At the Thursday, Sept. 4 meeting of the Guilford County Board of Commissioners, the board voted unanimously to approve County Manager Victor Isler’s appointment of Natalie Craver as the county’s new assistant county manager.
The county uses lively names for its job titles and Craver will oversee the “Successful People” section of Guilford County’s government and she will also, perhaps even more importantly, serve as the director of the Guilford County Department of Health and Human Services.
That’s one of the county’s largest and hardest to run departments, so she’ll have her hands full from day one.
The Department of Health and Human Services is a consolidation of Public Health and Social Services: Years ago, the county commissioners joined the two departments that now cover behavioral health, child support and court services, food assistance, Medicaid, integrated services, juvenile detention and other services.
Craver joined Guilford County in April of 2024 as the deputy director of the department. Prior to that, she had a decade and a half long career in local and federal government during which she did nonprofit work with a focus on health, human services and child welfare.
Now she’s become both a top deputy to the county manager and the director of the largest service-delivery agency in Guilford County government.
Following the Board of Commissioners’ vote, Craver said she was honored to accept the role and she described it as a homecoming of sorts. She grew up in Guilford County before leaving for Washington, DC – where she earned a bachelor’s degree in human services and a Master of Public Administration at George Washington University.
“It’s a privilege to continue serving the community where I grew up,” she said. “Together, we will continue to enhance our services, support our residents and strengthen the overall health and well-being of our county.”
Isler is in a fairly new role himself. He took over the county manager position after the sudden and mysterious “retirement” of Mike Halford, the previous manager for five years, and, before that, Guilford County’s budget director for over a decade.
Isler praised Craver and told commissioners that she had already shown herself to be a leader capable of managing a wide portfolio.
“Natalie has already demonstrated outstanding leadership and a strong commitment to innovation and service excellence,” he said.
Craver’s elevation also signals a continuation of Guilford County’s push toward integrating health and social services. The Department of Health and Human Services was created by combining Public Health and Social Services into a single umbrella organization with the aim of improving efficiency and eliminating duplication.
That combination of the two departments took years to put into effect but now, more and more, they can be thought of as a single department.
County officials have said the change allows different parts of the system to work more closely together – for instance, by tying social workers into health care programs or aligning child welfare cases with behavioral health services.
As the new director, Craver will have to manage challenges that include a very high demand for services, staffing shortages in key areas and the increased pressure on public health infrastructure in recent years.
Also, Guilford County has been expanding social services programs, bolstering juvenile services and investing in behavioral health partnerships with Cone Health and other providers.
The county’s foster program has faced tremendous hurdles in recent years.
All of these problems now fall in Craver’s lap.
The Guilford County Department of Social Services has been a subject of major scandals and problems in the past. In 2014, the director was forced to resign after making up reports about the speed and number of applications being processed. Many applications were just literally being stuffed in the back of drawers or boxed away and then reported as processed. When the Rhino Times started getting desperate calls and complaints from many social services clients, it became apparent that something was terribly wrong. When the Rhino Times asked DSS about each case, those cases would be processed; but the Rhino Times discovered later – through a massive public records request – that, internally, employees were being instructed to process cases quickly if the Rhino Times called or emailed asking about a particular case.
That scandal was so massive that it could have theoretically ended all federal food and nutrition assistance to the state of North Carolina.
After a massive search in 2014, the combined Health and Human Services Department was run by a Harvard-educated Bruce Springsteen-loving director who took the job with Guilford County, drew up these incredibly complex plans to merge the departments and gave many presentations using a lot of 50 cent words – but there never seemed to be any actual changes or movement toward unifying the departments. After exactly one year of making big plans and a huge salary – that director flew the coop for greener pastures. (Many consider two years the minimum moral obligation for remaining in a post of that sort.)
In 2023, an investigation by the North Carolina Department of Health and Human Services – after three children being watched over by Guilford County social services died in a fire on December 12, 2022 – found many highly disturbing issues with the way the Guilford County Division of Social Services checked the household prior to the fire. The final report from the state was extremely damning.
Of course, public health and social services have had some very good years and practices as well – and that’s the atmosphere that Craver hopes to create during her tenure.
For Craver, the new position means overseeing a workforce that stretches across dozens of locations in Greensboro and High Point, along with satellite offices scattered through the county. The department’s budget is gigantic and is funded by a mix of county tax dollars, state and federal allocations and grants. Decisions made under her watch will influence how quickly families can receive food assistance, how the county responds to public health emergencies, and how juvenile justice cases are handled.
Craver pointed to the importance of collaboration in a job like this.
She said she intends to work closely with community groups, nonprofit partners and other government agencies to make sure programs are aligned with the needs of residents.
Her appointment underscores the board’s current focus on Successful People – one of the four priorities that guide Guilford County’s budgeting and strategic planning. Alongside the categories of Safe and Secure Community, High Performing Government, and Infrastructure and Growth, the Successful People area emphasizes education, health, housing and human services.
Guilford County’s population has grown to more than 550,000, and demand for services has climbed with it. The Department of Health and Human Services often finds itself at the center of local debates over poverty, homelessness, child welfare and access to health care.
Hopefully Craver is up to all of these challenges.
Her appointment was effective immediately following the September 4 vote by the commissioners.
