In the Interest of G.C. and L.C., Minor Children

IN THE COURT OF APPEALS OF IOWA

No. 22-1875
Filed April 12, 2023

IN THE INTEREST OF G.C. and L.C.,
Minor Children,

K.C., Mother,
Appellant,

JAMI J. HAGEMEIER,
Guardian Ad Litem-Appellant.

STATE OF IOWA,
Appellant.
________________________________________________________________

Appeal from the Iowa District Court for Polk County, Rachael E. Seymour,

District Associate Judge.

A mother appeals the termination of her parental rights. The State and the

guardian ad litem appeal the denial of the termination of the father’s parental rights.

AFFIRMED ON THE MOTHER’S APPEAL; REVERSED AND REMANDED ON

THE GUARDIAN AD LITEM’S APPEAL AND STATE’S APPEAL.

David V. Newkirk of Branstad & Olson Law Office, Des Moines, for appellant

mother.

Jami J. Hagemeier of the Youth Law Center, Des Moines, appellant and

guardian ad litem.
2

Brenna Bird, Attorney General, and Mary A. Triick, Assistant Attorney

General, for appellant State.

Considered by Schumacher, P.J., Ahlers and Buller, JJ.
3

SCHUMACHER, Judge.

We address three separate appeals in this opinion. A mother appeals the

termination of her parental rights to a set of two-year-old twins, G.C. and L.C. Both

the State and guardian ad litem (GAL) appeal the court’s order that denied

termination of the father’s parental rights to the twins.

We conclude clear and convincing evidence supports the termination of the

mother’s parental rights under Iowa Code section 232.116(1)(g) (2022). We also

conclude termination of the mother’s parental rights is in the children’s best

interest. And, like the juvenile court, we determine that no statutory exceptions

should be applied to preclude termination of the mother’s parental rights.

Accordingly, we affirm the juvenile court as to the termination of the mother’s

parental rights.

As to the State and GAL appeals, we determine the State established a

ground for termination of the father’s parental rights, termination of the father’s

parental rights is in the children’s best interest, and no statutory exception should

be applied to preclude termination of the father’s parental rights. We reverse the

decision of the juvenile court that declined to grant termination of the father’s

parental rights and remand for entry of an order terminating the father’s parental

rights pursuant to Iowa Code section 232.116(1)(g).

I. Background Facts & Proceedings

The cause of injury to G.C. in March 2022 was trauma. As described by Dr.

Nielsen, a member of the University of Iowa’s multi-disciplinary team, G.C. had

bilateral subdural hemorrhages—bleeding inside her skull but outside of her

brain— on both sides of her head. The radiology report revealed the hemorrhages
4

were subacute to chronic in nature, meaning the injury did not occur immediately

prior to G.C.’s March hospitalization.1 G.C.’s injuries were suspected to be

nonaccidental trauma, as her caretaker, the father, could provide no plausible

accidental cause for the extent of the injuries. Physical abuse was listed as the

highest concern.

Dr. Nielsen described G.C.’s trauma as a type of force that causes injury,

and for subdural hemorrhages, it is generally a large trauma, such as a motor

vehicle accident, falls from significant height of greater than four feet, a forceful

attack, or abusive head trauma. G.C. also presented at visits with the mother in

January and February 2022 with numerous bruises and scratches on her face and

other limbs, which the mother photographed. Dr. Nielson, in reviewing the images

of the bruises and scratches, however, could not say with certainty that they were

not from child play.2 But Dr. Nielsen did opine with a reasonable degree of medical

certainty that G.C.’s head injury was not from being knocked over by a family pet,

a normal toddler fall, or from banging her head against things, all explanations

offered by her father. Dr. Nielsen also noted that following a hematology consult,

1 G.C. required medical care in January 2022 after the father’s wife reported she
found G.C. unresponsive. Dr. Nielsen testified that G.C.’s January medical event
was not outside the realm of possibility for the date of the incident causing the
subacute hematoma.
2 G.C. was also discovered to have a torn upper labial frenulum, the tissue that

connects the upper lip to the gums. This injury was not able to be determined to
be inflicted and it could not be ruled out that the torn upper labial frenulum was
caused by G.C. having a normal toddler fall and hitting her mouth. Dr. Nielsen
noted G.C.’s teeth were in poor condition.
5

the hematology team did not feel that there was any underlying bleeding disorders

that contributed to G.C.’s subdural hemorrhage.3

To put G.C.’s injuries and the termination proceedings in the context of Iowa

Code section 232.116(1)(g), one of the grounds the juvenile court relied on for the

termination of the mother’s parental rights, and also the ground raised on appeal

by both the State and the GAL concerning the father’s parental rights, a timeline

of parental involvement with the court and Iowa Health and Human Services (HHS)

is essential.4

The mother has given birth to seven children, none of which are in her

custody. Her parental rights were terminated to four of the five children not

involved in the current appeal, with the fifth child being placed in the sole custody

of that child’s other parent. The father is the biological parent of four of the seven

children: M.M., B.C., and the twins involved in the instant proceedings. Like the

mother, none of the father’s children are in his custody. His parental rights were

previously terminated to M.M. and B.C.

The parents’ involvement with the Iowa HHS began in 2015 because of

domestic abuse the father perpetrated against the mother in front of two children.

In re M.M., No. 17-0237, 2017 WL 2461889, at *2 (Iowa Ct. App. June 7, 2017).

3 The juvenile court order noted an “abnormality in G.C.’s hematology labs which
requires a follow up lab work in a year with a hematologist to rule out any bleeding
disorders.” But Dr. Nielsen and the hematology team determined no underlying
bleeding disorders would have caused G.C.’s intercranial hemorrhage. And while
the father called a registered nurse to testify as an expert to G.C.’s injuries, this
witness had never examined the child. The father’s expert’s opinion was that the
injuries to G.C. were caused by trauma, nonaccidental or accidental, or a medical
condition. A specific medical condition was not identified in the record.
4 The State’s petition pled a single statutory ground with respect to the father–

section 232.116(1)(g).
6

Concerns in that case centered primarily on the parents’ unhealthy and

domestically violent relationship, including a pattern of dishonesty by both parents

as it related to disclosing their relationship to providers and the court. Id. The

father also used methamphetamine. The juvenile court terminated the parental

rights of both parents under Iowa Code section 232.116(1)(h) (2016). Termination

of the father’s parental rights was affirmed on appeal. Id. However, on appeal,

this court reversed the juvenile court’s order terminating the mother’s parental

rights, focusing on the mother’s progress in separating from the father by moving

to Missouri. Id. at *3.

The mother’s progress was short-lived. It was discovered that the mother

had been dishonest about her relationship with the father. In re M.M., No. 19-

0598, 2019 WL 3317403, at *2 (Iowa Ct. App. July 24, 2020). She minimized the

father’s domestic abuse and failed to prioritize her relationship with her child,

frequently missing visits. Id. The juvenile court terminated her parental rights to

M.M pursuant to Iowa Code section 232.116(1)(h) (2018). That decision was

upheld on appeal. Id. at *3.

The parents were involved in proceedings again for two more children, A.M.

and J.C.5 See In re A.M., No. 19-1735, 2020 WL 825975, at *1 (Iowa Ct. App.

Feb. 19, 2020). A.M. tested positive for methamphetamine. Id. at *2. The mother

struggled to maintain stable housing and continued her unhealthy relationship with

the father. She made light of the dangers the father posed to her and the children.

5 The mother is the biological parent of both A.M. and J.C. The father was
determined through paternity testing not to be the biological parent of either child,
although he acted as a legal parent to A.M. The rights of any putative fathers of
the children were terminated.
7

Id. at *3. The father, for his part, was often aggressive with providers, including

while on the witness stand. The mother’s parental rights to both children were

terminated under Iowa Code section 232.116(1)(g) and (h) (2019), which was

affirmed by this court.6 Id. at *2-3.

The State moved to terminate the parents’ rights to another child, B.M., in

late 2019. See In re B.M., No. 20-0609, 2020 WL 4207406, at *2 (Iowa Ct. App.

July 22, 2020). Reasonable efforts were waived in that case because the parents

had failed to make sufficient progress since 2015 despite services focused on

mental health, domestic violence, and substance abuse. Id. Once again, the

parents were dishonest about the nature and extent of their relationship.

The juvenile court noted in the termination order that “both parents are

either unable or unwilling to take the necessary steps to provide a safe and stable

home for the child free from domestic violence or substance abuse issues and

neither additional time or services would correct the situation.” Id. Stable housing

remained an issue. Id. And the father had to be hospitalized for excessive drinking

in 2019. Id. at *4. In the order of termination, the juvenile court noted, “The Court

has seldom seen individuals have so few qualms about repeatedly lying under

oath. The only thing the Court can trust about the parents’ statements is that they

will say whatever they believe will best serve their immediate needs or position.”

The juvenile court terminated the parents’ rights under section 232.116(1)(g),

which was affirmed on appeal. Id. at *3-4.

6This court affirmed as to section (h) but did not consider (g). See A.M., 2020 WL
825975, at *3.
8

G.C. and L.C., the children at issue in the instant appeal, were born

prematurely in June 2020. The children were removed from parental custody in

July upon release from the neonatal intensive care unit and placed in the custody

of a relative who had adopted A.M. and J.C. HHS was primarily concerned about

the parents’ unresolved domestic abuse issues, including the father’s anger and

controlling behavior and the mother’s lack of insight into his abuse; their lack of

protective capacity; and the father’s substance abuse. There were also ongoing

issues with contact between the parents. The children were adjudicated in need

of assistance (CINA) pursuant to Iowa Code section 232.2(6)(c)(2) and (n) (2020).

Paternity testing established the father was a biological parent of the twins in

September.

The father married J.M. in June 2020, who had four children from a prior

relationship.7 J.M.’s children in the home were ages six, three, three, and two.

J.M.’s children were safety planned out of the home for a period following G.C.’s

hospitalization in March 2022 but were later reunited with their mother.

Following paternity confirmation, the father participated in Safe Care, a

child-parent psychological assessment, individual therapy, marriage counseling,

and maintained a job and housing. He and his therapist focused on his anger,

including coping with triggers. They have also focused on overcoming the “trauma

bond” he shares with the mother. The father obtained a new individual therapist

upon HHS’s request in May 2022.

7The juvenile court’s order noted that the father’s wife had previously testified she
knew the father for six months before their marriage. The father later testified he
has known his new wife for twelve years.
9

Despite the work on the toxic relationship with the mother, the father had

ongoing contact with the mother from the fall of 2021 through February 2022. The

substance of the communications—which included phone calls and text

messages—were frequently inappropriate, including the father asking the mother

for sexually explicit photos and exhibiting controlling behavior, such as inquiring

about her whereabouts and what vehicle she was driving. The messages also

indicate the mother hung-up on the father repeatedly, which angered him. The

communications only came to the attention of HHS after the mother disclosed the

taped conversations in March 2022. The father, while not denying the

inappropriate nature of the messages, contends the messages and phone calls

were focused on co-parenting.

Following a permanency hearing, the court granted the father an additional

six-months for reunification efforts. The twins were placed in the father’s custody

in September 2021, about fifteen months after the initial removal. The stay in the

father’s custody was brief. In January, G.C. required hospitalization after the

father’s wife reported G.C. had a seizure. G.C. was taken to the hospital, where

staff recommended she see a neurologist. After G.C’s release from the hospital

to her father, the father failed to schedule this neurological appointment. Then, in

early March, G.C. was rushed to the hospital after the father’s wife reported she

had found G.C. unresponsive. The father had not yet scheduled the neurology

appointment recommended two months earlier.

G.C. was transported to the University of Iowa Hospitals where testing

concluded G.C. had suffered trauma to the head, which a medical expert ascribed

to either a car crash, a fall from over four feet high, or abuse. The father suggests
10

G.C.’s injuries resulted from the child being clumsy, being knocked over by one of

the family pets, or that G.C. caused the injury herself by self-soothing, in banging

her head against a wall. G.C. underwent surgery and a shunt was placed in her

head, allowing fluid to drain from her head into her stomach. Due to the

unexplained injury and the discovery of ongoing communication between the

parents, the children were removed from the father’s custody and placed back in

the custody of the relative where they remained at the time of the termination

hearing.

Throughout G.C. and L.C.’s underlying CINA case, the mother’s

involvement has been inconsistent. She did not have any contact with the children

from July 2021 until January 2022. Since March, she had two fully supervised

visits a month. She attended individual therapy designed to address her history of

enduring domestic violence but allowed contact with the father.

The juvenile court noted in the ruling filed June 2022 following a contested

permanency review hearing that placement outside the home remained

necessary, in part due to “the parents lack of protective capacity and numerous

unexplained injuries to G.C. resulting in hospitalization and brain surgery.”

The State petitioned to terminate the parents’ parental rights in April 2022.8

A hearing that lasted eight days began July 5 and ended August 25.9 On the first

8 While hearing on the termination petition was set for begin in June 2022, it was
continued to allow the permanency review and modification hearing to be
concluded.
9 Our appellate record also contains the transcript from the contested permanency

review hearing which was held on April 6, May 13, May 31, and June 21, 2022.
Portions of this hearing were judicially noticed into the termination proceedings,
specifically the testimony of Dr. Nielsen and Katherine Thornton. Our appellate
record does not contain the transcript from the permanency hearing.
11

day of trial, the mother orally consented to the termination of her parental rights,

asserting it was in the children’s best interests. The mother did not attend the next

six days of the hearing. She re-appeared on the final day of the hearing,

August 25, and orally revoked her consent. She later filed a motion titled,

“Revocation and Rescission of Consent to Terminate Parental Rights” on

September 8, along with a request for a six-month extension.

The HHS case manager testified that the father continued to do only the

minimal amount. And the father only disclosed minimal information, which he had

done historically in past cases. She stressed that since the father was dishonest

with his own treatment providers, he was not making progress. “When you’re

continuing to lie and hide, you’re just not able to address your needs, and so you

can go to therapy or treatment and sit there, but you’re not really engaging

meaningfully in that service.” And the case manager, who had been involved with

the parents since the filing of the underlying CINA petition, added:

I think Dad has been trying to stress that in the last three
weeks he has started to make significant progress in his therapy
services, but I think that that’s been a pattern for him. I think that he
will consistently try to portray that he’s making progress in his therapy
services and then—and then something will come out, and then we’ll
start over in a sense or we’ll backpedal, and these children should
not have to wait any longer. It’s been almost two years of the back
and forth, and they deserve permanency.

The district court terminated the mother’s parental rights on October 31,

2022, pursuant to Iowa Code section 232.116(1)(a) and (g) (2022). But the court

declined to grant the State’s requested termination of the father’s parental rights.
12

The children remained placed out of parental custody.10 The mother, the State,

and GAL appeal.11

II. Standard of Review

Our review of the termination of parental rights is de novo. In re P.L., 778

N.W.2d 33, 40 (Iowa 2010). We examine both the facts and law, and we adjudicate

anew those issues properly preserved and presented. See In re L.G., 532 N.W.2d

478, 480 (Iowa Ct. App.1995). We give weight to the findings of the juvenile court,

especially concerning the credibility of witnesses, but we are not bound by them.

See id. at 480–81.

While giving weight to the findings of the juvenile court, our statutory
obligation to review termination proceedings de novo means our
review is not a rubber stamp of what has come before. We will thus
uphold an order terminating parental rights only if there is clear and
convincing evidence supporting termination of the parent’s rights.
Evidence is “clear and convincing” when there are no serious or
substantial doubts as to the correctness of the conclusions of law
drawn from the evidence.

In re D.H., No. 14-1965, 2015 WL 1055517, at *1 (Iowa Ct. App. Mar. 11, 2015)

(internal citations omitted).

We review the termination of parental rights in a three-step analysis. P.L.,

778 N.W.2d 39. We first examine “if a ground for termination exists under section

232.116(1).” Id. We then determine if termination is in the best interests of the

child. Id.; see also Iowa Code § 232.116(2). Finally, we may decline to terminate

parental rights if any exception found in section 232.116(3) applies. Id.

10 Although the order entered following the termination hearing originally placed
custody of the twins with HHS for pre-adoptive placement, a nunc pro tunc order
later confirmed custody remained with a relative.
11 The State filed a responsive brief to the mother’s appeal; the father did not file a

responsive brief to the State and GAL’s appeals.
13

III. Mother

The mother appeals the termination of her parental rights. She claims the

State failed to establish a ground for termination, termination is not in the children’s

best interests, and that her close bond with the children should prevent termination.

A. Ground for Termination

The district court terminated the mother’s rights under section 232.116(1)(a)

and (g). “When the juvenile court terminates parental rights on more than one

statutory ground, we may affirm the juvenile court’s order on any ground we find

supported by the record.” In re A.B., 815 N.W.2d 764, 775 (Iowa 2012). We

choose to focus on section 232.116(1)(g). That section is met when the court finds

all of the following:

(1) The child has been adjudicated a child in need of
assistance pursuant to section 232.96.
(2) The court has terminated parental rights pursuant to
section 232.117 with respect to another child who is a member of the
same family or a court of competent jurisdiction in another state has
entered an order involuntarily terminating parental rights with respect
to another child who is a member of the same family.
(3) There is clear and convincing evidence that the parent
continues to lack the ability or willingness to respond to services
which would correct the situation.
(4) There is clear and convincing evidence that an additional
period of rehabilitation would not correct the situation.

We agree with the juvenile court that the State provided clear and convincing

evidence to support termination of the mother’s parental rights under Iowa Code

section 232.116(1)(g). The mother has been absent for a bulk of the proceedings,

electing not to see her children for seven months. Her participation in services has

been minimal. She has not consistently addressed her mental health needs. She

has failed to demonstrate a stable living arrangement. We determine an additional
14

period of time, given the mother’s previous seven years of involvement with HHS

and her performance in the current case, will not correct the situation.12

B. Best Interests of the Children

The mother claims termination is not in the children’s best interests. When

considering the children’s best interests, we “give primary consideration to the

child's safety, to the best placement for furthering the long-term nurturing and

growth of the child, and to the physical, mental, and emotional condition and needs

of the child.” Iowa Code § 232.116(2).

We find termination is in the children’s best interests. First, the mother

conceded at the termination hearing that termination was in the children’s best

interests. She did not see the children at all from July 2021 until January 2022, at

which point she only saw the children twice a month. She has not progressed

beyond supervised visits. The children have never lived with the mother.

While the mother appears to have made some progress addressing her

unhealthy relationship with the father, such progress tracks a long history—

beginning in 2015—of making apparent progress only to regress shortly afterward.

See In re C.B., 611 N.W.2d 489, 495 (Iowa 2000) (“Insight for the determination of

the child’s long-range best interests can be gleaned from ‘evidence of the parent’s

past performance for that performance may be indicative of the quality of the future

care that parent is capable of providing.’” (citation omitted)). “This is

unquestionably one of those unfortunate cases in which a parent progresses and

12Because we find the State proved the statutory ground under Iowa Code section
232.116(1)(g), we do not address the statutory ground relied on concerning the
mother’s consent under Iowa Code section 232.116(1)(a).
15

regresses, the progress is not enough to have the child returned to their care, and

matters simply reach a point at which the child’s best interests command

permanency and stability.” In re I.S., No. 20-0976, 2020 WL 6481088, at *4 (Iowa

Ct. App. Nov. 4, 2020). The children need permanency. Termination of the

mother’s parental rights is in their best interests.

C. Statutory Exception to Termination

While we question whether the mother preserved this issue, we elect to

reach the merits of the mother’s claim. The mother asserts her close bond with

the children should prevent termination. See Iowa Code § 232.116(3)(c). But the

mother bears the burden of establishing the applicability of any statutory

exceptions to termination. In re A.S., 906 N.W.2d 467, 476 (Iowa 2018). In her

petition on appeal, the mother does not highlight any facts suggesting a close bond

with the children, nor does she indicate how termination would be detrimental to

the children. Upon our review, it is evident the bond between the mother and

children is minimal. The mother elected not to participate in visits between July

2021 and January 2022. We decline to apply the exception to preclude termination

of the mother’s parental rights.

IV. Father

The State and GAL appeal the juvenile court’s decision declining to

terminate the father’s parental rights. The State sought to terminate the father’s

parental rights under section 232.116(1)(g). The juvenile court determined the

State had not established the last two elements by clear and convincing evidence.

The State and GAL assert the father continues to act dishonestly in regards to his

relationship and communications with the mother, has failed to meaningfully
16

address his anger and controlling behavior in therapy, failed to provide adequate

medical care to G.C., and has either failed to supervise or is actively abusing G.C.

We begin our analysis of the claims concerning the father by highlighting a

recent decision from our supreme court. When interpreting section 232.116(1)(g),

our supreme court has explained:

It is also the only ground that examines whether a “parent continues
to lack the ability or willingness to respond to services,” only applying
to those parents who continue to repeat their parenting wrongs in
spite of the services they’ve received in both the past and present
termination cases. [Iowa Code] § 232.116(1)(g)(3). Thus, unlike
other grounds for termination, which focus more on the parents’
behavior in the case at issue, the juvenile court must specifically
examine the parents’ past termination cases in deciding whether
termination is appropriate under Iowa Code section 232.116(1)(g).
The State still retains the burden of proof under section
232.116(1)(g), but the parents’ history of past terminations—
especially when those terminations were under similar
circumstances—is highly relevant in proving the parents lack the
ability or willingness to respond to services.

In re J.H., 952 N.W.2d 157, 166-67 (Iowa 2020).

The first two elements of the statute are met—G.C. and L.C. were

adjudicated CINA and the father’s parental rights have been terminated to two of

the children’s siblings. See M.M., 2017 WL 2461889, at *2; B.M., 2020 WL

4207406, at *4. The concerns in those cases were primarily the father’s anger and

domestic abuse, his ongoing contact with the children’s mother, dishonesty with

providers, and substance abuse.

In concluding that the State failed to meet it’s burden with respect to the

father, the juvenile court summarized the father’s compliance yet issued a warning:

However, Father has literally complied with every request [HHS] has
made of him, even after removal of these children, over his continued
denial of abuse. He has switched therapists, he has attended the
children’s doctor appointments, he drives almost an hour for his
17

visitation, he has abided by [HHS] visitation limitations, he continues
to attend individual therapy, he continues to attend couples therapy,
he has provided negative drug screens upon request, he has
completed parenting assessments and successfully discharged
child-parent therapy. He does continue to struggle with his toxic
relationship with Mother. However, testimony from Ms. Skogland-
Williams indicates they have not yet started addressing domestic
violence curriculum but have begun work on boundaries and how
Mother and Father’s boundaries have historically been unclear due
to the toxic nature of their relationship. As pointed out by Father’s
counsel, Father has responded to services in the past to address
safety issues, such as his substance abuse. Under this evidence,
the Court cannot find by clear and convincing evidence Father is
unwilling or unable to respond to services which could correct the
situation or that additional time would not correct the situation. If
going forward, Father fails to correct his failure to provide necessary
medical care, there are new incidents of domestic violence, is
engaged in relationship with unsafe persons, or confirmed reports of
physical abuse, the Court may make a different finding.

On our de novo review, we disagree. We determine the State established

by clear and convincing evidence that the father lacked the ability or willingness to

respond to services or that additional time would rectify the situation. The father

has been involved in services through the department since 2015, a period of

nearly seven years. A lack of protective capacity is not a new deficiency assigned

to the father. As noted by the juvenile court, the father has been more consistent

in services in the present case than in the past. But merely going through the

motions does not equate to being able to safely parent within an additional period

of time. See J.H., 952 N.W.2d at 168 (“Although Dad crossed participating in

therapy off of his list of services, we cannot say he made changes from it based

on the pattern of dishonesty he demonstrated with his therapist.”).

The father’s individual therapist acknowledged that the father continues to

face issues involving coping with his anger and overcoming a “trauma bond” he

shares with the mother. The father engaged in inappropriate communication with
18

the mother between fall of 2021 and February 2022. He only admitted this after

the mother produced recorded phone calls. And he did not provide this information

to his therapist until after the mother produced the evidence. The juvenile court

noted the father’s hostility at the permanency hearing and the parents’ continued

“toxic” relationship. Along with the previous years of extensive services, the father

has already been granted an extension of time for reunification of efforts following

the permanency hearing. And after that extension of time, the children were

removed for a second time due to the life-threatening injuries to G.C. At the time

of the current termination hearing, he denied he had any current issues with

domestic violence or that he was in need of domestic violence services. And he

blamed his prior terminations on the mother, indicating that “hooking up” with the

mother was the reason he “lost so many kids.”

Most concerning is the father’s unwillingness or inability to address the

trauma G.C. experienced in his home. He failed to schedule important medical

appointments for G.C., such as obtaining a neurologist. His explanation—there

was a busy signal when his wife called for an appointment and the father and his

wife were busy with other matters.

The father denies abuse of G.C. by himself or his new wife. He offers no

plausible accidental event that could have caused the trauma to G.C. The record

is clear that G.C. was placed with the father when the injuries occurred and the

father failed to provide appropriate medical care. See, e.g., In re S.H., No. 03-

0059, 2003 WL 1056591, at *2-3 (Iowa Ct. App. Mar. 12, 2003) (affirming

termination of parental rights when mother in charge of the child who sustained

life-threatening injuries could not give a valid explanation as to how the injuries
19

occurred and did not seek treatment for them). And as noted, the children have

been removed on two separate occasions during the underlying CINA proceeding,

extending for two years. They are young, unable to self-protect, and the time has

long past for permanency given their ages. G.C. and L.C. have been out of

parental custody for all but approximately five months of their lives.

“Children simply cannot wait for responsible parenting.” A.S., 906 N.W.2dat

474 (quoting In re C.K., 558 N.W.2d 170, 175 (Iowa 1997)). “While we recognize

the law requires a ‘full measure of patience with troubled parents who attempt to

remedy a lack of parenting skills,’ Iowa has built this patience into the statutory

scheme of Iowa Code chapter 232.” In re Z.P., 948 N.W.2d 518, 523 (Iowa 2020)

(per curiam) (quoting C.B., 611 N.W.2d at 494). The legislature carefully

constructed this time frame to balance the parent’s efforts toward reunification and

the child’s best interests. Id. at 524. For the twins’ age, that time frame is six

months, and then “termination proceedings must be viewed with a sense of

urgency.” Id. at 523-24 (quoting C.B., 611 N.W.2d at 495).

While the father has gone through many years of extensive services, there

is clear and convincing evidence that the father continues to lack the ability or

willingness to respond to services which would correct the situation and there is

clear and convincing evidence that an additional period of rehabilitation would not

correct the situation. Despite years of court intervention and HHS reasonable
20

efforts, the children are not safe with the father and on this record, we determine

that an additional period of rehabilitation will not correct this situation.13

AFFIRMED ON MOTHER’S APPEAL; REVERSED AND REMANDED ON

GUARDIAN AD LITEM’S APPEAL AND STATE’S APPEAL.

13 For the same reasons, on our de novo review, we determine termination of the
father’s parental rights is in the children’s best interests. And on our careful review
of this record, we decline to apply any exception found in section 232.116(3) to
preclude termination.