In the Termination of the Parent-Child Relastionship of: M.B.-L. and R.B. (Minor Children) and, J.B. (Mother) v. Indiana Department of Child Services (mem. dec.)

MEMORANDUM DECISION
FILED
Pursuant to Ind. Appellate Rule 65(D), Feb 16 2018, 7:59 am
this Memorandum Decision shall not be
CLERK
regarded as precedent or cited before any Indiana Supreme Court
Court of Appeals
court except for the purpose of establishing and Tax Court

the defense of res judicata, collateral
estoppel, or the law of the case.

ATTORNEYS FOR APPELLANT ATTORNEYS FOR APPELLEE
Steven E. Ripstra Curtis T. Hill, Jr.
Jacob P. Wahl Attorney General of Indiana
Ripstra Law Office
Jasper, Indiana Abigail R. Recker
Deputy Attorney General
Indianapolis, Indiana

IN THE
COURT OF APPEALS OF INDIANA

In the Termination of the Parent- February 16, 2018
Child Relationship of: Court of Appeals Case No.
19A01-1707-JT-1577
M.B.-L. and R.B. (Minor Appeal from the Dubois Circuit
Children) Court
and, The Honorable Nathan Verkamp,
Judge
J.B. (Mother)
Trial Court Cause Nos.
Appellant-Respondent, 19C01-1701-JT-5
19C01-1701-JT-6
v.

Indiana Department of Child
Services,
Appellee-Petitioner.

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 Barnes, Judge.

Case Summary
[1] J.B. (“Mother”) appeals the termination of her parental relationship with her

children, M.B. and R.B.1 We affirm.

Issue
[2] The sole issue before us is whether there is sufficient evidence to support the

termination of Mother’s parental rights.

Facts
[3] Mother gave birth to M.B. in January 2014 and R.B. in September 2014. On

May 17, 2015, the DuBois County Office of the Department of Child Services

(“DCS”) removed the children from Mother’s care on an emergency basis due

to allegations of physical abuse and neglect. Investigators observed that M.B.

and R.B. had acute diaper rash and scabies. R.B., who has significant medical

issues due to his premature birth, was extremely thin and appeared

malnourished; he also had contusions on his face, head, hands, and leg.

[4] On May 19, 2015, DCS filed petitions alleging that M.B. and R.B. were

children in need of services (“CHINS”). The trial court adjudicated the

children as CHINS on July 30, 2015. On August 28, 2015, the trial court

1
The children’s father’s parental rights were also terminated; he is not a party to this appeal.

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 ordered the children removed from Mother’s care and granted wardship to DCS

pursuant to a dispositional decree. Under the DCS’s case plan, Mother was to

maintain weekly contact with her family case manager and to participate in

recommended services, including parent aide services, individual therapy, and

supervised visitation sessions.

[5] On January 23, 2017, DCS filed verified petitions for involuntary termination

of Mother’s parental rights. The trial court conducted a fact-finding hearing on

April 12, 2017. Family Case Manager Supervisor Shannon Blaize testified that

she investigated the allegations of physical abuse and neglect in May 2015. She

testified,

R.B. had multiple contusions to the right side of his head, his left
eye, bridge of nose, behind his right ear, both of his hands, and
his left leg. He also had a child-sized bite mark on the right side
of his back. Both the boys had significant diaper rash along with
a lot of dirt underneath their fingernails.

Tr. p. 10. Blaize testified further that R.B. had reportedly suffered the

contusions while Mother was asleep, likely at the hands of Mother’s nephew.

Blaize testified that when she asked Mother about the children’s health

conditions, Mother responded that “there were no concerns.” Id. at 11.

[6] Former DCS Family Case Manager Jessica Wilson testified that, at the

beginning of the case, the condition of Mother’s house was

extremely smoky, extremely dirty, all of that. Then it had
improved greatly. Then they got cats . . . and it wasn’t being
cleaned. And so it got pretty bad again, and so that’s when we
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 had switched visits to a different location until she would get that
stuff cleaned up. And then it did get cleaned up, and we had
started visits back at the house again.

Id. at 56.

[Visitation] went from supervised to monitored, but then there
was some bruising that was found on [R.B.]. And it could not be
said for sure where the bruising was coming from, so it was
recommended from DCS to move back to supervised just to see
then, like, if they’re normal bruises that come from children just
being children then we would see those continue. But if it was
something that had to do with the safety of the children, then that
would stop. And so we went back to supervised visits, and then
at that point it remained at supervised until I had left.

Q: And had the bruises stopped?

A: . . . . Whenever we went back to supervised, then the
bruising had stopped, yes.

Id. at 41. Wilson also testified that, during a supervised visit, Mother and her

then-boyfriend

went outside to smoke and were just going to leave the kids in the
house unsupervised. And so then that was addressed about how
that wouldn’t be appropriate.

Id. at 43. Wilson testified that, although Mother initially cooperated with

services, she was unable to maintain her progress after her work schedule

changed; “[Mother] was having trouble balancing the sleep and everything. So

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 then she wasn’t attending the visits and she wasn’t making the appointments.”

Id. at 46.

[7] Wilson testified further that, at the beginning of the case, Mother was receiving

parent aide services. She testified that Mother participated well initially, but her

efforts waned “because she had received a job and she was oversleeping or she

was asleep and didn’t wake up for the door, things of that nature.” Id. at 42.

Lastly, regarding a mental health assessment of Mother, Wilson testified:

. . .[W]hat I can remember is that due to maturity – like they said
that she seemed not to have an understanding of what is realistic
for a child, like what is safe versus was is not safe. And like even
with her sleeping habits, what is realistic as far as how much
sleep one would need in order to be able to properly supervise her
children.

Id. at 52.

[8] Paul Minn (“Minn”) and his wife were the children’s foster parents

immediately after removal. Minn testified that that M.B. and R.B. were his

wards from May 2015 through September 2016, when the children were moved

to their pre-adoptive home. He testified that the children arrived in extremely

poor condition with skin infections. He testified further that “[R.B.] had marks

and so forth on him”; and “he was very, very thin.” Id. at 95. He added,

[R.B.] was just nearly emaciated. He just seemed terribly
malnourished, his ribs showing and, you know, his back bones
sticking up through his skin. His face was all sunk in. His eyes
were kind of bulging. . . .[H]e just didn’t look like a normal
[child].
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 Id. Minn testified that M.B. appeared developmentally delayed, and “was not

walking yet.” Id. He testified that “[w]ithin a few weeks of being with us,

[M.B.] started walking. We just gave him some encouragement and, you

know, . . . he was doing good.” Id. at 96. Minn testified that in time, “[the

children] kind of came around” under the Minns’s care. Id. at 96. The Minns

“got [R.B.] back involved with” his nutritional specialist, who prescribed a

special formula for him, “[a]nd he started, you know, fattening up and filling

out . . . and, you know, seemed to act and look more like a normal infant.” Id.

Minn testified that Mother had “just quit” taking R.B. to his appointments with

the nutritional specialist and neonatologist. Id. at 97.

[9] Minn testified that he and his wife had to transport R.B. to appointments with

medical specialists located throughout the state. He testified further that the

children each were delayed in achieving developmental milestones: “I know

[R.B.] had a physical therapist and [M.B.] had a developmental therapist that

would come and work with them on things that they probably should have

already been – you know, had a grasp on.” Id. at 99.

[10] Minn also testified that, in addition to the nutritional specialist and the

neonatologist, R.B. also sees a pulmonologist for his lung issues. He testified,

His breathing was always an issue. And in fact, the
pulmonologist informed us that, you know, obviously, you
know, he couldn’t be around cigarette smoke. But he said – he
had told us that even the – if you’re not smoking around the kid
but you’re a smoker and it’s in your carpet or, you know, on your

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 couch or on your clothes, it’s still just as detrimental . . . to a
child, I mean, particularly one that’s very sensitive to that.

Id. at 99. Minn testified that after, visits with Mother, the children occasionally

returned smelling of cigarette smoke, dirty, and/or presented with questionable

injuries on R.B. Minn also testified that, following the children’s visits with

Mother, his home became infested with bedbugs and he contracted a “C.Diff”2

infection. Id. at 101. Lastly, Minn testified that, when the children left his

home for their pre-adoptive home,

[They] had developed into completely different kids. . . . They
were happy and outgoing. [R.B.] had started walking, speaking a
few words. They both seemed very healthy. I mean, they had
gotten – you know, gotten all the nurturing and nutrition that,
you know, we could give them that they needed. In fact, that’s
what the . . . neonatologist, he said, you know, he just couldn’t
believe the improvements. And he said that nurture was just as
important as nutrition.

Id. at 102.

[11] Janice Williams of Ireland Home Based Services testified that she assisted

Mother’s reunification efforts by providing intensive services in the areas of

housing, employment, parenting, and meeting the children’s basic needs.

Williams testified that Mother lacked housing and employment when she began

2
Clostridium difficil, or “C.Diff,” is a bacterial infection of the colon that can be contracted in unsanitary
conditions.

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 receiving services. She testified that, although Mother succeeded in securing a

job, she “had trouble waking up,” and “[s]he had a problem remembering

appointments and things she was supposed to do . . . .” Id. at 17. She testified

that she had a recurring concern regarding Mother’s inability to moderate her

sleep: “At times they were sleeping whenever I would arrive. . . . Like

[Mother] had admitted she had problems waking up . . . .” Id. at 19, 22.

Williams testified further that, under the Homebuilders program, “the children

have to be returned within a month or we close services.” Id. at 23. She

testified that, although the majority of program participants successfully achieve

reunification, Mother showed “[n]ot really significant progress” and was

discharged as “not successful.” Id. at 20, 21.

[12] Home-based family caseworker Bethany Glazebrook, who supervised Mother’s

parenting time from July 2015 through July 2016, testified that “[they] work[ed]

on parenting skills” and on “[w]hat the children should accomplish for their

age[s], like the walking, the talking, their development.” Id. at 62. She testified

that Mother was receptive to services but was inconsistent, cancelling seventeen

of approximately one hundred and fifty visits, usually due to illness,

oversleeping, and missing appointments.

[13] Heather Rockman-Boatman of Ireland Home Based Services testified that she

provided supervised visits to Mother to help her with discipline, housing,

employment, bonding, and positive interaction. She testified that Mother had

“a lot of missed visits, so I can’t say that there’s consistency.” Id. at 77.

Mother failed on a few occasions to call ahead to confirm that she was going to

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 attend her scheduled visits, which resulted in the children being transported for

visits that she did not attend. Rockman-Boatman also testified that the

supervised visits occur in “a very controlled room so there’s not a lot of

concerns as far as safety” – a stark departure from the reality of parenting two

young boys. Id. at 79.

[14] Kathleen Speedy, a case manager with Southern Hills Counseling Center,

testified that she works with clients on “parenting skills, organizational skills,

anxiety, [and] coping skills . . .” Id. at 84. She testified that, as Mother’s parent

aide, she met with her approximately two or three times each week. She

testified that she observed a lack of consistency in supervised visits: “On those

she had about 13 no-shows and a canceled -- call canceled by [Mother] in about

ten of those.” Id. at 85. Mother was ultimately discharged for poor attendance.

Mother’s program goals were obtaining her GED; getting her driver’s license;

securing safe housing; and improving her parenting and organization. Speedy

testified that, at the time of the termination hearing, Mother had not obtained

her GED or driver’s license, and was living in an apartment that presented a

safety concern. Mother was discharged having “not successfully completed”

the program. Id. at 87.

[15] Kelly VanMeter, a staff therapist with Southern Hills Counseling Center,

testified that she was Mother’s individual therapist. She testified that Mother

failed to follow up on her reunification goal “[a]s far as therapy with me . . .

because she has missed more sessions than she has made sessions.” Id. at 91.

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 She testified that, although she notified Mother in writing of the process for

reinstatement, Mother failed to follow through.

[16] Hannah Cannon, a case manager with The Villages, a licensed child placement

agency, testified that she worked with the Minns to establish “specific goals for

the children for their development, cognitive functioning, speech, that type of

thing.” Id. at 105. As for the children’s medical issues, Cannon testified that

M.B. works with a speech therapist and “really doesn’t have any specific

medical needs.” Id. at 106. She testified that R.B., however, has lung issues;

gastrointestinal issues, including a milk protein allergy; must take formula

because he has difficulty gaining weight; and sees a developmental therapist

and a physical therapist.

[17] Ann Staff, the children’s CASA throughout the entire CHINS period, testified

that Mother “loves those boys,” and that their relationship is “close” and

“bonded.” Id. at 132. However, she testified further that Mother “has trouble

dealing with both of [the children] at the same time.” Id. Asked whether she

had “concerns for the boys if they are in Mother’s care,” Staff testified:

I don’t think that she is capable of raising the boys. I have
concerns that she would be able to take care of them financially.
Yes, she’s been doing a great job about having a job and she
continues, you know, to have a job. But having a job then means
time away from the boys as well. And she doesn’t have a good
support system.

It’s not like she has family that she can rely on. She can’t drive.
She doesn’t really want to drive. There are things that are

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 needed to take care of the boys, the doctor’s visits. I mean, just
the fact that it took so long to find a ride to the hospital when --
you know, when [R.B.] was initially injured. You know, she’s
young. She’s very young. And I think she is growing. I think
she is learning. I am happy that she is doing these things. But
it’s not to the level where I would feel comfortable having the
boys reunited with her.

Q: As the CASA, what would you have liked to have seen
from Mother to facilitate reunification?

A: Attending every visit. You know, the initial problem with
her having the boys removed was the fact that she fell asleep and
couldn’t, you know, take care of them, you know, couldn’t keep
them safe. She continues to fall asleep. She misses visits because
she can’t get up in time. She does not keep appointments. She
doesn’t keep child and family team meetings because she doesn’t
write them down or she forgets or I don’t know. They don’t
happen. She’s just not responsible enough to take care of them.

Id. at 132-33. Staff also testified as follows that the children had made

significant developmental strides in foster care:

[Upon removal, R.B.] didn’t walk and he didn’t talk. He
grunted, but [made] very little communication whatsoever. And
[R.B.], you know, coming out of the hospital was just, you know,
very – he was sick. I mean, he was lethargic . . . . He was tired.
But since then they really developed personalities. [M.B.]
learned to walk, is speaking better.

[M.B.] is not to the level where he needs to be, but has improved
greatly. [R.B.] couldn’t even crawl. It mean, he – it was
probably nine months ago he wasn’t even – he was doing arm
crawls and that was it. He’s now walking and running and, you

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 know, talking and just – you know, they’re happy. They’re
outgoing. They’re growing rapidly. At the -- you know, at one
of the team meetings the report on the doctor’s visit, you know, it
was great news to hear that [R.B.] would grow out of any of the
issues that he’s -- you know, was born with. And they’re meeting
more and more of their milestones. So they’re catching up,
especially [R.B.] catching up with his age level and [M.B.] with
his developmental level.

Id. at. 135. Staff testified that her recommendation was that the “boys would be

best suited where they are,” and that adoption was in their best interest. Id. at

136.

[18] Former family case manager Stephanie Gilmour testified that she served as case

manager for M.B. and R.B. from August 2016 to March 2017. She testified that

Mother was not “consistent with participation” in parent aide services,

individual counseling or therapy sessions, and supervised visitation; that

Mother failed to do what was necessary for reunification; and that adoption

was in the children’s best interest. Id. at 145.

[19] Mother testified that she had a good relationship with R.B. and M.B. and

acknowledged the following: (1) that she had not obtained her driver’s license;

(2) that she was “probably not up to date completely” regarding R.B.’s medical

issues; (3) that she had failed to regularly comply with or to attend supervised

visitations, meetings with her parent aide, and individual counseling; and (4)

that she had recurring issues with punctuality, oversleeping, missing

appointments, and unreliable transportation. She also testified that she “could

[have] do[ne] more” to effect reunification with R.B. and M.B. Id. at 121.

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[20] On June 9, 2017, the trial court entered orders, containing extensive findings,

for involuntary termination of Mother’s parental relationship with M.B. and

R.B. She now appeals.

Analysis
[21] Mother contends that there is insufficient evidence to support the termination of

her parental rights. The Fourteenth Amendment to the United States

Constitution protects the traditional right of parents to establish a home and

raise their children. In re I.A., 934 N.E.2d 1127, 1132 (Ind. 2010). “A parent’s

interest in the care, custody, and control of his or her children is ‘perhaps the

oldest of the fundamental liberty interests.’” Id. (quoting Troxel v. Granville, 530

U.S. 57, 65, 120 S. Ct. 2054 (2000)). “Indeed the parent-child relationship is

‘one of the most valued relationships in our culture.’” Id. (quoting Neal v.

DeKalb County Div. of Family & Children, 796 N.E.2d 280, 285 (Ind. 2003)). We

recognize that parental interests are not absolute and must be subordinated to

the child’s interests when determining the proper disposition of a petition to

terminate parental rights. Id. Thus, “‘[p]arental rights may be terminated when

the parents are unable or unwilling to meet their parental responsibilities.’” Id.

(quoting In re D.D., 804 N.E.2d 258, 265 (Ind. Ct. App. 2004), trans. denied).

Courts need not wait until a child is irreversibly influenced by a deficient

lifestyle such that his or her physical, mental, and social growth is permanently

impaired before terminating the parent-child relationship. Castro v. State Office

of Family & Children, 842 N.E.2d 367, 372 (Ind. Ct. App. 2006), trans. denied.

“Rather, when the evidence shows that the emotional and physical

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 development of a child in need of services is threatened, termination of the

parent-child relationship is appropriate.” Id.

[22] When reviewing the termination of parental rights, we do not reweigh the

evidence or judge witness credibility. I.A., 934 N.E.2d at 1132. We consider

only the evidence and reasonable inferences that are most favorable to the

judgment. Id. We must also give “due regard” to the trial court’s unique

opportunity to judge the credibility of the witnesses. Id. (quoting Ind. Trial

Rule 52(A)). Here, the trial court entered findings of fact and conclusions

thereon in granting DCS’s petition to terminate Mother’s parental rights, as

required by Indiana Code Section 31-35-2-8(c). See In re N.G., 61 N.E.3d 1263,

1265 (Ind. Ct. App. 2016). When reviewing findings of fact and conclusions

thereon entered in a case involving a termination of parental rights, we apply a

two-tiered standard of review. First, we determine whether the evidence

supports the findings, and second, we determine whether the findings support

the judgment. I.A., 934 N.E.2d at 1132. We will set aside the trial court’s

judgment only if it is clearly erroneous. Id. A judgment is clearly erroneous if

the findings do not support the trial court’s conclusions or the conclusions do

not support the judgment. Id.

[23] Indiana Code Section 31-35-2-8(a) provides that, “if the court finds that the

allegations in a petition described in [Indiana Code Section 31-35-2-4] are true,

the court shall terminate the parent-child relationship.” Indiana Code Section

31-35-2-4(b)(2) provides that a petition to terminate a parent-child relationship

involving a child in need of services must allege, in part:

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 (B) that one (1) of the following is true:

(i) There is a reasonable probability that the conditions
that resulted in the child’s removal or the reasons for
placement outside the home of the parents will not be
remedied.

(ii) There is a reasonable probability that the continuation
of the parent-child relationship poses a threat to the
wellbeing of the child.

(iii) The child has, on two (2) separate occasions, been
adjudicated a child in need of services;

(C) that termination is in the best interests of the child; and

(D) that there is a satisfactory plan for the care and treatment of
the child.

DCS must establish these allegations by clear and convincing evidence. Egly v.

Blackford County Dep’t of Pub. Welfare, 592 N.E.2d 1232, 1234 (Ind. 1992).

[24] Here, the trial court found that continuation of the parent-child relationships

posed a threat to M.B. and R.B. Mother disputes that finding.3 When

considering whether there is sufficient evidence to support such a finding, trial

3
Because Indiana Code Section 31-35-2-4(b)(2)(B) is written in the disjunctive, DCS needed to prove only
one of the requirements of subsection (B). We conclude there is sufficient evidence that continuation of the
parent-child relationship posed a threat to M.B. and R.B.’s well-being and need not consider whether there is
a reasonable probability that the conditions resulting in the children’s removal from Mother’s care would not
be remedied. See In re B.J., 879 N.E.2d 7, 20 (Ind. Ct. App. 2008).

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 courts must “consider a parent’s habitual pattern of conduct to determine

whether there is a substantial probability of future neglect or deprivation.”

Bester v. Lake Cty. Office of Family & Children, 839 N.E.2d 143, 152 (Ind. 2005).

“At the same time, however, a trial court should judge a parent’s fitness to care

for his [or her] child as of the time of the termination proceeding, taking into

consideration evidence of changed conditions.” Id.

[25] The trial court made extensive findings regarding Mother’s inconsistency, lack

of engagement, and unwillingness and/or inability to comply with DCS’s case

plan, including service providers’ treatment plans regarding supervised visits,

individual counseling, therapy sessions, and work with a parent aide, all of

which were intended to aid her reunification efforts:

17. Mother and Father were to participate in recommended
services by the Department.

*****

33. Mother was offered the opportunity to participate in parent
aide services, individual therapy, and visitations.

34. Mother admits that she has not regularly met with her Parent
Aide and is unable to remember the last time that she met with
her Parent Aide.

35. Cathy Speedy of Southern Hills Counseling Center sent
Mother a letter on February 22, 2017, explaining that because of
her missed visits in order to continue with Parent Aide services
Mother needed to attend a one (1) time group session.

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 36. Mother admits to receiving such letter, however has not
attended the required group session.

37. Mother had missed ten (10) parent aide sessions. Specifically,
Mother cancelled six (6) sessions and no showed four (4)
sessions.

38. Mother has not made progress towards any of the goals set
out for her.

39. Kelly VanMeter is the mother’s individual therapist at
Southern Hills Counseling center.

40. Since August 2016, Mother has had eleven (11) scheduled
individual therapy sessions, however she has only completed five
(5) sessions with the most recent occurring on January 4, 2017.

41. Mother was not on time for all five (5) therapy sessions she
attended.

42. Mother has not made any progress with her individual
therapy goals.

43. Mother admits that it is important to have counseling.
However she missed counseling for various reasons.

44. Mother missed visitation for reasons such as “I missed the
date and time” or “I didn’t have a ride there.”

45. Bethany Glazebrook supervised Mother’s parenting time
until December 2016.

46. Mother made progress when her parenting time was
supervised from July 2015-July 2016. However Mother missed
visits due to oversleeping and transportation issues.

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 47. Mother was occasionally not prepared for the visit due to
being asleep when [Glazebrook] arrived at the home.

48. During visitations, one child would remain on her lap and
Mother would care for the other child.

49. Mother was never able to interact with both children at the
same time.

50. Heather Rockman-Boatman of Ireland Home Based Services
testified that since December 2016, she has been the supervisor of
parenting time.

51. Mother has been inconsistent in her visitation, as well as
regularly ended visits early.

52. Heather Rockman-Boatman then began supervising parenting
time in December 2016.

53. From December 2016 to March 2016, Mother was offered
forty-one (41) visits and attended eighteen (18) visits.

54. Mother has a problem of sleeping through appointments and
visits, as well as, is frequently late to scheduled appointments and
visits.

55. Mother admits that she could have done more to reunify with
[R.B. and M.B].

App. Vol. II pp. 9-11. The trial court also entered findings regarding Mother’s

unreliability, lack of a support system, and inability to meet either the children’s

basic needs or R.B.’s unique medical needs as follows:

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 56. Mother lacks transportation, appropriate housing, and
consistent employment.

57. Mother, per her own admission, relies on friends for
transportation and believes it’s “probably not a good idea to get a
license right now” due to her finances.

58. Mother’s current home has had some work completed to
make the home more appropriate for [the children]. However, at
this time, and without certain items, the home is still not
appropriate for children.

59. Mother acknowledges that six (6) months is her most
consistent period of employment.

60. Mother acknowledges that DCS became involved in this
matter when [M.B.] had severe diaper rash. [R.B.] sustained
injuries in Mother’s care while she was sleeping nearby.

61. Ann Staff, CASA, reports concerns about [the] length of time
it took Mother to take [M.B.] and [R.B.] to the hospital when
they were removed from the home.

62. [R.B.] has significant medical history due to being born
premature and meets with different medical specialists.

63. Mother is not up to date on the current medical status of
[R.B.].

64. Mother, at points in the case, made positive progress towards
reunification. However, Mother moved back down to supervised
visitations when [R.B.] returned from visits to Foster Care with
unexplained bruises and other injuries.

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 65. Following a return to supervised visitations, the bruises
ceased.

66. When [M.B.] and [R.B.] were placed in his home, [R.B.] had
bruises and marks on him, was very thin, and looked
malnourished.

67. When both children were placed in the home, they had severe
diaper rash and scabies.

68. Paul McMinn acknowledged that [M.B.] and [R.B.] initially
returned from visitations smelling of cigarette smoke and at one
point brought bed bugs into his home.

69. [R.B.] is unable to be around cigarette smoke due to lung
issues.

70. Mother admits that she smokes cigarettes, smoked cigarettes
in the home, and knew that she needed to go outside to smoke
cigarettes due to medical conditions of [R.B.].

71. Paul McMinn notes that from when [M.B.] and [R.B.] were
placed in his care to when they left his care for new Foster
placement, they were “completely different kids.”

72. Based on parents’ lack of progress and consistency, Former
FCM, Stephanie Gilmour, as well as CASA, Ann Staff, testified
that testified that adoption and termination of parental rights was
in [M.B. and R.B.’s] best interests.

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 Id. at 11-12. We cannot say the foregoing findings, which reflect the trial

court’s weighing of the evidence and judging of witness credibility, are clearly

erroneous.

[26] This case is made especially difficult because Mother’s family case managers

and service providers recognized her love for the children and actively worked

to aid her efforts to reunite with M.B. and R.B. Sadly, they had a complacent

partner in Mother, who failed to rise to the occasion despite receiving

significant support. The children were removed from Mother’s care because of

allegations of physical abuse and neglect. The record reflects that Mother failed

to appreciate the extent of her children’s needs—especially R.B.’s—as well as

the adverse impact of her chronic inconsistency and her inability to make

necessary changes for their wellbeing.

[27] Family Case Manager Blaize testified that when she asked Mother about the

children’s medical issues, she responded that they had none. The record is clear

that, at least at the outset of the CHINS period, M.B. required speech therapy;

and R.B. required treatment from a host of medical specialists. Specifically, as

to R.B.’s breathing problems, several witnesses testified that Mother continued

to smoke during the CHINS period, despite warnings that he could simply not

withstand it.

[28] Mother’s decision to forgo obtaining a driver’s license, which was vital to

ensuring R.B.’s routine access to medical specialists as well as to emergency

care, is troubling and reinforces CASA Staff’s testimony that Mother is neither

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 “responsible,” conscientious, nor “capable” of appropriately parenting M.B.

and R.B. Id. at 132-33. Mother missed so many sessions with her individual

therapist and parent aide that those service providers discharged her. Foster

parent Minn testified that Mother had “just quit” taking R.B. to his

appointments with his medical providers. Id. at 97. Her shoddy record of

appointment no-shows and cancellations with her parenting aide, individual

therapist, and even for supervised visits—at a time when she was pursuing

reunification and receiving peak-level support—does not inspire confidence in

her ability to self-govern had reunification occurred. Lastly, various witnesses

testified to the remarkable turnaround made by each child once he was in a

stable, nurturing environment with access to necessary services, treatment, and

support.

[29] Given the children’s youthful ages and R.B.’s medical challenges, it was

incumbent upon Mother to demonstrate her desire, ability, and noted progress

toward improving her attentiveness and supervision, management of R.B.’s

medical appointments, and her ability to meet the children’s basic needs so that

they could achieve developmental milestones in her care as they did under the

Minns’s care. In light of the foregoing, we agree with the trial court that

allowing continuation of Mother’s parent-child relationships with M.B. and

R.B. poses a threat to their wellbeing. The trial court’s findings on this issue

were not clearly erroneous.

[30] Mother also contends that termination is not in M.B. and R.B.’s best interests.

When considering whether there is sufficient evidence that termination of

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 parental rights is in a child’s best interests, we consider the totality of the

evidence and look beyond the factors identified by DCS. In re J.C., 994 N.E.2d

278, 289-90 (Ind. Ct. App. 2013). The interests of the parents must be

subordinated to the needs of the child. Id. at 290. Recommendations of DCS

caseworkers and court-appointed special advocates, combined with evidence

that continuation of the parent-child relationship poses a threat to the child, are

sufficient to prove by clear and convincing evidence that termination is in a

child’s best interests. Id. Children have a paramount need for permanency,

which is a central consideration in evaluating a child’s best interests. In re E.M.,

4 N.E.3d 636, 647-48 (Ind. 2014).

[31] The record reveals throughout that Mother failed to demonstrate the level of

commitment and consistency necessary to assure DCS and service providers

that she could meet M.B. and R.B.’s unique needs. Various witnesses testified

that she simply lacked the will, maturity, and discipline to engage in services

intended to improve her parenting, organizational, and coping skills. Although

she made limited progress, the evidence overwhelmingly establishes that

Mother failed to meet virtually all goals established for under DCS’s case plan.

Both the children’s CASA and Family Case Manager recommended

termination of Mother’s parental rights and adoption in their foster placement.

Given Mother’s minimal progress and the genuine risk of harm to the

children—particularly R.B.—from her complacency, it is unclear how long

M.B. and R.B. would have to wait for those conditions to improve, if at all.

We conclude that there is sufficient evidence to support the trial court’s finding

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 that termination of Mother’s parental rights was in M.B. and R.B.’s best

interests.

Conclusion
[32] There is sufficient evidence to sustain the termination of Mother’s parental

relationship with M.B. and R.B. We affirm.

Affirmed.

Najam, J., and Mathias, J., concur.

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