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Emergency placement funds to help counties provide appropriate placements for children in DSS custody

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RALEIGH — The North Carolina Department of Health and Human Services distributed funds this week to county departments of social services to help improve placements for children in DSS custody who have complex behavioral health needs. These critical funds come at a time when an average of 32 children are living in DSS offices each week because there is no place for them to go that is appropriate for their care.

“Some children in the care of social services have particularly complex needs and can get stuck waiting in emergency departments or sleeping in government offices,” said N.C. Health and Human Services Secretary Kody H. Kinsley. “We are providing our county partners flexible funding to replicate and expand programs already working in pockets of the state to help ensure these children get the right care at the right time.”

The DSS Emergency Placement Fund is a pilot program funded by the NC General Assembly in the 2023 North Carolina state budget. The program provides nearly $2.3 million this year and $5.5 million next year to assist county DSS offices in creating better, more reliable placement options for children in their custody who have behavioral health needs. The funds will help to improve outcomes by preventing children and youth from having to stay in a DSS office overnight while they await placement into Medicaid funded treatment.

“We are grateful to our partners at the General Assembly for providing these funds so we can help our county DSS offices who have been using every resource they have to make sure children in their custody are safe,” said NCDHHS Deputy Secretary for Children and Family Well-Being Susan Osborne. “We all want children to have the resources and health care they need so they can thrive, and this pilot program is one step forward in improving the lives of children in DSS care.”

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The DSS Emergency Placement Fund improves care options by enabling DSS offices to implement practices that have been shown to support better placements for children with complex behavioral health needs. These practices can include:

  • Maintaining a crisis placement provider on retainer who can provide temporary emergency placement that is suitable to a child’s behavioral health needs until a treatment placement can be located.
  • Providing short-term rate increases to placement providers who care for children with behavioral health needs who require an exceptional level of supervision. These funds are to be used to improve the placement provider’s ability to meet the child’s individual needs.
  • Implementing local solutions that prevent a child in DSS custody from spending a night in the DSS office while awaiting an appropriate placement for behavioral health treatment. These alternate practices are to be submitted to the NCDHHS Division of Social Services for approval.

To ensure sufficient and equitable funding for all counties, allocations were made based on each county’s percentage of the foster care census. Funds were available beginning Feb. 1, 2024, with reimbursement beginning in March 2024.

The DSS Emergency Placement Fund is one initiative within $80 million allocated to directly support child and family well-being with specialty treatment programs and intensive supports for children with complex behavioral health needs. These investments mean fewer children boarding in DSS offices, more children in DSS custody living in a home setting appropriate for their behavioral health needs and potentially fewer emergency department visits or stays for children experiencing a behavioral health crisis.

The work is made possible by the Medicaid expansion signing bonus, which provided a historic $835 million investment to transform behavioral health for everyone in North Carolina, including children and families.



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