In the Matter of the Welfare of the Child of: A. K., Parent.

This opinion will be unpublished and
may not be cited except as provided by
Minn. Stat. § 480A.08, subd. 3 (2016).

STATE OF MINNESOTA
IN COURT OF APPEALS
A17-1258

In the Matter of the Welfare of the Child of: A. K., Parent.

Filed January 16, 2018
Affirmed
Florey, Judge

Ramsey County District Court
File No. 62-JV-16-2201

Patricia J. Stotzheim, St. Paul, Minnesota (for appellant)

John J. Choi, Ramsey County Attorney, Robert Hamilton, Assistant County Attorney, St.
Paul, Minnesota (for respondent)

Darlene Heinz, St. Paul, Minnesota (guardian ad litem)

Considered and decided by Florey, Presiding Judge; C onnolly, Judge; and Jesson,
Judge.
U N P U B L I S H E D O P I N I O N
FLOREY, Judge
Appellant-mother challenges the district court’s order terminating her parental
rights. She argues that the district court a bused its discretion when it determined that
(1) respondent made reasonable rehabilitative efforts to reunite the family, (2) the statutory
grounds for termination were supported by cl ear and convincing evidence, and (3) the
termination of parental rights was in the child’s best interests. We affirm.

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FACTS
Appellant-mother A.K. gave birth to E.K. in June 2015. Whil e at the hospital,
medical professionals noticed that appellant was not consistently feeding E.K. or changing
his diaper. The medical professionals reporte d that appellant misrepresented the amount
and frequency that she was feeding E.K., and appeared unable or unwilling to place E.K.’s
needs ahead of her own needs. Medical pr ofessionals determined that if E.K. was
discharged to appellant, she would need to be supervised at all times while caring for him.
A 72-hour hold was placed on E.K., and appellant was discharged from the hospital without
E.K. after she refused an offer to board at the hospital.
Respondent Ramsey County Community Human Services Department (the county)
initiated a child-protection investigation and filed a child in need of protection or services
(CHIPS) petition with the district court, alle ging that appellant ne glected E.K. and was
unable to meet his physical needs. The CH IPS petition was dismissed in July 2015 after
appellant received therapy and mental-health services direct ed at reuniting her with E.K.
Appellant, who was residing with E.K.’s father at the time, was reunited with E.K.
In September 2015, the co unty filed a second CHIP S petition after appellant
exhibited erratic behavior, demanded to take E.K. from his father’s home, and the county
learned that appellant had been hospitalized three times over the course of a month for

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mental-health issues.1 In January 2016, the district cour t found that E.K. was in need of
protection or services after appellant admitted to the allegations in the petition.
The county created a case plan requiring appellant to complete a chemical-
dependency evaluation, complete a mental-h ealth assessment, take her prescribed
medications, attend therapy to assist with her mental-health diagnoses, work with a mental-
health case manager, complete a parenti ng-skills evaluation, and attend parenting
education. Appellant was also required to pursue permanent housing for herself and E.K.,
apply for financial assistance , and attend E.K.’s medical a ppointments. The case plan
informed appellant that she would be required “to address her mental health and chemical
health and understand how untreated mental and chemical health impacts the parenting of
her child,” in order for E.K. to be returned to her care.
In April 2016, appellant secured housing at a home for homeless pregnant women.
The home permitted supervised visits with E.K. Appellant had successful visits with E.K.
and was progressing toward a trial home visit when she abruptly m oved to Grey Eagle,
Minnesota in June 2016 withou t consulting her social worke r. A number of appellant’s
services were disrupted or discontinued when she moved to Grey Eagle, and appellant did
not see or care for E.K. for nearly two mont hs following her move. In September 2016,
appellant reestablished supervised visits with E.K., though she did not visit him

1 In August, appellant was placed on two 72-hour holds at a hospital. Once after appellant
had delusions that E.K. was possessed by the devil and tried to perform CPR on him, and
again after she believed she was poisoned by a household cleaning product. She was also
hospitalized after she exhibited odd behavior while camping.
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consistently on a weekly basis, and cancelled a number of the scheduled visits. She also
began attending therapy and a number of referrals were made to reestablish services.
On August 31, 2016, the county filed a pe tition to terminate appellant’s parental
rights to E.K. A trial commenced in February 2017, but was continued after appellant was
hospitalized on March 28 and spent three week s in a psychiatric facility during judicial
commitment proceedings in Todd County. The Todd County district court found that
appellant was mentally ill for purposes of a judicial commitment, but stayed the
commitment for a period of six months on the requirement that appellant satisfy certain
treatment conditions.
At trial, appellant’s social worker tes tified that appellant had failed to show
sufficient insight into her ment al-health issues and to change the behaviors that led to
E.K.’s placement out of the home. She also testified that appellant’s home was not safe
for children at the time of the trial, even though appellant had lived at the home for a year.
Appellant testified that, as part of the conditions of the stay of commitment, she would be
required to remain at an intensive residential treatment facility for a period of 30 to 90 days.
At the time of trial, appellant had not star ted the treatment program and was awaiting an
opening at a facility. E.K. would not be permitted to reside with appellant at the intensive
residential treatment facility.
At the conclusion of the trial, the district court found that it was in E.K.’s best
interests to terminate appella nt’s parental rights on three grounds: failure to correct
conditions, palpable unfitness, and the child is neglected and in foster care. See Minn. Stat.
§ 260C.301, subd. 1(b)(4), (5), (8) (2016). Th e district court found that the county had
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made reasonable efforts to rehabilitate appella nt and reunite her with E.K., despite there
having been a gap in services after appellant moved to Grey Eagle. The district court found
that the provision of further services would be futile and “unlikely to bring about a lasting
parental adjustment enabling a return of the child to [appellant’s] care within the reasonably
foreseeable future.”
This appeal followed.
D E C I S I O N
A district court may terminate parental rights if clear and convincing evidence
establishes that (1) the county made reasonable efforts to reunite the family; (2) a statutory
ground for termination exists; an d (3) termination is in the ch ild’s best interests. Minn.
Stat. § 260C.301, subds. 1(b), 7, 8 (2016); In re Welfare of Children of S.E.P., 744 N.W.2d
381, 385 (Minn. 2008). We review both a dist rict court’s determination that a statutory
basis to terminate parental rights is presen t and a district court’ s ultimate termination
decision for an abuse of discretion. In re Welfare of Children of J.R.B., 805 N.W.2d 895,
901, 905 (Minn. App. 2011), review denied (Minn. Jan. 6, 2012). But we review the district
court’s factual findings for clear error. In re Welfare of Children of T.R., 750 N.W.2d 656,
660 (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 evid ence as a whole.” Id. at
660-61 (quotation omitted). We will give considerable defere nce to the district court’s
decision to terminate a person’s parental rights because the “district court is in a superior
position to assess the credibility of witnesses.” In re Welfare of L.A.F., 554 N.W.2d 393,
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396 (Minn. 1996). We will also closely inquire into the suffi ciency of the evidence to
determine whether the evidence was clear and convincing. S.E.P., 744 N.W.2d at 385.
I. Reasonable efforts
Before terminating parental rights, the di strict court must determine whether the
county provided reasonable e fforts to rehabilitate the parent and reunite the child and
parent, unless the provision of further services would be futile or is not required by statute.
Minn. Stat. § 260C.301, subd. 8; T.R., 750 N.W.2d at 664. For efforts to be reasonable,
the services the county offers must be: “(1) relevant to the safety and protection of the
child; (2) adequate to meet th e 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) (2016). The district court must make “specific
findings” that the county made reasonable efforts, and “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. St at. § 260C.301, subd. 8. The district court
“must also consider the length of time the county wa s involved and the quality of effort
given.” In re Welfare of Child of J.K.T., 814 N.W.2d 76, 88 (Minn. App. 2012) (quotation
omitted).
Appellant argues that the district court cl early erred when it determined that the
county provided reasonable rehabilitative efforts aimed at alleviating the issues that led to
the out-of-home placement. She argues that the case plan did not adequately address how
she could further demonstrate insight into her mental health, when, at trial, she
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acknowledged her mental-health issues and testified that medication and therapy are
helpful to her.
“The nature of the services which cons titute ‘reasonable efforts’ depends on the
problem presented.” In re Welfare of S.Z. , 547 N.W.2d 886, 892 (Minn. 1996). “The
county’s efforts “must conform to the problems presented” and “be aimed at alleviating the
conditions that gave rise to out-of-home placement.” J.K.T., 814 N.W.2d at 88.
“Reasonable efforts at rehabilitation are services that go beyond mere matters of form so
as to include real, genuine assistance.” In re Welfare of Children of S.W., 727 N.W.2d 144,
150 (Minn. App. 2007) (quotations omitted), review denied (Minn. Mar. 28, 2007); see
T.R., 750 N.W.2d at 666 (concluding that a county’s efforts were not reasonable where no
services were offered to address the father’s chemical-dependency issues and lack of verbal
skills and cognition, and the social worker did not visit his home).
Here, the most significant issues that appellant needed to address for reunification,
as directed in the case plan, were her ment al-health issues and he r understanding of how
her mental health impacts her ability to care for a child. To this end, the county required
appellant to complete a mental-health assessment, take her prescribed medications, attend
therapy for her mental health, and use the services of a ment al-health case manager. The
district court found that these efforts were offered to address the issues that led to the out-
of-home placement and were reasonable. Despite these efforts, appellant denied that her
criminal behavior and the behavior that led to the CH IPS petitions were a result of her
mental-health issues, instead placing blame on third parties. The evidence supports the
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district court’s conclusion that the efforts were reasonable and directed at the issues that
led to the out-of-home placement.
Appellant also argues that the efforts of the county were untimely and not “the real,
genuine assistance” required by law because th e county primarily made referrals for
services or relied on services that appellant already had in place. The district court
determined that there were gaps in some of the services offered to appellant and that some
of the gaps were attributable to appellant’s abrupt move made without consultation with
the county. For exampl e, the move resulted in the loss of a mental-health case manager
and a public-health nurse. The move also di srupted parenting-education services and an
in-progress parenting-skills eval uation. But the district cour t also found th at the county
shared part of the blame for the delay in se rvices and a visit by the social worker to
appellant’s home. Despite this, the district c ourt found that the effo rts of the county to
rehabilitate appellant were reasonable.
The record supports the district court’s conclusion. While services and efforts for a
trial home visit were delayed over the summer of 2016, the record reveals that the county
made efforts to reestablish services throughout the fall of 2016 and into the spring of 2017.
Those efforts included referrals to parenting classes, pare nting assessments, continued
supervised visitations, and atte mpts to contact appellant for a home visit. The county’s
service referrals allowed appellant to successfully complete some portions of her case plan.
And while appellant had several services in place prior to the county’s creation of the case
plan, the social worker explained that the prio r services were incorp orated into the case
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plan because they were appropriate and beneficial to appellant. The district court did not
clearly err in finding that the efforts of the county were reasonable, despite some delays.
Appellant also argues that the district c ourt clearly erred when it found that any
further services would be futile and not likely to bring abou t lasting parental adjustment
within a reasonable period of time. By the e nd of the trial, appella nt had complied with
many aspects of her case plan aimed at treatm ent of her mental health. But the district
court found that, although appellant had made progress, she still failed to demonstrate
insight into how her mental health has impact ed her behavior and the risk that untreated
mental health may pose to E.K.
For example, in March 2017, during the pendency of the trial, appellant had a
mental-health crisis which led to a three-we ek hospitalization in a mental-health unit and
judicial commitment proceedings. While hos pitalized, appellant was diagnosed with
bipolar disorder, manic with acute psychosis. A court-appointed examiner opined that
appellant presented a risk of harm to herself and others and that she had no insight into her
own mental illness. At trial, appellant de nied that the hospitalization and commitment
proceedings were a result of a mental-health crisis. Instead, she indicated that it was a
result of her “irritability and anger” and a pr obation officer’s attemp t “to stir up some
trouble.” Likewise, appellant testified th at she knew how to be a reasonable and
presentable adult so that she could “be off” he r medication. The district court found that
further services would not enable appellant to effectively provide for E.K.’s physical,
mental and emotional needs in the foreseeable future because of her lack of insight into her
mental-health issues. The findings are reasonably supported by the record as a whole.
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II. Statutory grounds for termination
A district court may involuntarily terminate parental rights if one or more of nine
conditions exist. Minn. Stat. § 260C.301, subd. 1(b). The district court must “make clear
and specific findings which conform to the st atutory requirements for termination” and
those findings must “address conditions that exist at the time of the hearing.” In re Welfare
of Chosa, 290 N.W.2d 766, 769 (Minn. 1980).
A. Palpable unfitness
The district court found that appellant is pa lpably unfit to be a party to the parent
and child relationship. A district court may find that a parent is palpably unfit if it finds
a consistent pattern of specif ic conduct before the child
or . . . specific conditions directly relating to the parent and
child relationship either of whic h are determined by the court
to be of a duration or nature that 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). Proving palpable unfitness is an onerous burden.
T.R., 750 N.W.2d at 661. The county must prove “a consistent pattern of specific conduct
or specific conditions existing at the time of the hearing that appear will continue for a
prolonged, indefinite period an d that are permanently detrim ental to the welfare of the
child.” Id. (quotation omitted). “When considering termination of parental rights, the court
relies not primarily on past history, but to a great extent upon the projected permanency of
the parent’s inability to car e for his or her child.” S.Z., 547 N.W.2d at 893 (quotations
omitted).
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Appellant argues that the district court’s findings do not supp ort a conclusion that
appellant is palpably unfit to be a party to the parent-and-child relationship. She argues
that “a person who lacks insight into her ment al illness, in and of itself, does not permit
termination of parental rights,” and that the conditions at the time of the hearing established
that she was presently able to parent E.K.
A parent’s mental illness, alone, cannot be used as the basis for terminating parental
rights. Id. at 892 (“Thus, while the nature of the parent’s [mental] condition may support
termination, it does not do so ipso facto .”). Rather, courts are to look at the parent’s
conduct to determine the parent’s fitness to maintain the relationshi p “so as to not be
detrimental to the child.” Id. (quotation omitted). If the pare nt is unable to care for the
child within a foreseeable time, the parental rights may be terminated. Id.
The district court did not rely solely on appellant’s diagnoses to terminate her
parental rights. Rather, the district court examined at length appellant’s statements and
conduct throughout the course of the trial, and found that appellant failed “to demonstrate
insight into the mental-health defi ciencies that place [E.K.] at risk of harm in her care.”
The district court cited the following as proof that appellant lacks the present insight into
her mental health to adequately parent E.K.: her denial of responsi bility for her criminal
behavior and any connection of those acts to her mental health; her denial of some of her
mental-health issues and the crises that le d to multiple judicial commitment cases; her
denial of her behavior that led to the CHIPS cases; her belief that she does not need to take
her medication, and her statements that carin g for E.K. is “too much sometimes.” The
district court concluded that appellant’s failure to recognize how her mental health affects
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her behavior has kept her fro m being able “to permanently provide a safe, stable and
healthy home for [E.K.].” These findings are adequately supported by the record.
Appellant argues that there was evidence demonstrating that she is presently able to
parent, such as her recent improvements in her mental stability and her positive parenting
reports. But multiple witnesses testified that appellant’s lack of insight into her mental-
health issues would impede he r ability to safely parent her child. The district court’s
findings are supported by clear and convincing evidence and they sufficiently support the
conclusion that there are “spe cific conditions directly relating to the parent and child
relationship . . . of a duration or nature that renders the parent unable, for the reasonably
foreseeable future, to care appropriately fo r the ongoing physical, mental, or emotional
needs of the child.” Minn. St at. § 260C.301, subd. 1(b)(4). Therefore, the district court
did not abuse its discretion in ruling appellant to be a palpably unfit parent. J.R.B., 805
N.W.2d at 901.
B. Failure to correct conditions
The district court also found that “reasonable efforts under the direction of the court
have failed to correct the conditions leadin g to [E.K.’s] placement” out of the home. See
Minn. Stat. § 260C.301, subd. 1(b)(5) (permitting termination of parental rights for failure
to correct conditions). In considering whet her a parent’s parent al rights should be
terminated for failing to correct conditions, “[t]he critical issue is not whether the parent . . .
complied with the case plan, but rather whether the parent is presently able to assume the
responsibilities of caring for the child.” J.K.T., 814 N.W.2d at 89.
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Appellant argues that the efforts of the co unty were not reasonable, and therefore
this statutory ground for termination is not satisfied. She argues that her compliance with
her case plan was a result of her own efforts to coordinate services, instead of timely aid
from the county.
As discussed above, the efforts of the county were reasonable, timely, and directed
at the issues that led to the out-of-home placement. The district court found that appellant
complied with some aspects of her case plan, but that she had not corrected the conditions
that led to E.K.’s placement out of the home. See In re Welfare of Children of K.S.F., 823
N.W.2d 656, 667 (Minn. App. 2012) (indicating that a parent’s completion of a case plan
does not “necessarily equate[] with a correcti on of the conditions th at led to the out-of-
home placement”). The record supports the district court’s conclusion. At the time of trial,
appellant had not applied for financial support, found suitable housing for a child, attended
many of the scheduled visits with E.K., or attended his medical appointments. Although
she was in compliance with her therapy and medication requirements, she had not
demonstrated that she understood the risk posed to E.K. if she were to have a mental-health
crisis or if she stopped taking her medication. The record supports the district court’s
finding that these circumstances indicate that appellant is not presently able to assume the
responsibilities of caring for E.K. Therefore, the district court did not abuse its discretion
by ruling that reasonable efforts failed to correct the conditions that led to the out-of-home
placement. J.R.B., 805 N.W.2d at 901.
Having concluded that two statutory grounds for termination are supported by clear
and convincing evidence, we need not address the other ground cited by the district court.
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See In re Children of T.A.A., 702 N.W.2d 703, 708 n.3 (Minn. 2005) (declining to address
all of the grounds for termination relied on by the district court).
III. Best interests of the child
We review a district court’s determination that termination of parental rights is in a
child’s best interests for an abuse of discretion. J.R.B., 805 N.W.2d at 905. A child’s best
interests can preclude termination of a parent’s parental rights, even if the district court
finds that a statutory basis for terminating parental rights is present. In re Welfare of Child
of D.L.D., 771 N.W.2d 538, 545 (Minn. App. 2009). “In analyzing the best interests of the
child, the court must balance three factors: (1) the child’s interest in preserving the parent-
child relationship; (2) the parent’s interest in preserving the parent-child relationship; and
(3) any competing interest of the child.” In re Welfare of R.T.B., 492 N.W.2d 1, 4 (Minn.
App. 1992); see also Minn. R. Juv. Prot. P. 39.05, s ubd. 3(b)(3). “Com peting interests
include such things as a stable environmen t, health considerations and the child’s
preferences.” R.T.B., 492 N.W.2d at 4. “[If] the interests of parent and child conflict, the
interests of the child are paramount.” Minn. Stat. § 260C.301, subd. 7.
Appellant argues that “it is not in E.K.’s best interest to terminate [appellant’s]
parental rights because [she] has demonstrat ed positive parenting strengths.” She cites
evidence in the record indicating that she could care for E.K.
The district court found that appellant has an interest in preserving the parent-child
relationship, but that E.K. does not have such an interest. The district court found that E.K.
needs a safe, stable, and healthy home; a pare nt that can meet his physical, mental, and
emotional needs; and a parent “who will make his health, safety and well-being a priority
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and place his needs above the parent’s needs.” The district court found that appellant has
not changed her behavior in order to provide these things to E.K. and that she “cannot meet
[E.K.’s] needs now, or in the reasonably foreseeable future.”
The district court’s findings are amply supported by evidence in the record.
Appellant has not procured a safe and perm anent home for E.K., nor has she secured
sufficient financial assistance, as required by the case plan. The social worker testified that
appellant “has a difficult time putting [E.K.’s] needs above hers or being able to respond
to his cues as to what he wants.” Witnesses doubted that appellant would be able to meet
E.K.’s needs and keep him safe because of he r unresolved mental and behavioral issues.
And as the district court noted, appellant is required, as part of the stayed civil-commitment
order, to participate in an intensive residential treatment program, where she would not be
able to care for E.K. E.K.’s interest in a permanent and safe home, which appellant is
unable to provide now or in the foreseeable future, outweighs appellant’s interest in
preserving the parent-child relationship.
While there is some eviden ce in the record to suppor t appellant’s position, the
district court was required to make credibility decisions when it cons idered the evidence.
Where credibility determinations are required, “[i]n the absence of a clear abuse of
discretion[,] the action of the trial court must be affirmed.” In re Welfare of Child of S.S.W.,
767 N.W.2d 723, 734 (Minn. App. 2009) (quotation omitted).
Affirmed.