In the Matter of the Welfare of the Children of: L. A. W., Parent.

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This opinion will be unpublished and may not be cited except as provided by Minn. Stat. § 480A.08, subd. 3 (2012). STATE OF MINNESOTA IN COURT OF APPEALS A12-2038 In the Matter of the Welfare of the Children of: L. A. W., Parent Filed April 22, 2013 Affirmed Hooten, Judge Ramsey County District Court File Nos. 62-JV-11-3738, 62-FA-08-1440, 62-JV-11-1095 Nicole S. Gronneberg, St. Paul, Minnesota (for appellant L.A.W.) John J. Choi, Ramsey County Attorney, Kathryn M. Eilers, Assistant County Attorney, St. Paul, Minnesota (for respondent county) Anne Gueinzius, St. Paul, Minnesota (for S.R.W.) James I. Laurence, St. Paul, Minnesota (for guardian ad litem) Considered and decided by Johnson, Chief Judge; Schellhas, Judge; and Hooten, Judge. UNPUBLISHED OPINION HOOTEN, Judge Appellant-mother challenges the juvenile court s order terminating her parental rights to her four children, arguing that the court erred by concluding that the county established by clear and convincing evidence that termination is warranted under four separate statutory grounds. She also argues that the court erred by concluding that that the county made reasonable efforts toward reunification and that termination is in the best interests of the children. Because there is clear and convincing evidence satisfying the requirements of the relevant statutory grounds for termination, and because the juvenile court did not err by finding that reasonable efforts were made towards reunification and that termination is in the children s best interests, we affirm. FACTS Appellant L.A.W. is the biological mother of three sons and a daughter. All of her children were removed from her home in April 2011. The Ramsey County Community Human Services Department (RCCHS) filed a children in need of protective services (CHIPS) petition, and the children were adjudicated in need of protection or services. RCCHS later filed a petition to terminate appellant s parental rights on December 15, 2011. Prior to the initiation of the current matter, appellant s family was referred to child protection on 11 occasions between 2002 and 2010. Chantel Houg was assigned as the RCCHS child-protection worker for appellant and her family in early 2011 after reports surfaced that appellant was physically abusing her youngest son, D.O.B. 7/20/2004. There were also concerns that appellant was smoking marijuana while pregnant, was intermittently homeless, and had limited parenting skills and limited understanding of the specialized needs of her children. After undergoing a mental-health assessment, appellant s eldest son, D.O.B. 6/4/2002, was diagnosed with major depressive disorder with a concern that he was a suicide risk. Appellant s middle son, D.O.B. 9/17/2003, was diagnosed with anxiety disorder and attention deficit-hyperactivity disorder (ADHD). Houg described the youngest son as the most challenging of her children. He was diagnosed with post2 traumatic stress disorder (PTSD), ADHD, and anxiety disorder, and his diagnostic assessment recommended that appellant participate in his therapy. Appellant s daughter, D.O.B. 3/6/2011, has not been diagnosed with special needs. Based on these assessments, Houg was mainly concerned with the specialized needs of the youngest son and appellant s mental health and developmental delays, tenuous housing situation, and financial issues. Appellant underwent a psychological assessment and was determined to have an IQ of 58 and the functional capacity of a 10 year old relative to her adaptive behavior skills. Appellant stated that she has difficulty delaying immediate needs and is often impatient. The psychologist assessing appellant s mental health concluded that appellant suffers from depression, PTSD, mild mental retardation and possible mixed personality disorder with antisocial, borderline, and avoidant personality features. The psychologist recommended that appellant should be under a conservatorship or guardianship because of her cognitive and mental-health problems and recommended that the best option for any attempt to reunite the children with appellant was in a family foster care facility. After the CHIPS adjudication, appellant was ordered to comply with a case plan, which included requirements that she cooperate with RCCHS in providing therapeutic services to the children, make sure that her youngest son took his medication, and get her children to school. She was also required to obtain mental-health services for herself, maintain her sobriety, undergo chemical urinalysis testing, manage her finances, and obtain suitable housing. 3 While appellant participated in an outpatient chemical-treatment program and was discharged with staff approval, she refused to provide urinalysis test samples to RCCHS because she did not think her drug use was still a problem. Houg testified that appellant was often short of money because appellant was unemployed and would frequently go to casinos and gamble the money for the rent. Appellant would ask Houg for rent money because she did not have her social security or welfare payments. RCCHS assisted appellant twice with her rent. Appellant did not accept Houg s suggestion that she obtain a representative payee to manage her finances. After their removal from appellant s home, the children were placed with a family friend, but appellant complained about this placement, and appellant and her family threatened the foster care provider. Because of his behavioral problems, the youngest son was placed in two additional foster homes before entering St. Joseph s Home for Children. The other children were also moved to another foster care home as a result of the problems caused by appellant. Houg explained that appellant and her mother caused problems at this placement as well, and that the children had a difficult time not knowing when they would return home, which was delayed by appellant s search for housing. Houg recommended that she apply for housing at Jackson Street Village because as a whole family foster care facility, it offered on-site case-management and recreational activities. Houg thought that Jackson Street Village offered the best shot she would have at maintaining the services that [Houg] set up once the children were returned home. 4 The youngest son s individual and group therapist at St. Joseph s testified that appellant reluctantly participated in family therapy with this son, failed to establish goals for the therapy, missed at least three sessions (with appellant failing to call or respond to attempts to reach her on two of these occasions), and became defensive when offered parenting suggestions. Her youngest son was fully engaged in the sessions and would initiate discussion, but appellant often appeared tired, disregarded her youngest son s attempts to engage her, and failed to provide meaningful feedback. Houg added that appellant was hostile to tolerant depending on her mood in dealing with St. Joseph s. She stated that appellant failed to understand the nature of the children s mental-health needs. When the youngest son was advised of appellant s scheduled visits to St. Joseph s, he consistently became anxious and would resort to aggression and dysregulation. Because of these problems, staff at St. Joseph s began a practice of not telling him when his mother would visit. Appellant initially refused the recommendation that her youngest son be given a sleep aid, but eventually agreed that the medication might be helpful. RCCHS sought to medicate the youngest son for his ADHD, but was required to obtain a court order to administer the medication. The youngest son responded well to this medication and graduated from St. Joseph s after exhibiting significant progress in school and in his behavior. Upon discharge, it was recommended that he continue with his medication. A trial home visit commenced in March 2012 after appellant was accepted into the Jackson Street Village program. Prior to the trial home visit, Houg reviewed in detail each item in the case plan with appellant and referred her to a mental-health worker to 5 help her with her needs and services. While appellant initially obtained a mental-health worker, she did not meet with her on a regular basis, which resulted in appellant losing this service. Houg also discussed with appellant her difficulties handling her finances, but appellant again refused to obtain a representative payee as Houg suggested. Problems arose once the children returned home for the trial home visit. The eldest son became aggressive at school and was suspended. Appellant did not keep all of her appointments with the children s skills service providers. The eldest son s mentalhealth practitioner testified that appellant cancelled five meetings because the eldest son was not home, and that after addressing the issue with appellant and her social worker, appellant continued to miss appointments. The mental-health practitioner assigned to work with appellant s youngest and middle sons recalled that appellant cancelled or failed to have the boys available for appointments on multiple occasions. She forwarded her concerns to Houg, and the agency sent letters to appellant indicating that treatment or services may be discontinued. She testified that appellant was only partially cooperative with her services. Appellant also failed to keep her eldest son on medication prescribed for his anemia, and did not follow up with an appointment to keep her youngest son on his medication, resulting in a lapse of his medication. In the spring of 2012, teachers were concerned that the youngest son was not medicated and that some of his old behaviors were returning. Appellant failed to meet with her case manager at Jackson Street Village. Houg testified that appellant s housing at Jackson Street Village was in jeopardy at one point because she was unavailable to meet with her case manager, but that loss of the housing 6 was not imminent. Management at Jackson Street Village made clear that failure to comply with a case plan might result in a loss of housing; management was also aware of an incident when appellant locked her children out of her house at Jackson Street Village, resulting in the suggestion that appellant leave a key at the front desk instead of leaving her children outside. Appellant also informed Houg that she was assaulted by her boyfriend and was not staying at her home, and that she was again out of money because she went to the casino after receiving social security and welfare payments. In July 2012, RCCHS received a report that appellant stabbed her mother in the lip in the presence of the children. RCCHS and the guardian ad litem requested revocation of the trial home visit. RCCHS stated that appellant failed to comply with almost all of the conditions of the trial home visit, including not attending her psychiatric and therapy appointments, not taking her psychiatric medications, failing to make the children available for in-home therapy and skills-work sessions, and failing to give her youngest son his medications. She did not cooperate with her weekly case management meetings required by Jackson Street Village or meet with her mental health worker. The children were also exposed to incidents of violence between appellant and her mother and between appellant and her boyfriend. The youngest son reported that appellant s boyfriend punched appellant in the face, causing her to fall on appellant s daughter. After the children returned to foster care, appellant missed, cancelled, or refused to visit the children at least a half to a third of the scheduled visits during the four to six weeks following removal. 7 Houg testified that appellant was partially compliant with her case plan, but made inadequate progress. She concluded that the children are at times unsafe in appellant s care because the children were often not under her direct care or left supervised. This concern was corroborated by a former neighbor of appellant who testified that appellant s children would frequently knock on her door for snacks and activities and would spend nights and weekends with her. Around the time of appellant s stabbing of her mother, this individual received a phone call from the middle son requesting that she pick him up. On her way to appellant s residence, appellant called her and said that she couldn t take it anymore. The middle and youngest sons spent the next three days in her care. The guardian ad litem recommended termination of appellant s parental rights to all of her children and that for their best interests, they continue in their current foster placement. The juvenile court terminated appellant s rights as to her children on October 25, 2012. This appeal follows. DECISION The juvenile court terminated appellant s parental rights pursuant to Minn. Stat. § 260C.301, subd. 1(b)(2), (4), (5) and (8) (2012), finding that termination is in the children s best interests, that RCCHS has made all reasonable efforts to rehabilitate and reunite appellant with her children, and that additional services will not likely bring about lasting parental adjustment enabling the children s return to appellant s care within a reasonable period of time. [O]n appeal from a district court s decision to terminate parental rights, we will review the district court s findings of the underlying or basic facts for clear error, but we review its 8 determination of whether a particular statutory basis for involuntarily terminating parental rights is present for an abuse of discretion. In re Welfare of Children of J.R.B., 805 N.W.2d 895, 901 (Minn. App. 2011), review denied (Minn. Jan. 6, 2012). [I]f at least one statutory ground alleged in the petition is supported by clear and convincing evidence and termination of parental rights is in the child s best interests, we will affirm. In re Welfare of Children of T.R., 750 N.W.2d 656, 661 (Minn. 2008). A finding is clearly erroneous if it is either manifestly contrary to the weight of the evidence or not reasonably supported by the evidence as a whole. Id. at 660 61 (quotation omitted). The county bears the burden of proving grounds for termination. In re Welfare of M.H., 595 N.W.2d 223, 227 (Minn. App. 1999). 1. Minn. Stat. § 260C.301, subd. 1(b)(2) (2012) The juvenile court may upon petition, terminate all rights of a parent to a child if it finds that the parent has substantially, continuously, or repeatedly refused or neglected to comply with the duties imposed upon that parent by the parent and child relationship, including but not limited to providing the child with necessary food, clothing, shelter, education, and other care and control necessary for the child s physical, mental, or emotional health and development, if the parent is physically and financially able, and either reasonable efforts by the social services agency have failed to correct the conditions that formed the basis of the petition or reasonable efforts would be futile and therefore unreasonable[.] Minn. Stat. § 260C.301, subd. 1(b)(2). Failure to satisfy requirements of a court-ordered case plan provides evidence of a parent s noncompliance with the duties and 9 responsibilities under section 260C.301, subdivision 1(b)(2). In re Welfare of Children of K.S.F., 823 N.W.2d 656, 666 (Minn. App. 2012). Appellant argues that the juvenile court s findings are clearly erroneous in light of uncontested evidence that the children were well-groomed, adequately fed, and have a strong emotional and loving attachment to appellant. She also highlights that there has been no suspicion of continuing physical abuse since initiation of the current proceedings and stresses that she completed outpatient chemical dependency treatment following the CHIPS adjudication, secured housing at Jackson Street Village, meets with a therapist, recognizes her mental-health issues, no longer gambles, sometimes leaves her children in the care of her mother, and no longer associates with abusive men. However, based upon the record, we conclude that the juvenile court did not clearly err in finding that appellant failed to satisfy the requirements of her case plan relating to her mental health and the well-being of her children. While she has provided two or three clean urinalysis samples in conjunction with her housing program, she has refused to provide the required samples to RCCHS. Appellant also has jeopardized her housing by failing to cooperate with the program at Jackson Street Village and by continuing to make reckless financial decisions by gambling with the money she had been given for rent. There is clear and convincing evidence indicating appellant s noncooperation with mental health services for herself and her children. Appellant was not cooperative with her youngest son s in-home practitioner appointments and treatment at St. Joseph s. Appellant also failed to maintain her children s prescriptions and did not cooperate with 10 attempts to provide her youngest son with medication to address his ADHD. She failed to attend her own appointments and refused to acknowledge that she had any mental health issues with gambling, drugs, or anger management. Despite undergoing a mentalhealth assessment and obtaining counseling, appellant stabbed her mother with a knife in July 2012, and there is evidence of numerous instances of abusive confrontations between appellant and her mother. The record also supports the juvenile court s finding that appellant is unable to provide the emotional support required by her children. She missed visits at St. Joseph s and at foster placements both before and after the trial home visit, causing her children to become very upset. The record reflects that even though appellant was given an array of reasonable services and support, she has repeatedly refused and neglected to comply with her case plan and as a result, has failed to resolve many of the problems leading to the CHIPS adjudication and termination petition. There is clear and convincing evidence supporting the juvenile court s findings that appellant has substantially, continuously, or repeatedly refused or neglected to comply with the duties imposed upon her as the mother of the children, particularly with regard to meeting the special needs of her children. 2. Minn. Stat. § 260C.301, subd. 1(b)(4) (2012) The juvenile court may also terminate a parent s rights to a child if it finds that a parent is palpably unfit to be a party to the parent and child relationship because of a consistent pattern of specific conduct before the child or of specific conditions directly relating to the parent and child relationship either of which are determined by the court to be of a duration or nature that 11 renders the parent unable, for the reasonably foreseeable future, to care appropriately for the ongoing physical, mental, or emotional needs of the child. Minn. Stat. § 260C.301, subd. 1(b)(4). [T]he county must prove a consistent pattern of specific conduct or specific conditions existing at the time of the hearing that, it appears, will continue for a prolonged, indefinite period and that are permanently detrimental to the welfare of the child. T.R., 750 N.W.2d at 661. [M]ental illness, in and of itself, does not permit termination of parental rights. Id. (quotation omitted). But termination may be warranted when a parent s mental illness is likely to be detrimental to a child. Id. at 661 62. [W]e consider the actual conduct of the parent to determine fitness to parent. Id. at 661 (quotation omitted). Appellant stresses that she sufficiently cares for her children s physical needs, has a strong bond with her children, has been meeting with an individual therapist to address her mental health issues, and that there have been no reports of physical abuse since commencement of the case. However, the evidence shows that appellant fails to understand the nature of the children s mental-health needs and has failed to engage in services intended to address these issues. See In re the child of P.T., 657 N.W.2d 577, 591 (Minn. App. 2003) (concluding that trial court did not clearly err in making determination of palpable unfitness given, in part, evidence of parents lack of emotional connection with child and their failure to understand parenting deficits), review denied (Minn. Apr. 15, 2003). Appellant was not cooperative with her youngest son s treatment at St. Joseph s or administering his medication, failed to attend numerous visits with her children prior to and after the trial home visit, and continued to rely on others to provide 12 her children with supervision. There is clear and convincing evidence supporting the juvenile court s findings underlying its determination that appellant s parenting deficiencies in caring for her children s mental and emotional needs will continue into the foreseeable future. Therefore, the juvenile court did not abuse its discretion by invoking this statutory basis for terminating appellant s parental rights. 3. Minn. Stat. § 260C.301, subd. 1(b)(5) (2012) The juvenile court may terminate a parent s rights to a child if it finds that following the child s placement out of the home, reasonable efforts, under the direction of the court, have failed to correct the conditions leading to the child s placement. Minn. Stat. § 260C.301, subd. 1(b)(5). Failure to correct the conditions leading to the child s removal from the home, as evidenced by noncompliance with a case plan, is a factor for termination under Minn. Stat. § 260C.301, subd. 1(b)(5). T.R., 750 N.W.2d at 663; see also In re Welfare of Children of S.E.P., 744 N.W.2d 381, 386 87 (Minn. 2008) (affirming termination under subdivision 1(b)(5) given mother s failure to comply with terms of case plan). Appellant argues that this matter was initiated because of allegations of physical abuse, and that there have been no such allegations during the pendency of the case. Appellant highlights her participation in therapy, her successful completion of outpatient treatment, and her secure housing. But [t]he critical issue is not whether the parent formally complied with the case plan, but rather whether the parent is presently able to assume the responsibilities of caring for the child. In re Welfare of J.K.T., 814 N.W.2d 76, 89 (Minn. App. 2012). 13 Clear and convincing evidence supports the juvenile court s findings underlying its determination that appellant has failed to sufficiently address the conditions resulting in the children s placement despite receiving numerous services. Houg also testified that appellant had problems complying with her case plan, and when her eldest son s case plan expired the week before trial, appellant failed to return phone calls made in an attempt to update the plan. In addition to the concerns that appellant was physically abusing her youngest son, Houg provided extensive testimony regarding the children s various mental-health conditions, appellant s insufficient understanding of those conditions, and her failure to cooperate with services intended to address those issues. The facts of this case are similar to those in J.K.T., where we acknowledged that appellant made some improvement under her case plan, but failed to demonstrate an appropriate level of concern or understand the seriousness of her child s medical condition, failed to manage medical appointments, and was inaccessible to service providers. 814 N.W.2d at 89. Based upon these facts, the record contained substantial evidence that, despite appellant s formal compliance with the case plan steps, she continued to exhibit an inability to properly care for the child. Id. Therefore, we conclude that the juvenile court did not abuse its discretion by invoking this statutory basis for terminating appellant s parental rights. 4. Minn. Stat. § 260C.301, subd. 1(b)(8) (2012) The juvenile court concluded that the children were neglected and in foster care pursuant to Minn. Stat. § 260C.301, subd. 1(b)(8), which also serves as a basis for terminating a parent s rights to her children. 14 Neglected and in foster care means a child: (1) who has been placed in foster care by court order; and (2) whose parents circumstances, condition, or conduct are such that the child cannot be returned to them; and (3) whose parents, despite the availability of needed rehabilitative services, have failed to make reasonable efforts to adjust their circumstances, condition or conduct, or have willfully failed to meet reasonable expectations with regard to visiting the child or providing financial support for the child. Minn. Stat. § 260C.007, subd. 24. In determining whether a child is neglected and in foster care, the court shall consider, among other factors, the following: (1) the length of time the child has been in foster care; (2) the effort the parent has made to adjust circumstances, conduct, or conditions that necessitates the removal of the child to make it in the child s best interest to be returned to the parent s home in the foreseeable future, including the use of rehabilitative services offered to the parent; (3) whether the parent has visited the child within the three months preceding the filing of the petition, unless extreme financial or physical hardship or treatment for mental disability or chemical dependency or other good cause prevented the parent from visiting the child or it was not in the best interests of the child to be visited by the parent; (4) the maintenance of regular contact or communication with the agency or person temporarily responsible for the child; (5) the appropriateness and adequacy of services provided or offered to the parent to facilitate a reunion; (6) whether additional services would be likely to bring about lasting parental adjustment enabling a return of the child to the parent within an ascertainable period of time, whether the services have been offered to the parent, or, if services were not offered, the reasons they were not offered; and (7) the nature of the efforts made by the responsible social services agency to rehabilitate and reunite the family and whether the efforts were reasonable. Minn. Stat. § 260C.163, subd. 9 (2012). The juvenile court did not specifically discuss any of these factors, but failure to do so does not render an order deficient if detailed 15 findings of fact demonstrate the existence of many of the factors outlined in the statute, and provide clear and convincing evidence of the standard for termination articulated in [section 260C.301, subdivision 1(b)(8)]. In re Welfare of A.D., 535 N.W.2d 643, 648 49 (Minn. 1995). Appellant argues that the conditions prompting this matter have been mitigated and that the trial home visit was revoked only because of the stabbing incident, which lacked evidentiary support connecting the incident with appellant s ability to care for her children. We conclude that the juvenile court s conclusion that the children are neglected and in foster care is supported by the broader factual findings addressing appellant s actions and omissions resulting in her children s placement and the termination petition. The juvenile court found that the children were removed from appellant s home in April 2011, that the children have been in numerous different placements, and that the trial home visit between March and August 2012 was not successful. With respect to appellant s efforts to adjust her circumstances, conduct, or conditions necessitating removal in an effort towards reunification, the findings regarding appellant s failure to adequately cooperate with the provided services are particularly relevant, as is appellant s failure to update her case plan with Houg prior to trial. While there was evidence that appellant visited her children during their time in foster care, Houg made clear that these visits were not consistent and that the children were upset when appellant missed visits. Finally, even though RCCHS provided appellant with a myriad of services, appellate failed to adequately cooperate with such services. Given her continuing behavior during and after the trial home visit, this record does not show that the juvenile court clearly 16 erred in finding that there is little indication that appellant has the capacity or ability to adequately address her issues in the foreseeable future. 5. Reasonable Efforts In any termination proceeding, the juvenile court is required to make specific findings that reasonable efforts to finalize the permanency plan to reunify the child and the parent were made including individualized and explicit findings regarding the nature and extent of efforts made by the social services agency to rehabilitate the parent and reunite the family. Minn. Stat. § 260C.301, subd. 8(1) (2012). In determining reasonable efforts to be made with respect to a child and in making those reasonable efforts, the child s best interests, health, and safety must be of paramount concern. Minn. Stat. § 260.012(a) (2012). When determining whether reasonable efforts have been made, the court shall consider whether services to the child and family were: (1) relevant to the safety and protection of the child; (2) adequate to meet the needs of the child and family; (3) culturally appropriate; (4) available and accessible; (5) consistent and timely; and (6) realistic under the circumstances. Minn. Stat. § 260.012(h) (2012). Appellant argues that RCCHS failed to provide services for several areas of concern, including the lack of any requirement that appellant receive services intended to address her anger management, gambling, and domestic violence problems. Appellant received a case plan for each child, a psychological evaluation, chemical-dependency treatment, individual therapy, the services of a mental-health 17 worker through the Jackson Street Village program, housing assistance, casemanagement services through RCCHS and Jackson Street Village, bus cards and food assistance, and was offered the services of a representative payee. The children received a myriad of services, including foster care, residential treatment, assessments, and therapy and skills services. Houg also reviewed the case plan with appellant on multiple occasions and created a calendar of appointments. These services were reasonable and appropriately tailored to address the issues resulting in the CHIPS petition and problems that remained throughout the matter s pendency. The services addressed appellant s financial and housing deficiencies and successfully resulted in stable housing during the trial home visit despite appellant s failure to comply with guidelines required by Jackson Street Village and appropriately manage her finances. More important, the services were directly intended to address problems regarding appellant s mental health and her children s diagnoses. The evidence establishes that the children benefited from these services. Houg testified that additional therapy was not offered to appellant at the time of the trial home visit because appellant denied that she had gambling or anger management issues. Houg explained that additional services for appellant beyond individual therapy would have been too much for her to handle given her problems balancing the children s services and appointment and her developmental delays. Under these circumstances, we conclude that the juvenile court did not clearly err by concluding that RCCHS provided sufficient reasonable efforts toward reunification. 18 6. Children s Best Interests Appellant argues that the juvenile court erred by determining that termination is in the best interests of the children, noting the strong bond between her and the children and her progress following her case plan. In any termination proceeding, the best interests of the child must be the paramount consideration, provided that . . . at least one condition in subdivision 1, clause (b), [is] found by the court. Minn. Stat. § 260C.301, subd. 7 (2012). Even if a statutory ground for termination exists, the district court must still find that termination of parental rights or of the parent-child relationship is in the best interests of the child. K.S.F., 823 N.W.2d at 668. In considering the child s best interests, the district court must balance the preservation of the parent-child relationship against any competing interests of the child. Id. Such interests include a stable environment, health considerations, and the child s preferences. Id. We review a district court s ultimate determination that termination is in a child s best interest for an abuse of discretion. J.R.B., 805 N.W.2d at 905. This court has explained that a parent may demonstrate children s bonds with [their] parent or siblings that would suggest potential harm caused by a termination of parental rights. In re Welfare of A.J.C., 556 N.W.2d 616, 620 (Minn. App. 1996), review denied (Minn. Mar. 18, 1997). Especially pertinent to termination cases, evidence on the positive significance of visitation contacts the children have enjoyed during a preceding period of foster care may demonstrate that termination is not in the children s best interests. Id. 19 Here, the record supports the juvenile court s finding that the children are bonded with appellant and with each other. The evidence also supports the finding that appellant has not kept up a consistent visitation schedule with her children, that this failure was partially due to domestic quarrels between appellant and her mother prior to the trial home visit, and that troublesome domestic incidents continued throughout the trial home visit. Despite testimony from members of appellant s extended family that appellant s children love her and that appellant has displayed improved parenting skills, there was no showing that extended-family relationships operated in any manner to increase the children s stability, especially given appellant s turbulent relationship with her mother. Aside from highlighting her bond with the children, appellant merely notes her progress in following her case plan. As discussed extensively above, the children have experienced less stability and more harm due to appellant s failure to adequately comply with her case plan. Important aspects of the case plan directly addressed the children s best interests. Appellant failed to keep up with the medications prescribed to her eldest and youngest sons and failed to adequately cooperate with services provided to her children. There is clear and convincing evidence that appellant has not been able to meet the children s specialized needs. Given the children s need for stability and specialized services, these considerations weigh heavier than appellant s singular interest in maintaining the parent-child relationship with her children. We conclude the juvenile court did not abuse its discretion by concluding that termination is in the children s best interests. Affirmed. 20

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