Are you a health care worker? We’d love to hear from you. Email editor at northcarolinahealthnews.org
By Rose Hoban
A 3-year-old boy drowns while in his mother’s care. A 14-month-old boy dies of malnutrition. A 14-year-old overdoses on antidepressants. These are all children who died while in the care of the social services system.
And lawmakers want these deaths to stop.
Now, after close to a dozen meetings, members of a group working on a reorganization of North Carolina’s social service system say they’re making progress with reform.
The Social Services Working Group was created as a result of the Child Protection and Accountability Act (HB 630), passed in 2017 and intended to reorganize the child welfare system, and with it, the rest of social services.
The law allows for the state to take over county social services agencies that are having difficulties, but more important, it creates a regional system that allows for more day-to-day state oversight of a system that’s currently run by counties.
“We have children, we have families, we have elderly that are hurting in this state and we can’t keep turning our backs,” said Sen. Tamara Barringer (R-Cary)
“Some of the counties are doing really good work in some areas, no county is doing perfectly,” she said. Barringer said the goal is to create “the same high-quality care for all vulnerable people no matter what county.”
According to Barringer, who sponsored HB 630, the measure was needed because of significant gaps in the child welfare system. The bill was combined with another measure named for 3-year-old Rylan Ott, who died after being returned to his mother by the Moore County Department of Social Services, despite her erratic behavior.
The state’s child welfare system has had problems for a while. Those problems were laid bare in a now-infamous 2013 incident in Union County when a child being fostered by a local social services supervisor was found in his underwear, shackled to a rural porch, with a dead chicken hung around his neck.
Further problems were highlighted in a review released in late 2015 by the federal Children’s Bureau that concluded that North Carolina did not meet standards in any of seven outcomes measures, such as children being protected from abuse or neglect. In early 2016, a private consulting firm found inadequate funding for child welfare, the need for better training of child social workers, lack of adequate state authority to address problems at the local level, high worker caseloads, and high staff turnover.
At the time state officials pointed to the difficulty of having state oversight of county-based systems, noting that it was difficult to identify problems in such a sprawling system and harder still to make improvements in county agencies answerable primarily to local governments.
Barringer and others moved to provide some state oversight at the regional level.
Initially, the thought of creating the oversight structure was a difficult sell, said Rep. Sarah Stevens (R-Mt. Airy), who championed the child welfare measures in the House.
“The additional thought of regional takeover was … it was the end of the world,” Stevens said.
States such as Pennsylvania, Virginia and Georgia have enacted similar regional oversight offices for local social service agencies. In fact, North Carolina is in the minority of states that retain so much local control over social services.
Stevens and Barringer co-chair the 18-member working group, which includes four county commissioners and three county DSS directors, who quickly embraced the concept of having a regional presence for state supervision as a way to increase support for counties.
“We really thought that county directors who run their social services may have some hostility,” Stevens said. “But they came right on board and said we understand and we do need that help and we can’t do everything.”
Part of the meeting at the UNC-Chapel Hill School of Government on Monday was a discussion of what to call the regional administrator; the group eventually settled on labeling the position as a “director.”[sponsor]
“They’ll have some power, but they’re not taking over,” Stevens said. “It’s not the intent to take over, it’s to keep them working.”
That oversight isn’t limited to children’s services, but to what UNC Chapel Hill School of Government facilitator Aimee Wall referred to as the “whole enchilada:” from children’s services to adult protective services, to welfare programs, adult care home oversight, all the functions performed by county social service departments.
The working group has also emphasized the data collection and creation of dashboards which will compile data and allow counties to benchmark themselves against one another.
At the legislature on Tuesday, DHHS Deputy Secretary Susan Perry-Manning gave an interim report to legislators on the progress of improving the child welfare system that is ongoing even as the work group is devising larger plans.
For instance, Perry-Manning said the agency was doing a better job of getting out into counties to investigate child deaths within five days, whereas in the past, it had taken a lot longer.
“We’re going into counties, really doing record review, providing feedback to social services directors relatively quickly, and providing guidance and tech assistance as we go,” said Assistant Sec. Michael Becketts, who oversees the Division of Social Services.
Both Perry-Manning and Becketts have worked with Barringer as part of the social services working group, and Barringer expressed her support of them, before venting her frustration with the current system.
“It’s appalling that we have 100 counties and depending on what county we’re in you get a different outcome, you get a different level of service,” she said. “One of the things that the Rylan’s law and the work we’ve been doing over the last year is to see that no longer happens.”