RALEIGH, N.C. (CN) — Children in foster care filed a federal lawsuit Tuesday against the North Carolina Department of Health and Human Services, claiming severe understaffing and a failure to monitor residential facilities is endangering them and others in the system.
In the class action lawsuit, the plaintiffs, who are all underage foster care children represented by adults, point to the lack of a cohesive digital case management system as one of the reasons the system is failing. Children are being over and under prescribed medication, including psychotropics, they claim, and denied behavioral and therapeutic help because they are being moved so frequently. The problem is further exacerbated by a lack of services, they argue, as more than 60% of counties don’t have any child psychiatrists.
The system is failing to find children permanent and stable homes, and isn’t removing them from dangerous situations, the plaintiffs say.
The case has the potential to affect almost 11,000 children in foster care in North Carolina.
Kody Kinsley, the secretary of North Carolina Department of Health and Human Services, has said that dozens of children in foster care are living in emergency departments and child welfare offices, and that a quarter of children needing additional help and coordination have been moved 50 times or more, the plaintiffs said.
The plaintiffs’ lawsuit also targets Mecklenburg County, in Charlotte, which is the largest city in the state. Mecklenburg County has a practice of taking foster children to hospital emergency departments for mental health treatment, and then leaving them there for weeks beyond medical necessity, because they can’t find them an appropriate placement, the plaintiffs claim.
“North Carolina’s foster care system has been operating in a state of crisis for years,” the plaintiffs say in the lawsuit. “The foster care population is increasing while foster home capacity decreases. Children are placed into institutions at twice the national average, are shuttled between placements with disturbing frequency, and do not receive adequate services or necessary medical treatment or education.”
Existing policies and practices have resulted in crushing caseloads for caseworkers and children languishing in state care and being placed in harm’s way because the state isn’t regulating licensed facilities, the plaintiffs argue. The Department of Health and Human Services has also failed to create an effective, statewide program for case management, plaintiffs say, resulting in the childrens’ medical information being poorly communicated to caretakers, and long-term plans for them to be permanently placed are infrequently evaluated. The plaintiffs want permanence plans evaluated at least once every six months — which the state is required to do under federal law.
One plaintiff, an 8-year-old boy referred to in the lawsuit under the pseudonym Jameson, has been in foster care for four years. He was removed from his parents, who sexually, physically and emotionally abused him, and has PTSD. For the first two years after he was placed in the care of the state, Jameson did not receive mental health treatment or specialized therapy, and was instead prescribed over eight medications, including psychotropic medications.
Jameson’s fifth foster parent petitioned the department of social services to reduce the psychotropics and placed Jameson in a specialized behavior therapy program.
The department recommended Jameson’s visits with his parents be increased to bi-weekly visits, despite a pattern of Jameson displaying worsened sexualized behaviors after seeing them. When Jameson was moved again, he was placed back on psychotropics and wasn’t able to continue with his therapist. The system still lacks a permanent plan for Jameson, the suit says, and he continues to change placements. The department has still not terminated his parents’ parental rights.
Two sisters, Megan and Chloe — also pseudonyms — aged seven and five, were taken into custody based on allegations of physical abuse, sexual abuse and neglect, the plaintiffs say. They were separated after going through nine different homes together, and Megan, who has ADHD and autism, was sent to a residential treatment facility. She was not enrolled in school, and instead spent her days in the Johnston County Department of Social Services office, where she says she was left alone with a 17-year-old boy, who sexually assaulted her. The sisters are still separated, in foster care, and no steps have been made towards reunification or adoption, despite them being in custody for over two years.
The state is responsible for their safety and wellbeing, the suit argues, and the Department of Health and Human Services has ignored numerous warnings and failed to investigate and resolve mistreatment in residential treatment facilities in multiple counties.
State law requires that social workers working with children in family foster homes be assigned no more than 15 children, but counties regularly ignore these standards, the plaintiffs say. Unmanageable caseloads result in high turnover, and delays permanent placements for children in the system, they add. Because of understaffing, children’s case plans are not regularly reviewed, which causes it to take longer for them to be assigned a permanent placement or reunified with their families.
“Children frequently and foreseeably suffer physical, psychological, and emotional harm in DCS custody,” the plaintiffs said. “They suffer harm in part because, in sharp contrast with the ideal of a stable and permanent home and family, they are continually shuttled between temporary and often nonfamilial custodial arrangements. Professional judgment and standards of conduct require the Defendants to make reasonable efforts toward placing children in their care in stable, permanent homes and families.”
The plaintiffs claim in their suit that the defendants’ actions have violated the First, Ninth and Fourteenth amendments, the Adoption Assistance and Child Welfare Act and the Americans with Disabilities Act. They are requesting that the department provide community-based therapeutic services to children with disabilities, comply with federal standards regarding timely permanence and placement stability, and place children in safe, appropriate placings and not congregate care.
“The Defendants’ ongoing failures place foster children at significant risk of serious harm in violation of their rights under federal law and the U.S. Constitution,” the plaintiffs said.
The suit follows another filed in early August targeting a North Carolina county that took custody of a mother’s children after she was temporarily hospitalized because of cancer treatment. The county institutionalized her disabled children, and delayed returning them to her, even after she was in remission and fighting to get her children back.
A representative for the North Carolina Department of Health and Human Services did not immediately reply to a request for comment.