This story is being co-published with The Imprint, a national nonprofit news outlet covering child welfare and youth justice.
Mary Moore and Dylan Matthews-Carroll welcomed their newborn daughter into the world late last year with all the joy and nervousness of any first-time parents.
The baby arrived earlier than expected, but she appeared to be otherwise healthy.
Moore recalled her daughter’s first robust cry, a good sign, she recalled, in a series of phone interviews from her small rural community in upstate New York.
“It just got so real when they put her on my chest,” she said.
But things would quickly change. The couple’s newborn daughter was diagnosed with a rare brain bleed shortly after her birth, and doctors in the local hospital reported the parents to child protective services on suspicion of shaken-baby syndrome. The baby spent two weeks in the hospital, and then left for home with Moore and Matthews-Carroll, who authorities had determined were safe caregivers.
Weeks later, the couple failed to bring her to a doctor’s appointment for follow-up care, and a second CPS report was made. Before they knew it, Moore and Matthews-Carroll, her fiancé, found themselves under investigation for child maltreatment — a first, frightening step that could result in a foster care removal.
“I was worried because I’m fresh and new to all of it,” Moore said. “The CPS situation was really scary.”
Situations like this are not uncommon across the country. But what happened next is.
Moore, 26, and Matthews-Carroll, 28, received a referral from the local child welfare agency to Clinton County’s 0-5 Program, administered by an organization called Youth Advocate Programs (YAP), which runs youth justice and child welfare services in 35 states and 16 New York counties.
The program’s focus is to keep families intact through alternatives to out-of-home placements. It’s relatively small and focuses on children 5 and younger. Currently, five families are being served and dozens participate each year. Most have been diverted from the early stages of child welfare cases; a smaller number of families have cases before the family courts and are attempting to reunify.
Parents in the program are assisted at home through various means — from help with basic needs like diapers and other household essentials to lessons in parenting skills and child discipline, as well as help with transportation to medical and other appointments. The program’s employees also supervise family visits when children have been placed into foster or kinship care.
The program’s “two-generation approach” addresses a commonality among many clients: unlike Moore and Matthews-Carroll, these parents grew up experiencing some aspect of the child welfare system as kids and have entered again as parents being investigated for abuse and neglect, or who are in need of services to prevent system involvement.
Kasey Young, YAP’s regional director for New York, New Hampshire, and Maine, said her team works with parents “to break that cycle.”
“We’re teaching them all the things they need to know to ensure that their kids are either staying with them or returning to their care,” Young said. “Most often, families that are subjects of child protection reports are in need of services.”
Helping with Essentials
Although Moore’s daughter was born prematurely in November, she was released from the hospital with her parents. At a check-up four days later, however, a doctor determined the baby was jaundiced and underweight.
Moore shared her story with The Imprint in an interview that included employees of Youth Advocate Programs.
Local doctors referred the baby to a specialist across state lines at the University of Vermont Children’s Hospital, where she was diagnosed with a rare condition found in some premature infants — brain hemorrhaging that can occur after birth. That’s when the infant spent two weeks in pediatric intensive care before her parents were cleared to take her home.
At the time, both Moore and Matthews-Carroll were on paid family leave that provided only a fraction of their normal income. Money was tight for transportation costs. They missed their daughter’s follow-up doctor’s appointment at the Vermont hospital more than an hour away, because they simply couldn’t afford gas for the drive.
In March, they were both laid off from their jobs.
Countless families across the country end up in the child welfare system due to reasons related to poverty, not intentional child neglect. Not every family gets the chance for an alternate pathway.
But a Clinton County caseworker with the Department of Social Services carefully considered Moore and Matthews-Carroll’s situation. He referred the couple to YAP, which provides “wraparound” services to families, addressing complex challenges that can include poverty and housing insecurity in addition to needing parenting skills.
The couple received money for gas, help to keep the house safe for the baby, and instructions on proper nurturing.
Intensive Family Coordinator Erin Mitchell is tasked with working with all the families in the 0-5 Program.
“Mary’s family was a good fit for the program because they needed parental support,” Mitchell said. “Mary needed help forming that bond with her daughter that she didn’t get a chance to have when she was born.”
Solving a Problem
The program in Clinton County emerged after leaders at the Department of Social Services set out to do something about the large percentage of young children under the age of 5 entering foster care. Mirroring figures across the country, almost half the children in Clinton County’s small foster care system — and 57% of the 42 children admitted to the system last year — were 5 years old or younger, according to state data.
Commissioner of Social Services Christine Peters — who has worked for the local agency for almost 20 years in various capacities — sought to replicate YAP programs that were operating in nearby St. Lawrence and Jefferson counties.
“We were looking at our statistics and said, ‘We got a lot of kids in foster care that are under 5,’” Peters said. “Those are children that we wondered, A, how did they end up in foster care, and B, how do we get them back home faster?”
Her county invested $150,000 for the first contract in 2017 and has sustained that amount each year for the program’s employees and related costs.
In a 2013 report, “Changing the Course for Infants and Toddlers,” the research firm Child Trends highlighted the stakes.
“The harsh reality of maltreatment in the form of abuse or neglect looms in the lives of thousands of infants and toddlers,” the nationwide survey found. “For young children, this threat arises at a crucial time in life, when early experiences are shaping the brain’s architecture into a foundation for learning, health, and future success.”
The authors concluded that while maltreatment “chemically alters the brain’s development and can lead to permanent damage of the brain’s architecture,” other risks such as cognitive delays, attachment disorders, poor self-esteem and social challenges “are exacerbated by removal from home and placement in multiple foster homes.”
Child Trends called on policymakers and child welfare administrators to focus on the first years of life as “a time of great vulnerability,” but also as an opportunity to intervene early and effectively, sparing young children long-term impacts from both maltreatment and foster care.
That is the central focus in Clinton County. Child maltreatment reports are initially investigated by a child protective services caseworker. If there is no evidence of harm or imminent risk, and the family needs intensive support, a preventive service supervisor will refer the family to the YAP’s 0-5 Program. CPS will continue to monitor the family for approximately 60 days before closing its investigation.
Some families come to the Department of Social Services asking for help and are referred to the program. Participation in preventive services is voluntary. But the county may consider bringing a case to family court if workers determine there is ongoing neglect and parents decline to participate in programs to ameliorate concerns.
“We’re working on preventing foster care placement; however, if an imminent danger situation exists that creates a great risk of harm, we have to make safety plans and, ultimately, may have to file a petition in family court,” Commissioner Peters said.
Parent advocates have long pushed back against foster care prevention programs offered by agencies that have the power to remove children, saying they believe the notion of “voluntary” participation is inaccurate because the arrangements are negotiated under a looming threat.
That was the case for Moore and Matthews-Carroll. While they were relieved not to have to fight for their baby in court, Moore said they nonetheless felt they were in jeopardy of losing her if they did not take part in what the social services department suggested.
The referrals to CPS had already landed Moore and her fiancé on the Statewide Central Register of Child Abuse and Maltreatment, which can be viewed by authorized agencies, including law enforcement and prospective employers. Names can stay on the list for decades unless parents successfully appeal.
Moore and Matthews-Carroll appealed to the state to remove their names from the registry, providing evidence that they had created a safer environment for their daughter. As of August, their names have been removed, according to a notice the couple received from an administrative law judge.
Similar programs exist in two nearby counties — St. Lawrence and Jefferson.
Mitchell, the program’s intensive family coordinator, works with each family for a minimum of five hours per week. She worked with Moore and Matthews-Carrol over three months, but families usually participate in the program for six to eight months — some for as long as a year.
Revealing the hands-on nature of her work, Mitchell’s office is stocked with diapers and wipes, in addition to brochures for referrals to parenting support services and counseling. She also provides one-on-one parenting assistance.
In Moore’s case, Mitchell showed the new mother how to hold her baby comfortably, and some infant-parent activities, like outside strolls and games that can be played on the living room floor.
Moore and Matthews-Carroll made swift progress, all parties agreed. The baby now sees a speech pathologist to assist with difficulty feeding, and a doctor surgically treated the baby’s lip tie — a medical condition in which there isn’t enough space between a baby’s upper and lower gums. Moore also received therapy for postpartum depression.
Families can be discharged from the program if they don’t need the help anymore, meaning they are deemed successful. Others can be discharged if they aren’t taking advantage of the services, or in rare cases, a social worker or court decides the child has to be removed from the home.
In Clinton County, the program is seeing positive results. Moore, a home health care aide, and Matthews-Carroll, a maintenance worker at the Vermont hospital where his daughter was treated, are both back at work again. Their daughter is now 9 months old and thriving, Moore said. Her latest milestones are crawling and pushing herself to a standing position.
“I definitely feel confident compared to before YAP got involved,” Moore said, after accepting her parting gift, a brand-new stroller.
These are the promising signs staffers in the program that served the family hope to see.
“We help build that safe environment for the children,” Mitchell said, “but I also say it’s a safe environment for the family all together.”