Special Efforts Being Made in North Carolina to Eliminate Child Abuse and Neglect Fatalities

In June 2017, North Carolina enacted House Bill 630, otherwise known as “Rylan’s Law” in memory of a toddler who drowned soon after a child welfare agency returned him from his foster care guardian to his mother.  Rylan’s Law provides that before DSS may recommend return of physical custody of a juvenile to the parent, guardian, custodian, or caretaker from whom the juvenile was removed, it shall first observe that parent, guardian, custodian, or caretaker with the juvenile for at least two visits that support a recommendation to return physical custody. Each observation visit shall consist of an observation of not less than one hour with the juvenile, and each observation visit shall be conducted at least seven days apart. The agency shall provide documentation of any observation visits that it conducts to the court for its consideration as to whether physical custody should be returned to the parent, guardian, custodian, or caretaker from whom the juvenile was removed.  [Recommendation 5.3]

Local effort in New Hanover County: In a response to an increase in deaths, the New Hanover County Child Protection Team launched a child fatality protocol requiring law enforcement to contact the District Attorney and DSS immediately after responding to a child’s death, and allowing the DA and DSS to gather crucial information at the scene and to educate the community about ways to prevent child fatalities. [Recommendations 6.2b, 6.1g]

Local effort in Rowan County:  Partnering for Excellence is a collaborative program between public child welfare agencies, mental health managed care organizations, and an advocacy group for providers. The program’s goal is to redesign how the child welfare and child mental health systems interact so they can provide trauma-informed services and improve family outcomes, reduce high-end services, and prevent children from being taken into DSS custody. The program involves child welfare workers screening children for trauma at early intervention stages. If screened positive, children are referred for a trauma-intensive comprehensive clinical assessment.  Recommendations for TF-CBT with a rostered clinician through the NC Child Treatment Program follow, with close monitoring and longitudinal data reviews of outcomes. [Recommendation 7.1k]

Local effort in Rowan County: Two mandated teams — Community Child Protection and Child Fatality Prevention — were combined to streamline processes and enhance the frequency of meetings. This has resulted in more time to review child fatalities and open child protective services cases. Among other things, the teams mailed letters to all medical providers (doctors, dentists and veterinarians) who prescribe opioids. The mailing included a letter from the newly appointed Secretary of Department of Health and Human Services, which encouraged registration on the Controlled Substance Reporting System, education on managing chronic pain, and screening of patients to determine risk for opioid use disorder. [Recommendations 6.2, 7.2]