House committee substitute changes the act's titles and replaces the content of the 4th edition with the following.

Part I.

Amends the purposes set forth in GS 7B-100 that are applicable to Subchapter I of GS Chapter 7B, governing abuse, neglect, dependency and termination of parental rights proceedings. Now states as a purpose of the Subchapter that when it is not in the best interest of the juvenile to be returned home, the juvenile will be placed in a safe, permanent home within one year from the date of the initial order removing custody (was, within a reasonable amount of time).

Expands the definitions of abused juveniles and neglected juvenile provided in GS 7B-101. Now includes any juvenile less than 18 who is found to be a victim of unlawful sale, surrender, or purchase of a minor under GS 14-43.14 (previously, included in the list of offenses that if committed by a parent, guardian, custodian, or caretaker of a juvenile under 18, deemed the juvenile an abused juvenile). Changes the statutory violations listed for which a parent, guardian, custodian, or caretaker of a juvenile under 18, the commission of which deems the juvenile abused pursuant to the definition of an abused juvenile. Now includes sexually violent offenses as defined in GS 14-208.6(5), applicable to the Sex Offender and Public Protection Registration Programs (replacing individually listed GS Chapter 14 sexual offenses previously listed). Now deems a neglected juvenile any juvenile less than 18 whose parent, guardian, custodian, or caretaker uses an illegal substance, abuses alcohol, or illegally uses a controlled substance and is unable to care for and provide a safe and appropriate home for the juvenile, or (2) uses an illegal substance, abuses alcohol, or illegally uses a controlled substance while a child is in utero.

Expands the available grounds for obtaining nonsecure custody of a juvenile alleged to be abused, neglected or dependent which are set forth in GS 7B-503. Now allows for a court to order nonsecure custody if the juvenile is an infant born exposed to alcohol, illegal substances, or illegally used controlled substances. However, the parent's use cannot be the sole ground for a nonsecure custody order if the parent is enrolled in and meeting or exceeding benchmarks of a substance abuse treatment program recommended by a medical provider or a LME/MCO. Adds a new requirement that the court must consider the developmental and attachment needs of the juvenile when making nonsecure custody determinations. 

Amends GS 7B-505, adding the juvenile's next of kin to the relatives and other persons with custody of any siblings of the juvenile which the department of social services (dss) must identify and notify within 30 days of the initial nonsecure custody order. Adds a new requirement that the court must consider the developmental and attachment needs of the juvenile in determining whether placement with an identified relative while in nonsecure custody would be contrary to the best interest of the juvenile.

Modifies the aggravating circumstances which require a court to direct, in the initial dispositional order, that dss is not required to make reasonable efforts for reunification of the juvenile under GS 7B-901(c). Regarding a court's determination of a parent's commission or encouragement of the commission of, or allowance of the continuation of, chronic or toxic exposure to alcohol, illegal substances, or controlled substances in violation of the law, now specifically states that in utero exposure to alcohol, illegal substance, or controlled substances in violation of the law is included. Directs the court to consider the parent's enrollment in and meeting or exceeding the benchmarks of a substance abuse treatment program recommended by medical provider or LME/MCO.

Amends GS 7B-903, which lists dispositional alternatives the court may order following the adjudication of a juvenile as abused, neglected or dependent, to require the court to consider the developmental and attachment needs of the juvenile when determining whether placement with a relative would be contrary to the best interest of the juvenile. Limited to the provisions of GS 7B-903 only, deems a foster parent to be nonrelative kin of the juvenile once the juvenile has resided in the home of the foster parent for a continuous period of at least nine months, so long as the juvenile is not a member of a State-recognized tribe.

Amends GS 7B-903.1(c) regarding required observation visits with the juvenile and the parent, guardian, custodian, or caretaker from whom the juvenile was removed, to specify that dss can recommend unsupervised visits or return of physical custody of the juvenile, whichever occurs first.

Regarding whether hearings which follow the initial dispositional hearing are designated review hearings or permanency planning hearings, amends GS 7B-906.1 to designate hearings for a juvenile who was residing with a caretaker at the time the abuse, neglect or dependency petition was filed as a permanency planning hearing (previously, review hearings were held for a juvenile that was not removed from a caretaker). Amends the required relevant findings the court must make at each review and permanency planning hearing under GS 7B-906.1 as follows. Removes the exception for hearings noticed and heard as permanency planning hearings from the requirement that the court schedule a permanency planning hearing within 30 days of a review hearing in which a juvenile is removed from the custody of a parent, guardian, or custodian. If relevant, requires the court to make written findings regarding whether reunification would be unsuccessful or inconsistent with the juvenile's health or safety and need for a safe, permanency home within one year from the date the initial order removing custody was entered (was, within a reasonable period of time). Adds that this finding must also address whether the parent has engaged in any of the factors described in GS 7B-901(c) which require that the court direct that reunification efforts are not required at initial disposition. Limits the court's authority to maintain or order a different placement, appoint a guardian of the person, or order any dispositional alternative under subsection (i) to permanency planning hearings. Specifies that visitation requirements under GS 7B-903.1 apply when the court orders custody or placement to dss, in addition to instances in which the court continues custody or placement with dss, under subsection (l). Limits the authority of the court to waive future hearings, subject to making five required findings, to permanency planning hearings only. Eliminates "cogent" from the evidentiary standard required for the court's findings to waive future permanency planning hearings, hold the hearings less often than required, or require written reports in lieu of hearings. Changes the five required findings for waiver under subsection (n) as follows. As an alternative to a finding that the juvenile has resided in the placement for at least one year, allowing for the parties to agree and the court to enter a consent order (was, that the juvenile has resided in the placement for at least six consecutive months and the court enters a consent order). Requires that all parties are aware that the matter can be brought before the court for review at any time by filing a permanency planning or modification motion (was, a motion for review) or on the court's own motion. Makes technical changes. 

Modifies the criteria for standing to petition or motion to terminate the parental rights (TPR) of a parent under GS 7B-1103(a) to include any person with whom the juvenile has resided for a continuous period of 15 months (was, 18 months) or more next preceding the filing.

Amends GS 7B-1109 to specify that the evidentiary standard to adjudicate a TPR ground is clear and convincing evidence (was, clear, cogent and convincing).

Amends the grounds upon which a parent's rights may be terminated under GS 7B-1111(a) to include that the parent has willfully left the juvenile in foster care or placement outside of the home for more than nine months (was, 12 months) without showing reasonable progress under the circumstances in correcting the conditions which led to the juvenile's removal.

Effective October 1, 2024, and applies to TPR petitions and motions filed on or after that date.

Part II.

Immediately stays the Regional Abuse and Medical Specialist (RAMS) program staffed within the NC Child Medical Evaluation Program (NC CMEP), pending compliance with three objectives, which include establishing program rules pursuant to GS Chapter 150A, amendment and federal approval of any State plan, and federal approval of RAMS program rules. Requires modification of any contracts or memorandums of understanding between the Department of Health and Human Services (DHHS) and the UNC School of Medicine to comply with the act. 

Directs the Social Services Commission (Commission) to adopt rules to implement the RAMS program and lists 10 required components, including limiting the RAMS team focus to screened-in cases meeting specified criteria, requiring the county dss director to decide issues where there is a disagreement between the local social services worker and the RAMS team, and establishing the frequency in which the RAMS team member and the social worker supervisor must meet during the family or investigative assessment period. Within 30 days of the completion of the rulemaking process, requires the DHHS Secretary (Secretary) or their designee to submit the proposed rules and any proposed changes to the State plan to the US Secretary of Health and Human Services (US Secretary) or their designee. Requires the Commission to initiate the rulemaking process within 30 days of the date the act becomes effective. Prohibits any rule, statute or plan amendment which the US Secretary determines would negatively impact federal funding to the State from becoming effective. Requires the Secretary or their designee to notify the Commission and the Rules Review Commission of the US Secretary's determinations within five days of receipt. 

Directs the Division to annually report to the specified NCGA committees and chairs beginning September 1, 2024, on the hiring, training, and oversight of the RAMS program and the rulemaking process. Requires all reports provided to the federal government relevant to the RAMS program to be simultaneously provided to the specified NCGA committees and chairs. 

Details the effective dates for rules adopted pursuant to the act, based on whether approval of the US Secretary is required or State plan amendments are necessary because of the proposed rules. Requires the Secretary to report to the Revisor applicable effective dates once known.

Part III.

Enacts GS 143B-138.1A, establishing a private cause of action against DHHS for any individual who experiences a loss or harm due to the Secretary or their designee taking any action or causing any action to be taken against an individual through a program created, administered, supervised, or funded by DHHS that is operating without going through the required rulemaking process. Provides for the prevailing individual to recover litigation costs. Applies to actions taken by DHHS on or after October 1, 2024.

Part IV.

Effective March 1, 2025, amends GS 108-9, GS 108A-15.8, and GS 153A-77 to require members of county boards of social services, regional boards of social services, and consolidated human services board members to attend education and training sessions provided for new board members during their first year of service. Directs the Division of Social Services (applicable to county and regional boards) and the Divisions of Social Services, Public Health, and Mental Health, Developmental Disabilities, and Substance Use Services (applicable to consolidated boards) to collaborate with specified stakeholders to create formal education and training sessions required of new board members, including a segment on the potential liabilities of the applicable board, with sessions available statewide by March 1, 2025. Requires all board members to have participated in the sessions by March 1, 2027.

Part V.

Directs the Administrative Office of the Courts (AOC) to conduct a feasibility and cost study of a proposed child support tribunal in which dedicate court officers would hear child support matter using quasi-judicial procedures. Details required considerations of the study. Requires AOC to submit its findings and recommendations to the specified NCGA committee by May 1, 2025.

Part VI.

Enacts GS 108A-15.16 to require county and regional departments of social services and consolidated human services agencies to expeditiously work to resolve conflicts of interest pursuant to applicable law and DHHS policies and procedures. Describes three instances which qualify as a conflict of interest, including when the department or agency cannot manage adverse interests of two individuals to whom the office owes a duty to serve. Requires DHHS policies and procedures to address financial and practice responsibilities associated with conflicts of interest. Provides for offices to contact DHHS when a conflict arises and grants DHHS final authority regarding conflicts of interest assignments when a dispute arises, with regional and central offices having initial authority as specified. Directs the Social Services Commission to adopt rules regarding conflicts of interest management that address described required components within 30 days of the date the act becomes law.

Directs the Social Services Commission to report to the specified NCGA committee within 30 days of adopting the rules addressing conflicts of interest.

Part VII.

Directs the Joint Legislative Oversight Committee (Committee) on Health and Human Services to study, evaluate, and make recommendations on five described proposals regarding foster children, foster families, and kinship providers. Further directs the committee to: (1) work with DHHS and county boards to create uniform standards regarding child welfare matters; (2) make recommendations from information updated provided by DHHS on the Child Welfare and Family Well-being Transformation Team; (3) work with the Supreme Court Chief Justice regarding improvements to child welfare cases, obtain updates from the Task Force of Adverse Childhood Experience Informed Courts, and make recommendations based on the information provided; (4) work with DHHS regarding the working group working to identify innovative Medicaid services to fill gaps in care for foster children and the development of the trauma-informed standardized assessment for foster cases, and make recommendations based thereon; and (5) any other issues the committee deems appropriate for the improvement of the child welfare system. Directs the Committee to report to the 2025 NCGA prior to its convening.