IN THE INTEREST OF O.T., Minor Child, A.F., Mother, Appellant.
from the Iowa District Court for Linn County, Barbara H.
Liesveld, District Associate Judge.
appeals from an order terminating her parental rights
pursuant to Iowa Code chapter 232 (2017).
E. Nelson of Office of the State Public Defender, Cedar
Rapids, for appellant mother.
J. Miller, Attorney General, and Kathryn K. Lang, Assistant
Attorney General, for appellee State.
L. O'Brien Licht, Cedar Rapids, guardian ad litem for
Considered by Danilson, C.J., and Mullins and McDonald, JJ.
appeals from an order terminating her parental rights in her
child O.T. (born 2016) pursuant to Iowa Code section
232.116(1)(h) (2017). O.T.'s biological father does not
appeal from the termination of his parental rights. On
appeal, Angel contends the Iowa Department of Human Services
(IDHS) failed to make reasonable efforts towards
reunification and argues termination is not in the best
interest of her child.
court reviews termination proceedings de novo. See In re
A.M., 843 N.W.2d 100, 110 (Iowa 2014). The statutory
framework authorizing the termination of a parent-child
relationship is well established and need not be repeated
herein. See In re A.S., 906 N.W.2d 467, 472-73 (Iowa
2018) (setting forth the statutory framework).
family came to the attention of IDHS in January 2017 when
then three-month-old O.T. was hospitalized twice due to
concerns regarding her significant weight loss while in
Angel's care. The child has special medical needs, but
there was no medical explanation for her failure to thrive.
IDHS offered the family extensive voluntary services. Despite
the provision of services, Angel failed to follow the
medically-recommended feeding plan, missed a number of the
child's medical appointments, remained unemployed, and
lacked stable housing. O.T. was removed from the parents'
care in May 2017.
has been largely non-compliant with services throughout the
life of this case. She has a long history of mental-health
concerns, but she refused to obtain a mental-health
evaluation until September 2017. She was diagnosed with
anxiety disorder, PTSD, ADHD, and insomnia. Her previous
diagnoses included OCD and depressive disorder. The
mental-health evaluation recommended individual therapy, but
Angel failed to attend. She failed to consistently take her
medications until shortly before the termination hearing.
Angel has a significant history of drug and alcohol abuse;
she began smoking marijuana at age twelve. Since that time,
Angel has completed substance-abuse treatment on multiple
occasions but always relapsed. During the pendency of this
case, she missed a significant number of drug screens despite
repeated reminders. She was not able to obtain stable housing
and was frequently homeless, bouncing between friends and
family members. While she did find some employment during the
case, she never held any position for any material length of
time. She refused parenting classes and required two
referrals for a parenting partner, who she met on only one
occasion. Her attendance at O.T.'s medical appointments
was sporadic. She was inconsistent with visitation, missing
all her visits in November 2017, one in December 2017, five
in January 2018, and two in February 2018. At the time of the
termination hearing on March 2, 2018, Angel had shown about
three weeks of improvement. She was "looking into
therapy," attempting to save for an apartment, starting
a new job, working with providers, and visiting her child.
However, her caseworkers were skeptical given her
"history of not following-through" and believed the
changes she made were in preparation for the hearing and not
"real changes." Ultimately, the juvenile court
terminated Angel's parental rights in O.T. in April 2018.
first address Angel's reasonable efforts argument. As
part of its burden of proving the child could not be returned
to Angel's care at the time of the termination hearing,
the State must prove it made reasonable efforts to return the
child to the care of the parent. See Iowa Code
§ 232.102(9) (providing the department of human services
must make "every reasonable effort to return the child
to the child's home as quickly as possible consistent
with the best interests of the child"). Reasonable
efforts "facilitate reunification while protecting the
child from the harm responsible for the removal." In
re J.W., No. 17-1937, 2018 WL 1099179, at *2 (Iowa Ct.
App. Feb. 21, 2018) (quoting In re M.B., 553 N.W.2d
343, 345 (Iowa Ct. App. 1996)). "[W]hat constitutes
reasonable services varies based upon the requirements of
each individual case." In re C.H., 652 N.W.2d
144, 147 (Iowa 2002) (citing In re H.L.B.R., 567
N.W.2d 675, 679 (Iowa Ct. App. 1997)).
argues IDHS did not make reasonable efforts to facilitate
reunification because she was not given a follow-up
mental-health evaluation after she and some providers
believed the first one was incomplete and because "she
was left to her own devices to identify and obtain
appropriate therapy services." This claim is waived.
Although Angel made one motion for additional services, the
motion related to visitation issues. Angel never raised in
the juvenile court any complaint regarding the mental-health
services offered. The failure to request different or
additional mental-health services in the juvenile court
precludes her challenge to the services on appeal. See
id. ("If . . . a parent is not satisfied with
[I]DHS' response to a request for other services, the
parent must come to court and present this challenge.");
In re C.B., 611 N.W.2d 489, 493-94 (Iowa 2000)
("We have repeatedly emphasized the importance for a
parent to object to services early in the process so
appropriate changes can be made."); In re
A.A.G., 708 N.W.2d 85, 91 (Iowa Ct. App. 2005) (stating
the parent has an obligation to demand other, different, or
additional services prior to the termination hearing or the
issue is considered waived for appeal); see also
Iowa Code § 232.99(3) ("The court shall advise the
parties that failure to identify a deficiency in services or
to request additional services may preclude the party from
challenging the sufficiency of the services in a termination
of parent-child relationship proceeding.").
Angel had not waived her challenge, her claim would fail.
Angel received a court-ordered mental-health evaluation.
Although the evaluation was not entirely consistent with
previous diagnoses, there is no reason Angel could not have
commenced therapy while awaiting an additional evaluation.
IDHS frequently reminded Angel to schedule therapy
appointments and provided her with several possible locations
for treatment. Testimony at trial established that funding
was not available for a second evaluation. But Angel's
caseworker assisted Angel in determining how her insurance
would cover the additional evaluation and offered
transportation assistance. We also note that Angel was given
a wealth of additional services. She was offered family
safety, risk and permanency services; financial planning
assistance; lactation consultants; in-home nursing; parenting
partners; cab services; supervised visitation; in-home
drop-in services; family team meetings; family foster care;
individual counseling; a mental-health evaluation; drug
testing; transportation assistance; protective daycare; a
family support worker; and parenting classes. This is not a
case in which the mother was not provided with adequate
services to facilitate reunification, ...