If you suspect abuse, who do you notify? What should county DSS do with reports?
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- All NC adults are expected to report suspected abuse, neglect.
- County DSS must screen abuse reports to assess dangers.
- Cases failing to reach a legal threshold aren’t investigated.
County social services departments across North Carolina are charged with keeping the most vulnerable people safe from abuse and neglect. That includes all children and adults living with disabilities.
When someone reports a potential case of abuse, the local DSS office is supposed to assess the allegations. Every report goes through this screening process, Hannah Jones, a press assistant with the North Carolina Department of Health and Human Services told The News & Observer.
“They screen the information in real time to determine if what has been reported meets the statutory threshold for a CPS assessment,” Jones said in a written response to questions.
Sometimes, the potential abuse reported doesn’t meet that threshold. DSS does not go any further if staff determines that a case doesn’t meet the legal requirements for abuse.
That’s led some to question whether the system is doing enough for vulnerable people. Krista Caraway, the legal guardian of a non-verbal autistic woman, told The N&O she has concerns about the quality of DSS oversights in Orange County.
In December 2023, she and others intervened on her ward Alexis Abernethy’s behalf to remove her from deteriorating living conditions with her adoptive mother — who eventually pleaded guilty to assault and false imprisonment.
“I want to see better for my people,” Caraway said. “At least get educated on the job you’re doing, because you failed big time.”
Caraway has called for a full review of DSS policies after she learned what Lexi had gone through.
What ranks as abuse or neglect in North Carolina?
All adults are required to report cases of potential child abuse or neglect to local DSS offices. If the allegations reported meet the legal requirements for child abuse, the county DSS will prompt an investigation.
According to the North Carolina Judicial Branch, a child is considered abused if their parent or legal guardian’s actions meet certain criteria including:
- Causing serious physical injury to the child
- Creating, or allows someone else to create, a risk of serious injury to the child
- Using “cruel or grossly inappropriate discipline on the child”
- Encouraging a child to commit sex crimes, commits them against the child themselves or allows others to do so
- Causing the child “serious emotional damage”
- Engaging in sex trafficking of the child
- Encouraging or approves of delinquent behavior that involves immoral acts by the child
If allegations meet the state’s definitions for child abuse, DSS opens an assessment. If the child is in unsafe conditions or a situation that could become unsafe in mere hours, child protective services (CPS) is tasked with starting the assessment immediately.
That process is started within 24 hours if a child has visible injuries due to neglect “that do not require urgent or emergency medical care,” according to the state’s Child Welfare Manual. And if allegations don’t meet criteria for an immediate response, CPS normally starts an assessment within 72 hours.
While child protective services will step in and investigate cases of potential child abuse, adult protective services (APS) is responsible for oversight of people 18-years or older who are physically or mentally incapacitated.
For county adult protective services to investigate, a report must also meet the state’s definitions of abuse, neglect or exploitation. And the adult must be “in need of protective services, unable to obtain essential care and without someone able or willing to help,” according to Jones.
The state defines abuse in this case as “the willful infliction” of physical pain or mental trauma, “unreasonable confinement” and when a caretaker withholds services necessary to “maintain mental and physical health.” Exploitation is defined as someone else profiting off of a disabled adult or their resources.
If the allegations in the report meet the state’s criteria, county DSS must begin an evaluation. If there is danger of death, that process starts immediately, within 24 hours if there is danger of “serious harm” and within 72 hours in all other cases.
State regulators have acknowledged there have been issues with DSS timeliness on when investigations are initiated. And while there has been improvement, DSS staff turnover and job vacancies are among the issues that can still cause delays in the investigation process, according to a DHHS assessment published in February 2025.
The DHHS report also noted that the department lacked a statewide system for tracking and responding to reports of child abuse or neglect, slowed down the process.
In June, NCDHHS launched PATH NC, which is intended to “help frontline staff better identify and assess risk and safety concerns when responding to reports of child abuse or neglect,” regulators said of the program when it launched.
Once assessments of abuse or neglect reports are completed, a county DSS staff member discusses the allegations with a DSS supervisor to determine if the report was screened accurate. If the report is “screened out” it means DSS decided not to dig deeper into the allegations.
“When a report does not meet these requirements, the county DSS will document and screen out the report,” Jones, the NCDHHS spokesperson, wrote in an email response. “The reporter may be referred to other appropriate resources or agencies for assistance.”
Internal reviews
After Caraway temporarily removed Lexi Abernethy from the home of Katherine Abernethy, Lexi’s adoptive mother was charged with neglect. In October of this year, she pleaded guilty to assault on an individual with a disability and false imprisonment.
She and others have called for a full third-party review of Orange County DSS policies. That includes some internal review of whether DSS guidelines were followed in investigating Lexi’s risk of abuse or neglect, something an East Chapel High School social worker and others had filed reports about.
“In general, Orange County DSS conducts internal reviews if a constituent concern is brought to our attention,” Orange County DSS Director Lindsey Shewmaker said in a statement to The N&O. “The North Carolina Department of Health and Human Services can also review cases when they feel there is a reason.”
Shewmaker said that there are channels for the public and advocates to use when they have concerns about a case decision or action. But she acknowledged it’s not always a path to direct impact.
Caraway said she is worried that if nothing changes, more children or disabled adults could end up in the dangers Lexi lived with.
EDITOR’S NOTE: If you believe a child, elderly adult or a disabled person is being abused or neglected, you can report concerns to your county’s Department of Social Services. Phone numbers for departments across North Carolina can be found here.
This story was originally published December 11, 2025 at 5:30 AM.
