- According to the lawsuit, foster children in North Carolina are placed into institutions at twice the national average, ranking in the bottom 10 states for placement stability in 2021.
A class action lawsuit filed last week in Charlotte accuses the state of turning an eye to the foster care system by abandoning children at hospitals.
Filed on behalf of minors in the foster care system, the suit alleges North Carolina’s foster system has been operating in a state of crisis for years, shuffling children between placements with “disturbing frequency.”
According to the lawsuit, foster children in North Carolina are placed into institutions at twice the national average, ranking in the bottom 10 states for placement stability in 2021. The lawsuit’s defendants include Gov. Roy Cooper, the Department of Health and Human Services, and Susan Osborne, the Assistant Secretary for County Operations of the Division of Social Services.
“North Carolina’s foster care system has been operating in a state of crisis for years. The foster care population is increasing while foster home capacity decreases,” the suit reads, adding that children do not receive adequate services or necessary medical treatment or education. “Caseworkers are not receiving adequate training or support, they cannot manage the crushing caseloads, morale is low, and turnover is outpacing recruitment. State leadership predicted, correctly, that this crisis would invite “a massive class action lawsuit.””
Earlier this year, Osborne addressed the Joint Legislative Oversight Committee on Health and Human Services to update them on the current state of child welfare in North Carolina. From 2022 to 2023, 15,047 children spent at least one day in foster care in North Carolina. Roughly 40% of children in the system are under the age of five, with children in rural counties entering foster care at twice the rate of children in urban counties.
“Regional support is how the state – in our state-supervised system – overseas, supervises, supports, and provides technical assistance to counties,” Osborne said during the meeting.
However, the role DHHS plays in overseeing the statewide system is at the forefront of the matter.
Karen McLeod, the Director of Benchmarks, a statewide association that represents Child Welfare providers, said it’s unusual for a state’s child welfare program to be county-administered and state-supervised like it is in North Carolina. Most states have a state-run foster care system, but nine states remain that are county-administered.
“What has happened is the counties contribute a pretty significant portion of the revenue to the child welfare system, and depending on the wealth of the county, determines how much money they end up contributing,” McLeod explained in an interview. “So poor counties have a lot more struggles because they just don’t have the funding that the larger wealthier counties have.”
The “extraordinarily complex system” faces many difficulties, including a high staff turnover, limited foster families since Covid, and working between Medicaid mental health services and child welfare for funding.
Hyland County, for example, only has just one foster family that only takes newborns. With five current children in the system, the local DSS office is forced to make tough decisions on where to send the children.
“The ideal would be to place them right there [in the county], but that’s not realistic because there are no placements,” said a DSS official.
The official said there are around 100 foster children sleeping either in an emergency room or DSS office every night across North Carolina. A child’s stay in the hospital can last several months.
“Is it better to be in the emergency room, or is it better be in my office?” asked the official. “You have no security, no food, maybe no shower. Where’s it better for the kid to be?”
But isn’t that a cost to the state anyway? Of course, the official said, and the state is paying it because all of the kids have Medicaid. By placing children in hospitals, the costs are inflicted on Medicaid, which is funded by the state and federal governments.
In an effort to help the situation, local leaders have proposed a project to repurpose a nursing home into an emergency shelter for children in two regions to temporarily stay while they await placement. Called Helping Hands in Hyde, the proposal was shot down by the county due to funding, but leaders continue to push the effort forward.
The Carolina Journal previously attempted to acquire data from DHHS on children left unattended in North Carolina hospitals, but the agency asserted it does not collect this data.
“NCDHHS is aware that county departments of social services have received reports of neglect because children have been abandoned in a hospital,” DHHS told the Carolina Journal. “However, the data that NCDHHS receives from counties on child neglect does not specify instances of children abandoned in hospitals.”
The General Assembly passage of Rylan’s Law in 2017 created regional oversight as a touch point below the state level. Seven regions are still in the process of hiring teams to provide additional guidance to individual counties, something that officials hope will lead to stronger support and training systems at the local level.
“A lot of it comes down to financing the system to support it effectively, and that falls on to the legislature,” McLeod added. “So really it goes back to, is the legislature in a position that they can fund it?”