Case Study

North Carolina Navigates Complex Multisystem Reform to Improve Service Delivery to Families

Legislation passed in the aftermath of the death of a child in the North Carolina Child Welfare system motivated State and county leaders to collaborate on ways to improve service delivery across multiple programs. Public Knowledge® was selected as an independent, third-party to help North Carolina achieve their goal.


Introduction

In June 2017, the North Carolina legislature passed what is known as “Rylan’s law.”1 Rylan was a child who died as a result of his mother’s criminal negligence after he had been returned to her care. The legislation required the Office of State Budget and Management (OSBM),2 in consultation with the Department of Health and Human Services (DHHS), to contract with a “third party organization to develop a plan to reform the State supervision and accountability for the social services system, including child welfare, adult protective services and guardianship, public assistance, and child support enforcement” − referred to in the legislation as the “system reform plan” and, as part of that work, develop a comprehensive “child welfare reform plan.”3

The legislation provided a long list of specific areas to be assessed and evaluated in the development of the plans and to be covered by the findings and recommendations in the plans.4

This included the expectation to make recommendations related to staffing for a regional management structure. The legislation also required a data dashboard to make public a standard set of performance and outcome metrics that would indicate how effectively the components of the social services system are working.

In recent years, those working on child welfare system improvement have increasingly recognized the importance of coordination and collaboration between child welfare programs and the other social services, health care programs (including mental health), and economic support services that serve families. While that was not necessarily the motivating factor behind the legislative decision to include all of the social services program areas, not just child welfare services, in the scope of the work, it provided an opportunity for the State and Public Knowledge® to consider and develop a much broader vision for how to promote better outcomes for North Carolina’s children and families.


Laying the Groundwork with Rylan’s Law

For the better part of a decade, North Carolina had undertaken efforts to identify and address obstacles to the effective functioning of the social services programs. While many of these efforts identified important challenges and produced good ideas for addressing them, they seldom gained traction or resulted in sustained reform. Some of these efforts focused on challenges the State DHHS faced in meeting its oversight responsibilities over county-administered social services programs; others focused on the challenges that the counties faced in meeting the needs of the populations they served.

However, these efforts generally proceeded either from a state agency perspective or from a county administrator perspective. Insufficient attention was paid to understanding and reconciling the differences between state and county when defining and addressing major challenges. Without bringing the collective wisdom of both perspectives to both defining the challenges and fashioning the solutions, little progress was made in implementing needed improvements.

As a result, structural and infrastructure issues in the state office and resource disparities among counties created and perpetuated a fragmented social services system with too many gaps to consistently meet the needs of vulnerable children and families.

The publicity generated by the Rylan case and the system failings that it reflected, combined with the results of the federal Child and Family Services Review (CFSR) and the Statewide Child Protective Services Evaluation of the State’s Child Protective Services, focused public and political attention on “troubling gaps and flaws in North Carolina’s child welfare system that are allowing too many of those vulnerable children and fragile families to fall through the cracks.”5

The legislature concluded that “North Carolina requires a plan of action to systemically reform the child welfare system.”6 North Carolina’s child welfare system is one part of a state-supervised, county-administered social services system that also includes adult protective services and aging services, public benefits, and child support.

DHHS is responsible for providing supervision and oversight to 100 separate County Human Services offices, each of which is a local government agency operating at the local level under the auspices of the county commission.

While Rylan’s law placed special emphasis on child welfare, the Legislature also sought to address shortcomings in the oversight and performance of other social services programs under the DHHS umbrella.


Building the Consultant Team: Experience, Thoroughness, Understanding & Expertise

Public Knowledge®’s success in working with North Carolina DHHS is directly attributable to the skills and experience Public Knowledge® staff brought to the project. The team members not only had substantive expertise in their respective fields, but they also had worked “in the trenches” − within relevant systems as both front-line service providers and supervisors, and as agency leaders and policymakers.

Public Knowledge® assembled a team that gave North Carolina officials access to the best thinking on the critical issues as they arose and connected them to evidence-based practices and promising approaches from other jurisdictions. North Carolina state and county officials noted that Public Knowledge® team members were people who themselves faced the challenge of implementing system improvement under the increased scrutiny of adverse publicity and were, therefore, able to identify actionable solutions and help the agencies minimize or avoid having to learn through failure.

Public Knowledge® made available a strong and consistent leadership team comprised of senior managers in the organization with experience leading health and human services programs.

This allowed for expedited decision-making and assignments of needed resources as the project evolved. This also facilitated effective communication with state leaders at critical junctures.

“Public Knowledge® was successful because of the expertise they brought to the table. They brought the best of both worlds—consultants who had national expertise but also people who understood the complexities of our state and local system and our operational nuances.”

STATE DHHS LEADER

From the onset, the team included an expert with experience working within North Carolina’s child welfare and social services system, ensuring the team had a good working knowledge of North Carolina’s structure, policy, and practice as well as an understanding of the political, cultural, and historical context of the programs.

It also meant that there was someone on the ground in North Carolina who was available to meet on a moment’s notice for face-to-face consultation or to participate in ad hoc meetings.

As the project progressed and issues around child welfare financing emerged, consultants with deep experience in child welfare funding were added to assist North Carolina with maximizing its leveraging of federal IV-E funds.

The team also deployed an impressive set of communication, engagement, facilitation, and project management skills, critical to supporting and guiding the various project activities.

This enabled the work to proceed at a relatively fast pace and demonstrated that the team understood and respected the time constraints facing leaders and stakeholders responsible for daily operations.

“Public Knowledge® staff did their research in advance of meetings—they were there not just as information seekers, but also as information sharers.”

County DSS Leader

Challenges Related to Scope of Work; Ambitious Timelines; Heightened Sensitivities; and Balancing Collaboration and Independent Assessment

The breadth and depth of the scope of work described in the State’s RFP, including the requirement that the selected team produce actionable recommendations across diverse social services program areas, was significantly challenging.

In addition, the project required a skilled team to have not only substantive knowledge in child welfare and social services, but also to have had experience in designing and implementing system improvement plans. Due to the tight timeframes for completing the project and the range of stakeholders that needed to be consulted throughout the process, it required an extremely efficient and effective approach to project management.

Compounding those challenges were the heightened sensitivities among the key stakeholders, including the counties, state, judiciary, and advocates. Any major reform that is driven at least in part by adverse legislative findings and negative publicity engenders a level of distrust and defensiveness among the various stakeholders.

It exacerbates tensions that are inherent in stakeholder perspectives, particularly the differences in viewpoint between state office administrators charged with supervision and oversight, and county administrators and staff who are facing the daily challenges of front-line work with families.

Similarly, when the reform framework includes the possibility of major system restructuring, it is easy for affected agencies and organizations to focus on self-preservation instead of envisioning how they could be part of a bigger solution. The Legislature, in requiring an external evaluation and in selecting the Office of State Budget and Management to lead and manage the project, sought to ensure the assessment would be objective.

However, an accurate and credible assessment could not be conducted without the benefit of the different perspectives of the various stakeholders; and no actionable improvement plan could be developed and implemented without collaboration and buy-in from all the stakeholders.

The technical assistance had to be, on the one hand, sufficiently “arms’ length” and transparent in its approach to inspire trust and confidence in the professionalism and objectivity of the consultant team; on the other hand, the consultants had to engage and partner effectively with each of the stakeholder groups and facilitate a collaborative approach among the stakeholders, if they were going to meet the critical requirement of producing actionable plans for improvement.

Adding to these challenges were the ambitious timelines set by the legislature. The project consisted of three distinct phases.

Phase 1

Phase 2

Phase 3

Also, the Legislature concluded that the challenges of effectively supervising the administration of complex social services programs, including, but not limited to, child welfare programs, would be more efficiently and effectively met through the creation of a regional structure for both supportive supervision of and collaboration among the local social services programs within each region.

They created and charged the Social Services Working Group (SSWG) with developing a plan to implement a regional structure and state quality assurance capacities while preserving the best aspects of local program practice, performance, and service delivery. The team quickly assessed the political landscape to determine the best ways to effectively operate in shared space with the SSWG.


Technical Assistance Frameworks

Public Knowledge®’s approach for providing technical assistance was well-suited to meeting these challenges. Their overarching framework for working on system improvement entails five interdependent core elements or “phases”7 organized around the keywords “engage, analyze, envision, synthesize, and empower.”


Public Knowledge®’s five steps in the project approach are described briefly as follows.

ENGAGE

The “engage” phase focused on effectively engaging in a collaborative effort and includes

  1. establishing processes for ongoing input and feedback from the project team, partners, and stakeholders;
  2. leveraging knowledgeable and experienced subject matter experts and team of national technical advisors; and
  3. using helpful models and tools developed over years of program practice and process consulting.

Effective engagement was both the critical first step in its work and an ongoing requirement throughout the work.

ANALYZE

In the “analyze” phase, the team compiled and analyzed qualitative and quantitative information to understand the program, processes, and current performance and to identify potential opportunities for improvement, utilizing subject matter experts, who are also skilled business process analysts, legal experts, well versed in legal issues and policy trends in human services, and experts in human services finance and budgeting.

ENVISION

The “envision phase” used a Solution Design Model to share (and validate) the results of the analysis and help a small but diverse working group envision what the desirable outcomes of the reengineered system would be and what the system would look like.

The envisioning discussions were framed around four core areas of system improvement: organizational and structural relationships; practices and processes, including budget and planning; people, including staffing levels, and educational and experiential qualifications; and performance quality outcomes.

“Public Knowledge® did not try to come in and run the show. They took a shared responsibility approach that was extremely helpful. They provided hands-on help with daily challenges like planning meetings, managing logistics, doing prep work, handling communications, and developing work product.”

County DSS Leader

SYNTHESIZE

In the “synthesize phase” using a Solution Design Evaluation Model, the team helped planning groups consider envisioned system improvement initiatives from three perspectives: critical success factors (for instance, whether the initiative requires a change in law); transitional strategies (for instance, if a change in law is not required, whether a rapid implementation initiative should be considered); and impact and value analysis (for instance, if new resources or funding are required, what will be the cost-benefit of adding them).

EMPOWER

The “empower phase” focused on moving forward from recommendations to action, by helping the leadership team prioritize recommendations for implementation and identify metrics that measure program impacts; and by providing ongoing oversight, monitoring, and constructive feedback as implementation began and moved forward.

Within this framework, the approach to conducting more in-depth child welfare system assessments, focused on specific practice issues, is via a framework using data and qualitative information to define problems to be addressed, and to identify the most promising solutions to these problems. The child welfare assessment work was also rooted in implementation science principles. Focused not only on what services or initiatives a system is implementing but on how they are being implemented as far as promoting the best chances of success for improving child welfare system outcomes.

A core value in the Public Knowledge® child welfare assessment approach lies in the belief that their work is not carried out for child welfare systems, but with child welfare systems, which requires engaging staff and stakeholders and working jointly to assess, design, implement, and monitor solutions.

As such, Public Knowledge® collaborated with leaders and key stakeholders to determine the appropriate research questions that identify the key factors driving the challenges or presenting issues.

By beginning with a clear sense of what the assessment is designed to explore, and linking specific review questions, data, and other inquiries to the research questions, Public Knowledge® increased the likelihood that they identified and fully assessed underlying factors that, if addressed through the implementation of appropriate recommendations, will lead to better outcomes for children and families.

Finally, recommendations for making needed improvements are at the heart of the assessment process. When an assessment has defined problem areas and underlying or contributing causes, a theory of change links findings to recommendations that are expected to lead to improvements.

This approach is focused on making recommendations that are relevant to the underlying and presenting issues, that can be implemented, and that are focused on a system’s priorities and greatest needs.

Framing the work and the deliverables in the context of a broadly inclusive collaborative process signaled that Public Knowledge® did not view their role as outside experts coming in to tell North Carolina what it needed to do, or as a “rubber stamp” to validate one particular stakeholder viewpoint.

It was the combination of the quality of seasoned, broadly experienced professionals assembled for its consulting team and the well managed collaborative process with enthusiastic and visionary partners in North Carolina that resulted in both an objective assessment, with broadly accepted findings and recommendations, and a widely embraced plans for moving forward to address those findings and meet the recommendations.8


The Collaborative Process

In some contexts, it is possible and perhaps preferable to take a traditional approach to conducting an assessment in which disinterested third party consultants conduct their work and issue findings. This approach relies on outside experts with no relationship to interested parties or places impacted, operating fully at arms-length to come into a jurisdiction, gather and review data, interview various stakeholders, and provide an opinion about how well or poorly the system is performing.

However, while North Carolina wanted an objective assessment, it also wanted recommendations and improvement plans that could be implemented successfully within a reasonable timeframe – short-term, mid-term, and long-term.

Three things were critically important: first, not only did the assessment have to be objective and accurate, but it had to be broadly perceived as objective and accurate; second, any recommendations and plans coming out of that assessment had to be “owned” by those whose support and hard work would be required to implement them; and, third, because the conflict between the state and county stakeholders was widely acknowledged to be a key obstacle to system improvement, the assessment process needed to be conducted in a way that built the capacity for effective collaboration.

A major factor contributing to the success in North Carolina was the team’s engagement with the client and stakeholders, throughout the life of the project. While maintaining its professional objectivity, Public Knowledge® approached the assessment and plan development as something to be done in partnership with, not apart from, the North Carolina state and county stakeholders. Early on, institutional stakeholders, key leaders, community-based service providers, advocates, case workers, and youth and family representatives were actively engaged.

Everyone worked together to develop a broadly accepted set of recommendations and a plan for implementation that North Carolina embraced as its own.

The collaborative technical assistance approach began with the first site visit, which occurred within days of contract award. The focus of those early meetings was on project management and communication channels to ensure the project would be completed on time, and that overarching concerns were understood, and expectations and hopes the stakeholders had for the project were heard. These initial meetings were very formal and throughout Phase 1 of the project, that formality persisted.

However, as Public Knowledge® slowly built trust and showed their willingness to listen, understand, and provide genuine and targeted recommendations and assistance, the formal project meetings moved away from contract-driven and took on a problem-solving focus.

During the transition to Phase 2, a commitment was made to conduct monthly, in-person meetings. Rather than simply being a place where project progress was reported, these became working sessions, which helped Public Knowledge® become a trusted partner as the project work progressed.

“It was very reassuring that during the first six months I had almost daily contact with Public Knowledge® staff, who took a hands-on approach to shared project management.”

State DHHS Leader.

Social Services Reform and Child Welfare Reform Plans

Three phases comprised this project. Within each of the three phases, the work was focused on a variety of activities and priorities, based on specific program needs. Two primary deliverables were produced to mark the completion of Phases 1 and 2.9 Phase 3 work concludes May 31, 2020.

Social Services Reform Plan

The work on the Social Services Reform Plan focused on the current framework for service delivery at both the state and local (county) levels and provided recommendations for improvement. The research focused on the five largest programs supervised by DHHS: Child Welfare; Child Support; Economic and Family Services including Food and Nutrition Services and Work First; and Aging and Adult Services. The Social Services Reform Plan addressed organization, staffing, and management of service delivery in these social services programs. The team completed the assessment using:

Several of these efforts were conducted concurrently. Key findings and related recommendations were based on the data gathered through these various activities. Findings and recommendations were also based on industry best practices, as well as program information and data from other jurisdictions.

Through focus groups, individual interviews and site visits, the team encountered leaders, line staff and program stakeholders who had a passion for the work, a willingness to face challenges and who were excited to explore new ways of doing business and work collaboratively to improve outcomes for the state’s most vulnerable citizens.

The assessment and associated recommendations were framed around several themes. Based on the assessment, the team made 48 recommendations organized around these themes.

The recommendations ranged from the relatively easy, such as “Create a repository for county salary information across all social services programs and establish protocols for regular reporting and updating” to more complex and long-term recommendations, such as “create a minimum of seven regional offices to support the counties”.

After releasing the Preliminary Recommendations Report, the team met with various stakeholders including the SSWG, DHHS leaders, and county social services program leaders and staff, briefing each on both the broad recommendations as well as those associated with specific programs. Through the various consultations and additional data gathering and assessment, Public Knowledge® recrafted the recommendations, focusing on those that were identified as having the greatest potential impact on the children and families served by the social services programs. Twenty-seven final recommendations were included in the Final Social Services Reform Plan, submitted on May 6, 2019.

Most of the work on the Social Services assessment concluded with the submittal of the Final Social Services Reform Plan to DHHS in May 2019. The final recommendations were grounded in the data, informed by the qualitative data gathered through focus groups and interviews, and in the end, provided DHHS and the county social services agencies with actionable steps they could consider while looking for ways to improve program performance.

The legislation also required DHHS to develop a plan for establishing regional offices charged with the supervision of administration of social services at the local level. The Department submitted the plan to the Joint Legislative Oversight Committee on Health and Human Services in November 2018.

The DHHS Plan for Regional Supervision and Support of Social Services and Child Welfare Programs closely mirrored the Social Services Reform Plan including most of their recommendations. As most of the recommendations required DHHS to address its internal structure and capacity to support the 100 counties, the agency took on the responsibility for implementing those recommendations.


Child Welfare Reform Plan

In addition to the Social Services Reform Plan, the team was responsible for developing a specific reform plan for child welfare.

The team and designated government officials discussed the substantive elements that would be addressed by the child welfare assessment at the first meeting. In the three months that followed the initial site visit, a variety of approaches were used to gather the information that would be useful as background for proper context and as data that would directly inform the assessment.

After that, the team gathered and reviewed management reports generated by the state management information system and ad hoc data that some counties used to aid in their administration of programs. Public Knowledge® also gathered qualitative data through surveys, and conducted a series of interviews with leadership, staff, and other stakeholders.

Staff planned and facilitated a series of focus groups and co-facilitated subject-specific meetings with the officials charged with oversight and implementation in those areas.

“TA providers do not always read everything you send them. We provided Public Knowledge® with large quantities of data and other information, which Public Knowledge® reviewed with a fine-toothed comb, so they came to meetings unusually well prepared. We did not have to take time to review everything with them. We could hit the ground running.”

STATE DHHS LEADER

The team used the data it gathered to facilitate a session (see July 2018 in Appendix A, Timeline) prior to developing preliminary recommendations for child welfare reform. The focus of this session was to develop a theory of change for child welfare. An agenda was developed that was relevant, sequentially logical, and participatory. With input from the Office of State Budget and Management, the team made the decision to limit the invitation list to include representative state and county child welfare and social services leaders to this session.10

The meeting served as an introduction of the Public Knowledge® team and as an invitation to participants to be key contributors in the planning process that would guide the reform. The information-sharing among peers, the input from family and youth members (via audio recordings), and the sense of working for a common cause to improve the system motivated the group to be a part of the solution.

Participants were able to witness and be a part of collaborative information-sharing that would be at the center of the broader assessment and planning process. Data-sharing that was part of the meeting capitalized on the strengths of stakeholders and introduced participants to a technical assistance approach that would help decision makers develop options and strategies for action rather than fixing problems for them.

The session resulted in a theory of change for North Carolina. All subsequent child welfare recommendations were made to align with agreements made during this session.

The provided feedback in two ways. Informal feedback was ongoing and provided continuously throughout the project. It was designed to be helpful and specifically target the issues with which stakeholders were most concerned. Public Knowledge® offered feedback, both affirming and challenging, to stakeholders to help shape and amend proposals, plans and reports.

“The involvement of the right people at the [session] helped create energy and enthusiasm for system improvement that carried forward as future work unfolded. I was encouraged to hear about exciting and innovative things that others were doing, and I left the meeting ‘pumped up.’”

County DSS Leader

Formal feedback was provided in the form of official reports submitted to the Office of State Budget and Management pursuant to the terms of the legislation and contract. An iterative process was used to develop the preliminary and final reports. In keeping with its commitment to collaboration, Public Knowledge® fully vetted its assumptions and findings with stakeholders before committing to them.

By spending a significant amount of time reaching out to stakeholders and structuring focus groups and listening sessions to make sure that the wide range of voices and perspectives were heard, thereby building confidence among the stakeholders in the assessment process and therefore increased the likelihood of the stakeholders reacting positively to those recommendations.

Ongoing feedback loops and opportunities for review and comment were used as findings and recommendations were developed and finalized. By providing multiple opportunities for input, the team ensured that the findings and recommendations ultimately arrived at and articulated in the plans required by the RFP were informed by the different perspectives of the key stakeholders.

“The Public Knowledge® reports validated issues that had been raised by both the State and the Counties. Public Knowledge®, as an independent third party, did a good job of capturing both perspectives. From the County’s perspective, however, the process moved very fast. It would have been better if the Counties had more time to respond to first drafts of the reports and had an opportunity to provide context for some of the findings.”

County DSS Leader

Public Knowledge® shared previews of the reports, and reviewers were invited to check facts and push back against the conclusions they questioned. Discussion was encouraged to bolster confidence in these positions or to revisit conclusions when the facts so dictated.

The team considered stakeholder feedback thoughtfully, but in keeping with the commitment to the objectivity, the team could not allow the feedback to be determinative in forming final content.

However, in response to stakeholder feedback, the team modified the language to be more directive in some instances; combined and reduced the total number of recommendations in the final reports; and prioritized recommendations to identify those that should be considered foundational or receive early attention for other reasons.

“They held listening sessions, showcased good work, and looped in county officials before the final report was issued. County officials and stakeholders knew they had input, felt involved in the process, and recognized that the recommendations were impartial. Ultimately, in response to everyone’s feedback, they reduced the number of recommendations and reframed some to provide clearer direction and priorities.”

State DHHS Leader

In formulating its recommendations and preparing its reports, Public Knowledge® considered both past efforts at reform and future obligations that might strain the social services and child welfare systems. Many long-time officials and advocates felt that North Carolina “had been studied to death.”

Public Knowledge® heard from stakeholders that the transparent, participatory, and comprehensive process used during the assessment process had bolstered their enthusiasm for this particular reform effort, but they stated concern that the momentum might wane as with other reform attempts had, if the recommendations were not actionable and integrated with ongoing initiatives.

Mindful of these warnings, the team delivered a robust set of recommendations that addressed both fundamental structural components of public agency organization and detailed elements of practice across program areas. Prompted by the enabling legislation, the recommendations were particularly forceful in reshaping major aspects of practice, policy, and approach for child welfare.

Because of the iterative and inclusive process used to formulate these recommendations, they were developed to be easily incorporated into the federal five-year Child and Family Service Plan (CFSP). This integration and consolidation of plans promotes sustainability and leveraging of resources that previous reform plans lacked.

“Public Knowledge® provided a great set of recommendations. They did not surprise anybody, but Public Knowledge® was able to articulate known concerns in ways that made sense and were actionable.”

State OSBM Leader

Implementation Support

Phase 3 had been considered an optional year as part of Rylan’s Law for ongoing “oversight and evaluation.”11 The North Carolina Department of Health and Human Services made the determination to proceed with ongoing child welfare support and for Public Knowledge® to conduct a deeper analysis of core practices and outcomes in the Aging and Adult Services system.12 13

The Department requested that Public Knowledge® provide specific support for “child welfare transformation” in North Carolina and to help ensure alignment with the Family First Prevention Services Act.

Public Knowledge® helped the state develop its required federal five-year CFSP. Public Knowledge® also assisted the state and counties to establish a Unified Leadership Team and it continues to provide facilitation and ongoing support for this team. Support is focused on assisting the team to assess the extent to which the CFSP is being implemented with fidelity and the impact on children and families over time.

Public Knowledge® is also helping this team to engage a broader group of stakeholders in the improvement process – through the establishment and formation of design teams focused on permanency, safety, well-being, continuous quality improvement, and the workforce.

Public Knowledge® assisted state program and finance leaders to develop a workplan to implement certain financing recommendations and the team facilitates regular meetings with these program and finance leaders to implement the activities in it. Public Knowledge® is also providing support related to developing statewide child welfare practice standards, another Rylan’s Law recommendation.

“The new leadership team at the State level approaches the work as more of a partnership. They want ideas from the counties, and they listen to our input.”

County DSS Leader

Conclusion

State reform is not an easy undertaking. Much credit is due to leaders and stakeholders in North Carolina. The state legislature, in response to a tragic child death, catalyzed a reform movement to build better management, policy, and operational structure across multiple program areas that serve families and children. State and county leaders took full advantage of the opportunity for change and improvement.

The roadmap for reform emerged from an independent assessment that evolved into a strong partnership for change. Public Knowledge® was able to develop strong relationships, use fact-based assessment methodologies, and build the case for positive change while serving as independent assessors, valued thought partners, and skillful implementors.

Public Knowledge®’s work to help craft visionary, yet practical, recommendations has helped shape organizational values, structures, policies, and practices. Public Knowledge® remains engaged with stakeholders and will provide its best guidance and support as North Carolina moves forward with implementation.

Public Knowledge® and North Carolina leaders and stakeholders are learning and building evidence for a broader approach to health and human services system improvement, one that relies on the coordination and collaboration between child welfare programs and the other social services, health care and mental health programs, child support, aging and adult services, and economic support services that serve families. This next critical phase of the work together will be the first real test of impact on both the workforce and children and families.14


A note about the authors and the purpose of this case study.

Public Knowledge® (formerly The Center for the Support of Families) asked Kent Berkley and Andy Shookoff to conduct interviews, read materials, and write this case study to document the primary problems that motivated North Carolina to undertake the assessment, key elements of the process by which the assessment was conducted, and the recommendations generated, achievements to date, and the strengths and challenges moving forward. Kent Berkley has dedicated three decades of work as a lawyer representing children and youth, a national consultant advocating for improved system performance in the child welfare and juvenile justice systems, and as an implementer of promising and evidence-based practices and policies. Andy Shookoff is an attorney and former Juvenile Court Judge of Nashville, Tennessee, has been a progressive and effective advocate for children and families for more than four decades.


1 https://www.ncleg.net/EnactedLegislation/SessionLaws/HTML/2017-2018/SL2017-41.html

2 The decision to have OSBM, rather than DHHS, issue, and award the RFP was intended to underscore the intent that the outside organization provides an objective assessment. That the contractor would be overseen by OSBM rather than DHHS created a more arms-length relationship between the contractor and that State department, which, as discussed in the next section, was helpful in facilitating the development of trust between the Public Knowledge® and the county stakeholders.

3 Section 2.1 (a).

4 Sections 2.1(a)-(d).  

5 Preamble to Rylan’s Law, S.L. 2017-41 (House Bill 630) (signed by Governor June 20, 2017)  

6 Id.  

7 The short description that follows suggests a linear sequence for system improvement, beginning with engagement and ending with empowerment. In practice, these elements might be more appropriately viewed as elements of a work cycle where each element remains relevant and periodically comes back into play as progress is made, additional feedback received, and adjustments made in response to that feedback.

8 Public Knowledge® emphasizes close collaboration not only because of its value to the specific project but also because, through working in close partnership with key stakeholders helps build the internal capacity of those stakeholders.  

9 These preliminary and final reports can be found at https://www.osbm.nc.gov/management/social-services-and-child-welfare-reform-reports.

10 Public Knowledge® had originally planned to ensure that the invitation list included key leaders and a broad group of stakeholders, including families and young people. It was determined that these key leaders needed time to build a consensus vision before engaging a broader group of stakeholders.

11 State of North Carolina Office of State Budget and Management, Request for Proposal #13-SL2017-41HB630, Social Services Reform and Child Welfare Reform Plans. Date of Issue September 29, 2017.

12 Through a subcontract in Phase 3, Public Knowledge® also continued to develop a data dashboard to make public a standard set of performance and outcome metrics that indicate how effectively the components of the social services system are working.

13 The analysis of core practices and outcomes in the aging and adult services system has been delayed because of the COVID-19 crisis. Plans are for this to continue in the future.

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