7 NC counties are under state oversight after child deaths and policy violations

Seven North Carolina counties are under state supervision and receiving support from the state’s health and human services department to fix issues in their child welfare systems. One county is also under full control of the state following the death of an 8-year-old child due to abuse.

When issues arise in the provision of child welfare services within DSS offices, the state Department of Health and Human Services (DHHS) can jump in to help. One way to do this is through corrective action plans, which require counties to develop strategies to improve outcomes.

In turn, DHHS conducts monthly reviews, provides guidance and more. The seven counties under state supervision are under corrective action plans. In more extreme cases, DHHS can also take control temporarily of child welfare in counties.

This oversight mechanism lines up with the structure of the state’s social service system, which is federally mandated, state-supervised and county-administered. This means the federal government authorizes national programs and a majority of the funding, while the state provides support and oversight to the 100 local county departments of social services, which deliver the services. It’s one of only nine systems nationwide that are county-administered. In most states, the state administers social services programs.

Child and family social work services administered by the local Department of Social Services (DSS) offices include protective services (abuse and neglect), foster care placement, adoption services and more. DSS offices also help deliver services to adults, such as health care services, including Medicaid and more.

The News & Observer requested public records explaining what happened in these cases. Documents show many of the same issues repeating themselves at multiple agencies: a lack of supervision and training, unsafe situations and risk factors that went unaddressed, and incorrect decisions on cases.

State control: Nash County

A takeover happened most recently in September, when DHHS assumed leadership of child welfare services at the Nash County Department of Social Services after identifying several policy violations, and after the death of an 8-year-old child under the purview of Nash County DSS, as previously reported by The News & Observer.

DHHS placed this county social services department on a corrective action plan after investigating the death but took control after deficiencies persisted.

The death that triggered the state moves appears to be the killing of 8-year-old Christal Lane, allegedly by her grandmother. This case led to the filing of a state Senate bill, which died in the House, and which initially had a section dubbed “Christal’s Law.” This section, which was cut in a committee hearing, would have granted the DHHS secretary expanded authority to review records and information related to any open or closed child welfare case.

DHHS assumed temporary operation of child welfare services, as authorized under state law, two other times: in Cherokee County in March 2018 and in Bertie County in May 2022. NCDHHS returned full control to Cherokee in October 2018 and Bertie in May 2023, Haight Connor said.

Corrective action plans: Guilford, Pitt and more

• Bertie County: A statement by DHHS at the time it took control of child welfare services said that the decision was made after “case and record reviews and on-site visits revealed a systemic lack of adequate training, supervision and capacity to deliver appropriate child welfare services in accordance with law, rule and policy.” A corrective action plan submitted by the county once it regained control is still in place and was most recently reviewed in late October, documents shared by DHHS show.

• Guilford County was required to develop a corrective action plan after DHHS became aware of the death of a child that occurred on Dec. 12, 2022. The county had an open case on this child’s family, documents show. Documents do not show names, but three children died in a house fire in Greensboro on that date, according to media reports. Other county violations cited by DHHS included subpar safety assessments and lacking contact with children and family members, whether under protective services or foster care. Guilford’s corrective action plan was approved in July and is still in place.

• Northampton County was required to develop a corrective action plan after DHHS became aware of the death of a child that occurred on May 12, 2022. This appears to be in reference to the death of a 2-month-old baby, whose mother was charged with involuntary manslaughter and child abuse, according to news outlets. The county had an open case. In a Sept. 13, 2022, letter requiring the county develop a plan, DHHS wrote that the county didn’t check on and interview key people within adequate timeframes in the child death case. Northampton is still under the corrective action plan.

• Pitt County was required to develop a corrective action plan after DHHS became aware of the death of a child that occurred on March 24, 2022. It’s unclear which case this is in regards to, but according to documents shared, the county did not follow policy and failed to conduct required contact with the children and family members. It also failed to contact substance abuse facilities to confirm the child’s parents were complying with requirements. On June 15, 2022, DHHS also became aware of “significant issues” with the county’s processes for using a state system, with the agency having over 200 more open cases than what was indicated in the system. A corrective action plan approved in early 2023 is still in place in this county.

Other counties under corrective action plans following the death of a child are Richmond, Sampson and Surry. Documents show much of the same issues seen in other counties were present for these cases, including lacking supervision and training, unaddressed risk and safety issues and incorrect case decisions. All remain under their respective corrective action plans.

Kids in DSS offices

According to a 2023 ranking by the Annie E. Casey Foundation, a private foundation that conducts research on child well-being, North Carolina ranks 33rd in overall child welfare. It also falls in the bottom half of states, with a ranking of 34th, in child and teen deaths.

Multiple reports have also said that children in the state’s strained foster care system, due to a lack of homes, have had to sleep in emergency rooms and county DSS offices, where social workers serve as caregivers.

In a statement, DHHS said more than 10,000 children are in foster care and another 6,300 are receiving in-home services in North Carolina. DHHS said more foster homes are needed, especially homes able to care and provide for children with complex or specialized needs, such as those who have been exposed to trauma or have substance abuse issues.

A DHHS report shared with legislators this year shows there are no therapeutic foster homes for children with complex needs in 10 counties and another 40 counties have fewer than 10 homes.

Also needed are more child welfare workers and more money, despite new funding in the budget passed this year, DHHS said, pointing out that North Carolina ranks last in per-child funding compared to other states with decentralized child welfare systems.

The budget included $80 million to strengthen specialized behavioral health treatment options in local communities and increase care options available to children to divert them from emergency rooms and local DSS offices, said DHHS.