VERONICA A. v. ADES, et al.

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NOTICE: THIS DECISION DOES NOT CREATE LEGAL PRECEDENT AND MAY NOT BE CITED EXCEPT AS AUTHORIZED BY APPLICABLE RULES. See Ariz. R. Supreme Court 111(c); ARCAP 28(c); Ariz. R. Crim. P. 31.24 IN THE COURT OF APPEALS STATE OF ARIZONA DIVISION ONE VERONICA A., ) ) Appellant, ) ) v. ) ) ARIZONA DEPARTMENT OF ECONOMIC ) SECURITY, R.A., D.A., A.R., T.R., ) V.R., R.L., ) ) Appellees. ) ) __________________________________) DIVISION ONE FILED: 9/24/2013 RUTH A. WILLINGHAM, CLERK BY: mjt No. 1 CA-JV 13-0077 DEPARTMENT E MEMORANDUM DECISION (Not for Publication 103(G) Ariz. R.P. Juv. Ct.; Rule 28 ARCAP) Appeal from the Superior Court in Maricopa County Cause No. JD-508567 The Honorable Brian K. Ishikawa, Judge AFFIRMED Thomas C. Horne, Arizona Attorney General By Eric Devany, Assistant Attorney General Attorneys for Appellee Arizona Department of Economic Security Mesa The Stavris Law Firm, PLLC By Alison Stavris Attorneys for Appellant Kingman D O W N I E, Judge ¶1 Veronica A. her parental rights. ( Mother ) appeals an order terminating For the following reasons, we affirm. FACTS AND PROCEDURAL HISTORY ¶2 R.A., Mother s born in five older September children 1998; D.A., ( the born in Children ) September are 2001; A.R., born in September 2004; T.R., born in January 2006; and V.R., born in May 2008. R.A. has cystic fibrosis and requires multiple daily breathing treatments, use of an airway clearance device ( vest ) at least twice a day, and daily medications. ¶3 Between ( CPS ) 2000 received and several 2010, reports Child about Protective the family, Services including concerns that: (1) Mother was not meeting R.A. s special needs; (2) the family home was filthy and infested with cockroaches; (3) Mother was using methamphetamine and marijuana; and (4) the Children were dirty, and had lice, rotten teeth, and insufficient food. ¶4 2006 Mother and 2008. participated In early in 2010, Family she Builders voluntarily Children with others because she was overwhelmed. time, R.A. improved healthier. physically, gained weight, services in placed the During that and appeared After about a month, though, the Children returned to Mother. ¶5 CPS continued to receive continuous concerns and calls about the Children s safety, including Mother s failure 2 to attend to R.A. s medical needs, and the Children having lice and missing excessive amounts of school. In April 2010, CPS noted that the family had been without water for more than a week. R.A. s vest was broken again, and a social worker expressed continued concerns about Mother s irresponsibility in caring for R.A. R.A. s physician, Dr. Radford, advised that Mother expected R.A. to care for herself and failed to provide daily medical treatments. Mother also admitted smoking marijuana a couple times a week. ¶6 In May 2010, CPS removed the Children from the home, which smelled strongly of marijuana and had cockroaches on the walls. R.A. had missed 95 out of 166 school days; D.A. had missed 55 out of 196 days; and A.R. had gone to kindergarten one week, was sent away because of his discipline problems, and never re-enrolled. Dr. Radford advised CPS that Mother was so inconsistent with R.A. s antibiotics and/or care hospitalization that every the child couple of required months. R.A. s weight and lung function were not stable, reducing her life expectancy. 1 Meanwhile, V.R. s foster mother took her to urgent care, where medical staff spent an hour removing wax and dirt from her ears. 1 Dr. Radford explained that the average life span for someone with R.A. s condition is somewhere in the 40s but that R.A. would be lucky to get to her 30s. 3 ¶7 On May 10, 2010, the Arizona Department of Economic Security ( ADES ) filed a dependency petition, alleging Mother was unable to parent due to: (1) medical neglect of R.A.; (2) a chronic history of neglecting the Children; (3) neglect due to substance abuse; and (4) mental health issues. provide services, including a parent aide, ADES agreed to substance abuse assessment/treatment/testing, and mental health services. The case plan goal was family reunification. ¶8 her Also in May, R.A. was admitted to the hospital because lung capacity antibiotics. 2 was During down a 30% and follow-up she needed appointment, intravenous the physician noted dramatic improvement and released R.A. to her foster home, where she appeared to be thriving. ¶9 CPS reported concerns about R.A. to the court, explaining that with vigilance, the child could maintain the level of time. likely she is at for a significant amount of However, should she need a lung transplant, R.A. would be family s care. functioning denied based demonstrated on her inability lifestyle to provide at home consistent and the medical CPS also reported that R.A. was extremely parentified, 2 Hospital staff explained that patients needing this type of treatment would typically be discharged after a week. In the past, though, medical staff were so concerned with R.A. s chaotic home situation that they kept her hospitalized for up to a month to finish her medications. 4 believing she has to protect and care for her mother rather than it being the other way around. ¶10 having CPS additionally detailed concerns about the Children head absences lice that infestation, for a significant could prevent class serious hygiene issues amount of time, promotions, with the the three school roach youngest children, and lack of follow through in obtaining services for behavioral and developmental issues. developmental delays and required Both T.R. and A.R. had extensive remedial dental Mother submitted seven urinalysis samples, four of which were positive for THC. She work. ¶11 In May and June 2010, began substance abuse treatment in July, and nine drug tests in July and August were negative. In June 2010, a parent aide began working with Mother, who made initial progress, though the aide voiced continuing concerns about her parenting skills. In October 2010, Mother was convicted of DUI (marijuana). ¶12 Mother completed services in November 2010. the first cycle of parent aide The aide reported that Mother had worked to improve her parenting skills, but had a way to go. Mother did not seem to understand the seriousness of [R.A. s] illness and that she needs to be supervised while using her treatments and medications. The aide was concerned that Mother 5 would become overwhelmed if all children are placed back in the home and recommended they not be returned at this time. ¶13 In January 2011, Mother requested increased visitation and services. She claimed ADES had not furthered the case plan goal because, among other things, it discontinued parent aide services and failed to arrange a psychological evaluation or services to help her address R.A. s medical needs. ADES responded that it had requested a new parent aide and scheduled an appointment for Mother to receive further education about R.A. s condition. After a hearing, the court denied Mother s motion. ¶14 Mother participated in a psychological evaluation in January 2011. Dr. Thal diagnosed her with, depressive disorder and personality disorder. inter alia, He labeled her abilities very limited and stated it would be exceedingly difficult for her to make the sorts of changes which would insure that her children s well being will not be an issue again in the future if reunification takes place. to [p]roceed with reunification recommended that presumably normal environment functioning, using healthy ADES assess very R.A. s to this He cautioned ADES carefully. health establish information while a He in baseline when a of considering reunification of a medically complex child with this parent. 6 Dr. Thal also suggested that individual therapy with a master s level counselor might be useful to Mother. ¶15 Mother began a new series of parent aide services in February 2011. She initially made [m]inimal progress, completing only one of two assignments and not displaying an understanding of positive discipline. Mother, however, made significant progress in cleaning her home, providing appropriate meals, gaining employment, self-sufficiency. and demonstrating increased But the aide was concerned that Mother did not accept responsibility and minimized past living conditions. ¶16 In April 2011, the parent aide advised that Mother had made minimal progress, but the home remained clean. Mother was reportedly more concerned with how the case manager perceived her progress than with making changes. lost her job. Additionally, Mother had In May 2011, the parent aide reported safety issues in the home, including cockroaches and ants. The aide was concerned that Mother was complying with services only to the degree of regaining custody but was unwilling or unable to change her style of parenting. ¶17 2011. deficit Mother participated in a psychiatric evaluation in May Dr. Rosengard diagnosed her with, inter alia, attention disorder (hyperactive impulsivity aspect) personality disorder with dependent and antisocial traits. and He opined that Mother s condition would continue for a prolonged, 7 indeterminate period of time because it had persisted despite a decade of interventions, evaluations, and treatment. Dr. Rosengard stated that a child in Mother s care would be at risk of neglect. He identified services that could potentially improve Mother s condition, including therapy with a masters degree level or higher therapist, but he gave Mother a poor prognosis for being able to adequately parent in the foreseeable future, even with the suggested interventions. ¶18 Mother gave birth to R.L. in July 2011. ADES took custody of him, and the court found him dependent. ¶19 In September 2011, CPS informed the court Mother was participating in therapy with a [m]asters or above therapist ; CPS approved reported 20 that visits. Mother In appeared November 2011, indifferent to the the parent aide children s needs and failed to properly supervise them or use information provided by the aide in interacting with them. unemployed. exhibited Mother remained In December 2011, CPS reported that Mother had not any change in behavior to indicate continue to neglect the children if returned. she would not Mother continued to demonstrate poor skills and little understanding of safe and appropriate parenting, despite parenting classes and months of parent aide services. The case manager opined that Mother s pattern of chronic neglect placed the Children at risk. 8 ¶20 ADES changed the case plan to severance and adoption in January 2012, which the court approved. Dr. Thal re-evaluated Mother. In February 2012, He reported that she suffered from, inter alia, personality disorder and generalized anxiety. Dr. Thal concluded Mother had a pattern of placing her needs ahead of her children and that a child in her care would be at risk. He was uncertain whether Mother would be able to adequately parent in the foreseeable future or if any proposed interventions, prepare her or to those parent in already the in place foreseeable would adequately future. Dr. Thal recommended that Mother consider allowing some of the children, including R.A., to remain in their current placements. ¶21 In March parental rights illness, time 2012, to in the care ADES moved to terminate Children based and inability an on neglect, to Mother s mental remedy circumstances that necessitated out-of-home placements. the In May 2012, ADES amended the motion to include R.L. ¶22 Mother s therapist recommended that counseling discontinued in May 2012, stating: Although [Mother] presents as deeply invested in getting her children back, in the past many months of working with her, she has gained little insight as to what would be helpful for her to process or learn in therapy that would be beneficial for her going forward. 9 be Instead, almost the entirety of her time in therapy is spent expressing frustration that she doesn t understand what CPS is asking or expecting of her as she feels she s already done it, revisits experiences with her case manager or parent aid and defends her actions, or blames the system for this predicament. The therapist attributed Mother s conduct to a lack of insight, versus willful non-cooperation. 3 ¶23 A contested severance trial was held in February 2013. Drs. Thal reports. even and Rosengard testified consistently with their Dr. Rosengard s view of Mother s poor prognosis was stronger at the time of trial because Mother had had additional opportunity to deal with her problems but had not been successful. Dr. Thal testified that information about Mother s lack of progress caused him to alter his opinion about her ability to adequately parent in the foreseeable future from uncertain to negative. Dr. Thal also testified that severance and adoption was the most appropriate plan. ¶24 A parent aide and the case manager both testified that Mother failed to take responsibility for the circumstances necessitating the out-of-home placements and failed to master parenting skills. The case manager 3 also testified that the Dr. Thal testified at the severance trial that the counselor s decision to terminate therapy was consistent with Mother s personality disorder diagnosis - which causes deeply entrenched views and a corresponding inability to change behaviors and thoughts. 10 older children had become the parent, in many ways, to help control the chaos. Dr. Radford testified that R.A. s health declined in Mother s care but improved significantly in foster care; she would have concerns if R.A. were returned to Mother. ¶25 The juvenile court found that Mother was unable to discharge her parental responsibilities due to mental illness; that she had neglected her children s basic needs and R.A. s special needs; and that the five older children had been in an out-of-home placement for 15 months or longer, and Mother was unable despite to remedy ADES s the circumstances diligent efforts in requiring providing that placement services. The court terminated Mother s parental rights to all six children. ¶26 Mother timely appealed. We have jurisdiction pursuant to Arizona Revised Statutes ( A.R.S. ) section 8-235. DISCUSSION ¶27 We will affirm a juvenile court s order based on findings of clear and convincing evidence unless no reasonable evidence supports those findings. Jennifer B. v. Ariz. Dep t of Econ. Sec., 189 Ariz. 553, 555, 944 P.2d 68, 70 (App. 1997). We will not reverse the juvenile court s order unless it is clearly erroneous. ¶28 The Id. juvenile court may terminate the parent-child relationship when it finds by clear and convincing evidence that a parent is unable to discharge parental responsibilities due to 11 mental illness and there are reasonable grounds to believe that the condition period. will A.R.S. supports the §§ continue for order prolonged -537(B). 4 8-533(B)(3), termination a based on indeterminate The mental record here illness. As such, we need not address the other independent grounds for the order. See Jesus M. v. Ariz. Dep t of Econ. Sec., 203 Ariz. 278, 280, ¶ 3, 53 P.3d 203, 205 (App. 2002) (to affirm severance order, appellate court need only determine that clear and convincing evidence supports any one ground for termination). ¶29 Among personality other disorder things, and Mother depressive has been diagnosed disorder. with According to Dr. Thal, her dependent traits have resulted in a pattern of placing her needs ahead of her children. that Mother s impulsive dependent behavior or personality disorder self-destructive negatively impact her children. Dr. Rosengard opined traits behavior that led to could He stated that Mother s mental health issues could cause her to be less diligent than she needs to be, placing the children at risk. Both doctors testified that Mother s mental health issues would continue for a prolonged indeterminate period. 4 Termination must also be in the best interests of the child, but Mother has not challenged the best interests finding, so we do not address it. See Mary Ellen C. v. Ariz. Dep t of Econ. Sec., 193 Ariz. 185, 191, ¶ 27, 971 P.2d 1046, 1052 (App. 1999) (citation omitted). 12 ¶30 of The doctors opinions were bolstered by other evidence record. children CPS with documented safe and Mother s adequate failure food and to provide shelter, her medical attention, and physical care, as well as her failure to make changes necessary to adequately parent, notwithstanding years of services. The evidence linked Mother s mental health issues to her neglect of the children. A parent s duty to support his or her child includes providing the child with food, shelter, and medical attention. No. JS-4963, 1984). 143 Maricopa County Juv. Action No. JS-5209 & Ariz. 178, 185, 692 her 1027, 1034 (App. [A] child s right to proper parental care include[s] the right to good physical care . . . . ¶31 P.2d Id. We disagree with Mother s contention that CPS denied the time and opportunity to participate in programs designed to improve her parenting because her case was open for eight months before a psychological evaluation was scheduled. CPS provided Mother with significant services immediately after the Children were removed, including drug treatment, visitation, and parent aide services. Mother cites no authority suggesting that ADES cannot prioritize services within the case plan; nor is the agency required to provide every conceivable service. Mary Ellen C., 193 Ariz. at 192, ¶ 37, 971 P.2d at 1053. Considering the totality of circumstances, the juvenile court 13 did not err in concluding that ADES made reasonable efforts to provide Mother with rehabilitative services. CONCLUSION ¶32 For the foregoing reasons, we affirm the termination of Mother s parental rights. /s/ MARGARET H. DOWNIE, Judge CONCURRING: /s/ LAWRENCE F. WINTHROP, Presiding Judge /s/ JON W. THOMPSON, Judge 14

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