NEW JERSEY DIVISION OF YOUTH AND FAMILY SERVICES v. E.W.

RECORD IMPOUNDED

NOT FOR PUBLICATION WITHOUT THE

APPROVAL OF THE APPELLATE DIVISION

 

SUPERIOR COURT OF NEW JERSEY

APPELLATE DIVISION

DOCKET NO. A-0

NEW JERSEY DIVISION OF YOUTH

AND FAMILY SERVICES,

Plaintiff-Respondent,

v.

E.W.,

Defendant-Appellant.

____________________________________

IN THE MATTER OF GUARDIANSHIP OF

T.W. and A.W.,

Minors.

________________________________________________________________

October 21, 2013

 

Submitted September 18, 2013 Decided

 

Before Judges Maven and Hoffman.

 

On appeal from the Superior Court of New Jersey, Chancery Division, Family Part, Hudson County, Docket No. FG-09-0116-12.

 

Joseph E. Krakora, Public Defender, attorney for appellant (Howard Danzig, Designated Counsel on the brief).

 

John J. Hoffman, Acting Attorney General, attorney for respondent (Andrea M. Silkowitz, Assistant Attorney General, of counsel; Lisa N. Brown, Deputy Attorney General, on the brief).

 

Joseph E. Krakora, Public Defender, Law Guardian, attorney for minors T.W. and A.W. (Christopher A. Huling, Designated Counsel, on the brief).

PER CURIAM

Defendant E.W., mother of T.W. and A.W., challenges a June 12, 2012 Family Part order terminating her parental rights and granting guardianship to the Division of Youth and Family Services (the Division)1 to secure the children s adoption. On appeal, defendant argues the evidence was insufficient to satisfy the statutory requirements of the third prong of the best interests test, N.J.S.A. 30:4C-15.1(a)(3), and claims her constitutional rights were otherwise violated by the trial court's decision. The Law Guardian supported termination before the trial court and, on appeal, joins the Division in urging us to affirm. We affirm.

I.

On April 8, 2009, the Division received a referral stating that defendant had tested positive for phencyclidine (PCP) after giving birth to her third child, A.W. The referent claimed that defendant "only went to one appointment at the clinic so . . . she received no prenatal care." The referent stated that defendant "has been using PCP for about a year and the last time she used was prior to delivery," and that defendant "seems to [be] mentally challenged."

The Division began its investigation that day by visiting the hospital, where it learned that the child, A.W., also tested positive for PCP. The Division interviewed defendant who informed the caseworker that she was aware of the positive drug results and confirmed the referent's claim that defendant went for prenatal care once when she was five or six months pregnant. Defendant told the caseworker that a man named E.K. was A.W.'s father, but he was incarcerated. The caseworker reported that defendant "appear[ed] to be limited."

The Division also spoke with defendant's sister, L.W.,2 who was "shocked" to hear that A.W. tested positive for PCP. L.W. stated that she was unaware that her sister was using drugs while pregnant. When asked whether she wanted to be the child's caretaker, L.W. stated that she "did not want to become involved with [the Division] again," but that she would "think" about it. A few months later, L.W. informed the Division that she would be unable to care for A.W.

On April 13, 2009, the Division substantiated a finding of neglect against defendant, and conducted a Dodd removal3 of A.W. At that time, the Division provided defendant a case plan in which defendant agreed to submit to a drug and alcohol evaluation, as well as attend a psychological evaluation and parenting classes. On April 15, 2009, the trial court granted the Division care, custody and supervision of A.W. The court found that "[i]t would be contrary to the welfare of the child to return [A.W.] to [the] mother due to her drug use" and "prior [Division] history." The court, however, granted defendant weekly supervised visitation, while ordering the Division to "explore any relatives offered as potential caretakers for the baby," and produce E.K. for the next hearing.

Two days later, the Division referred defendant for a substance abuse evaluation. Defendant admitted that she had been using illegal drugs since she was sixteen years old and last used drugs on March 9, 2009 while pregnant. She also reported that she previously received three rounds of drug treatment, but only remembered entering the Straight & Narrow program in 2008, which she did not complete. Defendant was subsequently referred for long-term residential treatment at Seabrook House, Inc., but she did not enroll due to her failure to complete the prerequisite pre-admission evaluations.

In August 2009, Leslie A. Trott, Ed.D., conducted a psychological evaluation of defendant. Dr. Trott reported that defendant "struggles to function independently and cannot cognitively compose solutions to average, day[-]to[-]day child management challenges" and that "she is mentally retarded." He also opined, "it is clear [defendant] lacks the potential to parent." Dr. Trott recommended that defendant comply with an inpatient treatment program, which included psychiatric services.

Following defendant's court-ordered hospitalization with Jersey City Medical Center (JCMC) in August 2009, its staff psychiatrist informed the Division in November 2009 that defendant's "case was closed due to [n]on-compliance with program rules." Specifically, defendant had been admitted into the facility four times between May and October twice with the psychiatric inpatient unit, once with the acute partial hospital program, and once with the partial hospital program. Each time, defendant displayed "zero commitment," declined services and medication, and dropped treatment. Defendant also refused to provide the Division caseworker with her latest address and telephone number.

In a November 2009 compliance review, the court noted defendant s failure to comply with Division services and warned defendant of the possibility of the termination of her parental rights. At a March 2010 permanency hearing, the court found that defendant "[had] not complied with services" and that "[defendant's] visits with the child [were] sporadic." The judge also noted that defendant s untreated drug and psychiatric problems continued to pose a danger to the child. As a result, the court accepted the Division's permanency plan providing for termination of defendant's parental rights followed by adoption of A.W.

On May 14, 2010, defendant tested positive for PCP. Defendant was referred for short-term residential treatment at Sunrise House. On May 27, 2010, the court ordered defendant to comply with substance abuse services and post-partum depression counseling. Because defendant had missed multiple scheduled visitation appointments, the court also required defendant to notify the Division on Fridays whether she would attend visitations with A.W. on Mondays. Defendant did not attend the May 27 hearing.

On June 29, 2010, Sunrise House discharged defendant for noncompliance. In a July 29, 2010 order, the judge wrote: "The failure of [defendant] . . . to comply with any provision of this order or [her] continuing failure to appear may result in a default entered by the court and termination of parental rights."4 By September, defendant had missed two scheduled psychological and bonding evaluations.

On September 23, 2010, defendant gave birth to a fourth child, T.W. At the time of delivery, defendant tested positive for PCP. The Division's referral report noted that defendant "is insisting that [the Division] is not getting this baby and that she is walking out of the hospital with the new born [sic] baby."

When a Division case manager arrived at the hospital for the child, defendant became very upset. Defendant informed the case manager that she had not received prenatal care and used PCP during her pregnancy, but "didn t use it like that." She then stated that she used PCP when her mother died in August. The Division also learned that T.W. tested positive for PCP, at which point, the Division conducted a Dodd removal of T.W. The court later found the emergency removal to be "appropriate and in the best interest of the child." On September 29, 2010, the Division referred defendant for another substance abuse evaluation. Defendant tested positive for PCP then and again on October 13, 2010.

On October 21, 2010, defendant failed to appear at A.W. s guardianship hearing. A few days later, however, defendant applied for the "Mommy and Me" program and re-entered the inpatient drug treatment program at Sunrise House. Another hearing was held in November, at which defendant appeared, and the court ordered her to comply with the drug treatment program. Nevertheless, Sunrise House discharged defendant days later for noncompliance.

Following a fact-finding hearing on January 20, 2011, the court found by a preponderance of the evidence that defendant abused or neglected T.W. "by exposing her to a substantial risk of harm by using PCP during her pregnancy." The court ordered defendant to comply with services, including another substance abuse evaluation. The judge also reviewed the guardianship matter regarding A.W.

From March 2011 through August 2011, defendant tested positive for PCP multiple times and failed to complete various treatment programs because of noncompliance, as well as hostile and aggressive behavior. On April 1, 2011, Liberty Health/JCMC informed the Division that defendant had been enrolled in its psychiatric program since March 10, 2011. The facility reported that defendant maintained irregular attendance5 and demonstrated poor judgment and insight. During this time, the Division caseworker contacted defendant, who became combative with the worker, "yelling and cursing when [the worker] asked her what were her plans in reference to A.W." Defendant informed the caseworker that she was participating in a program, but she refused to disclose the name. She also refused to provide her mailing address.

An August 24, 2011 report from the Welfare Substance Abuse Initiative indicated that defendant tested positive for marijuana in July 2011 and failed to attend her follow-up appointment. As a result, defendant's welfare services case was closed and sanctions were requested. The following day, defendant failed to attend a September 8, 2011 hearing during which the judge accepted the Division's permanency plan providing for termination of defendant's parental rights to T.W. followed by adoption by her current caretaker.

On December 22, 2011, the Division caseworker left messages to inform defendant that the agency was seeking to terminate her parental rights, as she had failed to comply with Division services. When defendant failed to respond to the messages, the caseworker attempted to conduct a formal search on January 9, 2012. Defendant appeared the next day for a court hearing. She provided the names of several family members she wanted the Division to explore as placement options for the children. The Division attempted to contact the relatives, including her sister, L.W., who declined to be considered. Defendant also provided the name of an aunt, but L.W. explained that she did not know to whom defendant was referring. That same day, defendant tested positive for PCP in a court-ordered drug screening.

On February 3, 2012, Samiris Sostre, M.D., conducted a psychiatric evaluation of defendant. During the interview, defendant told Sostre that "I do not think I have a problem with drugs" and "I do not feel that PCP is a problem." Dr. Sostre reported: "[Defendant] must be able to maintain long-term sobriety. . . . Prognosis for improvement is very poor especially in view of the fact [defendant] minimizes her drug use, minimizes its severity, and has been unable to maintain any length of sobriety in the past." Dr. Sostre further opined that defendant

[d]oes not meet criteria at this time for a mood disorder, psychotic disorder, or anxiety disorder. She may benefit from treatment with a low dose of an atypical antipsychotic that may improve her irritability and make her less likely to be angry while at treatment programs, so that she is more likely to follow-up and stay in programs without arguing with others. Therefore, she may benefit from referral to a MICA (mentally ill/chemical abuser) inpatient program. If this is unavailable, she would benefit from an inpatient substance abuse treatment program and follow-up with a psychiatrist.

On February 27, 2012, Charles Daly, Ph.D., administered a forensic evaluation of defendant, as well as a bonding evaluation between defendant and the children. Dr. Daly opined:

It is my opinion, within a reasonable degree of psychological certainty, that to allow [defendant] to have a custodial relationship with her children at this point in time would be an egregious error, as it would put them at severe, unacceptable physical and emotional risk. Her children clearly do not know her and are not comfortable in her presence and to place them with her in any capacity would represent a severe clinical risk. I do not believe that [defendant] will ever have the capacity to parent a child, as she has had four and has not succeeded in providing a stable and loving environment for any of them. There is no reason to suggest that her behavior in the future will be any different. I have no reason to opine that her behavior and lifestyle in the future will be any different, as the best predictor for future performance is past behavior. It is also my opinion, within a reasonable degree of psychological certainty, that the likelihood of [defendant] recovering from her drug addicted status, is at the very best, guarded.

 

With respect to the bonding evaluation, Dr. Daly reported: "[Defendant] is not the psychological mother of these two young children and is clearly not bonded to them. To suggest that these children could have a kind, loving, and stable relationship with [her] would be seriously inaccurate."

In addition, Dr. Daly administered a bonding evaluation of the children and their foster mother. He determined that their interactions were positive and exceptional, resulting in an "unequivocal" bond.

During the guardianship trial, held before the Honorable Lois Lipton, J.S.C. on April 24, 25, and 27, 2012, the court heard testimony from the Division caseworker, Elizabeth Rosa; and the Division's expert witnesses, Dr. Sostre, and Dr. Daly. The court also heard testimony from defendant. Numerous Division documents were introduced into evidence.

In addition to recounting the history of the Division's involvement with the family, Rosa testified to defendant's visitations with A.W. and T.W. She noted that for a period of one year, defendant did not request or attend any visitations with A.W. After T.W. was born, defendant did not request time with A.W., but rather the Division, on its own initiative, included A.W. in the visits with defendant and T.W.

Dr. Sostre testified that she conducted a psychological evaluation of defendant. In addition to testifying consistently with her report, Dr. Sostre explained her recommendation for a long-term MICA program. When asked if she thought a MICA program would be beneficial to defendant, Sostre stated:

My impression at the time was because behavior problems had interfered with her ability to stay in a regular program that maybe a MICA program would have staff that could handle aggression, agitation, irritability, interpersonal problems with other patients in the program a little bit better.

Sostre went on to state that

it's hard to find an inpatient MICA program . . . There aren't that many[.] I don't even know at this point where there's - - some hospitals do but . . . I know they're difficult . . . to find. So I had added in there if you can't fin[d] a MICA program, inpatient program, then a regular rehabilitation program would be helpful with the psychiatrist maybe prescribing medicine to decrease impulsivity and decrease anger . . . .

Dr. Daly, who was accepted as an expert in the field of psychology, testified with respect to the February 27, 2012 psychological evaluation of defendant, and the bonding evaluations between the children and defendant, and the children and their foster mother. He particularly noted that the foster mother remained in the room during the bonding evaluation between defendant and the children. When asked by defense counsel if he regularly includes the foster parents, he responded "almost never." In this case, he explained,

[t]he children were in a significant . . . state of panic. . . . I observed that they were so upset, that when she attempted to leave, they basically followed her and threw themselves into her body. . . So, it didn't make any sense whatsoever to cause the children pain and suffering. So, I had her stay.

With regard to the interaction between defendant and the children, Daly stated that A.W. "had an idea that [defendant] was part of [his] life, but [T.W.] was absolutely terrified."

Defendant testified to her desire to have the children returned to her. She stated that she would go into a drug rehabilitation program, but denied having a drug problem. She further denied having mental health issues, stating that "[t]here's nothing wrong with me . . . ."

The trial judge issued an oral opinion on June 12, 2012. The judge found the Division's three witnesses credible. She concluded the Division had met its burden of proving the elements of N.J.S.A. 30:4C-15.1a by clear and convincing evidence. The court issued a June 12, 2012 judgment of guardianship terminating defendant's parental rights. This appeal ensued.

II.

It is well settled that this court's review of the Family Part judge's factual findings and credibility determinations is limited. N.J. Div. of Youth & Family Servs. v. M.M., 189 N.J. 261, 278-79 (2007). See also Cesare v. Cesare, 154 N.J. 394, 411-12 (1998) (citations omitted) ("The general rule is that findings by the trial court are binding on appeal when supported by adequate, substantial, credible evidence."); N.J. Div. of Youth & Family Servs. v. F.M., 375 N.J. Super. 235, 259 (App. Div. 2005) (citations omitted) ("When the credibility of witnesses is an important factor, the trial court's conclusions must be given great weight and must be accepted by the appellate court unless clearly lacking in reasonable support."). Particular deference is accorded "[b]ecause of the family courts' special jurisdiction and expertise in family matters," N.J. Div. of Youth & Family Servs. v. M.C. III, 201 N.J. 328, 343 (2010) (quoting Cesare, supra, 154 N.J. at 413), and because the trial judge "has the opportunity to make first-hand credibility judgments about witnesses who appear on the stand[.]" N.J. Div. of Youth & Family Servs. v. E.P., 196 N.J. 88, 104 (2008). This "'feel of the case' . . . can never be realized by a review of the cold record." Ibid. (quoting M.M., supra, 189 N.J. at 293).

Reversal is warranted only when the trial judge's conclusions "went so wide of the mark that a mistake must have been made[,]" M.M., supra, 189 N.J. at 279 (citations and internal quotation marks omitted), including instances in which the findings were "'so manifestly unsupported by or inconsistent with the competent, relevant and reasonably credible evidence as to offend the interests of justice.'" Rova Farms Resort, Inc. v. Investors Ins. Co. of Am., 65 N.J. 474, 484 (1974) (quoting Fagliarone v. Twp. of No. Bergen, 78 N.J. Super. 154, 155 (App. Div.), certif. denied, 40 N.J. 221 (1963)).

Consequently, when a reviewing court concludes there is satisfactory evidentiary support for the trial court's findings, "'its task is complete and it should not disturb the result, even though it has the feeling it might have reached a different conclusion were it the trial tribunal.'" Beck v. Beck, 86 N.J. 480, 496 (1981) (quoting State v. Johnson, 42 N.J. 146, 162 (1964)). However, the trial judge's "interpretation of the law and the legal consequences that flow from established facts" are subject to our de novo review. Manalapan Realty, L.P. v. Twp. Comm. of Manalapan, 140 N.J. 366, 378 (1995).

A.

We begin with defendant's general assertions that she suffered infringement of her fundamental constitutional rights as a parent. Defendant does not provide a specific argument supporting her claim, but rather generally contends "[p]arental rights may not be terminated by merely showing that the child would be better off with a prospective adoptive parent."

While constitutionally protected, parental rights are not absolute. In re Adoption of a Child by W.P. & M.P., 308 N.J. Super. 376, 382 (App. Div. l998) (citations omitted), vacated on other grounds, 163 N.J. 158 (2000). The government "is not without constitutional control over parental discretion in dealing with children when their physical or mental health is jeopardized." Parham v. J.R., 442 U.S. 584, 603, 99 S. Ct. 2493, 2504, 61 L. Ed. 2d 101, 119 (1979) (citing Wisconsin v. Yoder, 406 U.S. 205, 230, 92 S. Ct. 1526, 1540, 32 L. Ed. 2d 15, 33 (1972)). Accordingly, the State, as parens patriae, may sever the parent-child relationship when necessary to protect a child from serious physical and emotional injury. W.P. & M.P., supra, 308 N.J. Super. at 382.

When a child's biological parents resist termination of parental rights, the court's function is to decide whether the parents can raise the child without causing further harm. In re Guardianship of J.C., 129 N.J. 1, 10 (1992). The cornerstone of this inquiry is whether parents can "cease causing their child harm" and become fit to assume the parental role within time to meet the child's needs. Ibid. "The analysis . . . entails strict standards to protect the statutory and constitutional rights of the natural parents." Ibid.

In a guardianship matter, a trial court's examination focuses upon what course serves the "best interests" of the child. In re Guardianship of K.H.O., 161 N.J. 337, 343 (1999). Our Legislature requires satisfaction of the "best interests of the child" test, codified in N.J.S.A. 30:4C-15, by clear and convincing evidence before termination of parental rights can occur. See N.J. Div. of Youth & Family Servs. v. I.S., 202 N.J. 145, 168 (2010) (citations and internal quotation marks omitted) (Clear and convincing evidence is defined as that which "should produce in the mind of the trier of fact a firm belief or conviction as to the truth of the allegations sought to be established.").

Specifically, the four-prong test set forth in N.J.S.A. 30:4C-15.1a requires the Division to prove:

(1) The child's safety, health or development has been or will continue to be endangered by the parental relationship;

 

(2) The parent is unwilling or unable to eliminate the harm facing the child or is unable or unwilling to provide a safe and stable home for the child and the delay of permanent placement will add to that harm. Such harm may include evidence that separating the child from his foster family parents would cause serious and enduring emotional or psychological harm to the child;

 

(3) The Division has made reasonable efforts to provide services to help the parent correct the circumstances which led to the child's placement outside the home and the court has considered alternatives to termination of parental rights; and

 

(4) Termination of parental rights will not do more harm than good.

These factors are neither discrete nor separate; rather, they "'relate to an overlap with one another to provide a comprehensive standard that identifies a child's best interests.'" E.P., supra, 196 N.J. at 103 (quoting K.H.O., supra, 161 N.J. at 348). Whether the State has satisfied each prong by clear and convincing evidence is an "extremely fact sensitive" inquiry, which must be based on "particularized evidence that addresses the specific circumstances of the individual case." N.J. Div. of Youth & Family Servs. v. R.L., 388 N.J. Super. 81, 88 (App. Div. 2006) (citations and internal quotation marks omitted).

While it is well settled that parents have a constitutionally protected, fundamental liberty interest in raising their biological children, Santosky v. Kramer, 455 U.S. 745, 753, 102 S. Ct. 1388, 1394-95, 71 L. Ed. 2d 599, 606 (1982), "[t]he law's concept of the family rests on a presumption that parents possess what a child lacks in maturity, experience, and capacity for judgment required for making life's difficult decisions." Parham, supra, 442 U.S. at 602, 99 S. Ct. at 2504, 61 L. Ed. 2d at 118. "[E]xperience and reality may rebut what the law accepts as a starting point[.]" Id. at 602, 99 S. Ct. at 2504, 61 L. Ed. 2d at 119.

Here, the Division removed both children from defendant's care because of her unabated substance abuse and untreated emotional illness. Despite the Division's extension of services to address these issues, defendant's continued conduct demonstrated that she ignored the needs of the children, thus precluding reunification. Following review of the sufficient credible evidence in the record, we reject defendant's claim she suffered a violation of her fundamental liberty interest in parenting A.W. and T.W.

B.

Defendant next challenges the court's finding that the Division met its burden to extend reasonable services to defendant.6 In particular, defendant argues that the Division failed to "provide a MICA program which was the only program that would have enabled [her] to adequately parent her children."

The first prerequisite under prong three requires the court to evaluate "whether [the Division] 'made reasonable efforts to provide services to help the parent' remedy the circumstances that led to removal of the children from the home." N.J. Div. Youth & Family Servs. v. F.M., 211 N.J. 420, 452 (2012) (quoting N.J.S.A. 30:4C-15.1(a)(3)). The statute defines "reasonable efforts" as

attempts by an agency authorized by the division to assist the parents in remedying the circumstances and conditions that led to the placement of the child and in reinforcing the family structure, including, but not limited to:

 

(1) consultation and cooperation with the parent in developing a plan for appropriate services;

 

(2) providing services that have been agreed upon, to the family, in order to further the goal of family reunification;

 

(3) informing the parent at appropriate intervals of the child's progress, development and health; and

 

(4) facilitating appropriate visitation.

 

[N.J.S.A. 30:4C-15.1c.]

Here, Judge Lipton made extensive findings with respect to prong three, spending more time addressing this prong than any other. The judge found that

[t]he record here is clear, that the Division[] made . . . many repeated efforts to provide [defendant] with services sufficient to meet the third prong.

 

The undisputed evidence shows many, many services that the Division attempted to offer her in terms of visitation; they set up visitation between her and the children. There are a number of times she missed visitation, didn't see or request to see [A.W.] for even a year. Her attempts at visitation were sporadic. She came late to visitations, although she did attend some visitations.

 

The Division provided assistance with mental health evaluations and treatment. She had been hospitalized at [JCMC and] had recommendations made. The Division attempted to help her follow up with the recommendations, but she neglected to follow up on a regular basis.

 

She was referred for post-partum depression to [JCMC] by a caseworker, [but] she did not comply. The John Brooks [Recovery Center] that she was, literally, transported to in Atlantic City by the caseworker, had a mental health component. But, [defendant] was discharged for noncompliance.

 

The Division offered psychiatric and psychological evaluations with regard to paternity. There were several efforts by the Division to locate the persons that [defendant] advised were the fathers. [E.K.] was tested on January 20, 2011, but the paternity test revealed he was not the father. [Defendant] never provided any other names of potential fathers for [A.W.].

 

. . . .

 

The Division provided transportation services to [defendant]. Transporting her to evaluations. There were times when transportation was set and [defendant] didn't show up or was unavailable. She was asked to contact the Division three days prior to an event that the Division was offering to transport her [to], and she neglected to do so a number of times.

 

. . . .

 

In addition, they provided bus cards on many occasions. The Division wrote letters advising of allotted scheduled evaluations, and so forth, made contact with her, according to the testimony and evidence. Many times the phone calls were not returned.

 

"'The diligence of [the Division's] efforts on behalf of a parent is not measured by' whether those efforts were successful." F.M., supra, 211 N.J. at 452 (quoting In re Guardianship of D.M.H., 161 N.J. 365, 393 (1999)). The record reflects that the Division continued to work with defendant, often rescheduling appointments and stressing the importance of her compliance with services. The court found that, in all, defendant "failed to comply with many of the recommendations, requirements, and [c]ourt orders mandating treatment," including court dates, supervised visitation, "at least three inpatient programs, substance abuse programs, and a host of substance abuse evaluations and outpatient programs."

"Whether particular services are necessary in order to comply with the diligent efforts requirement must [] be decided with reference to the circumstances of the individual case before the court, including the parent's active participation in the reunification effort." D.M.H., supra, 161 N.J. at 390-91. "[S]ervices, including those provided in conjunction with the reunification plan developed by [the Division], such as day care, housing assistance, referrals to drug treatment or medical and health care, parenting classes, financial assistance, and the like, must be evaluated on a case-by-case basis." Ibid.

Dr. Sostre indicated in her psychiatric evaluation report that defendant did not meet the criteria for a mood disorder, psychotic disorder, or anxiety disorder. Nevertheless, she testified at trial that "maybe" defendant could benefit from referral to a MICA (mentally ill/chemical abuser) inpatient program, or an inpatient substance abuse treatment program. Dr. Sostre explained that it was her impression that "a MICA program would have staff that could handle aggression, agitation, irritability interpersonal problems with other patients in the program a little bit better." In other words, Dr. Sostre was suggesting a means to address defendant's impulsivity and anger issues, two factors that have prevented defendant from completing prior inpatient programs. Notwithstanding her suggestion, Dr. Sostre stated that there were not many MICA programs available, and she could not identify where any existed. Finally, despite this discussion, Dr. Sostre stated on redirect examination that she did not observe any of the characteristics in her evaluation of defendant that would suggest that defendant would benefit from such a program.

The record demonstrates, and the court found, that the Division made numerous recommendations and referrals to programs to address defendant's mental health and substance abuse issues. The court ordered defendant to attend treatment at JCMC Partial Hospital Program; however, defendant failed to complete the program in May 2009, September 2009 and October 2009. Likewise, defendant failed to complete the John Brooks substance abuse program. There is no evidence that defendant would have participated were a MICA program available.

We are satisfied the Division's repeated attempts to overcome defendant's refusal to engage in treatment fulfilled its statutory obligation to extend reasonable efforts. Overall, the record clearly supports that the Division satisfied the third prong by clear and convincing evidence. Therefore, the judge's findings were reasonable.

In sum, we conclude substantial, credible evidence in the record supports Judge Lipton's finding that the Division presented clear and convincing evidence satisfying the four prongs of the best interests of the child standard, codified in N.J.S.A. 30:4C-15.1a. Further, the court's legal conclusions are solidly grounded on the applicable law. See N.J. Div. of Youth & Family Servs. v. H.B., 375 N.J. Super. 148, 172 (App. Div. 2005). Additionally, defendant failed to provide any support for her claim that her constitutional rights were violated. We, therefore, affirm the order terminating defendant's parental rights and awarding the Division guardianship of T.W. and A.W.

Affirmed.

1 On June 29, 2012, the Governor signed into law A-3101, which reorganized the Department of Children and Families and renamed the Division as the Division of Child Protection and Permanency. L. 2012, c. 16, eff. June 29, 2012.

2 On May 8, 2008, the trial court granted kinship legal guardianship of defendant's other children, N.W. and C.W., to L.W. following a finding of neglect after defendant gave birth to N.W., who tested positive for PCP.

3 A "Dodd" removal is an emergency removal of a child from the home without a court order, authorized by the Dodd Act, N.J.S.A. 9:6-8.21 to -8.82, which was authored by former Senate President, Frank "Pat" Dodd. N.J. Div. of Youth & Family Servs. v. P.W.R., 205 N.J. 17, 26 n.11 (2011) (quoting N.J. Div. of Youth & Family Servs. v. N.S., 412 N.J. Super. 593, 609 n.2 (App. Div. 2010)).

4 This order also applied to A.W.'s putative father, E.K.

5 Also around this time, the Division caseworker learned that defendant had been briefly incarcerated in April 2011 for failing to appear on a criminal assault matter, which involved "stabbing . . . an elderly woman."

6 Defendant does not challenge the court s findings with respect to prongs one, two and four. Nor does defendant address the second requirement under prong three, whether the Division considered "alternatives to termination of parental rights." See N.J.S.A. 30:4C-15.1(a)(3). Therefore, we limit our consideration to her argument as to the first requirement of prong three. R. 2:6-2(a)(5).