In the Interest of S.H., Minor Child

IN THE COURT OF APPEALS OF IOWA
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No. 25-2005
Filed February 11, 2026
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In the Interest of S.H., Minor Child,
M.T., Mother,
Appellant,
W.H., Father,
Appellant.
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Appeal from the Iowa District Court for Woodbury County,
The Honorable Kristal Phillips, Judge.
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AFFIRMED ON BOTH APPEALS
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Molly Vakulskas Joly of Vakulskas Law Firm, P.C., Sioux City,
attorney for appellant mother.

Marchelle M. Denker of Juvenile Law Center, Sioux City,
attorney for appellant father.

Brenna Bird, Attorney General, and Michelle R. Becker,
Assistant Attorney General, attorneys for appellee State.

Maxine Buckmeier, Sioux City,
attorney and guardian ad litem for minor child.
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1
Considered without oral argument
by Tabor, C.J., and Badding and Langholz, JJ.
Opinion by Tabor, C.J.

2
TABOR, Chief Judge.

A mother and father separately appeal the termination of their parental
rights to their toddler daughter, S.H.1 We find the State presented clear and
convincing evidence that the child cannot be returned to their custody and it
serves her best interests to terminate their parental rights.

The disturbing prelude to this case occurred in 2019 when the father
pleaded guilty to second-degree manslaughter for the death of his two-
month-old daughter in Minnesota. After drinking and smoking marijuana, he
put a heavy quilt over the crying infant’s face, suffocating her. Because of the
father’s drug use and criminal history, the Hennepin County Department of
Health and Human Services were already involved with the family. The
father voluntarily terminated his parental rights to two other children.

Moving to this case. S.H. was born in March 2024. The Iowa
Department of Health and Human Services intervened from the start
because of the father’s history. Plus, current events were concerning. The
mother tested positive for methamphetamine. The father tested positive for
THC but had a medical marijuana card and said he didn’t smoke around the
baby. The juvenile court adjudicated S.H. as a child in need of assistance
(CINA), and the parents agreed to a safety plan and voluntary services.

That spring and summer held more trouble for the family. The
department received two tips that they were using drugs, but investigations
did not confirm the reports. In July, a hair stat test on S.H. was positive for
methamphetamine and THC. The parents agreed to stay with a cousin as
1
We review termination-of-parental-rights proceedings de novo. In re A.S., 906
N.W.2d 467, 472 (Iowa 2018). “We are not bound by the juvenile court’s findings of fact,
but we do give them weight, especially in assessing the credibility of witnesses.” Id.
(citation omitted).

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part of another safety plan, which broke down almost immediately. The court
approved S.H.’s removal from her parents, and the department placed her in
foster care. The parents’ participation in services and visitation was mixed at
best. They attributed their mediocre performance to turnover in their service
providers and difficulties scheduling around their jobs. Communication and
transportation were also obstacles. And the parents were not always truthful
with the department or service providers.

Fast forward to fall 2025. The parents had an apartment and jobs. The
mother completed substance-use treatment and had all negative drug tests.
The father participated in a few court-ordered therapy sessions. Meanwhile,
S.H. remained with her foster parent. At the time of the termination hearing,
S.H. was about eighteen months old.

Although S.H. appeared healthy at birth, over the year that she was
out of parental custody, her dire medical condition revealed itself. At the
termination hearing, her foster mother testified in detail about the child’s
potentially life-threatening diagnoses, the precariousness of her day-to-day
health, the medications she takes and treatments she undergoes, and the
need for careful daily monitoring of her symptoms.

The foster mother also testified that the parents rarely attended S.H.’s
medical appointments. She estimated out of more than fifty appointments in
the last year, the parents attended less than ten, either in person or virtually,
despite the foster mother calling them at every appointment. The foster
mother also offered the parents rides to S.H.’s appointments, which were
sometimes in Sioux Falls or Omaha. The parents’ unfamiliarity with their
child’s serious medical condition came through in their testimony. Neither
parent could identify the host of S.H.’s health concerns, her providers,

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medications, necessary medical equipment or how to use it, nor the signs to
watch for that required immediate medical attention.

After absorbing that telling testimony, the juvenile court terminated
both parents’ rights under Iowa Code section 232.116(1)(h) (2025). They
appeal separately.

We review termination proceedings in three steps. In re A.B., 957
N.W.2d 280, 294 (Iowa 2021). First, we evaluate whether the State has
proven a statutory ground under Iowa Code section 232.116(1). Id. Second,
we assess whether terminating parental rights is in the child’s best interests
under section 232.116(2). Id. Third, we consider whether any exceptions in
section 232.116(3) preclude termination. Id.

The parents object to termination under section 232.116(1)(h).2 They
argue the State presented insufficient proof of the fourth element, which
requires clear and convincing evidence that the child cannot be returned to
parental custody at the present time as provided in section 232.10. 3 Iowa

2
Much of the termination hearing focused on the department’s reasonable efforts
to reunite the family. See Iowa Code § 232.102; In re C.B., 611 N.W.2d 489, 493 (Iowa
2000). The State bears the burden of showing the department made “reasonable efforts
as a part of its ultimate proof the child cannot be safely returned to the care of a parent.”
In re S.O., 967 N.W.2d 198, 209 (Iowa Ct. App. 2021) (citation omitted). In February 2025,
the juvenile court found the department failed to make reasonable efforts for the family in
October, November, and December 2024, due to “issues with the provision of the family
centered services, including visitation.” In the same order, the court found the
department corrected the concerns. And at termination, the court again found the
department made reasonable efforts. On appeal, neither parent reprises their reasonable-
efforts challenge.
3
Our caselaw offers two formulations for what it means when a child “cannot be
returned” to parental custody as provided in section 232.102, which discusses transferring
the child’s custody if staying in the home would be “contrary to the welfare of the child.”

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Code § 232.116(1)(h)(4); In re L.M., 904 N.W.2d 835, 839 (Iowa 2017)
(finding “at the present time” means the date of the termination hearing).

The mother argues she is sober, has a stable home, and is ready to
provide “the minimal level of care” required to resume custody of S.H. The
father also points to their “appropriate housing” and his positive interactions
at visitation. Both parents cite their lack of financial resources as a barrier and
argue it shouldn’t prevent the court from returning S.H. to their custody.

True, the mother allayed concerns about her drug use by completing
treatment and demonstrating her sobriety with negative drug tests. But the
biggest roadblock to reunification at the time of termination hearing was the
parents being ill-prepared to handle S.H.’s complex medical condition. They
insist that they didn’t need to know her medications or use her equipment
during their visitation hours. Yet it was knowledge about their daughter they
should have gleaned by attending her doctor’s appointments or asking for
updates from the foster parent. But whether the parents lacked the interest
or the aptitude, they did not ready themselves to take over her care. They
also could have improved their understanding of her medical needs by
working toward unsupervised or overnight visitation. That never happened
because they were inconsistent with attendance until just before termination
when visits were moved to their home.

In contesting termination, the parents complain that the department
has been unfair to their family through “moving of the goal post” during the

See In re M.M., 483 N.W.2d 812, 814 (Iowa 1992) (holding child cannot be returned if
return exposes child to “any harm amounting to a new [CINA] adjudication”); In re T.W.,
No. 20-0145, 2020 WL 1881115, at *1–3 (Iowa Ct. App. Apr. 15, 2020) (collecting cases
specifying an inability to “safely return” children to the parents’ care). Under either
formulation, the State met its burden of proof here.

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CINA proceedings. But the reality is that S.H.’s serious medical needs
emerged over time. And the parents failed to rise to the occasion. Our cases
commonly consider parents’ ability to deliver reliable care to children with
unique medical needs. See, e.g., In re J.H., 952 N.W.2d 157, 170 (Iowa 2020)
(upholding termination when young child had serious medical needs but
father was “content to sit back and let others care for J.H.”); In re J.M.,
No. 25-1570, 2025 WL 3654271, at *3 (Iowa App. Dec. 17, 2025) (citing
child’s complex medical condition and parent’s failure to attend doctor’s
appointments in support of termination). Here, we doubt whether either
parent could respond appropriately to the evolving demands of S.H.’s health,
especially in an emergency. Because her condition remained fragile, and the
parents were not equipped to handle her situation, we find clear and
convincing evidence that S.H. could not be returned to their custody at the
time of the hearing.

The same concerns inform the parents’ second contention. They
contend it is not in S.H.’s best interests to terminate their rights. At this step,
Iowa Code section 232.116(2) requires us to consider the child’s safety as
well as the best placement for furthering her long-term nurturing and growth,
including her physical, mental, and emotional condition and needs. S.H. has
been out of her parents’ care since she was four months old. In that time, the
parents have succeeded in some regards. And no doubt they love their child.
But their inaction surrounding her serious medical needs provides clear and
convincing evidence that they would not be a safe option to promote her
short- or long-term nurturing and growth.

AFFIRMED ON BOTH APPEALS.

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