In re: O.P.

Panel: Fader, C.J., Meredith, Friedman, JJ. Fader, C.J. ^{136 531} We must first determine the correct standard of proof for a juvenile court to apply to a petition for continued shelter care 1 of a minor pending consideration of a petition to find that the minor is a child in need of assistance. We conclude that for a juvenile court to authorize the continuation of shelter care, the court must find by a preponderance of the evidence that (1) returning the child home is contrary to the child's safety and welfare, and (2)(a) removal is necessary due to an alleged emergency and to provide for the child's safety, or (b) reasonable efforts were made but were unsuccessful in preventing or eliminating the need for removal. Here, the Circuit Court for Anne Arundel County, sitting as a juvenile court, did not err in applying the preponderance standard to the petition for continued shelter care filed by the appellant, Anne Arundel County Department of Social Services (the "Department"). ⁵³² We are asked, second, to determine whether the juvenile court clearly erred in making certain findings of fact or abused its discretion in ultimately determining that the Department did not carry its burden of proof.

On this record, we conclude that the juvenile court did not clearly err as to the findings of fact on which it based its ultimate conclusion or abuse its discretion and, therefore, we affirm. Decisions concerning continuation of shelter care, especially where the minor is an infant, are some of the most difficult that a court can face. Information is often unavoidably scarce, facts are often developing and disconcertingly unclear, the law requires immediate action, and the interests and stakes involved-the health and safety of defenseless children and parents' fundamental liberty interest in raising their children-are among the most important a court can be called upon to assess. The General Assembly has implemented a statutory scheme to navigate these issues and balance these interests.

That scheme calls upon a juvenile court to find by a preponderance the necessary factors or, if it cannot do so, to deny continued shelter care. After reviewing the principles and interests involved, we find no compelling constitutional principle that would permit, much less compel, us to depart from that scheme. BACKGROUND Emergency Shelter Care O.P. was born seven weeks prematurely, on October 7, 2018, to parents N.R. ("Mother") and S.P.

("Father"). He spent the first seven weeks of his life in the neonatal intensive care unit ("NICU") of Johns Hopkins Hospital until his discharge on November 23. Three weeks later, on December 14, the Department received a report that O.P. had been admitted to Johns Hopkins Hospital due to unexplained brain injuries. On December 21, the hospital discharged O.P to the Department's custody to be placed in emergency shelter care. ⁵³³ The Department's First Petition for Continued Shelter Care On December 26, the next day the courts were open, the Department filed a Child in Need of Assistance ("CINA") petition ¹³⁷ and a request for continued shelter care with the juvenile court.

The petition included the following allegations: • According to O.P.'s parents, on December 12, there had been an incident in which O.P. was choking and "appeared to have stopped breathing." Father "performed CPR" and Mother called 911. The parents reported that the emergency personnel who responded to the incident determined that O.P. "appeared fine at that time." • When O.P. visited his pediatrician two days later, the doctor "was concerned about the infant's increased head circumference and had [O.P.] sent immediately to Johns Hopkins Hospital emergency room." • O.P. was admitted to the hospital after it was determined that he "had both subdural and subarachnoid hemorrhaging." • Medical providers "indicated that the injuries and finding [sic] are consistent with abusive head trauma and strongly recommended that [O.P.] not be returned to the parents' care at that time, given that there was no plausible explanation as to what caused the brain bleeds and both parents' troubling mental health histories." 2 • The Department held a "Team Decision Making meeting" on December 26 in which O.P.'s parents participated. They "were unable to develop a plan that would assure [O.P.'s] safety other than to place him in out of home care." ⁵³⁴ That same day, December 26, a juvenile magistrate held a hearing and granted the Department's request for an order continuing shelter care pending adjudication.

The First De Novo Shelter Care Hearing Mother exercised her statutory right to request an immediate review of the magistrate's order and the juvenile court held a de novo shelter care hearing the next day. 3 The Department presented (1) the testimony of child protective services worker Joshua Kay and (2) the hospital's discharge summary for O.P. In light of the nature of the challenge to the juvenile court's findings and ultimate determination, we present Mr. Kay's testimony in some detail. 4 Mr. Kay testified regarding what the parents had told him about the incident in which O.P. had stopped breathing: • The incident occurred on December 12; • Father, who was home with O.P. at the time, heard O.P. "beg[i]n to ¹³⁸ make choking noises" and then it "appeared that he had stopped breathing." • When Father checked and "could not hear or feel any breathing," he administered CPR. • O.P. then began to breathe and at some point, Father called Mother who called 911. • O.P's parents told Mr. Kay that emergency medical services ("EMS") personnel checked O.P's vitals and determined that O.P. was "okay." ⁵³⁵ • The paramedics then gave the parents three options: allow EMS to take O.P. to the hospital, take O.P. to the hospital themselves, or take O.P. to a previously scheduled doctor's appointment the following day. • "EMS then recommended that they just go to the appointment that was already scheduled on the 13th." Mr. Kay also spoke to O.P's pediatrician, Dr. David Dominguez, and others within Dr. Dominguez's office. Based on those conversations, Mr. Kay testified that O.P. was "schedule[d] to have weekly appointments" because "he had been having trouble gaining weight." The pediatrician's office told Mr. Kay that O.P. had been scheduled for an appointment on December 12, which was missed, and that he had never been scheduled for an appointment on December 13. The parents brought O.P. for an appointment on December 14, at which Dr. Dominguez became concerned about O.P.'s "expanded head circumference" and "the observable veins in [his] head." As a result, Dr. Dominguez told Mr. Kay, he "sent them to the ER." The parents never informed Dr. Dominguez about the incident in which O.P. was choking and stopped breathing.

The doctor learned about that incident only later from Dr. Mitch Goldstein of Johns Hopkins Hospital. Mr. Kay also testified about his communications with Dr. Goldstein, the physician in charge of the child protection team that evaluated O.P. at the hospital. Dr. Goldstein told Mr. Kay that he had conducted tests and reviewed some of O.P's medical records. Dr. Goldstein also reported that there was "intracranial bleeding," specifically "subdural hematoma and subarachnoid hematoma," which was "consistent with abusive head trauma" incurred "on two different occasions." The doctor believed the injuries occurred on two different occasions because there was "newer blood and older blood" in "two different locations," which could not be the result of a birth defect or medical issue.

Notably for our purposes, Mr. Kay also reported that Dr. Goldstein said that he could not determine the timing or age of the two bleeds, other than "that one was older and one was ⁵³⁶ newer." Although the Department had attempted to get information that would narrow the timeframe, Dr. Goldstein told Mr. Kay that "medical technology does not allow them to put any dates, whether it was, you know, two weeks old, two months old or [sic] either of the bleeds." Indeed, on cross-examination, when asked if "[t]he bleeding could have occurred while [O.P.] was in the NICU," Mr. Kay responded that "[w]hat was explained to [him] is, yes, that there is just no time frame for when the bleeding occurred." Mr. Kay also acknowledged during cross-examination that Mother had shown him a picture from when O.P. was still in the NICU in which he had the same protruding veins that had concerned Dr. Dominguez on December 14. Finally, Mr. Kay testified that he had initially attempted to establish a safety plan under which O.P. "could come home and be under 24-hours a day/seven days a ¹³⁹ week supervision by the maternal grandfather, [who lived in the same home with O.P. and his parents], that he would ensure that the parents were never left alone with" O.P. However, once the Department received information from Dr. Goldstein that O.P.'s injuries were consistent with abusive head trauma, he became concerned that the grandfather might "be a possible cause of the head trauma" and so the Department was no longer "comfortable doing a safety plan with the parents." O.P.'s hospital discharge summary, which the court admitted into evidence, indicates that on December 14, O.P.'s head circumference was 40 centimeters, his "[s]calp veins were prominent," and his "[e]yes showed mild sundowning." Notes near the end of the summary state that the hospital's child protective team "noted concern[ ] for possibility of inflicted neurotrauma." An MRI taken on December 19 identified multiple hemorrhages and hematomas in O.P.'s head. 5 The summary also noted that the protruding veins were "likely ⁵³⁷ secondary to trauma"; and that this "[c]onstellation of findings can be seen in the setting of nonaccidental injury, clinical correlation recommended." Mr. Kay testified that in addition to this discharge summary, he had Dr. Goldstein's "written findings" in his possession, but he did not produce them at the hearing. At the conclusion of the Department's case, the juvenile court granted Mother's request to deny the petition for continued shelter care.

The court determined that the Department had failed to meet its burden, even construing the facts presented in the light most favorable to the Department. As a result, the court ordered the immediate return of O.P. to his parents. 6 The First Appeal The Department immediately noted an appeal and sought an injunction from this Court. We granted a temporary stay and remanded the matter "to permit the juvenile court to explain the basis for its decisions and to allow for preparation and transmission of all of the evidence considered by the juvenile court" so that we could consider the request further. In the meantime, we ordered that, pending the issuance of a new order by the juvenile court, "the parties shall return to the status quo that preceded the issuance of the juvenile court's December 27, 2018 decisions (i.e., the infant O.P. shall be immediately returned to the Department's emergency shelter care)." Further Juvenile Court Proceedings On December 31, 2018, the juvenile court issued a memorandum opinion and order explaining its December 27 decision. ⁵³⁸ On January 3, 2019, the Department filed in the juvenile court an amended CINA petition with an amended request for shelter care, stating that it had acquired additional evidence.

The amended petition included the following new allegations: ¹⁴⁰ • Although the parents had contended that the incident in which O.P. was found choking and not breathing occurred on December 12, the Department had learned that it occurred on December 10. The responding paramedics indicated that Father had told them that O.P. "had been gagging" and that Father "picked up [O.P.] and began stimulating and delivering back slaps." The paramedics did not mention any "administering [of] CPR or [O.P] not breathing." • Those paramedics also stated that O.P.'s parents had refused their recommendation that O.P. "be transported to the Emergency Room for evaluation at that time." • When seen on December 14, O.P. had "sunsetting of his eyes" as well as the "increased head circumference" that were "concerning for hydrocephalus, [ 7 ] which was not present at prior visits." • O.P.'s birth records, also newly-received, "indicate that [O.P.'s] head was examined and determined to be normocephalic [ 8 ] and atraumatic [ 9 ] on at least three occasions during the child's birth stay [at the NICU], including at discharge on November 23," and that there was no "concern for [O.P.'s] head size or condition, or that [O.P.] suffered any brain related incidents while in the hospital." ⁵³⁹ • At O.P.'s appointments with his pediatrician on November 27 and December 5, his "head was described as normocephalic and atraumatic." On January 2, 2019, Mother filed a motion in this Court to lift its stay and immediately return O.P. to his parents.

The Department opposed the motion in a filing that noted its new evidence and newly-filed amended petition. We denied Mother's motion but ordered that the stay would expire as soon as the juvenile court entered an order resolving the Department's amended shelter care request. On January 7, a magistrate held a hearing on the amended request and granted continued shelter care. The parents again requested an immediate review by the juvenile court, which held a de novo hearing on January 8 and 9 limited in scope "to all new allegations not contained in the original Petition." The Second De Novo Shelter Care Hearing At the second de novo hearing, the Department again presented Mr. Kay as its only witness and also introduced additional documentary evidence, including EMS records from the paramedics who responded to the incident that occurred on December 10 and medical records from O.P.'s time in the NICU and subsequent visits to the pediatrician.

Mr. Kay testified as to the new information he had learned in the 12 days since the first hearing, which consisted almost entirely of the contents of the EMS and medical records. He testified that the EMS records showed that the incident in which O.P. had choked and stopped breathing had actually occurred on December 10, which meant that it had taken the parents four days, not two, to take O.P. to a doctor following that incident. Those records also ¹⁴¹ showed that Father "had refused medical advice" that O.P. be "taken immediately to the E.R," whereas Father "had previously stated that he had followed the recommendations of the paramedic to go to the pediatrician the following day." Mr. Kay also testified that medical records from Dr. Dominguez's office showed that Dr. Dominguez had expressed concern that O.P. had missed medical appointments with specialists, ⁵⁴⁰ including a gastro-reflux doctor and an ear, nose, and throat doctor, and that Mother did not follow through "for postpartum discretion [sic] screening." As identified in the amended petition, the pediatric records also note that when O.P. was taken in on December 14, he had "an increasing head circumference," "bulging ... scalp veins," and "sunsetting of his eyes," which were "concerning for hydrocephalus." Mr. Kay also testified that O.P.'s records from the NICU, which he had obtained since the first hearing, indicated that O.P.'s "head circumference [was] normal." Mr. Kay testified that he had not spoken with Dr. Goldstein or any other members of the Hopkins evaluation team since the first hearing. He also acknowledged that the written findings from Dr. Goldstein that he referred to in his testimony at the first hearing, but did not produce, were in the form of an e-mail "sent from a coordinator that was in reference to statements that were from Dr. Goldstein, but it was not part of the records that we received." The e-mail was not presented to the court.

The EMS records the Department introduced into evidence identify the choking incident as having occurred on December 10. The records also reveal that the paramedics informed O.P.'s parents that "EMS recommends transport to local pediatric ER for evaluation but indicate they no longer believe it to be necessary .... Parents were also advised if they did not transport [O.P.] to local ER of their choice to still contact [O.P.'s] pediatrician in the morning." The EMS personnel obtained Father's signature for "refusal of services" against medical advice. However, the EMS records also reflect that the provider's "Primary Impression" of O.P. as a result of the incident was "No Apparent Illness/Injury [Unknown]." The space for a secondary impression is left blank.

The narrative explanation of the incident also notes that the EMS providers found O.P. "in no apparent distress with good skin color," and that his "baseline vitals were assessed and stable." ⁵⁴¹ The Hopkins medical records contain findings from several different evaluations performed during O.P.'s seven weeks in the NICU and at three pediatric visits. The NICU records indicate that O.P.'s head circumference at birth was 31cm. By November 19, four days before discharge, his head had grown to 37.6 cm.

Pediatric records from a visit on December 5 state that his head circumference was 37.5 cm. Each of these records from birth through December 5 describes O.P.'s head as both "normocephalic" and "atraumatic." None of the medical records before December 14 appear to identify any concern with the size of O.P.'s head. After the Department closed its case, the court considered, and then denied, a motion by the parents to dismiss the petition. The parents then presented testimony from both Mother and Father.

Mother testified that O.P. suffered from acid reflux, causing him to have difficulty "keeping his food down," and had been prescribed Zantac. He also had laryngomalacia, which caused episodes of sleep apnea and had caused him to stop breathing twice while in the NICU. "One time he corrected it himself, and then another time the nurse ... had to get involved and help him." Mother testified ¹⁴² she was not given any instructions from the hospital regarding the laryngomalacia or what to do if O.P. stopped breathing again. Mother acknowledged that Dr. Dominguez had advised her to make an appointment with a specialist for O.P.'s conditions.

She had missed the appointment for the laryngomalacia because it had been scheduled on a date when O.P. was still in the hospital for the brain injury. She also attempted to schedule an appointment for the acid reflux, but was told that, absent an emergency, an appointment could not be scheduled for approximately one month. In explaining the discrepancy as to the date of the incident in which O.P. choked and briefly stopped breathing while at home, Mother testified that she "had [her] dates mixed up" when she initially spoke with Mr. Kay. She also testified that the paramedics did not inform her of a health risk if she did not take O.P. to the hospital right away and she explained that ⁵⁴² she did not do so because she assumed the incident was just another incidence of what had occurred in the NICU: "[S]o I wasn't too worried about it because it's happened before and with that condition it's more than likely to happen again." With respect to missing pediatric appointments, Mother testified that she had missed the appointment on December 12 due to a confusion about the time.

She made an appointment for the following day, but that morning was informed that Dr. Dominguez would not be there. She then made the appointment for December 14, which led to O.P.'s hospitalization. She acknowledged that she had not told Dr. Dominguez about the December 10 incident during that appointment, but said that she did not have the opportunity because Dr. Dominguez "seemed really urgent about the head circumference and he just wanted us to go to the ER." Mother also introduced a medical chart from the hospital showing O.P.'s head growth over time. The chart depicts the head circumference-for-age percentiles for premature boys of 23.5 to 50 gestational weeks (i.e., based on age since conception rather than age since birth) with curves identifying the 3rd, 10th, 50th, 90th, and 97th percentiles, and plots O.P.'s head circumference on the same chart.

According to the chart, (1) O.P.'s head circumference at birth (33 gestational weeks) was right at the 50th percentile; (2) his head circumference increased over the following few weeks, rising above the 90th percentile by 39 weeks and almost to the 97th percentile at approximately 40 weeks, which was around the time of his discharge; (3) his head circumference then stopped expanding for a brief period, falling back under the 90th percentile by approximately 42 weeks; and (4) then measured well above the 97th percentile line beginning at approximately 44 weeks, which corresponds to his visit to the pediatrician on December 14 and subsequent hospitalization. Father's testimony was more limited. He testified that he learned infant CPR in the Navy and performed it on O.P. on December 10 when he "heard no breathing." When the paramedics arrived, O.P. "was breathing, crying, and he seemed ⁵⁴³ back from where he was." The paramedics "indicated that they didn't seem that there was a continuing emergency" and that a baby crying following CPR "is the best sound you can hear." On January 10, 2019, the court issued a second memorandum opinion and order in which it made findings of fact including the following: • Following the December 10 choking/not breathing incident, O.P. was checked by the paramedics "and determined to be normal." "The EMT narrative clearly indicates" that ¹⁴³ transport to the emergency room "was advised for 'evaluation' and not for emergency treatment, as the EMT's found the child's condition on the scene to be normal." • The Department "did not produce the pediatrician at either review hearing." • Dr. Goldstein, as relayed through Mr. Kay, "characterized his findings ... as being 'consistent' with abusive head trauma, 'in the absence of plausible explanation.' " However, Mr. Kay "acknowledged that he made no inquiry of Dr. Goldstein about what other scenarios would be 'consistent' with [O.P.'s] condition" nor did the Department undertake efforts "to investigate the care of [O.P.] while in the hospital NICU for 48 days; the majority of the young infant's life." • "[O]f greatest significance, [Mr.] Kay testified that he was advised by Dr. Goldstein that current medical science cannot date the age of either of the two hemorrhages." The Department "produced no additional evidence at the second hearing to establish a timeline for the injuries, nor any evidence as to the cause of such injuries." • Although the Department alleged "neglect by the parents in not allowing the EMT's to transport [O.P.] to an emergency room, and waiting four days to see the pediatrician, there was no evidence presented that those decisions by the parents in any way harmed the child." ⁵⁴⁴ • "While in the NICU, [O.P.'s] head was growing abnormally large." • "The Court finds both parents to be completely credible, especially as to their descriptions of the events at issue, and most especially their concern and caring for an infant with multiple medical challenges.

They are young, a bit overwhelmed by the events, especially since the filing of the CINA petition, and clearly have had challenges navigating the healthcare system." • "It is telling that the [Department] ... never questioned the parents as to the care of the minor child during the 22 days he was in the home after the initial stay in the NICU, except for the administration of medications. Neither were questioned whether any events occurred in the home to explain the internal head injuries." • Mr. Kay "only summarize[d] hearsay conversations with the doctors, leaving a number of details unanswered." "[T]he Court was not given the opportunity to judge first-hand the accuracy, consistency or credibility of either the EMT's or the pediatrician. Such witnesses were available to the [Department], which did not avail itself of compulsory process, nor gave any real explanation of why such witnesses were not produced, other than 'we tried...'. This is a critical consideration for the Court having found the parent's [sic] descriptions of events and explanations of minor discrepancies to be credible." • "The Court finds that the timing of the two hemorrhages cannot be determined.

All of the intra-cranial bleeding could have occurred while [O.P.] was in the NICU ... for seven weeks, or during the 22 days after the child was home, including during the justifiably vigorous administration of CPR at the time of the choking/[not] breathing event. The stubborn refusal of [the Department] to thoroughly investigate the hospital stay is inexplicable." "As such, no ¹⁴⁴ reasonable inferences can be ⁵⁴⁵ drawn placing responsibility for such injuries upon the parents." • The Department "did not make reasonable efforts in preventing or eliminating the need for removal of the child from the home." The Department abandoned the safety plan prepared "solely on the basis of Dr. Goldstein] of Hopkins telling [Mr.] Kay that in the absence of any plausible explanation, the head injuries were due to non-accidental trauma. The Court finds that to be insufficient reason to decline to pursue the safety plan ...." Based on these findings, the Court concluded that the Department "failed to meet its burden, even by a preponderance of the evidence, to prove that the injuries suffered by [O.P.] were 1) non-accidental or; 2) that they were caused by the abuse or neglect of the parents while in their custody or control." The Department also "failed to meet its burden to prove that the parents neglected their child by failure to allow the EMT's to transport the child for evaluation after the choking/[not] breathing incident, or by waiting four days to see the pediatrician." The court therefore denied the Department's request for continued shelter care and, because this Court's injunction automatically expired upon the issuance of the juvenile court's opinion and order, ordered the Department to return O.P. to his parents that day. The Department and O.P. noted immediate appeals and again sought an injunction from this Court.

We denied the request for an injunction pending appeal but expedited briefing and argument and directed the parties to address in their briefing the appropriate legal standard for continuing shelter care. DISCUSSION In Part I of this opinion we lay out the relevant statutory scheme as it relates to CINA cases generally and the shelter care proceedings that are the focus of this appeal. In Part II, we turn to Mother's claim that we lack jurisdiction over this interlocutory appeal. We conclude that we have jurisdiction under the collateral order doctrine because the ⁵⁴⁶ juvenile court's order constitutes the final resolution of an important issue-whether O.P. should be placed in shelter care on an emergency basis-that is completely separate from the merits of the CINA petition and that would be effectively unreviewable on appeal.

In Part III, we address the core dispute among the parties as to the proper standard of proof to apply in a shelter care hearing. The parties' arguments reveal a wide chasm in their respective positions on this issue. The Department contends that the correct legal standard of proof is "reasonable under the circumstances." O.P. similarly argues for a "reasonable grounds to believe" standard. Father, on the other hand, argues for a preponderance of the evidence standard, which is what the juvenile court employed, while Mother argues for clear and convincing evidence.

Based on the plain language of the statute, as well as on its context and the important interests involved, we conclude that preponderance of the evidence is the correct standard. In Part IV, we return to the facts of this case and address the claims of the parties that they each should prevail regardless of the applicable standard of proof, including the claims of the Department and O.P. that the juvenile court made clearly erroneous findings of fact and erred in reaching its ultimate conclusion. ¹⁴⁵ The standard of review applicable to CINA proceedings is well-established: (1) we review factual findings of the juvenile court for clear error, (2) we determine, "without deference," whether the juvenile court erred as a matter of law, and if so, whether the error requires further proceedings or, instead, is harmless, and (3) we evaluate the juvenile court's final decision for abuse of discretion. In re Adoption/Guardianship of H.W. , 460 Md. 201 , 214, 189 A.3d 284 (2018). I. THE STATUTORY SCHEME A. CINA Proceedings Generally A "child in need of assistance," or CINA, is "a child who requires court intervention because: (1) The child has been ⁵⁴⁷ abused, has been neglected, has a developmental disability, or has a mental disorder; and (2) The child's parents, guardian, or custodian are unable or unwilling to give proper care and attention to the child and the child's needs." Cts. & Jud.

Proc. § 3-801(f), (g). The General Assembly has codified the provisions of the law governing CINA proceedings in Subtitle 8 of Title 3 of the Courts and Judicial Proceedings Article, and has defined the "purposes of th[e] subtitle" as: (1) To provide for the care, protection, safety, and mental and physical development of any child coming within the provisions of this subtitle; (2) To provide for a program of services and treatment consistent with the child's best interests and the promotion of the public interest; (3) To conserve and strengthen the child's family ties and to separate a child from the child's parents only when necessary for the child's welfare; (4) To hold parents of children found to be in need of assistance responsible for remedying the circumstances that required the court's intervention; (5) Except as otherwise provided by law, to hold the local department responsible for providing services to assist the parents with remedying the circumstances that required the court's intervention; (6) If necessary to remove a child from the child's home, to secure for the child custody, care, and discipline as nearly as possible equivalent to that which the child's parents should have given; (7) To achieve a timely, permanent placement for the child consistent with the child's best interests; and (8) To provide judicial procedures for carrying out the provisions of this subtitle. Id. § 3-802(a). The statute also commands that it "shall be construed liberally to effectuate these purposes." Id. § 3-802(b).

Subtitle 8 establishes a comprehensive statutory scheme to govern proceedings when a child is alleged to be a CINA. The ⁵⁴⁸ statute gives "exclusive original jurisdiction" to a juvenile court over proceedings arising from CINA petitions, id. § 3-803(a)(2), and establishes, among other things, the scope of the court's jurisdiction over children, venue for proceedings, assignment of judges, the appointment and authority of juvenile magistrates, the review of decisions or recommendations of magistrates to the juvenile court, the confidentiality of proceedings, the scope of a local department's obligation to make reasonable efforts to reunify children and parents, and the State's obligation to provide counsel to represent children, as well as indigent parents and guardians of an alleged CINA, in CINA proceedings, id. §§ 3-804, 3-805, 3-806, 3-807, 3-810, 3-812, & 3-813. A local department of social services is required to file a CINA petition if, after receiving "a complaint from a person or ¹⁴⁶ agency," "it concludes that the court has jurisdiction over the matter and that the filing of a petition is in the best interests of the child." Id. § 3-809(a). "A CINA petition ... shall allege that a child is in need of assistance and shall set forth in clear and simple language the facts supporting that allegation." Id. § 3-811(a)(1).

Once a CINA petition is filed, a juvenile court "shall hold an adjudicatory hearing," id. § 3-817(a), for the purpose of "determin[ing] whether the allegations in the petition, other than the allegation that the child requires the court's intervention, are true," id. § 3-801(c). At the adjudicatory hearing, the rules of evidence apply and the allegations of the petition must "be proved by a preponderance of the evidence." Id. § 3-817(b), (c). Following an adjudicatory hearing, the juvenile court must "hold a separate disposition hearing," either "on the same day as the adjudicatory hearing" or later. Id. § 3-819(a).

With respect to a child who is alleged to be a CINA arising from abuse or neglect, the court's disposition may entail (1) finding that the child is not a CINA and terminating the case, (2) finding that the child is not a CINA and awarding custody to a noncustodial parent, or (3) finding that the child is a CINA ⁵⁴⁹ and making a custody determination from among various options. See generally id. § 3-819. Depending on the disposition, additional proceedings that are beyond the scope of this opinion follow. 10 B. Shelter Care Proceedings Section 3-815 of the Courts and Judicial Proceedings Article authorizes a local department that believes a child may be a CINA to place the child in emergency shelter care under certain circumstances. As explained further below, shelter care is not a necessary stage in a CINA proceeding but instead is a parallel proceeding to provide interim protection for a child pending completion of the adjudicatory hearing and disposition.

Subsection (a) of § 3-815 provides the general authorization for emergency shelter care: "In accordance with regulations adopted by the Department of Human Services, a local department may authorize shelter care for a child who may be in need of assistance and has been taken into custody under this subtitle." Subsection (b) then establishes the following parameters: (b) A local department may place a child in emergency shelter care before a hearing if: (1) Placement is required to protect the child from serious immediate danger; (2) There is no parent, guardian, custodian, relative, or other person able to provide supervision; and (3) (i) 1. The child's continued placement in the child's home is contrary to the welfare of the child; and ⁵⁵⁰ 2. Because of an alleged emergency situation, removal from the home is reasonable under the circumstances to provide for the safety of the child; or (ii) 1. Reasonable efforts have been made but have been unsuccessful in preventing or eliminating the need for removal from the child's home; and ¹⁴⁷ 2.

As appropriate, reasonable efforts are being made to return the child to the child's home. Following placement of a child in emergency shelter care, "the local department shall immediately file a petition to authorize continued shelter care." Id. § 3-815(c)(1). The court is required to "hold a shelter care hearing on the petition before disposition to determine whether the temporary placement of the child outside of the home is warranted." Id. § 3-815(c)(2)(i). Absent good cause, the hearing must "be held not later than the next day on which the circuit court is in session." Id. § 3-815(c)(2)(ii).

It is such a petition for continued shelter that is at issue here. Subsection (d) provides the criteria for the circuit court to use in determining whether to authorize continued shelter care: (d) A court may continue shelter care beyond emergency shelter care only if the court finds that: (1) Return of the child to the child's home is contrary to the safety and welfare of the child; and (2)(i) Removal of the child from the child's home is necessary due to an alleged emergency situation and in order to provide for the safety of the child; or (ii) Reasonable efforts were made but were unsuccessful in preventing or eliminating the need for removal of the child from the home. The duration of a term of shelter care is expressly limited: "A court may not order shelter care for more than 30 days except that shelter care may be extended for up to an additional 30 days if the court finds after a hearing held as part of an ⁵⁵¹ adjudication that continued shelter care is needed to provide for the safety of the child." Id. § 3-815(c)(4).

II

THIS COURT HAS JURISDICTION TO REVIEW THE JUVENILE COURT'S SECOND ORDER DENYING THE DEPARTMENT'S REQUEST FOR CONTINUED SHELTER CARE. Before addressing the parties' respective positions regarding the applicable standard of proof in a shelter care proceeding, we must first address Mother's contention that neither of the Department's appeals are properly before us. Mother moved to dismiss on two grounds: (1) that the juvenile court's December 27 order is moot because it was superseded by the January 10 order; and (2) that neither of the orders is "appealable as a final, collateral, or interlocutory order." We agree with Mother that the December 27 order is moot but we conclude that the January 10 order is appealable under the collateral order doctrine. A. The December 27 Order Is Moot.

Following the juvenile court's December 27 order, the Department filed an amended CINA petition with a request for continued shelter care. After a magistrate continued shelter care pursuant to the amended petition, the juvenile court held a second de novo hearing and issued the January 10 opinion and order denying continued shelter care. The juvenile court's second order superseded the first. As a result, the first order is moot and "vacating [it] will provide no relief whatever to appellants." In re Joseph N. , 407 Md. 278 , 303, 965 A.2d 59 (2009) (quoting In re Justin D. , 357 Md. 431 , 444, 745 A.2d 408 (2000) ); see also In re Iris M. , 118 Md. App. 636 , 643, 703 A.2d 1279 (1998) (noting that an initial no-contact order was superseded by a subsequent no-contact order, rendering the first order moot). 11 ^{148 552} B. The Denial of a Petition for Continued Shelter Care Is Appealable Under the Collateral Order Doctrine.

An order denying continued shelter care is an interlocutory order. Interlocutory orders are ordinarily appealable only in three circumstances: "appeals from interlocutory orders specifically allowed by statute; immediate appeals permitted under Maryland Rule 2-602 ; and appeals from interlocutory rulings allowed under the common law collateral order doctrine." Salvagno v. Frew , 388 Md. 605 , 615, 881 A.2d 660 (2005). We find the juvenile court's January 10 order falls under the collateral order doctrine exception. 12 The collateral order doctrine "is a very limited exception to the principle that only final judgments terminating the case in the trial court are appealable ...." In re Foley , 373 Md. 627 , 633, 820 A.2d 587 (2003). It "treats as final and appealable a limited class of orders which do not terminate the litigation in the trial court." Id.

(quoting Bunting v. State , 312 Md. 472 , 476, 540 A.2d 805 (1988) ). To be appealable under the collateral order doctrine, the order must: (1) "conclusively determine[ ] the disputed question"; (2) "resolve[ ] an important issue"; (3) "resolve[ ] an issue that is ⁵⁵³ completely separate from the merits of the action"; and (4) "be effectively unreviewable if the appeal had to await the entry of a final judgment." Dawkins v. Balt. City Police Dep't , 376 Md. 53 , 58, 827 A.2d 115 (2003) (quoting Pittsburgh Corning v. James , 353 Md. 657 , 660-61, 728 A.2d 210 (1999) ). "[I]n Maryland the four requirements of the collateral order doctrine are very strictly applied." In re Foley , 373 Md. at 634 , 820 A.2d 587 .

The first, second, and fourth requirements are easily satisfied here. As to the first, the issue to be resolved at a shelter care hearing is "whether the temporary placement of the child outside of the home is warranted." Cts. & Jud. Proc. §§ 3-801(bb) & 3-815(c). The grounds on which such a placement may be warranted are that not doing so "is contrary to the safety and welfare of the child" and that either removal "is necessary due to an alleged emergency situation and in order to provide for the safety of the child" or "[r]easonable efforts were made but were unsuccessful in preventing or eliminating the need for removal of the child from the ¹⁴⁹ home." Id. § 3-815(d).

A juvenile court's order denying continued sheltered care conclusively resolves the issue as it returns the child home for the duration of the CINA proceedings, the only period of time at issue. The second requirement is also satisfied because the issue resolved is an undeniably important one. Denying continued shelter care returns the child to the very situation that the Department contends presents an imminent risk to the child's health and safety. As to the fourth requirement, a decision to deny continued shelter care is effectively unreviewable on appeal from a final judgment.

Because shelter care is designed to provide emergency protection for a child only until a juvenile court rules on the merits of a CINA petition, it will always be moot and effectively unreviewable when the merits are reached. If the juvenile court's shelter care decision was wrong, and the child suffers the harm against which the Department was trying to protect, nothing within any appellate court's power will be able ⁵⁵⁴ to turn back the clock and place the child in safety during that time period. The nature of the decision makes it unreviewable if not by immediate appeal. Notably, the fourth requirement of the collateral order doctrine necessarily involves a judgment on "whether delaying review until the entry of final judgment 'would imperil a substantial public interest' or 'some particular value of a high order.' " Harris v. State , 420 Md. 300 , 321, 22 A.3d 886 (2011) (quoting Mohawk Indus. v. Carpenter , 558 U.S. 100 , 107, 130 S.Ct. 599 , 175 L.Ed.2d 458 (2009) ).

As discussed further below, the protection of children from imminent risks to their health and safety is a substantial public interest in general and is particularly so in light of the parens patriae responsibility of the courts in furthering that interest. Absent a right of immediate appeal, a decision by a juvenile court judge that is contrary to that of a magistrate and to the view of the State agency charged with protecting the health and safety of children would be effectively unreviewable. Our consideration of the third requirement of the collateral order doctrine-whether the decision "resolves an issue that is completely separate from the merits of the action," Dawkins , 376 Md. at 58 , 827 A.2d 115 (citation omitted)-presents a closer question. The merits of the action here is whether O.P. is a CINA.

That requires a determination regarding whether O.P. "requires court intervention because" (1) he "has been abused, has been neglected, has a developmental disability, or has a mental disorder" and (2) his parents "are unable or unwilling to give proper care and attention to [him] and [his] needs." Cts. & Jud. Proc. § 3-801(f). As set forth above, the decision as to whether a child is a CINA happens in two separate proceedings, the adjudicatory hearing and the disposition hearing, and the outcome, if the Department is successful, is to work toward a long-term arrangement focused on providing the child a healthy, stable, and permanent arrangement.

A request for continuation of shelter care frequently accompanies a CINA petition, but it is neither a ⁵⁵⁵ necessary step in a CINA proceeding nor does it constitute part of the CINA determination. Although the facts relevant to a determination of whether to authorize continued shelter care and whether a child is a CINA may substantially overlap, the issues in the two proceedings are fundamentally distinct. The core issue in a shelter care proceeding is whether there is an impending risk to the health and safety of a child-from whatever source and for whatever reason-if the child is returned ¹⁵⁰ home before the court can complete the disposition phase of a CINA proceeding. Id. § 3-815(d).

The resolution of that issue will determine where and with whom the child will reside prior to the adjudication of the merits of the CINA petition. The core issues in a CINA proceeding, by contrast, are (1) whether the child has been abused or neglected and whether his or her parents or guardians are unwilling or unable to care for him or her, and (2) if so, what plan the court will approve for permanency for the child subsequent to the adjudication and disposition of the CINA petition. Id. §§ 3-801(f) ; 3-819(b). The unique nature of shelter care proceedings informs our conclusion that an order denying continued shelter care is completely separate from the merits of a CINA proceeding for purposes of the collateral order doctrine.

Because a hearing must be held on a petition for continued shelter so soon after a local department places a child in emergency shelter care, the Rules of Evidence do not apply at the hearing. Md. Rule 11-112(d). As a result, as in this case, much of the evidence that is submitted can be based on hearsay that would be inadmissible in any subsequent proceeding. The purpose of a shelter care hearing is thus not to gather evidence for either side to prove its ultimate case, nor is such a hearing a necessary step on the path to an adjudicatory hearing or disposition.

Instead, it is parallel to and separate from the proceedings that ultimately lead to the CINA decision. That distinguishes the orders resulting from such proceedings from others that our appellate courts have found not to constitute appealable collateral orders. ⁵⁵⁶ In Harris v. State , for example, the Court of Appeals declined to extend the collateral order doctrine to include an order granting the State's discovery request for medical records, including competency evaluations, in a murder trial. 420 Md. at 318 , 22 A.3d 886 . The discovery request aimed to uncover critical facts that could be outcome determinative in a competency hearing, the resolution of which would ultimately affect the merits of the trial. Id. at 319 , 22 A.3d 886 .

The Court noted that "[i]f an order decides an issue merely as a step toward final disposition of a prosecution, it is interlocutory; however, if it disposes of a separable branch of the case, it is an appealable final judgment." Id. at 320 , 22 A.3d 886 (quoting Sigma Reprod. Health Ctr. v. State , 297 Md. 660 , 666, 467 A.2d 483 (1983) ). A competency hearing, although "a distinct phase of a criminal trial," is " 'a step toward the final disposition of a prosecution.' " Harris , 420 Md. at 320 , 22 A.3d 886 (quoting Sigma , 297 Md. at 666 , 467 A.2d 483 ). Here, by contrast, a ruling on continuation of shelter care is a "separable branch of the case," not a step on which other steps build.

Similarly, in In re Samone , the Court of Appeals declined to treat an order denying a mother's motion for an independent evaluation to determine whether a bond existed between her and her children as an appealable collateral order. 385 Md. at 316 n.13, 869 A.2d 370 . There, the children had been adjudicated CINA and, after a periodic review hearing, were placed on a permanency plan of adoption. Id. at 288, 869 A.2d 370 . Before an annual review hearing, the mother filed a motion for an independent clinical study to assess her relationship with the children and to determine whether removal of the children from foster care would be harmful.

Id. at 291, 869 A.2d 370 . The trial court denied the mother's motion and reaffirmed the adoption permanency plan. Id. at 296, 869 A.2d 370 . Although the primary focus of the Court's opinion was on whether the order was appealable under § 12-303(3)(x) of the Courts and Judicial Proceedings Article -and the Court found it was not, ¹⁵¹ id. at 316, 869 A.2d 370 -the Court also concluded that the order was not appealable under the collateral order doctrine.

Id. at 316, 869 A.2d 370 n.13. Addressing the third prong of ⁵⁵⁷ that doctrine, the Court concluded that the order was "not completely separate from the merits of the action because such studies are one factor that the court relies upon to assess child placement." Id. Here, the shelter care determination is not a "step toward the final disposition" of a CINA proceeding. Shelter care runs its course not in the path of the CINA adjudication, but collaterally, in its own lane, without advancing or hindering the final CINA decision.

That, combined with its conclusive resolution of an important issue that is effectively unreviewable on direct appeal, renders it among the narrow class of orders reviewable under the collateral order doctrine.

III

THE COURT MUST FIND, BY A PREPONDERANCE, THE FACTORS REQUIRED TO CONTINUE SHELTER CARE. As a matter of first impression, we must determine what standard of proof a juvenile court must use in determining whether to authorize continued shelter care. Here, the juvenile court used a preponderance of the evidence standard. Father argues that the juvenile court got the standard right.

The Department and O.P. contend that the court must apply a lower standard: either reasonable under the circumstances or reasonable grounds to believe that continuation of shelter care is warranted. Mother advocates for a clear and convincing standard. We begin our analysis, as we must, with the plain language of the statute. A. Statutory Construction "When we construe a statute, we search for legislative intent." Bell v. Chance , 460 Md. 28 , 53, 188 A.3d 930 (2018).

Our "primary guide" in that search is the statutory text. Id. "We begin our analysis by looking to the normal, plain meaning of the language of the statute." Wash. Gas Light Co. v. Md. Pub.

Serv. Comm'n , 460 Md. 667 , 682, 191 A.3d 460 (2018) (quoting Shealer v. Straka , 459 Md. 68 , 84, 184 A.3d 391 (2018) ). We "read[ ] the statute as a whole to ensure that no word, clause, sentence or phrase is rendered surplusage, superfluous, meaningless or nugatory." Id. We also read ⁵⁵⁸ the plain language "within the context of [its] statutory scheme," and "consider[ ] the purpose, aim, or policy of the Legislature in enacting the statute ...." Espina v. Jackson , 442 Md. 311 , 322, 112 A.3d 442 (2015) (quoting Bd. of County Comm'rs v. Marcas, LLC , 415 Md. 676 , 685-86, 4 A.3d 946 (2010) ).

We must also "check our interpretation against the consequences of alternative readings of the text. Throughout this process, we avoid constructions that are illogical or nonsensical, or that render a statute meaningless." Bell , 460 Md. at 53 , 188 A.3d 930 (internal citation omitted). The provision we are construing is § 3-815(d) of the Courts and Judicial Proceedings Article, which provides: (d) A court may continue shelter care beyond emergency shelter care only if the court finds that: (1) Return of the child to the child's home is contrary to the safety and welfare of the child; and (2)(i) Removal of the child from the child's home is necessary due to an alleged emergency situation and in order to provide for the safety of the child; or (ii) Reasonable efforts were made but were unsuccessful in preventing or eliminating the need for removal of the child from the home. ¹⁵² The parties do not dispute what the juvenile court must find before it may authorize continued shelter care. The statute spells that out in subsubsections (d)(1) and (d)(2).

Nor do the parties dispute that it is the local department's burden to prove those things. 13 The question at the center of their dispute is the standard by which the juvenile court must find those things. The statute provides that a court may continue shelter care "only if it finds" the conditions listed in the statute. In arguments that are grounded more in policy than the language ⁵⁵⁹ of the statute, the Department and O.P. argue that this language does not mean that the court need find that those things are true-even by the standard of more likely than not-but that it need only conclude that there is a reasonable possibility that they might be true. Our analysis here is guided by that of the Court of Appeals in