Experts urge coordinated "plans of safe care" to reduce infant removals and improve outcomes in Harrison County

A panel of judges, child-welfare researchers and Mississippi child-protection officials told a Harrison County Board of Supervisors workshop that coordinated “plans of safe care” and upstream prenatal supports can reduce unnecessary removals of infants and improve long-term outcomes for children.

Mike Dickinson, Harrison County youth court judge, opened the workshop and introduced speakers including retired youth court judge John Hudson; Sean Couch of the National Center on Substance Use and Child Welfare; Christopher Church of Casey Family Programs; and Andrea Sanders, commissioner of the Mississippi Department of Child Protection Services (MDCPS). The presenters described legal rules that constrain removal, federal funding requirements and models that other states use to coordinate medical, substance-use and social supports for pregnant people and newborns.

Why it matters: Speakers said removal from a home is legally and practically significant—federal rules require courts and agencies to show “reasonable efforts” to prevent removal and to move children to permanency quickly if reunification fails. Presenters argued that plans of safe care — multi-agency, family-centered care plans required under the federal Comprehensive Addiction and Recovery Act (CARA) — can reduce crisis-driven removals by connecting pregnant people and new parents to treatment, housing and other supports before or at the birth event.

John Hudson, a longtime former youth court judge who spoke about Mississippi law, summarized the legal baseline: parents have a presumption to parent and removal requires a court finding of a significant or imminent risk of harm and, where applicable, a showing that no reasonable alternative exists. He noted legislative changes that limit removal for some test results: “The legislature included this language in the youth court law... removal cannot be based solely upon a positive drug test of the parent or of the newborn child for marijuana,” and that removal for other controlled substances requires a nexus between the drug use and the parent’s inability to provide proper care.

Sean Couch, who leads practice work on prenatal exposure at the National Center on Substance Use and Child Welfare, described CARA and how states implement “plans of safe care.” Couch said the plan should address both the infant’s needs and the family’s needs, and be used as a coordination tool that moves upstream — for example, with prenatal screening in OBGYN clinics and hospital newborn-risk assessment tools that feed into a plan before discharge. “No single agency can do it alone,” Couch said, urging county-level collaboratives that allow hospitals, treatment providers, home visiting and courts to share a common pathway.

Christopher Church of Casey Family Programs presented federal and regional data and local comparisons. Church said Harrison County’s most recent 12-month removal count (federal fiscal 2024) was 31 children, about 2.2 removals per 10,000 children, which he noted is below the statewide rate he cited (about 3.2 per 10,000). He described placement and permanency trends that jurisdictions monitor — for example, the value of placing children with relatives when possible and the federal emphasis on avoiding long stays in congregate care. Church said Harrison County showed strengths in high rates of exits to legal permanency and relatively low reentry.

Andrea Sanders, commissioner of MDCPS, described the agency’s constraints and local supports. She said the state’s foster-care population and child-welfare caseloads are serious, and noted broader public-health context: Mississippi’s infant mortality rate is well above the national average. Sanders described current local practices the department has implemented on the coast, including weekly staffing with neonatal intensive-care-unit (NICU) staff in hospitals and renewed relationships with law enforcement and hospital teams to improve rapid response and information sharing.

Panelists and county officials discussed specific program strategies states have used to make plans of safe care meaningful rather than a paperwork exercise: prenatal initiation of plans, newborn risk assessment tools in hospitals, care coordinators who meet families at birth, co-located prenatal and treatment services, and peer-recovery support. Church highlighted data uses: tracking removals, discharges, placement types and reentry to align practice with goals.

The workshop concluded with an emphasis from presenters and the commissioner on building a Harrison County collaborative that leverages the family intervention court, Memorial Hospital at Gulfport and local community and faith-based services to implement upstream plans of safe care and reduce crisis-driven removals.

Sources: Presentations and exchanges at the Harrison County supervisors’ workshop with John Hudson (retired youth court judge), Sean Couch (National Center on Substance Use and Child Welfare), Christopher Church (Casey Family Programs) and Andrea Sanders (MDCPS).