In the Matter of the Welfare of the Children of: A. V., Parent.

This opinion is nonprecedential except as provided by
Minn. R. Civ. App. P. 136.01, subd. 1(c).

STATE OF MINNESOTA
IN COURT OF APPEALS
A24-1445

In the Matter of the Welfare of the Children of: A. V., Parent.

Filed March 17, 2025
Affirmed
Reyes, Judge

Hennepin County District Court
File No. 27-JV-24-490

Brooke Beskau Warg, Hennepin County Adult Representation Services, Minneapolis,
Minnesota (for appellant-mother A.V.)

Mary F. Moriarty, Hennepin County Attorney, Britta Nicholson, Assistant County
Attorney, Minneapolis, Minnesota (for respondent Hennepin County Human Services and
Public Health Department)

Ellen Murphy-Fritsch, E. Murphy Law Office s, PLLC, White Bear Lake, Minnesota (for
respondent-father H.C.)

Drew Bryant, Minneapolis, Minnesota (guardian ad litem)

Considered and decided by Reyes, Presiding Judge; Bjorkman, Judge; and Bond,
Judge.
NONPRECEDENTIAL OPINION
REYES, Judge
Appellant-mother challenges the district court’s termination of her parental rights ,
arguing that the county failed to provide reasonable efforts to assist her in addressing her
chemical-dependency issue. We affirm.

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FACTS
On September 20, 2022, the Hennepin County Human Services and Public Health
Department (the county) filed a petition alleging that appellant-mother A.V.’s two children,
A.C. and M.C., needed protection or services. According to the petition, mother had given
birth to M.C. on the lawn of her apartment on September 3, 2022. A neighbor called 911
out of concern for M.C. because the baby was turning blue. At the hospital, mother refused
to allow the hospital to draw her blood or conduct a COVID test. A medical professional
from the hospital stated that mother’s umbilical cord came back positive for amphetamines,
methamphetamines, codeine, and morphine. The county later obtained mother’s medical
records, which stated that mother only had three prenatal-care visits during her pregnancy
and refused any blood draws or urine labs. The records further noted that mother had a
history of depression, schizophrenia, and drug use and had been prescribed antipsychotic
medications to limit her hallucinations.
During an investigation of mother’s home, an investigator observed that M.C. had
a hematoma the size of a tennis ball on the back of her head. 1 The investigator also
observed that mother had a sore on her face and healed circular marks running the length
of her arm and on her chest, which they suspected were attributable to drug use. Mother
denied any drug use during her pregnancy. The investigator also noted eleven pill bottles
in her home, two of which were old with illegible writing on them. Appellant claimed she
obtained these two bottles from a pain-management clinic in St. Paul. The investigator

1 An investigator went to mother’s apartment on September 15, 2022, less than two weeks
after she gave birth to M.C.
3
also found two full bottles of Naproxen.2 Mother told the investigator that she and her son
had an active order for protection (OFP) against H.C., the father of her children. A.C. and
M.C. were then placed on a 72-hour health-and-welfare hold away from mother.
The district court held a children in need of protection or services (CHIPS) trial in
January 2023. The district court ruled that the children needed protection and services due
to mother’s chemical-dependency issues, failure to provide necessary medical care to A.C.,
and the domestic violence between mother and father. The county’s court-approved case
plan required mother to comply with the following actions:
1) Submit to random urine analysis (UA) and abstain from all
substance use. (Any missed UAs were considered positive.)
2) Complete a chemical-dependency[3] assessment and follow
all recommendations.
3) Complete a psychological evaluation and follow all
recommendations.
4) Engage in parenting-education programming and follow all
recommendations.
5) Participate in domestic -violence programming and follow
all recommendations.
6) Remain law abiding by following all probation conditions
and criminal court orders.
7) Cooperate with the [county] and sign all releases.
8) Maintain safe suitable housing.
9) Engage in supervised visits with the children.

In March 2024, the county submitted an update on mother’s progress with the case
plan to the district court. According to the update, mother (1) had not provided a urine
sample for eleven appointments, which were then presumed positive; (2) had not completed

2 Naproxen is a medication often prescribed to treat pain.
3 A chemical-dependency assessment is an evaluation to determine whether a person has a
drug or alcohol-use disorder.
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a chemical-dependency assessment; (3) had not completed a psychological evaluation;
(4) had not completed parenting education; and (5) had not signed any of the releases from
the county. The update noted that, to the best of the county’s knowledge, mother had
maintained safe , suitable housing and remained law abiding. 4 After mother failed to
comply with the requirements in the case plan, the county petitioned to terminate her
parental rights.
The district court held a court trial beginning in May 2024. The district court
received over 150 exhibits into evidence and testimony from various witnesses, including
mother, the child-protection social worker (CPSW), the assigned child-services worker
(CSW), the guardian ad litem (GAL), and father.
The CPSW testified that mother had only provided four urine samples after the case
was opened, failed to submit any tests for 20 months, had not demonstrated sobriety since
the inception of the case, did not complete a chemical-dependency assessment, and had not
shown insight into her chemical-dependency issues. To facilitate mother completing her
urine testing, the social worker offered to escort her to Hennepin County Medical Center
(HCMC) and later referred her to in-home testing and peer support. Despite this, mother
did not provide any additional urine samples.

4 While the county’s update indicated that at the time of the filing of the case update mother
had been law abiding, the district court found based on exhibits and the CPSW’s testimony
that mother had not been abiding by prior court orders including an OFP and a probationary
offense from a prior criminal proceeding which required mother to register as a predatory
offender.
5
To address mother’s mental-health issues, the CPSW testified that she referred
mother to Hennepin County Mental Health Center (HCMHC) to complete her
psychological assessment. To accommodate mother while she was waiting for an
appointment, the CPSW referred mother to talk therapy until she could complete the
psychological evaluation at HCMHC. Although mother went to a few therapy sessions,
she never completed the psychological evaluation. The CPSW learned from the provider
that mother was unwilling to talk about her mental health and only wanted to discuss her
relationship with father and the children returning to her care instead. The CPSW further
opined that mother’s failure to address her mental-health issues “make[s] it difficult for her
to keep the children’s wellbeing in focus” and expressed concern that mother would
continue to struggle with domestic violence in the foreseeable future because she had
difficulty abiding by the current OFP that father had against her. The CPSW testified that
mother would violate the OFP by texting father about matters not relating to the children,
and that she would go to his apartment to leave money. The district court found the social
worker’s testimony to be credible.
The CSW testified that it was in the children’s best interest to have mother’s parental
rights terminated because the children made significant progress while in foster care. The
CSW also expressed concern that if mother retained her parental rights, the environment
she would provide for the children would not be safe because mother and father had prior
interactions that involved law enforcement, and because mother had not shown that she
could meet the children’s medical and behavioral-health needs based on her lack of
demonstrated proper behavior at medical appointments. The CSW also testified that she
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did not see mother do anything dangerous to the children, appear to be on drugs or
intoxicated, or experience any mental-health crises. The district court found the CSW’s
testimony to be credible and persuasive in all respects.
The GAL testified that he had concerns regarding mother’s ability to meet the
children’s needs based on the reports from the county which documented mother’s inability
to demonstrate sobriety and because mother had refused to participate in supervised
visitation for several months prior to the trial. The district court found the GAL’s testimony
to be credible and persuasive.
Mother testified that she did not know what morphine, codeine, and
methamphetamine were, and that her daughter’s umbilical-cord test results came back
positive from “poppy seeds.” Mother testified adamantly that she had completed
everything in the case plan related to demonstrating sobriety and that when she called to
complete a chemical-dependency assessment she was “refused.” Mother also maintained
that she had not abused chemicals since October 2022 and that she had not historically had
issues with substance abuse. Mother further testified that she regularly communicated with
the social worker via text before mother blocked the social worker’s number in January
2024. When questioned about a text sent from mother’s phone to the social worker about
an “8 ball,”
5 mother testified that she did not know what an “8 ball” was and denied sending
the message. The district court did not find mother’s testimony about her drug use and

5 An “8 ball” is a slang term that generally refers to an amount of illicit drugs. See, e.g.,
Burns v. State, 621 N.W.2d 55, 59 (describing an “eight ball” as a quantity of
methamphetamine), rev. denied (Minn. Feb. 21, 2001).
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mental health credible but found her testimony about her love for her children and desire
to retain her parental rights credible.
Following the trial, the district court issued a detailed 57-page order terminating
mother’s parental rights. The district court found that the county made reasonable efforts
to reunite mother with her children by “mak[ing] referrals for [m]other to engage with
chemical dependency programming, mental health assessments and services, . . . parenting
education, and domestic violence programming.” The district court noted that the county’s
referrals included: “the HCMC color code program, the In-Home Peer S upport Program,
therapy at Nystrom & Associates, HCMHC, Phyllis Wheatley [Community Center, for
domestic violence programming], The Family Partnership, and the Family Enhancement
Center.” The district court found that “[w]henever possible, the [social worker] identified
providers who could provide culturally appropriate services to [m]other, and she requested
Hmong providers on her referrals” and that the county provided her with resources to
obtain a comprehensive assessment, even though she asked to be relieved of this
requirement. Additionally, the district court noted that it was difficult to determine whether
mother’s behavior during the visits with her children and during the trial “stemmed from
mental health symptoms or from using controlled substances.”
6
The district court also found that mother had not “made efforts to adjust the
circumstances, conduct, or conditions that led to the [c]hildren’s removal”; had not
“engage[d] in chemical dependency treatment or attempt to demonstrate sobriety since

6 The district court noted, consistent with the record, that mother had several outbursts
throughout the trial, often interrupting the proceedings.
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October 2022”; and “refused to take anti-psychotic medications or engage in a court-
ordered psychological evaluation over the past year.”
The district court found that the county presented clear and convincing evidence
that (1) three statutory grounds for termination were met, see Minn. Stat. §§ 260C.301,
subd. 1(b)(4), (5), (8) (2022); (2) the county made reasonable efforts to rehabilitate mother
and reunite her with her family; and (3) termination is in the best interests of the children.
Mother appeals.
DECISION
Appellant argues that the district court erred by finding that the county provided
reasonable efforts to address her chemical-dependency issues. We are not persuaded.
“A district court may terminate parental rights if (1) at least one statutory ground
for termination is supported by clear and convincing evidence, (2) the county made
reasonable efforts to reunite the family, and (3) termination is in the child’s best interests.”
In re Welfare of Child of J.H., 968 N.W.2d 593, 600 (Minn. App. 2021), rev. denied (Minn.
Dec. 6, 2021). Before a district court may terminate parental rights, it must make “findings
and conclusions as to the provision of reasonable efforts” by the county. Minn. Stat.
§ 260.012(h) (2024). These findings must include “individualized and explicit findings
regarding the nature and extent of efforts made . . . to rehabilitate the parent and reunite the
family.” Minn. Stat. § 260C.301, subd. 8(1) (2024). When determining whether
reasonable efforts have been made, the district court must consider whether the services
provided were:
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(1) selected in collaboration with the child’s family and, if
appropriate, the child;
(2) tailored to the individualized needs of the child and
child’s family;
(3) relevant to the safety, protection, and well- being of the
child;
(4) adequate to meet the individualized needs of the child
and family;
(5) culturally appropriate;
(6) available and accessible;
(7) consistent and timely; and
(8) realistic under the circumstances.

Minn. Stat. § 260.012(h).
This court reviews a district court’s factual findings of whether reasonable efforts
were made for clear error. See In re Welfare of Child. of S.E.P., 744 N.W.2d 381, 387
(Minn. 2008) (reviewing district court’s reasonable-efforts findings for clear error). We
defer to the district court’s credibility determinations of witnesses. In re Welfare of Child
of J.K.T., 814 N.W.2d 76, 90 (Minn. App. 2012). A finding is clearly erroneous if it is
“manifestly contrary to the weight of the evidence or not reasonably supported by the
evidence as a whole.” In re Welfare of Child. of T.R., 750 N.W.2d 656, 660-61 (Minn.
2008) (quotation omitted).
I. Mother did not forfeit her sufficiency-of-the-evidence challenge.
The county argues that mother forfeited the argument that it did not prove by clear
and convincing evidence that it made reasonable efforts to address her chemical-
dependency issue. We are not persuaded.
The county contends that mother forfeited her arguments that the county failed to
provide reasonable efforts because she did not raise them below. Generally, appellate
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courts will not consider matters not raised to the district court for the first time on appeal.
Thiele v. Stitch, 425 N.W.2d 580, 582 (Minn. 1988). Although mother argued that she did
not have a chemical-dependency issue at trial, on appeal mother challenges whether the
district court’s findings on this point are not supported by the evidence presented at trial.
Minn. R. Juv. Prot. P. 21.03 permits appellate courts to review whether a district court’s
findings are clearly erroneous, even if the party raising the question did not object to the
findings or did not make a motion to amend the findings below. See also In re Welfare of
Child of S.S.W., 767 N.W.2d 723, 733 (Minn. App. 2009) (concluding that, even when no
motion for new trial has been made, questions for review include “whether the evidence
sustains the findings of fact and whether such findings sustain the conclusions of law and
the judgment” (quotation omitted)). Because Minn. R. Juv. Prot. P. 21.03 allows a party
to argue that the evidence does not support the district court’s findings of fact, even if the
finding was not challenged below, we conclude that mother’s argument has not been
forfeited and is properly before this court.
II. The district court did not clearly err by finding that the county had made
reasonable efforts to reunite mother with her family.

As an initial matter, we note that mother’s challenge is limited to whether the district
court’s findings that the county made reasonable efforts to address her chemical-
dependency issue are clearly erroneous. Mother does not challenge the district court’s
statutory basis for termination its finding on the best interests of the children, or that the
county made reasonable efforts with respect to her mental-health issues and the provision
of other services. However, in analyzing whether the district court clearly erred in finding
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that the county made reasonable efforts, we must review the district court’s findings in
their entirety. See T.R., 750 N.W.2d at 660-661.
Reasonable efforts “are services that go beyond mere matters of form so as to
include real, genuine assistance.” In re Welfare of Child. of S.W., 727 N.W.2d 144, 150
(Minn. App. 2007) (quotation omitted), rev. denied (Minn. Mar. 28, 2007). The district
court must consider the amount of time the county has been involved in the case and the
quality of the efforts provided. In re Welfare of Child of A.M.C., 920 N.W.2d 648, 655
(Minn. App. 2018). But the type of services that constitute “reasonable efforts” are
dependent on the individual facts of the case. J.H., 968 N.W.2d at 601.
In support of her argument, mother cites to T.R., 750 N.W.2d at 664-65, in which
the supreme court reversed the district court’s termination of parental rights, concluding
that the county’s testing of the father, T.M., for chemical use, without more, did not
constitute a reasonable effort toward reunification when he demonstrated issues with
sobriety. The county made no effort to help T.M. understand the custodial proceedings,
despite a psychological assessment which showed that he lacked verbal skills and had a
lower average IQ. T.R., 750 N.W.2d at 666. In addition, T.M. acknowledged that he had
a chemical-dependency issue, complied with the case plan by obtaining suitable housing,
obtained full-time employment, attended the child’s school meetings, obtained health
insurance that would provide coverage for the child, and completed a psychological
assessment. Id. at 660. Also, the district court made no findings to suggest that there was
a causal connection between T.M.’s alcohol- and drug-use issues and his inability to care
for his child. Id. at 663.
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The facts of this case differ. In contrast to T.R., mother never acknowledged having
a chemical-dependency issue, at least during the TPR proceedings. Here, the county made
reasonable efforts to address mother’s chemical-dependency issues in light of her apparent
mental-health issues and culture by referring her to various providers, requesting Hmong
providers, offering to escort her to the lab at HCMC to provide a urine sample, and referring
her to in-home urine sampling and peer support. Moreover, the record shows that the
county continued to make reasonable efforts, even when mother thwarted those efforts by
failing to respond to the department, preventing the department from contacting her by
blocking various phone numbers, threatening the CPSW, and discontinuing visitation with
her children. Mother’s decision not to materially comply with the case plan or
meaningfully work with the county, despite its repeated efforts to assist her, hindered the
county’s ability to further assist mother in addressing her chemical-dependency issue. See
In re Child. of T.A.A. , 702 N.W.2d 703, 704-05, 707, 710 (Minn. 2005) (affirming
termination of parental rights when mother refused to accept responsibility to protect her
children from abuse, denied drug use, and refused to recognize and address her children’s
special needs).
Mother contends that the county “was required to comply with the terms of the case
plan” and “provide reasonable efforts to [mother] to allow her the opportunity to
successfully complete her case plan.” We agree that the county must make reasonable
efforts toward reunification of families. However, that effort is not unilateral; it requires
participation from the county and the parent. See T.R., 750 N.W.2d at 665-66 (requiring
that both parties follow the case plan). The record shows that mother rejected the county’s
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efforts to address her chemical dependency. Notably, the county referred mother to obtain
a chemical-dependency assessment with Avivo. During a visit after the case was opened,
the social worker asked mother if she had completed the assessment and encouraged her to
complete it early to ensure that she was able to do it before she began addressing the other
aspects of the case plan. Mother never completed the assessment. Given the county’s
concern for mother’s mental health and its likely influence on her chemical-dependency
issues, the county referred mother to engage in talk therapy and attempted to connect her
with a Hmong provider. Even with these accommodations, mother never completed a
chemical-dependency assessment or a psychological assessment to address either of her
issues.
We conclude that the district court’s finding that the county provided reasonable
efforts to mother is supported by the record and not clearly erroneous.
Affirmed.