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New Lawsuit Asserts North Carolina Discriminates Against Disabled Children in Foster Care

December 12, 2022
Source: Disability Rights North Carolina (DRNC)

Advocates for civil, disability, and children’s rights filed a federal lawsuit today against the North Carolina Department of Health and Human Services (DHHS) for its pervasive, system-wide practice of unnecessarily warehousing children with disabilities in foster care in dangerous, locked psychiatric institutions—a harmful, unlawful practice that also falls most heavily on children of color. 

The lawsuit is brought on behalf of a class of North Carolina youth in foster care with mental and behavioral health needs, together with Disability Rights North Carolina (DRNC) and the North Carolina Chapter NAACP State Conference (NC NAACP). The Plaintiffs are represented by lawyers at DRNC, NC NAACP, the national advocacy organization Children’s Rights, and the law firm Moore & Van Allen, PLLC. 

The federal Complaint describes DHHS’s practice of discriminating against children with disabilities in foster care by locking up more than 500 of them every year in prison-like psychiatric residential treatment facilities, known as PRTFs, rather than providing them with integrated community-based housing and services that they are eligible for. The unnecessary use of these prison-like settings is both unlawful and widely recognized as harmful to youth, who fare far better when supported in family-like settings in communities with supportive services. 

As described in the Complaint, North Carolina children confined to PRTFs routinely face traumas instead of treatment. They regularly suffer from broken bones, sprains, bruises, and dangerous physical and chemical restraints. They endure abuse, bullying, and hate speech by both youth and staff, and receive strong cocktails of psychotropic medications instead of therapeutic treatment and care. DHHS is aware of these harms, yet [it] continues to warehouse children in PRTFs instead of building community-based placements and services. DHHS further compounds the harm by shipping significant numbers of youth in its care to other states as far away as Utah, severely limiting ties to family and community, not to mention oversight by a child’s North Carolina-based caseworker.

Children living in institutions suffer negative outcomes from their time in PRTFs, such as longer stays in state custody, lack of connection to family and community, and denial of opportunities for a permanent family home. Some experience grave outcomes when they leave the system, such as homelessness and incarceration. Black and Brown children in North Carolina, are overrepresented in the state’s child welfare system and are also over-represented in PRTFs. They wrongfully bear the brunt of the state’s failures. According to recent DHHS data, children of color make up over 40% of the children on Medicaid confined to PRTFs. 

[Caption:] The above pictures were taken during DRNC monitoring visits at 4 PRTFs in North Carolina. [Descriptions of four pictures are added below.]

[Picture 1: The bed is a narrow, metal cot with a thin mattress, a small thin pillow, and a blanket in an empty room with a window on the far wall covered by a window shade.]

[Picture 2: Two single mattresses are pushed against one wall on the floor of an empty room, each covered with a sheet. There is one small, cube-like table between the beds. A small window without a shade on the far wall is located high above the floor, next to the ceiling.]

[Picture 3: A large, flat, empty yard that is mostly dirt with a few patches of grass is enclosed by a high metal fence. A taller wooden fence encloses the metal fence. The tops of many trees appear behind the wooden fence, completely outside the fenced yard area.]

[Picture 4: A slab of concrete and a small, flat, empty yard with dirt and a few patches of grass are enclosed by a high fence covered with sheets of black plastic. The concrete slab has one lawn chair, a large, square wooden post, and it is shaded by a dark wooden deck or overhang. A house or building on the left and right sides of this area close off other access to the yard space. There is blue sky and the very tops of trees off in the far distance, if you look up from the concrete slab area.]

“DHHS is failing hundreds of children with disabilities in foster care, warehousing them in dangerous, expensive, damaging institutions. DHHS is obligated to provide these children the helpful support and care they need in their home communities. These children deserve and have the right to a family and place in our communities where they can meet their full potential. Instead, they receive institutionalization and irreparable harm to their childhood and wellbeing,” said Virginia Knowlton Marcus, Chief Executive Officer of Disability Rights North Carolina.

“DHHS’ failure to provide community-based, family-based housing and supports for Black children with mental health needs is cruel, irresponsible, discriminatory, and must be rectified,” said Deborah Dicks Maxwell, President of the North Carolina NAACP State Conference. “North Carolina already rips Black children from their families and throws them into foster care at an alarming rate, a lasting trauma that the state compounds by its brutal use of institutional care. It is past time to fix this.”

“This case seeks to stop DHHS’s inhumane and unlawful system-wide failures that harm the very children it exists to support and protect,” said Marissa C. Nardi, Lead Counsel for Children’s Rights. “Children belong with families, not in facilities. DHHS must be held accountable for getting children out of these dangerous places once and for all.”

“As pro bono counsel we are proud to be a part of this litigation and hope DHHS will work with us on a resolution to improve the lives of so many children with disabilities in need of care and support,” said Josh Lanning, Lead Counsel at Moore & Van Allen, PLLC.

About Disability Rights North Carolina
Disability Rights North Carolina is the federally mandated protection and advocacy system in North Carolina, dedicated to advancing the rights of all people with disabilities, of all ages, statewide. DRNC is an independent, 501(c)(3) nonprofit organization and a member of the National Disability Rights Network. Learn more about Disability Rights North Carolina at

Our mission is to achieve equity, political rights, and social inclusion by advancing policies and practices that expand human and civil rights, eliminate discrimination, and accelerate the well-being, education, and economic security of Black people and all persons of color.

About Children’s Rights
Through relentless strategic advocacy and legal action, we hold governments accountable for keeping kids safe and healthy. Children’s Rights, a national non-profit organization, has made a lasting impact for hundreds of thousands of vulnerable children. For more information, please visit

About Moore & Van Allen, PLLC
Moore & Van Allen PLLC (, founded in 1945, has nearly 400 attorneys and professionals serving clients in over 75 areas of focus.

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