In the Interest of A.B., Minor Child

IN THE COURT OF APPEALS OF IOWA

No. 23-0092
Filed March 29, 2023

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

A.B., Mother,
Appellant.
________________________________________________________________

Appeal from the Iowa District Court for Linn County, Cynthia S. Finley,

District Associate Judge.

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

AFFIRMED.

Mark D. Fisher, Cedar Rapids, for appellant mother.

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

General, for appellee State.

Kimberly A. Opatz of Linn County Advocate, Inc., Cedar Rapids, attorney

and guardian ad litem for minor child.

Considered by Bower, C.J., and Badding and Buller, JJ.
2

BADDING, Judge.

In the face of positive tests for methamphetamine and marijuana—for

herself and her child—the mother denied having a “drug problem.” Her denials

amid continued positive tests led the juvenile court to terminate her parental rights

to the child, born in 2019, under Iowa Code section 232.116(1)(h) (2022). The

mother appeals, challenging each of the steps in our termination framework—

though her focus is on the reliability of her sweat patch test results.

I. Background Facts and Proceedings

In January 2022, the mother brought the child to an emergency room in

acute respiratory failure. He was observed to be toxic-appearing with an ashen

gray color. The child’s urine screen was positive for marijuana. He was transferred

to a nearby hospital where hair testing showed systemic exposure to

methamphetamine and THC through ingestion or inhalation, along with

environmental or passive exposure to cocaine and cannabinoids.1 The mother’s

hair test was also positive for methamphetamine, yet she denied any use.

Instead, the mother theorized the child’s exposure to multiple drugs was

from a thirteen-year-old babysitter, the mother’s ex-boyfriend (although he did not

live with her or the child), or drugs the child was given in the ambulance or at the

hospital (which was ruled out by the hospital). As for her own positive test, the

mother thought that it could have been from someone putting methamphetamine

in her drink or sprinkling it on a pizza she had ordered.

1 The level of methamphetamine present in the child’s body was 25,458 pg/mg,
with “native THC” at 4307 pg/mg. To put those numbers into perspective, the
testing cut-off level for methamphetamine was 100 pg/mg and 40 pg/mg for native
THC.
3

The child was discharged from the hospital in early February, removed from

his mother’s care, and placed into foster care where he has since remained. He

was adjudicated as a child in need of assistance in April. The mother consistently

participated in supervised visits, completed a substance-abuse evaluation, and

was successfully discharged from extended outpatient treatment in July. She had

suitable housing, reliable transportation, and stable employment. And she had a

strong bond and positive interactions with the child.

But the mother could not consistently provide negative drug screens. Five

of her sweat patch tests were positive for methamphetamine and amphetamines,

while ten were positive for THC. She also had positive urinalyses for marijuana

metabolites, though many of those came after she obtained a medical marijuana

card in July to treat her recently-diagnosed anxiety. Yet the mother maintained

that she did not use any illegal substances. To combat what she said were false-

positive sweat patch tests, the mother submitted to urine tests every Monday,

Wednesday, and Friday at her substance-abuse treatment facility, where she

participated in a continuing care program. But even those were positive for THC

at what the mother’s case manager with the Iowa Department of Health and

Human Services said were high levels. And she also began testing positive for

alcohol.

The mother’s lack of “accountability for what happened [to the child], how it

happened or how she contributed to it,” led the department to recommend

termination of her parental rights. The State filed a petition in September. In a

report to the court before the termination hearing in December, the department’s

case manager summarized her concerns:
4

[The mother] has continued to deny any use of illegal
substances. She continues to report she only uses her medical
marijuana. She continues to test positive for methamphetamine.
[The mother] also provided multiple [urinalyses] . . . that were positive
for alcohol, but she doesn’t see this as an issue since alcohol is not
“part of her case.” [The mother] becomes aggressively defensive
and argumentative when trying to discuss anything with her. She
asks what she needs to do to move forward and [the case manager]
advises she needs to be substance free, and she argues that she is
and her [urinalyses] “cover her”. . . .
[The mother] has spent so much time being dishonest and
trying to hide things during this case that it has been impossible to
move forward . . . .

The case manager concluded that although the mother is bonded with the child,

“the safety risks are so significant that the need for safety outweighs any bond.”

The juvenile court agreed after hearing the parties’ evidence, ruling: “At trial,

[the mother] maintained her position that she does not use illegal substances, and

her alcohol consumption is minimal. . . . She was completely unable to take any

accountability and, therefore, it would be unlikely that she can make any lasting

change.” The court terminated the mother’s parental rights under Iowa Code

section 232.116(1)(h). The mother appeals.2

II. Analysis

We review termination proceedings de novo. See In re L.B., 970

N.W.2d 311, 313 (Iowa 2022) (noting that in conducting our de novo review, we

“give weight to the [court’s] factual findings but are not bound by them”). In

performing that review, we apply a three-step analysis that asks whether (1) a

statutory ground for termination is satisfied, (2) the child’s best interests are served

by termination, and (3) a statutory exception applies and should be exercised to

2 The father’s rights were also terminated. He has not appealed.
5

preclude termination. See id.; see also Iowa Code § 232.116(1)–(3). The mother

challenges each of these steps.

A. Ground for Termination

For her challenge to the statutory ground for termination, the mother only

contests the State’s proof of the final element of section 232.116(1)(h)—that the

child could not be returned to her custody at the time of the termination hearing.

See Iowa Code § 232.116(1)(h)(4); see also In re A.S., 906 N.W.2d 467, 473 (Iowa

2018) (examining whether there is clear and convincing evidence that “at the time

of the termination hearing, the child could not be safely returned” to the parent’s

custody). In arguing that the child “could have and should have been returned” to

her, the mother points to her urine tests, which were negative for all substances

“other than marijuana, for which she has a medical marijuana card, and alcohol,

which was not an issue in the case and has not been linked to safety concerns.”

To accept this argument, however, we would have to ignore the mother’s

six positive tests for methamphetamine. One of these positive results was from a

hair test at the beginning of the case. The other five were from sweat patches. At

trial, the mother testified to her belief that the negative urinalyses were more

reliable than the sweat patch tests. But she had no explanation for why the patches

were positive, testifying: “It’s just disappointing, because I haven’t touched

anything. I don’t know. And I wish that I could fix it. I would.” As for the child’s

positive drug tests, the mother continued to blame them on improbable sources,

insisting: “[I]t wasn’t from me doing anything around my son.”

Our court has said “that sweat-patch tests are a generally reliable method

for determining drug use,” though there may be “certain instances where [persons
6

testing positive] offer compelling reasons to believe that positive test results from

sweat patches are erroneous.” In re S.B., No. 19-1170, 2019 WL 4301591, at *3

n.1 (Iowa Ct. App. Sept. 11, 2019) (quoting United States v. Meyer, 483 F.3d 865,

68–69 (8th Cir. 2007)); accord In re K.T., No. 21-0670, 2021 WL 3075733, at *3

n.4 (Iowa Ct. App. July 21, 2021); In re A.C., No. 20-0736, 2020 WL 4516075, at

*2 (Iowa Ct. App. Aug. 5, 2020); In re A.W., No. 18-0382, 2018 WL 2084913, at *2

(Iowa Ct. App. May 2, 2018). The mother has not offered any reasons, let alone

compelling ones, to believe her five positive sweat patch tests were erroneous.

See United States v. Jittaphol, 598 F. Supp. 3d 22, 33 (D. Mass. 2022) (recognizing

that while “there is a risk that a single positive sweat patch result may be false, it

is less likely that two tests will result in false positives”).

The mother’s negative urine tests do not change our mind because, as the

juvenile court found, they were “unobserved and certainly not random, [and]

therefore, of little value in determining her sobriety.” See Meyer, 483 F. Supp. 3d

at 870 (noting the possibility for “individuals to escape urinalysis detection through

any number of devices and methods”). In addition, the department’s case

manager testified that in her experience, sweat patch tests “are more sensitive. . . .

[T]hey need a lesser amount to be positive . . . based on their different testing

mechanisms.” And she explained that sweat patches test for a longer period of

use than urinalyses: “methamphetamine goes through your system regarding

urinalysis testing very quickly.”

We have also considered allegations of the mother’s methamphetamine

use before this case began, including the mother’s positive test for cannabis and

methamphetamine when the child was born, an unconfirmed report to the
7

department in July 2021 that the mother was using methamphetamine while caring

for the child, and observations by the child’s daycare provider that led her to

“wonder[] if the mother is on drugs sometimes.” With this history, the juvenile court

“was rightly concerned about [the mother’s] lack of insight into the danger that her

methamphetamine addiction posed” to the child—a danger that was realized by

his hospitalization at the start of this case. See K.T., 2021 WL 3075733, at *3.

While the mother had some periods of sobriety, “we cannot overlook her persistent

denial of addiction,” not just to methamphetamine but to marijuana and alcohol as

well. See id.

Although the mother had a medical marijuana card for an anxiety diagnosis

in July, she did not obtain a mental-health evaluation until just before the

termination hearing. And she had no intention of participating in therapy because

she felt her anxiety was completely controlled with the “cannabis, the THC.” The

department, however, suspected she was using “regular old marijuana” given her

high test levels and her house smelling like marijuana, which the mother tried to

blame on a dead mouse under her couch. As for the alcohol, the mother testified

that she “barely drink[s],” despite six positive urinalyses for alcohol and a past

conviction for operating while intoxicated.

Given the harm the mother’s unaddressed addiction already caused the

child, her refusal to accept any responsibility for that harm, and her unabated use

of substances, we find clear and convincing evidence that the child could not be

safely returned to her custody. See In re L.F., No. 21-1760, 2022 WL 469596,

at *2 (Iowa Ct. App. Feb. 16, 2022) (finding a child could not “be returned safely to

the parents at present with their history of exposing children to methamphetamine
8

and their continued refusal to take any responsibility for this child’s exposure

before birth”).

B. Best Interests and Statutory Exception

Highlighting the positives—her housing, stable employment, reliable

transportation, and consistent visitation—the mother claims termination was not in

the child’s best interests. She argues that the child is “bonded with her and, other

than the allegation that [she] has used illegal substances, there does not appear

to be any serious concern regarding [the child’s] safety.”

The defining elements of a child’s best interests are safety and need for a

permanent home. See In re H.S., 805 N.W.2d 737, 748 (Iowa 2011); see also

Iowa Code § 232.116(2) (giving “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”). As

discussed above, we are not dealing with allegations of substance use but instead

multiple positive tests for methamphetamine, marijuana, and alcohol. The mother

has already demonstrated the child is not safe in her care, and she has done

nothing to change that situation with her continued insistence that she has “not

touched meth” or “been around anyone using.” See In re A.B., 815

N.W.2d 764, 777 (Iowa 2012) (considering a parent’s refusal “to acknowledge any

illegal drug use despite strong evidence to the contrary” in assessing a child’s best

interests). This, coupled with the child’s developmental growth and comfort in his

foster home, convinces us that termination of the mother’s parental rights is in his

best interests.
9

As for the permissive exception cited by the mother, Iowa Code

section 232.116(3)(c) authorizes the court to forgo termination when it “would be

detrimental to the child . . . due to the closeness of the parent-child relationship.”

See In re M.W., 876 N.W.2d 212, 225 (Iowa 2016) (noting the application of a

statutory exception to termination, if one exists, is “permissive, not mandatory”

(citation omitted)). We agree the record shows a loving connection between the

mother and her child. Yet we must give greater weight to the child’s safety and

need for a permanent home, which are best served out of the mother’s care given

her unresolved substance-abuse issues. See H.S., 805 N.W.2d at 748.

C. Additional Time

Buried within her requested relief, the mother suggests that we should

“extend the time for reunification by six months.” See Iowa Code §§ 232.104(2)(b);

.117(5). But she provides no substantive analysis or supporting authority for this

request. See Iowa R. App. P. 6.903(2)(g)(3); L.N.S. v. S.W.S., 854

N.W.2d 699, 703 (Iowa Ct. App. 2013). Even if she had, there is no evidence the

need for removal would no longer exist at the end of an extension because of her

insistence that she does not have a “drug problem.” See In re W.T., 967

N.W.2d 315, 323 (Iowa 2021) (“[T]he juvenile court may deny termination and give

the parent an additional six months for reunification only if the need for removal

‘will no longer exist at the end of the additional six-month period.’” (quoting Iowa

Code § 232.104(2)(b)); see also In re L.L., 459 N.W.2d 489, 495 (Iowa 1990)

(“Given [the father’s] past performance we are not convinced additional time or

services will change him.”).
10

For these reasons, we affirm the termination of the mother’s parental rights.

AFFIRMED.