Dependency Of J.n.c. Donna Lynn Ruble, Appellant V. Dshs, Respondent

:GU:rr OF APPEALS DiV
STATE OF WASh'INGTGh
2013 APR 29 	AH 10: 29
IN THE COURT OF APPEALS OF THE STATE OF WASHINGTON
In the Matter of the Dependency of J.N.C.
STATE OF WASHINGTON,
DEPARTMENT OF SOCIAL AND
HEALTH SERVICES,
Respondent,
v.
DONNA LYNN RUBLE,
Appellant.
No. 68859-6-1
DIVISION ONE
UNPUBLISHED OPINION
FILED: April 29, 2013
Appelwick, J. — For over two years after her son was found dependent, Ruble
failed to make progress toward addressing her parental deficiencies and remains in
denial about her substance abuse. 	The trial court terminated her parental rights. 	We
affirm.
FACTS
J.C. is blind, deaf, and appears to be autistic. 	He requires 24 hour care due to
his exceptional vulnerabilities. 	In July 2009, his older brother, D.C., called 911 to report
their mother's erratic behavior. 	As a result of his call, Donna Ruble was hospitalized for
being intoxicated. 	She had a blood alcohol content of .485. 	Ruble was subsequently

No. 68859-6-1/2
hospitalized two more times. 	D.C. reported similar behavior on those occasions, but
Ruble declined blood alcohol content tests at the hospital.
J.C. 	was 	removed 	from 	Ruble's 	custody 	in August 	2009. 	He was 	found
dependent in December 2009, when he was 	15 years old. 	The dispositional order
required Ruble to participate in a drug 	and alcohol evaluation and follow treatment
recommendations, 	participate 	in 	scheduled 	urinalysis 	testing, 	and 	complete 	a
psychological 	evaluation 	with 	a 	parenting 	component 	and 	follow 	treatment
recommendations. 	The psychological evaluation was to take place after Ruble provided
30 days of clean urine samples.
Ruble completed a substance abuse assessment at New Traditions in December
2009. 	Although it was recommended that she participate in inpatient drug treatment,
she unilaterally determined she only needed outpatient treatment. 	She attended only
two group sessions at New Traditions. 	After a month of not showing up for scheduled
sessions, she contacted her counselor, Shino Harada, and requested information about
other 	treatment 	agencies 	closer 	to 	her 	home. 	Harada 	gave 	Ruble 	the 	contact
information for Community Psychiatric Clinic and recommended that she enter a co-
occurring disorder group to address her mental health and substance abuse issues.
There is no indication that she followed-up on that referral.
Ruble 	participated 	in another substance 	abuse 	evaluation 	at Sound 	Mental
Health (SMH) in June 2010. 	SMH determined that Ruble was alcohol dependent and
recommended intensive outpatient treatment including four groups per week, four sober
support meetings per week, and two one-on-one sessions with her counselor per month
for 90 days. 	Ruble participated in treatment from June until December 2010. 	But,

No. 68859-6-1/3
during that time she was often non-compliant. 	She missed group sessions and sober
support meetings, and was altogether absent from treatment for extended periods of
time. 	Ruble was 	discharged 	in February 2011. 	Despite 	the 	fact that 	intensive
outpatient 	treatment 	normally 	takes 	90 	days 	and 	that 	Ruble 	was 	enrolled 	for
approximately nine months, she never completed the program.
In November 2010, Dr. Michael O'Leary issued a psychological evaluation report.
He diagnosed Ruble with "Alcohol Dependence (in early remission), Anxiety Disorder
Not Otherwise Specified, 	Parent-Child 	Relationship 	Problem, 	Rule-Out Somatoform
Disorder 	Not Otherwise 	Specified, 	and 	Mixed 	Personality 	Disorder with 	histrionic,
avoidant, and passive-aggressive features." 	Dr. O'Leary determined that Ruble was in
denial about her substance abuse, and he was unable to conceive of any services that
would be likely to remediate her deficiencies, because of the depth of her denial. 	He
opined that J.C. would be at active risk if he was placed with a caregiver with those
types of issues and stated that anyone involved in decision-making for J.C. should be
sober.
At hearings in March 2010, August 2010, December 2010, June 2011, November
2011, and April 2012, the court determined that Ruble had not made progress toward
remedying the parental deficiencies that necessitated J.C.'s removal. 	Meanwhile, J.C.
made significant progress in foster care. 	He gained weight and stamina, and improved
his self-care and occupational skills.
In October 2011, the State petitioned to terminate Ruble's parental rights. 	After
six 	days 	of 	testimony 	in April 	2012, 	the 	trial 	court 	entered 	findings 	of fact 	and
conclusions of law. 	Based on its findings, it terminated Ruble's parental rights. 	J.C.

No. 68859-6-1/4
was 	at that time 17 years old. 	In addition to citing J.C.'s specific needs, 	Ruble's
substance abuse, and Ruble's extreme level of denial, the trial court found that Ruble
was not a credible witness. 	It found that Ruble's "perception of events is often skewed
and self-serving," that her "recitation of history is not reliable or consistent," and that she
lied to 	substance abuse counselors and failed 	to 	follow 	court orders. 	In short, 	it
concluded that "truth is malleable" to Ruble.
DISCUSSION
Parents 	have a 	fundamental 	liberty interest in the care and welfare of their
children, and State interference is never to 	be taken 	lightly. 	In re 	Dependency of
Schermer. 161 Wn.2d 927, 941, 169 P.3d 452 (2007). 	But, the State has an interest in
protecting the physical, 	mental, and emotional 	health of children, 	as well. 	]d. 	To
terminate parental rights, the State must first prove the six elements of RCW 13.34.180
by clear, cogent, and convincing evidence. 	In re Dependency of K.N.J.. 171 Wn.2d
568, 576-77, 257 P.3d 522 (2011). 	Clear, cogent, and convincing evidence exists when
the 	ultimate fact 	in issue is shown 	by the evidence to 	be highly 	probable. 	In re
Dependency of K.R.. 128 Wn.2d 129, 141, 904 P.2d 1132 (1995). 	The six requirements
are:
(a) That the child has been found to be a dependent child;
(b) That the court has entered a dispositional order pursuant to
RCW 13.34.130;
(c) That the child has been 	removed or will, 	at the time of the
hearing, have been removed from the custody of the parent for a period of
at least six months pursuant to a finding of dependency;
(d) That the services ordered under RCW 13.34.136 have been
expressly 	and 	understandably 	offered 	or 	provided 	and 	all 	necessary

No. 68859-6-1/5
services, 	reasonably 	available, 	capable 	of 	correcting 	the 	parental
deficiencies 	within 	the 	foreseeable 	future 	have 	been 	expressly 	and
understandably offered or provided;
(e) That there is little likelihood that conditions will be remedied so
that the child can be returned to the parent in the near future....; [and]
(f) That continuation of the parent and child relationship clearly
diminishes the child's 	prospects for early integration 	into a stable and
permanent home.
RCW.13.34.180(1). 	Once these six statutory elements are met, the State must still
prove by a preponderance of the evidence that termination is in the best interests of the
child. 	RCW 13.34.190(1)(b); K.N.J.. 171 Wn.2d at 577.
On appeal, findings of fact must be supported by substantial evidence in light of
the clear, cogent, and convincing standard. 	State v. Broadawav, 133 Wn.2d 118, 131,
942 P.2d 363 (1997); K.N.J.. 171 	Wn.2d at 576-77. 	We do not weigh the evidence or
credibility of the witnesses. 	In re Welfare of Aschauer, 93 Wn.2d 689, 695, 611 	P.2d
1245 (1980). 	Rather, 	we give deference to 	the trial court's advantage in directly
observing witness testimony. 	|g\ 	Unchallenged findings of fact are verities on appeal.
In re Interest of J.F.. 109 Wn. App. 718, 722, 37 P.3d 1227 (2001).
Ruble argues that the State failed to establish that it promptly offered or provided
all necessary, reasonably available services, that the continuation of the parent-child
relationship clearly diminishes J.C.'s prospects for early integration into a stable and
permanent home, 	or that it is in J.C.'s best interests to terminate Ruble's parental
rights.1
1 	Ruble also assigns error to the trial court's findings that Ruble would not
adequately 	redirect 	J.C.'s 	inappropriate 	sexual 	behavior 	because 	she 	does 	not
recognize the problems with the behavior, and that the behavior is a learned trait that is
attributable to Ruble. 	But, she offers no argument in support of the assignment of error.
Failure 	to 	accompany 	an 	assignment 	of error with 	argument 	precludes 	appellate

No. 68859-6-1/6
I. 	Necessary, Reasonably Available Services
Ruble argues that the State did not meet its obligations in this case, because it
did not timely provide a referral for a psychological evaluation or offer a referral or
funding for mental health counseling. 	She contends that the State knew of Ruble's
need for mental health services even before J.C. was found dependent in December
2009, 	but did not refer her for a psychological evaluation until July 2010. 	Then, in
November 2010, the doctor who performed her psychological evaluation concluded that
any services that could be helpful to Ruble "would be outside of the timeframe allowed
the [State] for establishing permanency."
Ruble's argument disregards key facts. 	Ruble was to complete the psychological
evaluation after 30 days of clean urine samples. 	It is unclear when she first reached
that threshold, 	but the 	record establishes that as of March 2010 she had 	not yet
complied. 	And, although Dr. O'Leary testified that any services that could be helpful
would 	be 	outside of the 	State's timeframe, 	he was 	referring 	to 	substance 	abuse
treatment, not mental health services. 	His comments came in the broader context of
explaining the extraordinary level of Ruble's substance abuse. 	Due to the depth of her
abuse and the severity of her denial, he determined that any effective treatment would
be "very slow and gradual."
More importantly, Ruble was referred to mental health services. 	Shortly after the
dependency was entered in December 2009, Ruble was scheduled to begin substance
abuse treatment at New Traditions. 	She attended treatment only twice, and missed
consideration. 	Escude v. King County Pub. Hosp. Dist. No. 2, 117 Wn. App. 183, 190
n.4, 69 P.3d 895 (2003).

No. 68859-6-1/7
scheduled treatment on multiple occasions. 	In January 2010, Ruble called Harada and
asked for a 	referral to a different treatment program closer to 	her home. 	Harada
referred Ruble to Community Psychiatric Clinic and recommended that she participate
in a co-occurring disorder group that addressed her mental health and substance abuse
issues. 	There is no evidence that she followed up on that referral, despite the fact that
the dependency order required her to follow treatment recommendations. 	As previously
explained by this court, there is no requirement that all necessary, reasonably available
services be offered or provided by the State itself:
[T]he court may consider any service received, from whatever source,
bearing on the potential correction of parental deficiencies. 	This does not,
however, mean that the source of a service is necessarily immaterial. 	A
parent forced to search out services independently may need more time to
navigate the system, 	may have greater difficulty complying with court
orders, and may be undermined in efforts toward reunification.
In re Dependency of DA. 124 Wn. App. 644, 651-52, 102 P.3d 847 (2004) (footnote
omitted). 	Here, Ruble was not left to search out services independently. 	She was
promptly referred to a clinic closer to her home, as she requested. 	She received the
referral in the month after the dependency was entered. 	And, she makes no argument
that she was in any way delayed 	by the 	fact that the initial 	referral came from a
treatment provider instead of the State.
Further, later in the dependency she repeatedly misrepresented that she was
receiving 	mental health counseling. 	At a June 2011 	permanency planning hearing,
Ruble reported 	that 	she was 	receiving mental 	health services from 	Sound 	Mental
Health, but she did not sign the release that would allow the State to verify her report.
The court ordered her to sign the release. 	At a November 2011 dependency review

No. 68859-6-1/8
hearing, the court learned that Ruble had still not signed the release. 	The court again
ordered her to sign it. 	The State is not required to offer additional services when the
services are unlikely to correct parental deficiencies within the foreseeable future and
when offering services would be an exercise in futility. 	In re Dependency of P.P.. 58
Wn. App. 18, 26-27, 792 P.2d 159 (1990).
Ruble 	was 	referred 	to 	mental 	health 	counseling 	by 	her 	substance 	abuse
counselor early on in the dependency. 	Under the dependency order, she was ordered
to follow all treatment recommendations. 	Nevertheless, she did not follow-up on the
referral. 	Later, she affirmatively misrepresented to the State and the court that she was
receiving mental health counseling. 	Substantial evidence supports the court's finding
that all necessary, reasonably available services were offered or provided.
II. 	Integration Into a Stable and Permanent Home
Ruble makes two 	brief arguments in support of her contention that the trial
court's finding that continuation of the parent-child relationship clearly diminishes the
child's 	prospects 	for 	early 	integration 	into 	a 	stable 	and 	permanent 	home 	is 	not
supported by substantial evidence. 	First, she claims that J.C. was already in a stable
placement and that his placement was not at risk, because he could remain in extended
foster care until age 21. 	But, stability and permanence are not the same things. 	On its
face, Ruble's argument admits that the foster placement is not permanent.
Second, Ruble asserts that no potential family had met J.C, that he was not in
adoptive placement, that the State likes to have a child placed in a home for six months
before finalizing an adoption, and that adoption was therefore unlikely to occur before
J.C. turned 18. 	But, the State does not have to establish that a stable and permanent
8

No. 68859-6-1/9
home is available at the time of termination. 	In re Dependency of K.S.C.. 137 Wn.2d
918, 927, 976 P.2d 113 (1999). 	The focus of the inquiry is whether the parent-child
relationship impedes the child's prospects for integration. 	Id. 	Ruble does not challenge
the court's finding that J.C.'s legal status was impeding his prospects for adoption:
2.60 	Unrebutted 	testimony 	indicates 	that 	despite 	[J.C.]'s 	significant
challenges, he has multiple prospects for adoption that cannot be
fully realized until his legal status is addressed.
Indeed, 	a supervisor in the State's adoptions unit testified that there is a group of
families 	in the 	community who 	have 	a 	passion 	to 	parent children 	like J.C. 	She
explained that six families had inquired about J.C, and three had expressed interest in
adopting him. 	She further explained that it was possible to finalize an adoption after a
child turns 18, but that not being legally free was a barrier to adoption. 	The court's
finding that J.C.'s legal status clearly diminishes his prospects for early integration into a
stable and permanent home is supported by substantial evidence.
III. 	Best Interests of the Child
Ruble argues that the trial court's determination that terminating her parental
rights is in J.C.'s best interests is not supported by substantial evidence. 	Her entire
challenge is that the evidence established that J.C. had a strong emotional bond to her,
and it was not in J.C.'s best interests to take that bond away. 	But, she does not
challenge the trial court's finding that, given J.C.'s challenges, "it is difficult to determine
the depth of the bond." 	And, even assuming that J.C. is strongly bonded to Ruble, her
argument does not account for the trial court's numerous uncontested findings that
amply support its conclusion.

No. 68859-6-1/10
The trial court clearly explained that J.C needs a caregiver and decision-maker
who is sober, able to act consistently and appropriately, and able to facilitate his groyvth
and independence:
2.32 	... 	Dr. O'Leary concluded that [J.C] would 	be at active risk if
placed with a caregiver who had not identified or addressed their
addiction issues and that anyone involved in decision-making for
[J.C] should be sober.
2.56 	[J.C] has a myriad of high needs and is likely to need ongoing care
for the rest of his life. . . . [J.C] is especially vulnerable and requires
that his caregiver protect him but also allow him to establish and
maintain boundaries to successfully socialize with others.
2.58 	. . . [J.C] requires that another individual make decisions on 	his
behalf. 	The decision-maker for [J.C] must demonstrate that they
can act consistently and appropriately on his behalf with his best
interests. 	[J.C] does require a capable caregiver who is able to
assist [J.C] to become his most full and realized self by allowing
him to achieve as great a level of independence as he can while at
the same time protecting and providing for him.
The trial court further found that, due to Ruble's mental health, substance abuse,
denial, and inability to care for herself, she is an ill-suited caregiver or decision-maker
for J.C:
2.32 	The mother does not recognize the extensiveness of her deficits
and consistently attempts to present herself as a person without
problems of any kind, or at the very least, believes she can address
them on her own. 	Ms. Ruble is overly confident and complacent in
regards to her alcoholism. 	Dr. O'Leary . . . was unable to conceive
of any specific services that are likely to remediate the mother's
deficiencies because of her level of denial.
2.33 	... Dr. O'Leary identified the mother's substance use as significant,
particularly her blood alcohol level of .485, which would cause a
light drinker to at best be in a coma. 	The mother's personality
disorder is identified as markedly deviant from reality.
2.41 	The mother's belief that she can stop drinking at any time and
maintains recovery by abstinence is not supportive of long term
sobriety or recovery.
10

No. 68859-6-1/11
2.42 	The mother is not engaged in any service or support to support
sobriety.
2.43 	... Ms. [Ruble] admits saying whatever she thinks will be helpful in
obtaining her desired result. 	Truth is malleable.
2.44 	The mother to date has never completed the recommended level of
substance abuse treatment to address 	her addiction to alcohol
including inpatient drug treatment and 	intensive 	outpatient drug
treatment.
2.45 	The mother's continued 	minimization of her use of alcohol, 	her
refusal 	to 	engage 	in the 	necessary 	treatment 	to 	address 	her
substance 	dependence, 	and 	her 	lack 	of 	any 	ongoing 	support
services for substance abuse treatment places her at high risk of
relapse, which would place [J.C] at great risk if in her care.
2.48 	The 	mother has 	repeatedly 	identified 	or blamed 	others for this
situation including [D.C], her mother, the [State], her diabetes, and
Seattle School system. 	The mother often engages in behavior that
is concerning for her mental stability including stalking [D.C] and
his foster 	placement, 	allegedly threatening 	the 	parties to 	these
proceedings, 	and 	accusing 	an 	. 	. 	. 	intern/visit 	supervisor 	of
molesting [J.C].
2.49 	The mother's perception of events that have occurred with drug
treatment, completion of her psychological evaluation, 	refusal to
complete the parenting observation and her statements about case
management offered to 	her causes significant concern regarding
her 	mental 	health 	and 	her 	ability 	to 	follow 	through 	with
recommendations for [J.C] by his treatment providers as well as
her ability to accurately recount information to the professionals in
[J.C.'s] life in order for them to provide appropriate care.
2.50 	The mother's refusal to engage in the services as recommended
supports Dr. O'Leary's observations and testing that to the extent
the 	mother 	denies 	problems 	with 	her 	behavior 	she 	will
correspondingly be unable to remedy her deficits.
2.51 	The mother has significant medical issues including diabetes that
require 	ongoing 	monitoring 	and 	management. 	The 	mother's
diabetes has been unstable and has required hospitalizations. 	The
mother has gone long periods of time without consistent medical
attention to monitor her diabetes. 	The mother's ability to model
adequate physical and emotional self-care is questionable. 	The
11

No. 68859-6-1/12
mother's difficulty in this area causes concern about her ability to
ensure she would follow through with [J.C.'s] high care needs.
2.57 	The mother's mental health and alcohol dependence remain and
place [J.C] at great risk due to his inability to self-protect, advocate
or disclose information.
2.58 	The mother continues to exercise poor judgment that places [J.C]
at a unique risk.
2.59 	The mother's inability to manage herself limits her ability to create
and maintain a safe, stable, nurturing, protective environment that
has structure and opportunities for [J.C.'s] development.
Ruble's inability to fill a 	role as J.C.'s caregiver or decision-maker is further
underscored by J.C.'s marked improvement after he was removed from Ruble's care:
2.56 	. . . [J.C] has made significant progress while being in foster care
related to self-care and occupational skills. 	He has gained weight
and stamina while in foster care.
Taken together, the trial court's uncontested findings overwhelmingly support its
determination that termination is in J.C.'s best interests.
We affirm.
WE CONCUR:
/^Z^g^
12