A nationwide program is training judges, child welfare agencies and attorneys to center the health of young children in dependency court proceedings.
In 2018, Washington state authorities removed Barbara Maefau’s newborn twin daughters from her just days after their birth due to her mental health condition. At the time, she was homeless and experiencing postpartum depression.
Then, she received an unexpected lifeline.
In a Pierce County courtroom after her daughters were placed in foster care, Maefau was given a choice: struggle through protracted legal proceedings to regain custody, or enroll in a program that could fast-track reunification.
Maefau opted for the latter and joined Best For Babies, a county program launched in 2016 that is part of a national effort to better serve infants, toddlers and their parents in the foster care courts.
While families in dependency court typically wait months between hearings and may have infrequent contact with social workers, courts supported by the national nonprofit Zero to Three provide intensive services for the youngest children, offering monthly hearings with the same judge, as well as medical and mental health care. The group’s Safe Babies Court Team model also offers parents and young children — who ordinarily would be barred from frequent contact following abuse and neglect allegations — more time together, in an attempt to nurture the critical bonding that occurs in the early years of life.
The model has spread rapidly since its inception in 2014, growing from a few sites to at least 65 active programs in cities and counties across 30 states with dozens more in development stages. But just as interest surged last year, the COVID-19 pandemic hit, straining municipal budgets and pulling health care resources into the fight against the coronavirus.
During the pandemic, the model has been challenged to maintain its level of in-person connection. Like all child welfare systems and the courts serving children and parents, contact with social workers and judges have been mostly virtual, with family visitation taking place over phone and video conference calls.
Safe Babies courts have had to be creative, encouraging moms and dads to read stories on their mobile devices, and chat with their toddlers while they eat and brush their teeth. In instances where physical contact is not possible, there are other measures deployed: the baby will be swaddled in a blanket with a mother’s smell.
In states where public health guidelines are less restrictive, the courts’ teams of professionals — including child welfare agency staff, mental health clinicians and education liaisons — make sure parents are prepared for visits by providing them with public transit passes and housing referrals.
These early attachment-building experiences are critical for families caught up in the child welfare system, said Janie Huddleston, who directs Zero To Three’s Safe Babies program.
Babies in her program left foster care months sooner than those who went through the traditional route of dependency court proceedings, and were less likely to return, according to a 2020 study by the American Institutes of Research. After leaving the program, caregivers reported the children were attached to family and a caring adult, in good health and on track developmentally.
Before she landed in the dependency courts, Maefau had cycled through criminal courtrooms as a homeless teenager experiencing drug addiction. In her early 20s, and newly sober, she was back in court; this time fighting to keep custody of her kids.
The Best For Babies model that greeted her was a welcomed, crucial intervention, Maefau said. The team assembled for her case seemed focused on repairing harm and getting her twins out of foster care. They also helped her find housing and enroll in parenting courses. She no longer felt alone.
“I was getting looked at as a person,” she said, “not just another mom who lost her babies.”
Maefau was reunited with her twin daughters, who are now 2, eight months into the program. She completed the program after 16 months and now works as a support to parents like her in Tacoma, Washington.
According to the American Institutes of Research, children in courts deploying the Safe Babies model left foster care between four and 10 months earlier than infants in conventional dependency court proceedings. The 2020 study examined children in nearly 1,800 dependency cases in Des Moines, Iowa; Little Rock, Arkansas and Tulsa, Oklahoma.
“This difference was statistically significant and practically meaningful, given that four months is a long time in the life of a child under the age of 3,” the authors stated.
Statistics compiled by Washington, D.C.-based Zero to Three show that more than 90% of infants and toddlers in Safe Babies courts were reunited with biological parents or in permanent placements with kin, guardianships or adoptive homes within a year, which Huddleston described as more than double the national average for this age group.
Children were also more likely to have health insurance, good oral health, child-parent psychotherapy sessions and exhibit signs of being developmentally on track with communication and social skills, researchers found.
Still, the American Institutes of Research identified some shortcomings, in sites where young children were repeatedly uprooted. In more than a quarter of the cases reviewed, babies and toddlers moved three or more times, and at least one site had difficulty bringing different agencies together to collaborate.
On average, 260,000 children in the U.S. are removed from their homes by social workers each year and of the more than 680,000 children who were in foster care nationwide as of 2019, nearly a third were infants and toddlers, according to Health and Human Services data.
Zero To Three launched the Safe Babies model to push the typically siloed dependency court process to address the root causes of harm that lead to children’s removal, and to work collaboratively to ensure babies’ brain development is unimpaired while families are under court supervision.
If a case is assigned to baby court, it is handled by either a Safe Babies-trained judge or a full Safe Babies team including the judge. The team approach is facilitated by a community coordinator who recruits and trains social workers, health care providers and others on how to support families in court. In the judge-only set up, the team methodology isn’t used in court.
Under both models, researchers found positive outcomes, as well as a “spillover” effect, with the program’s more holistic approach being applied to cases involving older children as well.
The U.S. Department of Health and Human Services funds grants nationwide for a mix of community organizations, health providers and municipal agencies who are incubating Safe Babies sites or building out existing programs. Zero To Three provides seed funding, planning support and ongoing training.
Prior to the coronavirus striking the globe, the organization had been developing statewide Safe Babies models in Florida, Tennessee, Ohio, Washington, New Jersey and South Carolina. The Arkansas Department of Human Services has just received a $425,000 grant from Zero to Three to expand into to develop similar programs in Benton, Sebastian and Jefferson counties.
Arkansas launched its baby court model in 2009 in Pulaski County, where it was spearheaded by retired Judge Joyce Williams Warren, the county's first black female judge.
Officials in Minnesota are also looking to expand baby courts statewide. But these days, Huddleston said, the growth and interest has dwindled amid budget uncertainty and resources needed to fight the spread of infection.
Nicole Cook, a former child welfare agency worker who now facilitates baby court team meetings in St. Louis County, Minnesota, said at the onset of the pandemic, many judges wanted to bring the Safe Babies program into their court but have since had to put those plans on hold.
The site has added at least six cases since June, but is now limiting intake to “the highest need children in our community,” Cook said, including infants who are drug-exposed and behind on immunizations.
“If parents in a family are struggling with substance abuse and mental health issues, it’s hard to not be able to go to their door,” Cook said of the virtual social worker visits taking place during the pandemic. “That was definitely a barrier; to not meet them and have those conversations face-to-face.”
Cook also said participants are developing greater skills as the program grows, but that more engagement is needed with health care providers and community-based organizations.
“As a social worker, I would’ve loved to have the judge hear what parents are going through,” Cook said. “But we also have to put it on the community to think, ‘what can we all do?’ It’s not just on social workers’ shoulders to support kids.”
In the model developed by Zero To Three, judges play a central role.
Rather than preside over adversarial proceedings, a judge trained on infant mental health meets with the parties — sometimes outside the courthouse — with the intent to resolve issues that triggered children’s placement in foster care.
For Shaun Floerke, a former judge in Minnesota’s Sixth Judicial District, the program involves looking upstream for sources of society’s troubles rather than a constant reaction to symptoms of deeply rooted issues.
“The earlier you intervene, the better the outcomes,” said Floerke, who now leads the Duluth Superior Area Community Foundation. “The only way to have a healthy culture and society is to have healthy kids who know how to attach. When your childhood is disrupted, or parents are offline, a baby or child doesn’t learn attachment and they replicate problems down the line.”
Duluth, like many U.S. regions, has been hit hard by the opioid crisis which also impacted child welfare cases. From the bench, Floerke realized the tools of the judiciary alone couldn’t address the complexity of the problems.
“People are pressed by learning disabilities, mental health, systemic racism, a whole list of big items that you didn’t fix by throwing people in a cage or by fining them,” he said.
During his time on the bench in Minnesota, Floerke hosted meetings outside the courthouse in a building that housed a pantry and donated clothes.
“Courthouses are big places and people have trauma connected to them,” Floerke said. “And it’s hard to grow when you feel threatened.”
Carrie Toy, a Florida courts administrator who led the statewide expansion of the Safe Babies model in her state, said judicial leadership was key to what became the Early Childhood Courts program. Judges realized a paradigm shift was needed to address the cycle of young children being the largest cohort in Florida foster homes and later experiencing health issues down the line, she said.
“There was a lot of interest from judges to make things better,” Toy said. “They’d see kids reunified and then coming back to court years later because of maltreatment or as parents themselves. They saw this as an opportunity to address underlying issues.”
Denise Moore, now a parent support coordinator in Iowa’s Polk County, said the baby court model could have transformed her family’s trajectory.
In 2003, Moore faced one of the worst moments of her life; living with drug addiction and having her children removed from her home. A social worker told Moore she’d have to enter addiction treatment, otherwise she could wind up losing custody entirely.
“I had to lie my kids on the couch and tell them I was gonna lose them,” Moore said. “My oldest son looked at me and his face said, ‘You picked drugs over me.’ I said, ‘just let me make this right.’”
Moore entered treatment as a condition of dependency proceedings and encountered a rigid system that neglected her family’s wider needs, such as addressing her childhood trauma and spousal abuse. For Moore, seeking comprehensive support from the state came with risks; disclosing her challenges could’ve led to further criminalization and trauma to her children.
“Parents are fearful of saying what they really need because the more they say, the further their kids get from them,” she said. “My fear was not going to prison. My fear was my kids going to foster care.”
Moore was reunified with her children in 2005. And that experience led her to pursue her current role supporting families navigating the child welfare process in a court deploying the Safe Babies model.
“We provide them a sense of hope that they’ll make it,” she said. “When you go in, it’s desolate; you feel you’re not gonna make it out of there with your kids. When I made it through, I said I need to go back and help families.”