State agency ‘very concerned’ with the number of Virginia children born substance-exposed that die

State agency tasked with investigating complaints involving children in foster care received 50 notifications of child fatalities

The state agency tasked with investigating complaints involving children in foster care is “very concerned” with the number of children born substance-exposed that die within six months of birth.

That’s just one of the findings of the Office of the Children’s Ombudsman (OCO), which can investigate child fatalities when the child victim’s family was involved with CPS or foster care prior to, or at the time of, the child’s death. The OCO was created, in part, to add a level of accountability in our child welfare system, according to Eric Reynolds, the director of the Office of the Children’s Ombudsman.

“Most of these deaths are preventable,” according to the OCO report, which says they received 50 notifications of child fatalities.

The average number of CPS reports made prior to the death of the children was 2.6.

“In one case involving the death of a 5-year-old child, there were twenty CPS reports made over a span of 11 years on the family about the child and the child’s siblings, half-siblings, and stepsiblings, including multiple reports of domestic violence, physical and sexual abuse, neglect, unstable housing, and unsafe conditions of the home. The allegations were reported to four different local departments of social services due to the family’s frequent moves. Several of the reports were screened out, unsubstantiated, or unfounded. The children often recanted their prior disclosures of maltreatment, with some of them expressing fear of retaliation by the parents,” the report says.

Another point in the report is the number of complaints about the department of social services and other agencies coming into the office for investigation, many from our region of Virginia.

Complaints Made Against Local Departments of Social Services During Q3 and Q4. (Courtesy: Office of Children's Ombudsman)

10 News is breaking down the report, just released Tuesday for State Fiscal Year 2023 covering July 1, 2022, through June 30, 2023.

The office received a total of 446 complaints, an increase compared to last year. However, the director attributes that to more people becoming aware of the state agency.

From January through June 2023, the most complaints were made against the following local department of social services offices:

  • Carroll County: 36
  • Shenandoah Valley: 8
  • Harrisonburg/Rockingham: 9
  • Norfolk: 8
  • Franklin County: 8
  • Pulaski County: 7
  • Roanoke City: 7
  • Roanoke County: 6
  • Wythe County: 5
  • Richmond City: 4

Deaths of children or families with connections to the system are concerning, state agency says

“Of the 50 child fatality notifications we received, eighteen of the children were reported as substance-exposed at the time of their birth. In 27 cases reported to us, there was a history of CPS involvement related to parental substance use, including six cases where siblings of the decedent children were reported as substance-exposed at their births,” the report says.

Director of the Office of the Children’s Ombudsman Eric Reynolds said that’s one of the more troubling findings of the report.

“We see in all of these cases these patterns that we need to identify and figure out why are these kids falling through the cracks,” Reynolds said. “What are we doing or what are we not doing in our process?”

The OCO received 50 notifications of child fatalities that met its criteria in FY 2023, compared to 31 notifications in FY 2022.

  • Nine children were in foster care at the time of their death.
  • Twelve of them were involved in open CPS cases at the time of their death: seven CPS Family Assessment cases, including three Substance Exposed Infants (SEI) Family Assessments; three CPS investigations; and two In-Home Services cases.
Most of the children who died were 5-years-old or younger. The Office of Children's Ombudsman received 50 notifications of child fatalities that met statutory criteria in FY 2023. (Courtesy: Office of Children's Ombudsman)

Most of the children who died were under 5 years old, according to the report.

  • Twenty-seven of the children were aged birth to six months, including five children who were less than a month old
  • Eleven children were between the ages of one and five years.
  • Nine were five to eighteen years old.

[READ MORE: Virginia Office of the Children’s Ombudsman now officially taking complaints]

According to the report, unsafe sleep, such as co-sleeping and unsafe sleep surfaces, continues to be a leading factor in child deaths among the cases reported to the OCO, with 21 children’s deaths reported to the OCO (42%) tied to circumstances indicating unsafe sleep conditions.

Causes of death

The causes of death, as reported in the case records, included the following (some children may have had more than one cause listed):

  • Sudden Unexpected Infant Death (SUID), associated with unsafe sleep (either co-sleeping or unsafe sleep surface): 6 children
  • SUID, undetermined: 1 child
  • Natural causes/serious medical conditions: 6 children
  • Fentanyl toxicity/intoxication: 3 children
  • Prescription drug overdose: 1 child
  • Medical complications from being born substance-exposed: 2 children
  • Vehicular accident: 6 children
  • Household accident: 1 child
  • Homicide: 2 children
  • Accidental fatal gunshot wound: 1 child
  • Suicide: 1 child
  • Suffocation, accidental possibly due to unsafe sleep: 1 child

The report says causes of death of the remaining nineteen children were reported as undetermined or have yet to be determined, but unsafe sleep is suspected for fourteen of these children.

“Most of these deaths were preventable. We recommend a review of the protocols in place that are established in law, regulation, and policy and across agencies to ensure that these children are better protected. Many of the current protocols depend on the willingness of parents to voluntarily receive services, such as home visiting programs, substance use treatment, and in-home parent coaching. When parents choose not to engage in these services or miss vital medical appointments for the child, the child’s risk of harm is greatly increased,” the report says.

The OCO has been involved in local cases. As 10 News reported, a Carroll County mom fighting for her kids got the state agency involved. The OCO investigation found significant issues with the way Angie Key’s case was handled from the very beginning.

Key’s attorney John Koehler said every child death’s is horrific but the increase is concerning.

“We have so much more work to do in changing and improving our system,” Koehler said. “Overall, the increase in numbers is distressing.”

10 News has covered this office since 2021, before it started taking complaints. You can find more information about the Office of Children’s Ombudsman, how it investigates and how to file your own complaint here.


About the Authors:

You can see Jenna weekday mornings at the anchor desk on WSLS 10 Today from 5-7 a.m. She also leads our monthly Solutionaries Series, where we highlight the creative thinkers and doers working to make the world a better place.

Amy Cockerham joined the 10 News team in January 2023.