RALEIGH, N.C. (WGHP) – A couple of bills working their way through the North Carolina General Assembly go right to the heart of a report released Monday about steps that would improve child safety in the state – only maybe not in the ways advocates would hope.

The annual report to the governor and General Assembly by that Child Fatality Task Force cites some alarming data about deaths among children ages 0 through 17 and offers 11 steps that lawmakers could take to improve those outcomes.

Among them were these two key points being debated and legislated during the current long session: expanding Medicaid to provide health care to more children and their families and finding ways to keep children safe from guns.

The House has passed its most recent version of Medicaid expansion, which conflicts with a bill the Senate passed last summer – and the House ignored – and likely won’t get a warm reconsideration in the Senate this session. There will be more discussion coming in both chambers.

But bills passed separately last week by the House and Senate make handguns more easily available in both cases, and one of them – the Senate’s version – contains language to address the “safe storage of firearms,” albeit to a limited extent.

Guns, the task force found, crossed that nexus between homicide and suicide, which has increased by its highest rate in two decades. In 2021 data compiled by the Centers for Disease Control and Prevention showed that North Carolina had the nation’s 12th-highest death rate, the report noted.

The report said that firearm death rates for children ages 0 to 17 increased 120.8% from 2019 through 2021 and by 231.3% from 2012 through 2021. “Firearms were the lethal means used in more than 70% of the 2021 suicides and homicides; especially among ages 15 – 17 (83%),” the report said.

And that was the No. 1 recommendation in this report, which cited 600 child firearm deaths in the state between 2012 and 2021. Democrats who debated against the passage of both bills cited the prolific number of deaths of children from firearms.

“Gun violence is the leading cause of death of children and teens, an alarming fact,” state Rep. Pricey Harrison (D-Greensboro) said in arguing against the House’s bill.

In the forward to their 34-page document, task force cochairs Karen McLeod, Jill Cox and Kella Hatcher wrote this:

“This year’s report shares disturbing data about a significant increase in firearm deaths and injuries to children and a crisis in youth mental health with increased rates of suicide and self-harm.”

About Medicaid funding

The recommendation for Medicaid expansion – which almost all legislators support but some oppose because of the attached actions, such as certificates of need and the licensed reach of nurse practitioners – looks at birth issues.

The report that the state’s infant mortality rate is among the nation’s 15% highest rates, and that it is 2.5 times greater among Black infants, which is attributed to levels of available health care. More Medicaid dollars can help that.

“For obstetrical care providers treating Medicaid patients, the reimbursement rate in NC pays only 59.4% of the Medicare rate; increasing this rate would attract more maternal care providers to take Medicaid patients, especially in rural areas where providers are lacking,” the report said.

Neither Harrison nor state Rep. Jon Hardister (R-Whitsett), the House majority whip, said they had had time to review the report and couldn’t comment for now.

State Sen. Michael Garrett (D-Greensboro) had seen the report and said it was an indication that leaders in the General Assembly should be focusing on what helps children with “meaningful and immediate action.

“Instead of waging culture wars on the back of our kids and making it easier for guns to fall on the wrong hands, we should be coming together to help our kids, their families, and our communities,” Garrett wrote in a text message to WGHP.  “The horrifying increase in firearm death rates in children needs to be addressed.”

Suggested actions

The report, which was delayed from last fall while data were being compiled, recommends actions legislators should consider this term as they are developing and passing the state’s biennial budget. These steps address the headliner issues noted but also support more availability for mental health care, more toxicology testing and even mandatory lifeguard for day camps. The complete list of recommendations:

• Launch a statewide firearm safe storage education and awareness initiative.
• Recurring funds to increase numbers of school nurses, social workers, counselors and psychologists.
• Implement a statewide electronic school health data system.
• Strength and restructure the statewide Child Fatality Prevention system.
• Funding to expand efforts to prevent infant deaths related to unsafe sleep environments.
• Medicaid funding to support maternal healthcare strategies known to produce better outcomes.
• Strengthen North Carolina’s infant Safe Surrender law.
• Strengthen NC’s child passenger safety law to address best practices for safety.
• Funding to enable comprehensive toxicology testing in child deaths.
• Funding for programs to prevent harm to youth and infants caused by tobacco/nicotine use.
• Require lifeguards at children’s day camps that offer time in the water.

The task force issued its most powerful “Support” recommendation for everything on the list except the last two items. The tobacco and lifeguard items received the “Endorse” reinforcement, meaning they are led by others but reinforced as an idea.

More findings

The report, which includes voluminous data collected from the state vital statistics collection – and an increase in multiracial data – found that the overall death rate for those ages 0-17 in 2021 was 59.1 per 100,000 residents, which is the highest rate since 2016. Those death rates declined between 1991 and 2016, but the current rates are a significant increase, especially for 15-to-17-year-olds, which grew by 26% from 2020 to 2021 and 47% since 2012.

The report says that can be traced to an increase in suicides and firearm-related homicides, which have increased dramatically. “Nearly all homicides of children over the age of 4 have involved firearms (93%),” the report said. “Homicide rates are particularly high in the 15-16-17-year-old age group.”

Overall significant increases involved homicide, suicide, motor vehicle injuries and other unintentional injuries unrelated to motor vehicles.
The task force gave its greatest reinforcement to the recommendations about firearms, citing a study from 2016 that said more than half of gun owners store “at least one gun unsafely” and that in 2021 about 2 in 5 adults in North Carolina have a firearm at home, more than half which are loaded and also unlocked.

The report also mentions a survey from 2021 in which 30% of high school students said it would “them less than an hour to get and be ready to fire a loaded gun without a parent or other adult’s permission.”

Other legislative action

The state already has a safe surrender law for infants, but the Senate last week unanimously passed a bill to change the specifications about to whom a child could be surrendered, citing a recommendation by the task force.

The bill also addresses privacy rights for the parent surrendering the infant and the adult taking care of the surrendered child.   

“Current law allows a person to surrender an infant to another responsible adult as long as the child is no more than seven days old and is not a victim of abuse or neglect,” WNCN-Channel 17 reported. “The bill would change that to call on a parent to surrender the infant to: health care providers, first responders or social services workers.”

“Right now, the law says that you can surrender a child to any adult. We’re very concerned about human trafficking and exploitation of a child,” the bill’s sponsor, Sen. Jim Burgin (R-Harnett), told WNCN.

Since 2007, 16 children have been surrendered under the law, the NC Department of Health and Human Services reported.  It’s unclear when the House might take up this bill.

The gun debate

But there was no hesitancy on gun bills. House Bill 50 dealt with ending pistol permits but otherwise did not include language for any other element – such as the safe storage funding that was passed in Senate Bill 41.  But the Senate did hear four amendments, one of which would have strengthened the section about safe storage.

“Safe storage is common sense,” state Sen. Natalie Murdock (D-Durham) said in proposing an amendment. “Most school shooters bring their weapons from home. … This amendment would provide more resources for safe storage.”

The amendment was tabled in a vote along party lines.

In arguing against HB 50, Harrison, who called herself a “proud gun owner,” said it was “the wrong bill and the wrong timing.”

Said Garrett: “We offered a safe storage amendment when Republicans were loosening restrictions on firearms, and they unanimously rejected it. Instead of investing in mental health services for kids while our child suicide rate is at the highest in over two decades, they waged a culture war with HB2 classroom edition.

“As a parent with two young children, I take these issues very personally. This should rise above partisan politics, our kids deserve better. “