Imagine a less adversarial system where social workers, court officials, community members and others work with families to help them address the issues that led to their children being taken away.
Imagine a system where children in foster care get permanent homes more quickly, whether that means being reunited with a parent, placed with another family member or adopted.
North Carolina doesn’t have to imagine any more. The state has joined a growing number of communities that are interested in transforming their child welfare system with a program called Safe Babies. In 2023, the state began what was to be a three-year pilot in several judicial districts. That’s now been extended to 2027 after some savings were found in the first year, according to Polly Handrahan, the state’s Safe Babies Court director.
It’s not a new concept. Safe Babies started in Texas, Mississippi and Iowa in 2005. It is now offered in more than 100 communities across 31 states. The program aims to strengthen families and prevent babies and toddlers from being removed from their homes.
Nationally, a baby or toddler is removed from their family due to alleged maltreatment or neglect every seven minutes, according to Safe Babies.
In North Carolina, about 30 percent of substantiated claims of child abuse or neglect involve children ages 3 or younger, according to the 2023 national child maltreatment report. When factoring in children through age 5, that goes up to nearly 42 percent.
J.H. Corpening II, chief district court judge for New Hanover and Pender counties, said Safe Babies can cut in half the time it takes to get a child into a permanent home.
“We are on the precipice of changing lives forever, changing a baby's life, changing a family's life, making it more likely that they're successful, making it less likely that family will intersect child welfare again,” Corpening, whose court was one of the first to pilot the program in North Carolina, said last year on the All Things Judicial podcast.
“That makes our community healthier. That makes our community better and makes our community safer,” he added. “This is really significant work.”
Trauma-informed approach
North Carolina Supreme Court Justice Paul Newby convened a task force in 2021 to look at the impact of trauma on children and to find ways to address adverse childhood experiences, or ACEs, within the state’s courts.
The taskforce recommended bringing Safe Babies to the state. The program was created by the nonprofit Zero to Three, which is focused on the healthy development of babies and toddlers. It is now being piloted in Brunswick, Durham and New Hanover counties, in Judicial District 35 (Avery, Madison, Mitchell, Watauga and Yancey counties) and Judicial District 41 (Rutherford and McDowell counties).
The infant-toddler court program focuses on the youngest children because research shows that those early years are the most important for lifelong mental health and well-being.
At this age, a child’s brain is growing at nearly a million neural connections per second, according to Harvard University’s Center on the Developing Child. Trauma in early childhood is associated with developing a smaller brain cortex, which is the area responsible for complex functions like memory, attention, perceptual awareness, thinking, language and consciousness, according to the National Child Traumatic Stress Network. A child’s IQ and ability to manage emotions can be affected by these changes.
Research shows that various types of trauma, such as poverty, racism, food insecurity and being exposed to drug use, neglect, abuse and unstable housing, can leave such physical — neurological — markers in children that linger into adulthood. Being separated from a parent is also a type of trauma, especially for young children who depend on interactions with their caregivers to teach them.
Creating a sense of well-being builds a connection that “sets the stage for social and emotional learning,” doctors Kyja Stygar and John Zadroga wrote in a Mayo Clinic article.
Negative experiences in young children can have a big impact on health, future opportunities and the chance of being a victim of or perpetrator of violence, according to research from the Centers for Disease Control and Prevention.
Trauma can even be passed on through DNA to the next generation, psychiatrist Lisa Amaya-Jackson, co-founder of the Durham-based nonprofit Center for Child and Family Health, said at the inaugural child trauma summit at N.C. State University in 2023. That can happen when pregnant mothers are exposed to significant stress. That can increase their stress hormones, which, in turn, affects their child’s development.
“Child adversities cast a very long shadow,” she said.
Long history of results
In Arizona, Best for Babies — a statewide initiative modeled after Safe Babies — aims to improve outcomes for young children and their families who are involved or at risk of becoming involved in the child welfare system.
The state changed to this approach after one county social services team attended a Zero to Three conference and heard about the nonprofit’s court teams for infants and toddlers, said Marshalle Manriquez, the statewide Safe Babies Court Teams coordinator with Prevent Child Abuse Arizona.
Initially, there was no funding, so Yavapai County (north of Phoenix) looked at how they could incorporate some of the Safe Babies concepts, she said. More recently, the state received federal funding to fully launch Safe Babies in several counties.
Funding for North Carolina’s Safe Babies Court comes from a variety of sources.
The Dogwood Health Trust is supporting the program by paying for the community coordinators in Yancey, Mitchell, Watauga, Avery, Madison, Rutherford and McDowell counties. The Duke Endowment pays for those positions in Durham, Brunswick and New Hanover counties. A Court Improvement Project Grant covers the salaries for the state director and coordinator. The state data and evaluation lead’s salary is covered through the General Assembly. (Disclosure: The Duke Endowment sponsors NC Health News to cover children’s health issues.)
In Arizona, early data on Safe Babies Court already shows the benefits, Manriquez said.
Reunification rates are 19 percent higher for parents who opt in to the Safe Babies supports programming than for those who don’t, she said.
North Carolina doesn’t have any data yet. The first pilot programs didn’t start enrolling families until July 2024. And some, like Yancey County, are so small, only a couple of families have opted in to the program so far, DSS officials told NC Health News.
But they know what the national data shows about how effective Safe Babies can be.
According to Safe Babies, about two-thirds of babies and toddlers in their program are reunified with a parent or family member. Nine in 10 children find a permanent home within 12 months, which is double the national standard, the organization said.
A 2023 study by RTI International showed that children in Safe Babies programs are 1.6 times as likely to leave foster care for a permanent home compared with children in the general foster care population.
Data also shows that babies and toddlers in Safe Babies are much less likely to be abused or neglected again. The repeat maltreatment rate for Safe Babies participants was 0.7 percent within 12 months compared with the national standard of 9.1 percent.
Increasing communication
In a typical child welfare case, months can pass between court hearings. In contrast, Safe Babies families are meeting with court and child welfare officials more often and in a less formal, less adversarial setting.
There are two types of meetings: family team meetings and judicial status conferences.
The family team meetings are led by the Safe Babies community coordinator. Parents share successes and obstacles, while team members provide support by offering encouragement, highlighting successes and helping parents set achievable goals.
They also help steer the family to appropriate resources, such as substance use treatment programs and therapy, as well as early education and even housing.
DSS attorneys have been able to interact with parents in a different, non-adversarial way, giving them the opportunity to tell parents they also want to see them succeed, Handrahan said.
“You should see how our parents respond to that,” she said. “It's amazing.”
The “judicial status conference” is not considered a court hearing, so it is more informal and less confrontational, said Kristin Stout, statewide Safe Babies coordinator.
Instead of standing in a courtroom looking up at a judge, parents in Safe Babies sit side by side with the judge in a separate room that is often decorated to be family- and child-friendly. Judges have been able to hold children or get down on the floor to play with them as part of this more informal atmosphere.
Not all of the courts have a dedicated space for the Safe Babies program. New Hanover County, for example, has a special room set aside with a child-friendly rug and lots of toys.
The western N.C. courts use the jury room, but they make it work, said Chief District Court Judge Rebecca Eggers-Gryder, who oversees the program in Yancey, Mitchell, Watauga, Avery and Madison counties. She doesn’t wear the traditional black robes to the judicial status conferences — one more reminder that this is not the typical approach to child welfare cases.
Eggers-Gryder jumped at the chance to add her courts to the pilot program. Most of her legal career before she became a judge in 2015 centered around family law. For about 16 years, her family’s firm contracted with the Watauga County Department of Social Services to handle their cases. She knows well the tensions that come from everyone fighting for their side.
She said Safe Babies is a “whole new approach.”
“We've all got one common goal. The child is the very center of Safe Babies Court — and getting permanence for that child as soon as possible,” Eggers-Gryder said.
Extra help
Everyone who meets the criteria is automatically referred to Safe Babies by the local county Department of Social Services. Judges and attorneys also let families know the program is an option. Families are given information about it, but they have to choose to participate.
A key component of the Safe Babies approach is to make sure the developmental needs of the child are met and that families are connected to resources to help them succeed.
According to Safe Babies, at least 83 percent of children in the program “receive needed developmental screenings, early intervention services, and evidence-based intervention to repair and strengthen the child-parent relationship within 60 or fewer days.”
Another component, the Active Community Team, works to create a map of resources available in their community to help families.
“We're identifying resources that maybe we didn't know we had before,” said Sonya Morgan, director of Yancey County Department of Social Services. And those resources will help all the children in the system, not just those participating in Safe Babies, she said.
That has been a big help for county social workers, according to Noah Worley, a Yancey County social worker who said he has spent hours hunting for help for his families.
“Sometimes it feels like it's us against the world,” he said. “We're trying to find these resources that these families desperately need, and it's hard to get the ear of people who either can make decisions or help connect us.”
In Arizona, the Active Community Team has been the longest-standing piece of that state’s Best for Babies program, Manriquez said.
She said Safe Babies is more than just a prevention strategy for re-entry to the child welfare system. It is a way to look further upstream to address questions such as “How do we do better as agencies to resource families appropriately? How are we supporting that differently and working at the family and community level even more?”
‘I feel supported’
While North Carolina doesn’t have data yet, some of the experiences so far suggest that Safe Babies is already having an impact.
Worley said having the Safe Babies coordinator has helped reach parents when they aren’t willing to listen to what he has to say, for example, when he has had to encourage a parent to address substance use issues.
“Sometimes as DSS, it's hard to get past the stigma around our industry and the negative connotations around [Child Protective Services], and so that person acts as a liaison,” he said.
A Power Point presentation Handrahan uses to share updates about the pilot program includes quotes from parents.
“I feel supported and am able to voice my questions, concerns as well as my progress and achievements in a less intimidating setting,” one parent said.
Another parent called Safe Babies “an invaluable resource.”
“I always understand exactly what is going on with my case, and I feel supported and comfortable sharing my needs,” that parent said.
Yancey County DSS Supervisor Tammy Sparks said programs like Safe Babies are needed because children and families deserve them.
“They deserve an opportunity to get better and to have a happy family and be … healthy and safe,” she said.
And if that isn’t going to work, then children deserve to be in a permanent home, Sparks said.
“Because permanency is the most important thing for our children,” she said.
This article first appeared on North Carolina Health News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.