospects. Raines proposed a solution for this group of Veterans who had limited options.

Beginning in 1936, Raines started documenting her ideas for a Veterans Foster Home program. She envisioned Veterans reentering society with the help of civilians willing to open their homes and hearts to these men. Because caretakers would be compensated by VA for their service, Raines would have to ensure that Veterans were housed properly and received quality care and ample meals. She would be responsible for finding and screening caretakers and inspecting their homes. Moreover, Raines anticipated that Veterans would thrive in their new surroundings rather than linger as patients in the VA Hospital.

Raines presented her vision for the program at the 1941 National Association of Social Workers Conference, and by then she had lined up more than a dozen caretakers to participate in the project. Unfortunately for Raines, World War II gasoline and automobile rationing hindered the program’s implementation. But Raines believed the failure of Tuskegee Hospital administrators to provide for the program, “constituted the most significant problem.” [4]

By 1948, it became possible for Raines to revisit the Foster Home Care program.  At that time, the department of social work at Tuskegee expanded to include four social workers and three stenographers. Raines was finally able to conduct field work and implement her well-designed program. She compiled records of Veterans and caretakers’ personalities and temperaments to match them accordingly. Raines insisited that Veterans and caretakers meet each other prior to the program to ensure a good fit. She instituted trial periods whereby the arrangements between Veterans and caretakers were reviewed after several months had passed. Veterans were not forced to remain in foster care, and they were permitted to return to the hospital at any time for any reason.

Raines’s papers contain a sampling of case studies. Most were successful but she encountered problems with some arrangements. For example, a Veteran living in a group setting felt the caregiver favored one Veteran over the other two. [5] Raines documented the successes and the pitfalls of the Foster Home Care program for future social workers to consider, and she compiled a “Family Care” manual to guide Veteran caretakers. 

Social workers from the VA Central Office in Washington, D.C., visited the Tuskegee VA Hospital in February 1949 to observe Raines’s program. Raines believed their presence impressed local administrators by underscoring the importance of social work in general and the Foster Home Care program specifically. [6] In the end, though, Raines received the greatest support from administrators as her career at the Tuskegee VA Hospital wound down. After decades of struggle her work was finally recognized and celebrated. In 1951, the Family Foster Care Program was implemented nationally by VA, and a Medical Foster Home program was introduced in 2002.

Twentieth century social workers like Anna B. Raines were the unsung heroes of the Veterans Healthcare System. They served as intermediaries between medical staff, Veterans, and their families. They improved Veterans’ lives by ensuring they lived in safe surroundings and had access to adequate food, clothing, and medication. In true form, upon retiring Raines commented, “The sacrifices made from 1926 to 1956 were worth all the ups and downs.” [7]

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[1] Anna B. Raines papers, Social Welfare History Archives, University of Minnesota Libraries. Box 1. https://archives.lib.umn.edu/repositories/11/resources/661

[2] Raines papers, “Veterans Administration Social Service at Tuskegee, 1946, pp. 10,11.

[3] Raines papers, “Consciousness of Social Problems” in Social Work in Hospitals, 1927, p. 3.

[4] Raines papers, “Historical Development of Foster Home Care at Veterans Administration Hospital, Tuskegee, AL,” 1950, p. 4.

[5] Ibid., p. 49.

[6] Ibid., p. 3

[7] Ibid., pp. ii, iii.