IN THE COURT OF APPEALS OF IOWA
No. 18-1969
Filed March 20, 2019
IN THE INTEREST OF A.V.,
Minor Child,
K.H., Mother,
Appellant.
________________________________________________________________
Appeal from the Iowa District Court for Linn County, Barbara H. Liesveld,
District Associate Judge.
A mother appeals the termination of her parental rights. AFFIRMED.
Judith Jennings Hoover of Hoover Law Office, P.C., Cedar Rapids, for
appellant mother.
Thomas J. Miller, Attorney General, and Kathryn K. Lang, Assistant
Attorney General, for appellee State.
Julie F. Trachta of Linn County Advocate, Inc., Cedar Rapids, attorney and
guardian ad litem for minor child.
Considered by Potterfield, P.J., Tabor, J., and Danilson, S.J.*
*Senior judge assigned by order pursuant to Iowa Code section 602.9206 (2019).
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DANILSON, Senior Judge.
A mother appeals the order terminating her parental rights pursuant to Iowa
Code section 232.116(1)(h) (2018). The mother concedes the first three
subsections have been established because the child is three years old or
younger, has been adjudicated a child in need of assistance (CINA), and has been
out of the parent’s custody for at least six consecutive months. See Iowa Code
§ 232.116(1)(h)(1)–(3). She argues, however, the State has failed to prove by
clear and convincing evidence the child cannot be returned to her custody at the
present time or within a reasonable extension of time. See id. § 232.116(1)(h)(4).
She contends the two-month suspension of visits constitutes a failure to make
reasonable efforts to reunify the mother and child. Further, she asserts the bond
between mother and child provides a basis to avoid termination under section
232.116(3)(c).
The child, A.V., was born in April 2017. She first came to the attention of
the department of human services (DHS) in July when her father left her in a car
unattended and a child-abuse assessment referral was made.1 Another
assessment referral was made when the parents gave the child Benadryl and put
her to bed face down on a pillow; she became unresponsive and was hospitalized.
In addition, the child has been involved in one of the couple’s domestic disputes.
Another abuse assessment was completed in December when the child was
repeatedly hospitalized due to the parents’ failure to follow through with needed
medication for the child’s ear infections. The child was diagnosed failure to thrive
1
The father’s rights were also terminated; he has not appealed.
3
and was removed from the parents’ custody on December 14. The child was
adjudicated CINA on December 19 and was placed in foster care. The child was
severely underweight at the time she was removed from her parents’ care.
Visitation with the parents, which had been scheduled for three, one-hour
visits per week, was suspended from June through July 2018 at the request of the
child’s primary physician. On June 19, the child’s physician wrote that she had
cared for the child since November 14, 2017. The physician expressed concern
for the child:
When I assumed care for [A.V.] she was struggling with gaining
weight and growing appropriately. She was having trouble meeting
her developmental milestones. There were apparent parenting
issues witnessed by me at her appointments. . . .
During the entire time of my care for [A.V.] since this time,
feeding has been an issue and constant struggle. Part of her feeding
issue is oral feeding refusal. She had been evaluated by speech
therapy during one of her hospitalizations early in life, however, at
[one] year of age, [A.V.] was starting to refuse feedings by mouth. I
then had her start regular visits with a speech therapist on an
outpatient basis to assist with what seemed to be oral aversion.
This letter is to detail my concern for [A.V.] with parental
visitations. . . . [The child] recognizes and cries when she sees the
DHS worker who takes her to her regular parental appointments.
There is a specific car seat she uses to visit her parents and will cry
when put in that seat specifically. Her parents often cancel or do no
show for visitations, so [A.V.] does not visit with them consistently.
However, she is consistent with her behavior following visitations
with her biological parents and I feel this is becoming a detriment to
her physical and mental health. Visits with parents are described as
“volatile” as witnessed by the speech therapist after they attended an
appointment and she had great concerns and came to me
personally.
As of June 5, 2018, oral aversion has been ruled out as a
diagnosis for [A.V.] by her speech therapist as she has varied eating
acceptance in relation to parental visits and her feeding therapy has
been put on hold. I and [the] speech therap[ist] have reached out to
a psychiatrist to ask for therapies and to date, this has been hard for
me to accomplish due to [A.V.’s] young age. There does seem to be
a psychological relation to [A.V.] not eating and her concerning
behavior with the time of the biological parents’ visitation.
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....
I would like to recommend that visits with biological parents
be suspended at this time to allow [A.V.] to be evaluated by
psychiatry and allow her to maintain a healthy relationship with eating
and food so that she can grow and thrive. I have strong concerns
about her emotional well-being given her intense reactions to food
and restless sleep following visits.
At the time of the termination hearing in September 2018, the child had been
out of the mother’s custody for about nine months. The mother contends she has
“worked on the case plan expectations and made progress in meeting the case
plan goals.” While we acknowledge the mother made some small progress,
especially after visits had been suspended and during the five weeks prior to the
termination hearing, her visits with the child remain fully supervised. See In re
C.B., 611 N.W.2d 489, 495 (Iowa 2000) (“A parent cannot wait until the eve of
termination, after the statutory time periods for reunification have expired, to begin
to express an interest in parenting.”). The mother had been inconsistent in
attending visits she was provided prior to suspension (attending forty-five of
seventy-four). She has not followed through with recommended substance-abuse
treatment. She has not demonstrated an ability to consistently feed her child
without coaching and guidance. She has not demonstrated that she understands
her child’s medical and psychological needs. In addition, the mother and the father
remain together and had just recently begun to attend counseling to address their
domestic relationship. The father has mental-health issues for which he takes
medications. He has anger-management issues.2 He is employed but works from
home because he is overanxious and hyper-vigilant around others. He is resistant
2
The father has a concealed carry permit, possesses a firearm, and has threatened DHS
he would use it. At one visit, the firearm was on the table.
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to services. We find there is clear and convincing evidence the child cannot be
returned to the mother’s care without risk of harm.
The mother contends the State failed to make reasonable efforts at
reunification and she should be granted additional time because her visits had
been suspended. As set out above, visits were suspended based on the concerns
of the child’s pediatrician. The first and foremost consideration in these juvenile
proceedings is the child’s best interests. Id. at 492. We find DHS has made
reasonable efforts to achieve reunification, but the mother has not sufficiently
responded to those services in order to have the child returned to her care.
We do not believe an extension of time is warranted. See Iowa Code
§ 232.104(2)(b) (requiring that in order to extend time the juvenile court make a
determination the need for removal will no longer exist at the end of the extension).
Nor do we find the bond between the mother and this young child who has been
out of parental custody for many months weighs against termination of parental
rights. See Iowa Code § 232.116(3)(c) (allowing court to not terminate a parent
child relationship where “[t]here is clear and convincing evidence that termination
would be detrimental to the child at the time due to the closeness of the parent-
child relationship”); see also In re A.M., 843 N.W.2d 100, 113 (Iowa 2014) (noting
the factors of section 232.116(3) “are permissive, not mandatory” (citation
omitted)). We affirm the termination of the mother’s parental rights.
AFFIRMED.