Robeson County teen in foster care part of new lawsuit against NC’s top health agency

By Sarah Nagem

sarahnagem@borderbelt.org

A 14-year-old boy from Robeson County has spent nearly three years at a psychiatric facility in Raeford, where he sleeps on a green pad in an otherwise bare room, eats meals and does school work in a small common area, and suffers insults from staff, according to a lawsuit filed this week. 

The teen, identified in court records as Timothy B. and a member of the Lumbee Native American tribe, lives “a regimented and segregated life” in “deplorable conditions” at the Hoke County facility, the lawsuit says.  

“He would like to participate in normal, adolescent activities such as playing sports, shopping, being with family, and going to a grocery store,” according to the lawsuit. 

Timothy B. is one of four children named as plaintiffs, along with Disability Rights North Carolina and the state NAACP, in a lawsuit filed Tuesday in federal court in the Middle District of North Carolina. 

The lawsuit was brought against Kody Kinsley, secretary of the North Carolina Department of Health and Human Services. It argues that the state unnecessarily houses children with disabilities who are in the foster-care system, particularly children of color, in locked psychiatric residential treatment facilities, known as PRTFs. 

Under state law, the lawsuit says, DHHS is “required to prioritize placement of children in foster care in the community, in families rather than in institutions” and provide community-based mental and behavioral health care.

“Instead, DHHS has an ongoing policy, practice, pattern, and/or custom of inappropriately and unnecessarily segregating children with disabilities in foster care in PRTFs, rather than placing them in integrated community-based placements with supportive services,” the lawsuit says.

The case could lead to wide-sweeping changes in the way North Carolina cares for some of its most vulnerable children. 

The lawsuit cites a six-month investigation by journalists in North Carolina and Virginia for the USA Today Network. A series of reports called “Locked Away” highlighted neglect and physical, verbal and sexual abuse at some psychiatric residential facilities. 

Kelly Haight, a spokesperson for DHHS, said the agency is reviewing the lawsuit and working to implement and propose “real solutions.” 

“Regardless of this specific litigation, North Carolina can and must do better for children with complex behavioral health needs,” Haight said.

The children

Steph C., who is in the custody of Craven County DSS and is one of the children named in the lawsuit, reportedly suffered two severe head injuries at a facility in Kinston, where he has been since April. In one instance, the 15-year-old was airlifted to a trauma center after another child “slammed his head to the ground, causing him to lose consciousness,” the lawsuit says.

Isabella A., a 13-year-old plaintiff under the custody of Montgomery County DSS, “has been the target of bullying behavior, including painful sexual harassment, from peers” at her current facility, which “has been cited by DHHS for staff failing to appropriately supervise children, such that suicide attempts, fighting, and serious injuries occur,” according to the lawsuit. 

Fifteen-year-old Flora P. was adopted when she was 3 but returned to DSS care as a teenager when her “adopted parents divorced and later abandoned her,” the lawsuit says. Now in the custody of Orange County DSS, she remains at a PRTF because a group-home placement is not available.   

DHHS removed Timothy B. from his mother’s house when he was “very young,” the lawsuit says. A few years ago, he moved from his father’s home and went to live with his mother again.

At the facility in Raeford, the lawsuit says, “Timothy B.’s room is totally bare, with only a green pad as a mattress, no mattress cover, one pillow, and a blanket. There is no furniture in his room. (He) has nowhere to keep private paperwork and has had staff throw out items that were important to him.”  

Since he arrived, the facility has been cited by DHHS for failing to make sure the residents receive judicial review hearings, according to the lawsuit. 

“DHHS also found that staff cursed at and picked on the residents, that one staff member had a former conviction of assault with a deadly weapon with intent to kill, and that one staff member was suspended for talking about guns and drinking within earshot of residents,” the lawsuit says. 

Timothy B. “has been the target of bullying from staff” who called him “crybaby” and other insults, according to the lawsuit. 

He meets weekly with a therapist and psychiatrist – “services that can be provided in the community,” the lawsuit says.

The teen says he feels unsafe at the facility, according to the lawsuit, and he wants to live with his grandmother. 

The lawsuit does not name the facility where Timothy B. lives. But it highlights two facilities in Raeford – Canyon Hills Treatment Facility and Hope Gardens Treatment Center. 

At Canyon Hills, according to the lawsuit, two nurses said they witnessed physical abuse by staff toward children, including one incident in which a child was choked. 

The residents, some of whom had lost weight, created a petition asking for more food, the lawsuit says. In response, the facility allegedly punished the children by serving smaller portions.

One child reported being sexually abused at the facility, according to the lawsuit, and staff used homophobic slurs toward residents. 

At Hope Gardens, a staff member allegedly choked a child and referred to another using racial and homophobic slurs. In one instance, the lawsuit says, staff members had to pull a colleague away from a child who was “screaming in pain.” 

State’s needs

More than 500 children involved with DHHS were placed in PRTFs over a one-year period ending in November 2021, according to the lawsuit. 

The lawsuit also alleges that DHHS puts “a substantial number” of children with disabilities who are in foster care in out-of-state facilities. It cited the “Locked Away” investigation, which said children from North Carolina have been sent to states such as Missouri and Utah. 

Despite an increase in the number of foster children, the state has not added community-based services for children, the lawsuit says, and the number of foster families has declined. 

North Carolina needs more options for placing children with behavioral health needs, including foster families and therapeutic treatment facilities, said Haight, the DHHS spokesperson. 

The state also needs more staff and better pay for workers in social services, Haight said. 

“The work necessary to keep more children out of crisis and support those in crisis in the least restrictive setting that meets their specific needs will require significant financial investment from the North Carolina General Assembly,” Haight said, adding that North Carolina ranks 36th in the country for per-child spending on child welfare services. 

“However,” Haight said, “it will take more than just funding to realize our shared goal that every child and family has what they need to cope, repair and heal from trauma and complex behavioral health challenges.” 

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