Matthew Whittle

In recognition of April 7-13 being Public Health Week, SEANC will highlight areas this month where state employees are working to improve public health.

We begin with North Carolina’s Children’s Developmental Services Agencies. These 16 agencies focus on providing services and support to families and children, ages birth to three, with developmental delays and disabilities. Unfortunately, as part of budget cuts demanded by the General Assembly, the state Department of Health and Human Services decided last year that it would consolidate four of the agencies in the east into one. This decision will combine the Rocky Mount, Cape Fear and New Bern agencies with Greenville’s, which is run by East Carolina University – a decision that will have far-reaching effects not just for the employees faced with either losing their jobs or taking significant pay cuts, but also for those children and families currently receiving services in those 28 counties.

SEANC spoke with three CDSA employees, none of whom wanted to be identified – not even by their agency or job position – because of fears of retaliation. They spoke not only about their concerns about the proposed consolidation, but also about what the CDSAs do for the community and what it takes to work for one.

To them, working for a CDSA is more than just a job or even a career. Together, they said, “it’s our calling” – particularly for the case managers, who work with both the children and their parents to coordinate services for the entire family and to make sure those services are being properly administered.

They explained that parents often are referred to a CDSA shortly after their child is born, whether because of premature birth, vision/hearing impairments, neurological deficiencies or congenital anomalies, such as Down Syndrome.

“Our people are the first contact for the family. We are the first line of support for them,” the administrators said. “They rely on us.”

Among the services the agency offers are medical, nursing, psychological and nutritional services; occupational, physical and speech therapy; and family training and counseling. And while all of the families they work with are in challenging situations, among the most unique are military families at Fort Bragg, Camp Lejeune, Seymour Johnson Air Force Base and Marine Corps Air Station Cherry Point – many of whom receive those posts because of the services available.

The administrators explained that they work with the parents to create goals for the children, from something as big as the child learning to walk, to something as small as the child being able to say what she wants to eat.

“It’s very parent-driven. It’s based on the needs and concerns of the family and the children,” they said.

But because working with parents to set those goals requires very close coordination, the administrators said they have been hearing from many parents who are concerned about the proposed consolidations and how it will impact their children’s care.

“A lot of parents are pretty upset,” the administrators said. “They really look to these case managers and rely on them for guidance.”

Now, the futures of those relationships are up in the air – particularly, the administrators said, because they and the parents have not received clear information on how or when a seamless transition will take place.

The administrators said they were told originally the transition would take place by July 1, but with no clear plan yet in place, they do not know if that will be possible. Furthermore, they said, the ongoing limbo not only makes parents nervous, it also hurts the more than 170 employees facing a reduction in force who do not yet know if they will be considered for the new jobs being created at ECU or how that application process will work.

“It’s so hard for the staff to continue on and perform their jobs. For us to be expected to apply for our jobs and then to see our benefits and salaries being cut …. It’s difficult when you have that weighing on you. Not having any answers is very frustrating,” they said. “And the families keep asking us what’s happening. Parents ask what’s going on and are they going to lose us.”

And while the actual services being provided are not likely to change – largely because many of the program’s details are federally mandated – the administrators voiced their concern about comments made by officials at ECU that they plan to hire recent graduates, rather than experienced case managers and others to fill the 150 new positions. They also are concerned that little has been said about what sort of case load those new employees might have to manage or the territory they might have to cover – and the effects those unknowns might have on efficiency and quality of the services being provided.

It seems clear to SEANC, though, that when the work force is being reduced, both in numbers and experience, services will suffer, and that if services suffer, then the families receiving them will suffer. SEANC is urging lawmakers to reconsider their priorities, such as the decision to give away millions of dollars to Hollywood in the form of tax incentives, and help North Carolina’s children instead.