North Carolina’s Department of Health and Human Services faces a minimum $1.7 million federal penalty after failing to meet child safety, placements, services, and other components by which state child and family services are measured for compliance.
Rafael Lopez, commissioner of the Administration on Children, Youth and Families at HHS, informed North Carolina DHHS Secretary Rick Brajer in a Jan. 29 certified letter that the state was being placed on a three-year performance-improvement plan to establish “effective strategies for achieving the level of improvement agreed upon.”
Pam Kilpatrick, assistant state budget officer, told the House Appropriations Committee on Health and Human Services on April 28 that Gov. Pat McCrory’s budget includes $9.3 million to add five full-time staff to help develop and implement the improvement program.
“The ratings we got seem abysmal,” said Kevin Kelley, section chief for Child Welfare, in the Division of Social Services at DHHS. Asked if the failure to meet the requirements is indicative of an agency in distress, Kelley responded, “I would say you’re wrong about the word ‘failure.’”
However, he said, “The whole intent of the review is to find areas for program improvement,” and its findings that North Carolina came up short “didn’t surprise us.”
Kelley said the assessment is a “specific kind of review” that may not capture the complete picture of the complex services that are difficult to execute under a sweeping DHHS umbrella of programs. In some areas, slight deviations, such as providing a service in 25 hours instead of the required 24, would be considered noncompliance.
Sherry Bradsher, DHHS deputy secretary, said whether the state must pay all, part of, or more than the $1,709,489 penalty “sort of depends where we wind up two to three years from now” as the improvement plan develops. Creating that response “is somewhat of a negotiation” and involves collaboration between the state and its federal counterparts.
Kelley said this is the third round of federal assessments, and North Carolina was one of eight states involved. Extensive reviews of 105 cases were conducted in Buncombe, Craven, Cumberland, Durham, Hoke, Jackson, Mecklenburg, Pitt, Scotland, Wake, and Wilson counties between April 1 and Sept. 30 last year.
Among findings of the federal review were that North Carolina achieved only a 75 percent rating under the safety-outcome category called “Children are, first and foremost, protected from abuse and neglect.” The state achieved only 57 percent in cases of the safety outcome called “Children are safely maintained in their homes whenever possible and appropriate.”
Permanency in placements was cited as a major failure, achieving only 34 percent compliance. And outdated statewide information systems, workforce training, case reviews, and other systemic program functions also were found substantially lacking in compliance.
“We are having some comfort calls” with other states that also had unfavorable reviews, Kelley said. “We’re all roughly at the same place with this development,” there is no “super clear guidance” as to what the new measurement tools and plan will look like, and “no one has a signed-off plan yet.”
“That $1.7 million penalty, regardless of how they’re going to end up assessing that, that’s the department saying we’re serious about you need[ing] to change things,” said Andrew Brown, an adoption law and policy attorney who is a senior fellow specializing in child welfare policy at the Florida-based Foundation for Government Accountability, a free-market oriented organization.
Brown said the low North Carolina scores were not surprising “because this is common among child welfare agencies across the country. [They] are a product of a system that’s overwhelmed, that’s trying to do too much,” and caseworkers are stretched to the breaking point while constantly exposed to “heartbreaking things,” Brown said.
“Our argument would be start working more with the local community,” Brown said. “There are programs like Safe Families for Children that are active, and trying to launch a chapter in North Carolina right now. They’re in the process of recruiting churches and families” to replicate their model originated in Chicago in 2003. It now has 72 chapters in 27 states, and has cared for more than 20,000 children.
The private, community-based intervention model outperforms the child welfare bureaucracy, especially on placement stability. Some children and youth services departments in other states are actively referring their low-impact cases to Safe Families so the government agency can concentrate on the more difficult, high-intensity cases, Brown said.
The average child in a government child welfare program “has a 50-50 shot of going back home to their biological family, and that’s after staying in the foster care system an average of about 700 days,” Brown said. In the Safe Families program more than 90 percent of children are returned to their biological parents after a 30-day average length of stay with a volunteer host family without ever going into foster care.
Safe Families uses trained volunteers from the community, supervised by trained social workers oftentimes with prior government jobs, to welcome children into their homes while their parents struggle with a temporary crisis such as job loss, medical situation, or transportation issues, that could result in a child neglect case and removal of the child from the family by the government agency. Other family members help the parent overcome the temporary crisis.
Brown said 70 percent of foster care cases stem from simple neglect, and one of the main reasons for neglect is because parents fear the power of the government to seize their children, and don’t seek services that might help their situation.
Safe Families is a less threatening environment lacking that enforcement power. Relationships are encouraged between the families. In government foster care, regulations prohibit such relationships. It is not uncommon for children and their parents to maintain extended family-type relationships with their host families long after their help, Brown said.
Dan E. Way (@danway_carolina) is an associate editor of Carolina Journal.