In re A.C., Minor Child

IN THE COURT OF APPEALS OF IOWA

No. 25-1404
Filed December 17, 2015

IN THE INTEREST OF A.C.,
Minor Child,

C.C., Mother,
Appellant.
________________________________________________________________

Appeal from the Iowa District Court for Dubuque County, Thomas J. Straka,

Judge.

A mother appeals the termination of her parental rights to one child.

AFFIRMED.

Myia E. Steines of Clemens, Walters, Conlon, Runde & Hiatt, L.L.P.,

Dubuque, for appellant mother.

Brenna Bird, Attorney General, and Lisa Jeanes, Assistant Attorney

General, for appellee State.

Kristy L. Hefel, State Public Defender, Dubuque, attorney and guardian ad

litem for minor child.

Considered without oral argument by Chicchelly, P.J., and Buller and

Langhholz, JJ.
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BULLER, Judge.

A mother appeals termination of her parental rights to a child born in 2024.

Because the father does not appeal, we focus almost entirely on facts relating to

the mother and the child. We reject the mother’s best-interests claim, request for

additional time, and permissive-exception claim.

Background Facts and Proceedings. To quickly sum up the mother’s

four previous termination cases, the Iowa Department of Health and Human

Services (HHS) first became involved with this family in April 2021 after the father

strangled the mother in the presence of two of the child’s older siblings. Between

December 2022 and September 2023, all four of the child’s older siblings were

removed and adjudicated as children in need of assistance (CINAs) after HHS

found numerous child abuse allegations credible. In January 2025, the juvenile

court terminated the parents’ rights to older siblings under Iowa Code

section 232.116(1)(f) and (h) (2025). The mother appealed, and a panel of this

court affirmed. In re T.K., No. 25-0424, 2025 WL 1704330, at *4 (Iowa Ct. App.

June 18, 2025).

In November 2024, the child at issue here was born. The child was born

with a hole in her heart and a chronic respiratory condition, and she spent a month

in a neonatal intensive care unit (NICU). Despite notice and opportunity, the

mother didn’t attend any of the child’s follow-up medical appointments. Medical

personnel explained to the HHS worker who attended the appointments that the

child’s condition is aggravated by cigarette smoke. The mother smoked cigarettes

through termination, but she disputed whether HHS told her to quit smoking.
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On the same day the child was born, the juvenile court ordered temporary

removal under Iowa Code section 232.95. The court also appointed a guardian ad

litem (GAL). HHS placed the child in foster care. And in early 2025, the juvenile

court also adjudicated the child as CINA. After a dispositional hearing, the court

ordered the mother to maintain suitable housing and employment, participate

consistently in mental-health services, and cooperate with HHS and providers.

The mother had been living at a shelter in Dubuque since October 2023. In

March, the mother moved out of the shelter and into a friend’s home in Eldora,

closer to the mother’s family. While staying with her friend, the mother refused to

allow HHS or other service providers to inspect the house. The mother attempted

to secure income-based housing, but the application required proof of income, and

she didn’t resume working until June. In June, the mother moved to the child’s

maternal great grandmother’s house, which HHS had previously determined was

unsafe for children. The day before the termination hearing, the child’s maternal

grandmother moved into a new house and suggested the mother could stay there

until her income-based housing application was approved.

As to the mother’s mental health, she participated in an intake appointment

and a single therapy session before termination. She also never progressed

beyond supervised visits with the child. HHS, service providers, and the GAL all

expressed concerns with the mother’s ability to independently care for an infant as

of trial or in the near future. The GAL questioned the mother’s “ability to internalize

the parenting skills needed to care for an infant, especially one with chronic

respiratory issues, without constant supervision and additional assistance.” During

visits, HHS required the mother to change into fresh clothes and wash her face
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and hands before interacting with the child to limit the child’s exposure to cigarette

smoke. In April, during a supervised visit, the child had to be rushed to the

emergency room after she started coughing, drooling, and turning red in reaction

to residual cigarette smoke on the mother. The mother panicked and the

grandmother and foster parents had to intervene to suggest medical intervention.

The child has lived with the same foster family since leaving the NICU. And

the child is well adjusted and bonded to the foster family. The foster parents take

excellent care of the child and are open to adoption.

The county attorney, HHS, and the GAL recommended termination of

parental rights. The juvenile court terminated the mother’s parental rights under

Iowa Code section 232.116(1)(g) and (h). The mother appeals, and we review de

novo. See In re W.M., 957 N.W.2d 305, 312 (Iowa 2021).

Best Interests. Because the mother does not contest the statutory grounds

for termination, we consider first whether termination is in the child’s best interests.

See, e.g., In re P.L., 778 N.W.2d 33, 40 (Iowa 2010). In assessing 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).

The mother’s petition on appeal conflates best interests with the permissive bond

exception at section 232.116(3)(c). See, e.g., In re L.A., 20 N.W.3d 529, 534–35

(Iowa Ct. App. 2025) (en banc) (“Conflating the [best-interests] and [permissive-

exception] steps based on a claimed bond with the child is not uncommon.”). To

the extent she urges the bond is independently relevant to her best-interests

argument, we are not persuaded it shifts the calculus. We, like the juvenile court,
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find termination is in the child’s best interests. The child’s respiratory system is so

compromised that the child had to be admitted to the emergency room after being

aggravated by the residual smoke on the mother’s clothes and hair during a visit.

Yet the mother has not quit—or even cut back on—smoking cigarettes despite

HHS discussing the safety risk to the child with her. And the mother seemed

unable to care for the child during this medical emergency without direction from

others. In contrast, neither we nor the juvenile court have any concerns about the

foster parents providing for the child’s medical needs.

Also, the mother’s housing situation remained unstable. Before moving in

with the great grandmother, the mother was living temporarily with a friend and

refused to allow HHS entry to inspect the home for safety concerns. And the great

grandmother’s house was already deemed unsafe for children. The GAL also

questioned the mother’s ability to care for a chronically ill child, given her poor

parenting skills and failure to attend the child’s medical appointments. Meanwhile,

the child is well-integrated into the foster parents’ home, and they understand and

address her medical needs. Termination is in the child’s best interest.

Bond Exception. The permissive bond exception permits the court to

decline termination if “termination would be detrimental to the child at the time due

to the closeness of the parent-child relationship.” Iowa Code § 232.116(3)(c). The

mother bore the burden to prove this exception by clear and convincing evidence.

In re A.S., 906 N.W.2d 467, 475–76 (Iowa 2018). And error preservation requires

a court to rule on a claim before we can decide it on appeal. E.g., Meier v.

Senecaut, 641 N.W.2d 532, 539 (Iowa 2002). Here, there was a passing mention

of a bond at trial, but no argument or ruling on this issue, so no preserved error for
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us to review. And even if error had been preserved, we wouldn’t thwart termination

because of the stability and safety afforded the child by termination and adoption

given this child’s unique medical needs and the mother’s unwillingness to change

her behavior to address them. See Iowa Code § 232.116(3)(c).

Six-Month Extension. The main thrust of the mother’s argument is that

the juvenile court erred by declining to grant a six-month extension of time for her

to work toward reunification. We assume without deciding that the mother

adequately preserved this issue. She frames her move to Eldora in March 2025

as forcing her to reset case expectations and asserts that, if given an extension,

she would continue to be compliant and cooperative with HHS and service

providers. But the mother was not adequately cooperating with HHS after the

move. She refused to allow HHS to inspect her housing in Eldora, and she only

attended a single therapy session for more than eight months. She also never quit

smoking despite the child’s respiratory condition. HHS, the GAL, and a provider

reported concerns with the mother’s ability to independently care for an infant

despite years of HHS involvement. The mother has not moved beyond supervised

visits or made the necessary case progression. Cf. In re L.H., 13 N.W.3d 627, 629

(Iowa Ct. App. 2024) (noting the parent “never progressed beyond fully-supervised

visits, which also prevented an immediate return of custody.”). On these facts, we

see no basis on which the court could have found the need for removal would no

longer exist after six months to justify an extension. See Iowa Code

§ 232.104(2)(b).

We affirm the termination of the mother’s parental rights.

AFFIRMED.