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You can search the entire site. or go to the recent opinions, or the chronological or subject indices. Denny M. v. State, Dept. of Health & Social Services, Office of Children's Services (1/13/2016) sp-7076

Denny M. v. State, Dept. of Health & Social Services, Office of Children's Services (1/13/2016) sp-7076

           Notice:   This opinion is subject to correction before publication in the P                    ACIFIC  REPORTER.  

           Readers are requested to bring errors to the attention of the Clerk of the Appellate Courts,  

                                                                                                                        

           303 K Street, Anchorage, Alaska 99501, phone (907) 264-0608, fax (907) 264-0878, email  

                                                                                                                          

           corrections@akcourts.us.  



                       THE SUPREME COURT OF THE STATE OF ALASKA                                      



DENNY  M.,                                                      )  

                                                                )          Supreme  Court  No.  S-15880  

                                Appellant,                      )  

                                                                                                                                     

                                                                )          Superior Court No. 3PA-13-00053 CN  

                                                                                                                  

                     v.                                         )          and 3PA-13-00054 CN (consolidated)  

                                                                )  

                     

STATE OF ALASKA,                                                                                

                                                                )          O P I N I O N  

                                                    

DEPARTMENT OF HEALTH &                                          )  

                                                    

SOCIAL SERVICES, OFFICE OF                                                                                        

                                                                )          No. 7076 - January 13, 2016  

                          

CHILDREN'S SERVICES,                                            )  

                                                                )  

                                Appellee.                       )  

                                                                )  



                     A                                                                                        

                        ppeal from the Superior Court of the State of Alaska, Third  

                                                                                         

                     Judicial District, Palmer, Gregory Heath, Judge.  



                                                                                                                 

                     Appearances: Lars Johnson, Assistant Public Defender, and  

                                                                                                                

                      Quinlan   G.   Steiner,   Public   Defender,   Anchorage,   for  

                                                                                                         

                     Appellant. David A. Wilkinson, Assistant Attorney General,  

                                                                                                           

                     Fairbanks, and Craig W. Richards,Attorney General,Juneau,  

                            

                      for Appellee.  



                                                                                                                 

                     Before: Stowers, Chief Justice, Fabe, Winfree, Maassen, and  

                                                   

                     Bolger, Justices.  



                                            

                     MAASSEN, Justice.  



I.         INTRODUCTION  



                                                                                                                                          

                     The Office of Children's Services (OCS) filed a petition to terminate a  



                                                                                                                                             

mother's parental rights to two of her daughters. The superior court granted the petition.  


----------------------- Page 2-----------------------

The mother appeals the superior court's finding that OCS made active efforts to reunify                                                                                                                             



the family, as required by state and federal law, as well as a few of the factual findings                                                                                                                       



underlying this conclusion. Because the superior court did not clearly err in finding that                                                                                                                                    



OCS made active efforts by providing services geared toward reunification - some by                                                                                                                                              



OCS directly and others through the mother's involvement in a therapeutic court - we                                                                                                                                            



affirm the termination decision.                             



II.               FACTS AND PROCEEDINGS                   



                                    Denny M. is the mother of three daughters, two of whom, Tony (born in                                                                                                                         



                                                                                                                                                       1  

                                                                                                                                                                                                                                

2008) and Kam (born in 2010), are involved in this case.                                                                                                    They are Indian children for  



                                                                                                                                                           2  

                                                                                                                                                                                                                

purposes of the Indian Child Welfare Act of 1978 (ICWA).                                                                                                        OCS first became involved  



                                                                                                                                                                                                                              

with Denny's family in 2010, when it received a report that Denny abused alcohol and  



                                                                                                                                                                                                                         

marijuana while pregnant with Kam and said she hated the baby.  OCS removed Tony  



                                                                                                                                                                                                                            

and Kam from Denny's care and began a trial home visit with their father, Tyler Y., who  



                                                                                                                                         

in April 2011 was given permanent custody of the girls.  



                                                                                                                                                                                                                           

                                    On May 30, 2013, OCS removed Tony and Kam from Tyler's home after  



                                                                                                                                                                                                                            

Kam "showed up at her day care provider's house with two black eyes, a blackened nose  



                                                                                                                                                                                                          

and swollen face," allegedly caused by Tyler.  The next day OCS filed an emergency  



                                                                                                                                                                                                                

petition for temporary custody based on both Tyler's physical violence and Denny's  



                                                                                                                                                                                               3  

                                                                                                                                                                                                   

mental health.  OCS placed the children with their aunt, Denny's sister. 



                  1                 We  adopt  the  pseudonyms  used  by  the  parties.  



                  2                 See  25  U.S.C.  §   1903(4)  (2012).  



                  3                 In  August  2013  both  Tyler  and  Denny  stipulated  that  the  children  were  in  



need  of  aid.   Tyler  stipulated  to  that  status  under  AS  47.10.011(6)  (risk  of  physical  harm)  

and Denny under AS 47.10.011(11) (parent's mental illness).   The parents also stipulated  

                                                                                                                                                                                                    (continued...)  



                                                                                                                -2-                                                                                                       7076
  


----------------------- Page 3-----------------------

                      OCS developed a case plan intended to promote the family's eventual                                        

reunification.  Denny started work on the plan in July 2013,                                       4               

                                                                                                      but her progress stopped  



                                                                                                                                    

in August when she was arrested for assaulting her father - her fourth arrest for assault  



                                                                                                                                        

since 2010.  She was incarcerated until October.  The disposition of her criminal case  



                                                                                                                             

required that she participate in a variety of services provided through a therapeutic  



                                                                                                                                          

mental health court, includingcounseling, psychiatriccare,medication management,and  



                                                                                                                                            

residence in an assisted living facility.  Despite those resources, Denny was admitted to  



                                                                                                                                                 

the Anchorage Psychiatric Institute (API) in December 2013, her thirteenth admission.  



                                                                                                                                             5  

                                                                                                                            

                      Beginning in February 2014, secondary OCS caseworkers in Anchorage 



                                                                                                                                                 

made near-monthly in-person visits to Denny to track her progress with the case plan.  



                                                                                                                                  

In March 2014, to advance one of the plan's goals, OCS referred her to Dr. Heather  



                                                                                                                                        

Macomber for a neuropsychological evaluation.  Dr. Macomber diagnosed Denny with  



                                                                                                                                            

"schizoaffective disorder and post traumatic stress disorder" and made a number of  



recommendations.  Among other things, she recommended that Denny have "ongoing  



                                                                                                                                  

psychiatric care" and "frequent appointments" with a doctor "to ensure her optimal  



                                                                                                                                      

response  to  psychotropic  medications";  that  she  "maintain  consistency  with  [her]  



                                                                                                                                     

medications to ensure her emotional stability, behavioralcontrol, and improve her reality  



           3(...continued)  



                                                                                                                                          

that OCS had so far made active efforts to reunify the family and that it was in the  

                                                                                                                                          

children's best interest to remain in OCS custody.   The superior court accepted the  

                    

stipulation.  



           4          OCS simultaneously created case plans for Tyler and the children.  But  

                                                                                                                                         

Tyler voluntarily relinquished his parental rights to Tony and Kam in June 2014.  

                                                                                                                             



           5          Denny's primary caseworker was in the Matanuska-Susitna Valley, where  

                                                                                                                                      

the  OCS  case  originated.                     Denny  later  moved  to  Anchorage,  and  OCS  assigned  

                                                                                                                                

secondary caseworkers there to continue working with her.  

                                                                                                    



                                                                     -3-                                                              7076
  


----------------------- Page 4-----------------------

testing"; that she remain in assisted living and have a guardian appointed "to ensure that                                                                                                                                                                                                                                    



 she is protected                                                from legal and                                                 financial  predation"; and that she undergo                                                                                                                                   another  



psychiatric evaluation to identify "the true limitations of her parenting skills, and the                                                                                                                                                                                                                                       



ways in which her current psychiatric symptoms impact her judgment and decision                                                                                                                                                                                                                            



making skills in the context of parenting." Denny's primary OCS caseworker, Raymond                                                                                                                                                                                                                    



Edwards, called                                               Denny toexplain theserecommendationstoher;asecondary caseworker                                                                                                                                                                    



later did the same in person.                                                                                  



                                                    These recommendations prompted OCS to refer Denny to Dr. Melinda                                                                                                                                                                                       



Glass, a clinical psychologist, in March 2014, for an evaluation of her prospects as a                                                                                                                                                                                                                                                 



parent.   Dr. Glass found it difficult to clarify Denny's history "due to her tangential and                                                                                                                                                                                                                                   



bizarre thinking," but she reported Denny's claims that through prayer she had learned                                                                                                                                                                                                                          



to   read,  healed   animals,   and   fixed   her   teeth.     Dr.   Glass   attributed   these   claims   to  



delusional thinking rather than any religious or cultural belief. Denny told Dr. Glass that                                                                                                                                                                                                                                   



her daughter had visited her in her dreams but stopped doing so when both of them "shut                                                                                                                                                                                                                                 



down."   She admitted to Dr. Glass that she had frequent emotional breakdowns that led                                                                                                                                                                                                                                           



to suicidal thoughts, though she said these resolved at least temporarily with visits to API                                                                                                                                                                                                                                 



                                                               6  

and medication.                                                                                                                                                                                                                                                                                                                     

                                                                         She admitted that she had reconciled with Tyler, who was still in  



                                                                                                                                                                                                                                                                                                           

prison, but she contended that he would not have assaulted the children in her presence  



                                                                                                       

and would not do it again.  



                                                                                                                                                                                                                                                                                                                                                

                                                   Dr. Glass diagnosed Denny with schizoaffective disorder-bipolar type and  



                                                                                                                                                                                                                                                                                                                           

 substance abuse but ruled out "anxiety disorder related to a history of trauma."  She  



                                                                                                                                                                                                                                                                                                

considered Denny's "grandiose delusions" about her "special powers" to be particularly  



                                                                                                                                                                                                                                                                                                                   

concerning, especially when they involved her children. Dr. Glass concludedthat Denny  



                          6                        Denny reported that she had been to API "so many times [she] cannot even  

                                                                                                                                                                                                                                                                                                                           

count."  

                              



                                                                                                                                                                 -4-                                                                                                                                                                      7076  


----------------------- Page 5-----------------------

did not have the capacity to parent young children and that her long-term prognosis was                                                                                                                                   



poor.   She concluded that Denny required a precise combination of medications and                                                                                                                                        



therapy to address her illness but that she had long struggled with consistency in both                                                                                                                                 



               7  

areas.                                                                                                                                                                                                               

                     Dr. Glass noted that finding the right balance would be difficult:  "[I]t could  



                                                                                                                                                                                                                            

never happen or it could happen within a week or two."  Regardless, Dr. Glass did not  



                                                                                                                                                                                                                         

believe Denny's children could be safely returned to her care in the near future.  She  



                                                                                                                                                                                                                          

wrote, "[Denny] has a serious mental illness and her acting out is dangerous.  The best  



                                                                                                                                                                                                                            

a consistent treatment program might provide is containment . . . but this would still not  



                                                                                                                                                                                                                  

make her able to protect and appropriately parent her children.  [Denny] would require  



                                                                                                                                                                                                               

constant supervision."  Dr. Glass testified at trial that Denny's schizoaffective disorder  



                                                                                                                                                                                

was "one of the hardest to manage" and unlikely to ever go away.  



                                                                                                

                                   Following Dr. Glass's report, Denny's secondary caseworkers continued  



                                                                                                                                                                                                                   

their meetings with her at the assisted living facility.  But Edwards testified that OCS's  



                                                                                                                                                                                                              

last contact with Denny was in August 2014.  After that, OCS mailed three certified  



                                                                                                                                                                                               

letters to her at the assisted living facility between October 2014 and January 2015  



                                                                                                                                                                                                          

requesting contact but received  no reply.  Edwards testified that he had "no indication  



                                                                                           

that she's moved anywhere else."  



                                                                                                                                                                                                              

                                   In December 2014 OCS filed its petition to terminate Denny's parental  



                                                                                                                                                                                                                      

rights.  In February 2015 there was a trial, which Denny attended; the superior court  



                                                                                                                                      

terminated her parental rights in a written order in March.  



                  7                Dr. Glass testified that "[t]he record is full of statements that she doesn't                                                                                                 



comply with her medication as given and is not consistent, and with this type of mental                                                                                                                            

illness she's really got to, to have any chance of even being able to be stable and think                                                                                                                              

normally, if that's possible."                                                Exacerbating the problem, in Dr. Glass's view, was that                                                                                     

Denny's "distrust is high and she is not entirely uncomfortable with her mental illness."                                                                                                                      



                                                                                                               -5-                                                                                                     7076
  


----------------------- Page 6-----------------------

III.          STANDARDS OF REVIEW                     



                           "In a case involving the termination of parental rights, we review a superior                                                     



                                                                                    8  

court's   findings   of   fact   for   clear   error."                                                                                                              

                                                                                          "Findings  are  clearly  erroneous  if,  after  



                                                                                                                                                                     

reviewing the record in the light most favorable to the prevailing party, we are left with  



                                                                                                                         9  

                                                                                                                                                                           

                                                                                                                             "Conflicting evidence is  

a definite and firm conviction that a mistake has been made." 



                                                                                                                                                            

generally insufficient to overturn the superior court, and we will not reweigh evidence  



                                                                                                                                              10  

                                                                                                                                

when the record provides clear support for the superior court's ruling."                                                                             



                                                                                                                                                                

                           "Whether  OCS  made  active  efforts  as  required  by  ICWA  is  a  mixed  



                                                     11  

                                                                                                                                                                          

                                                          Whether "the trial court's active efforts finding failed to  

question of law and fact." 



                                                                                                                                                         12  

                                                                                                                                               

comport with ICWA's requirements" is a question of law reviewed de novo. 



IV.          DISCUSSION  



                           The main issue Denny raises on appeal is whether the superior court erred  

                                                                                                                                                                    



in finding that OCS made active efforts to provide resources designed to prevent the  

                                                                                                                                                       



             8            Doe v. State, Dep't of Health &Soc. Servs., Office of Children's Servs.                                                                   , 272   



P.3d 1014, 1019 (Alaska 2012) (quoting                                               Maisy W. v. State, Dep't of Health & Soc.                                       

Servs., Office of Children's Servs.                                 , 175 P.3d 1263, 1267 (Alaska 2008)).                          



             9            Maisy W. , 175 P.3d at 1267 (quoting Brynna B. v. State, Dep't of Health  

                                                                                                       

& Soc. Servs., Div. of Family & Youth Servs., 88 P.3d 527, 529 (Alaska 2004)) (internal  

                                                                                                                                                             

quotation marks omitted).  

                                  



             10           Id. (internal citations omitted).  

                                                                      



             11            Sandy B. v. State, Dep't of Health &Soc. Servs., Office of Children's Servs.,  

                                                                                                                                                                 

216 P.3d 1180, 1186 (Alaska 2009) (citing N.A. v. State, Div. of Family & Youth Servs.,  

                                                                                                                                                                

 19 P.3d 597, 600-01 (Alaska 2001)).  

                                                            



             12           Id. (citing Carl N. v. State, Dep't of Health & Soc. Servs., Div. of Family  

                                                                                                                                  

& Youth Servs., 102 P.3d 932, 935 (Alaska 2004)).  

                                                                                        



                                                                                    -6-                                                                            7076
  


----------------------- Page 7-----------------------

break-up of her family. As a subsidiary issue, she contends that the superior court made                                                                                                                       



errors of fact in support of its active efforts finding.                                                        



                 A.	              The Superior Court Did Not Clearly Err When It Faulted Denny For                                                                                                                 

                                  Losing Contact With OCS.                                   



                                  Denny argues that the superior court clearly erred when it found that she  



moved from the assisted living facility in August 2014 without giving OCS a forwarding  

                                                                                                                                                                                               



address.  The superior court found, based on the testimony at trial, that the secondary  

                                                                                                                                                                                                  



caseworker "visited [Denny] at her residence in Anchorage each month; but, beginning  

                                                                                                                                                                                                   



in August 2014, [OCS] struggled to contact her. In response, [OCS] mailed three letters  

                                                                                                                                                                                                             



certified, the last one on January 29, 2015.  The letters requested that [Denny] contact  

                                                                                                                                                                                   



the caseworkers for further support."  The court concluded that "[t]he monthly visits by  

                                                                                                                                                                                                                      



the caseworker and the caseworker's inability to contact [Denny] on those occasions  

                                                                                                                                                                                                   



tends to show that [Denny] has moved fromher assisted living facility without providing  

                                                                                                                                                                                                    



a forwarding address to her new place of residence."  

                                                                                                                                        

                                  The evidence about whether Denny moved is unclear,13  

                                                                                                                                                                                                     

                                                                                                                                                                                  but we conclude  



                                                                                                                                                                                                               

that whether the superior court erred in that finding is immaterial.  The important point  



                                                                                                                                                                                                        

in the context of the active efforts analysis was not whether Denny moved but whether  



                                                                                                                                                                                                                  

she could be faulted for the loss of contact with OCS.  "[A] parent's demonstrated lack  



                                                                                                                                                                                                                     

of willingness to participate in treatment may be considered in determining whether the  



                 13               The    trial    transcript    shows    Denny's    primary    caseworker,    Edwards,  



testifying, "She has moved.                                                She didn't notify me."                                        He later testified, "As far as [I]                                           

know, she's still receiving cab vouchers from OCS to the same address. . . .                                                                                                                       I have no  

indication that she's moved anywhere else."                                                                             The trial court could reasonably have                                                   

understood Edwards's testimony on this point in different ways. But as explained above,                                                                                                                     

any difference is immaterial to the relevant question of whether Denny may be faulted                                                                                                                      

for the loss of contact.             



                                                                                                           -7-	                                                                                                 7076
  


----------------------- Page 8-----------------------

                                                                                          14  

 [S]tate has taken active efforts."                                                             The superior court's other relevant factual findings   



-  about the OCS caseworkers' near-monthly visits to the assisted living facility, their                                                                                                                                           



last visit in August 2014, and the three unanswered certified letters between October                                                                                                                                    



2014 and January 2015 - are supported by the evidence and are sufficient without more                                                                                                                                             



to show that Denny could be faulted for the loss of contact.                                                                                                        If the superior court did err                                        

in finding that Denny moved, the error was harmless.                                                                                                 15  



                                                                                                                                                                                                               

                   B.	               The Superior Court Did Not Err In Finding By Clear And Convincing  

                                                                                                                                                                                         

                                     Evidence That OCS Made Active Efforts Toward Reunification.  



                                                                                                                                                                                                      

                                     Denny's primary argument on appeal is that "[g]iven the possibility that  



                                                                                                                                                                                                                                 

 [she] could have rapidly improved, the trial court erred in concluding that OCS made  



                                                                                                                                                                                                                             

active efforts to prevent the break-up of the family." She essentially concedes the gravity  



                                                                                                                                                                                                                                      

of her mental health issues but argues that OCS failed to adequately address them, in part  



                                                                                                                                                                                                                                       

by passively relying on the therapeutic mental health court to provide many of the  



                                                                                                                                                                                                                            

necessary services.   But we conclude that the evidence supports the superior court's  



                                                

finding of active efforts.  



                   14                Sylvia L. v. State, Dep't of Health &Soc. Servs., Office of Children's Servs.                                                                                                                            ,  



343 P.3d 425, 432 (Alaska 2015) (first alteration in original) (quoting                                                                                                                        E.A. v. State, Div.                   

of Family & Youth Servs.                                               , 46 P.3d 986, 991 (Alaska 2002)).                                          



                   15                Denny also contends that it was unreasonable for the court to note in its  

                                                                                                                                                                                                                                         

decision, and apparently to hold against her, the fact that she "was unable to appear in  

                                                                                                                                                                                                                      

person at any of her meetings with OCS and court proceedings in this matter; she only  

                                                                                                                                                                                                                                    

appeared by telephone." But as Denny acknowledges, the court was aware that "Denny  

                                                                                                                                                                                                                           

lived in Anchorage while [OCS] meetings were in Palmer" and that it is "common for  

                                                                                                                                                                                                    

clients to attend meetings telephonically."  In our view, the court's brief reference to  

                                                                                                                                                                                                                                          

Denny's telephonic participation cannot reasonably be read as anything other than a  

                                                                                                                                                                                                                                            

minor, neutral detail in the explanation of how contact between Denny and OCS was  

                                                                                                                                                                                                                                     

eventually lost.  

                                              



                                                                                                                    -8-	                                                                                                          7076
  


----------------------- Page 9-----------------------

                               "In a termination proceeding involving Indian children, the superior court                                                                                   



must find, by clear and convincing evidence, that the State has made active efforts to                                                                                                            



provide remedial services and rehabilitative programs designed to prevent the breakup                                                                                                



                                                                                                                                                    16  

of the Indian family and that those efforts were unsuccessful."                                                                                                                            

                                                                                                                                                           The superior court  



                                                                                                                                 17  

                                                                                                                                                                                               

analyzes OCS's active efforts on a case-by-case basis.                                                                                  "Although there is 'no pat  



                                                                                                                                                                              

 formula . . . for distinguishing between active and passive efforts,' we have recognized  



                                                                                                                                                                                     

that what is critical is OCS's involvement with a parent after it has drawn up the parent's  



                         18  

                                                                                                                                                                                     

case plan."                    Generally, "OCS makes active efforts . . . when it helps the parents develop  



                                                                                                                                                                                                   

the resources necessary to satisfy their case plans, but its efforts are passive when it  



                                                                                                                                     19 

requires the parents to perform these tasks on their own."                                                                                                                            

                                                                                                                                          "The court should look to  



                                                                                                                                                                      

OCS's  involvement  in  its  entirety,  and  may  consider  a  parent's  demonstrated  



                16             Philip J. v. State, Dep't of Health & Social Servs., Office of Children's                                                                      



Servs., 314 P.3d 518, 527 (Alaska 2013) (citing 25 U.S.C. § 1912(d) (2012));                                                                                                        see also   

CINA Rule 18(c)(2)(B).       



                17             Ben M. v. State, Dep't of Health & Soc. Servs., Office of Children's Servs.,  

                                                                                                                                                                                        

204 P.3d 1013, 1021 (Alaska 2009).  

                                                                      



                18             SandyB. v. State,Dep't of Health &Soc. Servs., Office of Children's Servs.,  

                                                                                                                                                                                        

216 P.3d 1180, 1188 (Alaska 2009) (alteration in original) (quoting A.A. v. State, Dep't  

                                                                                                                                                                                          

of Family & Youth Servs., 982 P.2d 256, 261 (Alaska 1999)).  

                                                                                                                             



                19             Sylvia L., 343 P.3d at 432 (quoting Sandy B., 216 P.3d at 1188); see also  

                                                                                                                                                                                     

A.A. , 982 P.2d at 261 ("Passive efforts are where a plan is drawn up and the client must  

                                                                                                                                                                                            

develop his or her own resources towards bringing it to fruition.  Active efforts . . . is  

                                                                                                                                                                                                

where the state caseworker takes the client through the steps of the plan rather than  

                                                                                                                                                                             

requiring that the plan be performed on its own." (quoting CRAIG  J.D                                                                                     ORSAY,T              HE  INDIAN  

                                                                                                                                   

CHILD  WELFARE  ACT  AND  LAWS  AFFECTING  INDIAN  JUVENILES  MANUAL   157-58  

                                                                                                                                                                                     

 (1984))).  



                                                                                                -9-                                                                                        7076
  


----------------------- Page 10-----------------------

                                                                                                                                                   20  

unwillingness to participate in treatment as a factor . . . ."                                                                                           But "an analysis of the                             



 [S]tate's active efforts is not limited to efforts by OCS"; the court may consider services                                                                                                     

provided by other state entities such as the Department of Corrections.                                                                                                       21  The services  



                                                                                                                                                                                                              

provided through the specialized therapeutic courts of the Alaska Court System -  



                                                                                                                                                                                             

wellness courts, mental health courts, and veterans courts - can also be an important  



                                                                                                                                                                                                                

part of a troubled parent's recovery.  OCS is entitled to rely on those services as well in  



                                                                                                                                                                                                          

its active efforts if in doing so it can avoid duplicating the programs in the parent's case  



plan.  



                                                                                                                                                                                                        

                                 Thesuperior court found byclear and convincing evidencethat "OCSmade  



                                                                                                                                                                                                              

timely, active efforts" to prevent the breakup of Denny's family. It commended OCS for  



                                                                                                                                                                                                              

appointing  a  secondary  caseworker  to  maintain  in-person  visits  with  Denny  in  



                                                                                                                                                                                                            

Anchorage after she moved there from the Valley.   It noted that "OCS paid for cab  



                                                                                                                                                                                              

vouchersto all referred services and visitation" because of Denny's inability to "navigate  



                                                                                                                                                                                                             

the bus system."  It highlighted the referral to Dr. Macomber, with OCS covering the  



                                                                                                                                                                                                          

cost, and the caseworkers' follow-up discussions of the doctor's recommendations with  



                                                                                                                                                                                                            

Denny "in person and at length."  The court noted that OCS also followed up on Dr.  



                                                                                                                                                                                

Macomber's recommendations by referring Denny to Dr. Glass "for a psychological  



                                                                                                                                                                                                       

evaluation specific to [Denny's] ability to parent."   The court noted that OCS again  



                20               Pravat P. v. State, Dep't of Health & Soc. Servs., Office of Children's                                                                          



Servs., 249 P.3d 264, 271 (Alaska 2011) (citing                                                                     Dale H. v. State, Dep't of Health &Soc.                                                

Servs., Office of Children's Servs.                                               , 235 P.3d 203, 213 (Alaska 2010)) (internal quotation                                                      

marks omitted);                         see also Sylvia L.                        , 343 P.3d at 432 ("In determining whether OCS made                                                                   

active efforts, the trial court may consider all services provided during the family's                                                                                                         

involvement with OCS; it need not focus on a distinct period of time.").                                                                                      



                21               Dashiell R. v. State, Dep't of Health & Soc. Servs., Office of Children's  

                                                                                                                                                                                          

Servs., 222 P.3d 841, 849 (Alaska 2009).  

                                                                                      



                                                                                                     -10-                                                                                               7076
  


----------------------- Page 11-----------------------

"covered the cost" and that Edwards gathered all of Denny's "past mental and physical  

                                                                                                                        



health records" from API and other institutions and "spent a prolonged amount of time  

                                                                                                                              



distilling that information into a set of records and documents specifically tailored to Dr.  

                                                                                                                                



Glass's  request for  information."                    The  court  noted  that Edwards prepared  a list of  

                                                                                                                                 



questions that would help Dr. Glass directly address Dr. Macomber's concerns about  

                                                                                                                            



Denny's  parenting  abilities  and  that,  after  Denny  failed  to  appear  for  her  first  

                                                                                                                             



appointment  with  Dr.  Glass,  Edwards  rescheduled  it  and  "coaxed  [Denny]  into  

                                                                                                                              



attending."  The court also took note of Denny's involvement with a therapeutic court,  

                                                                                                                            



"the Community Resources Project," and its provision of services that OCS was not  

                                                                                                                                



required  to  duplicate.             Finally, the court noted that OCS set up  monthly  visitation  

                                                                                                                      



between Denny and her daughters and referred Denny to a family therapy counselor "to  

                                                                                                                                



establish a visitation plan."  And, as discussed above, the court concluded that Denny's  

                                                                                                                        



eventual disengagement from OCS assistance was due in large part to her own failure to  

                                                                                                                                  



respond to the agency's attempts to contact her.  

                                                                           



                    Dennycontendsthat theseefforts were not enough, first because they failed  

                                                                                                                            



to focus on stabilizing her mental health issues; this in turn, she contends, would have  

                                          



aided  her  ability  to  parent  and  given  her  a  more  realistic  perspective  on  Tyler's  

                                                                                                                   



destructive influence in her life.  Denny points out that she attended the psychological  

                   



evaluations to which OCS referred her and that she was willing to pursue some, though  

                                                                                                                          



not all, of the doctors' recommendations.  She argues that "OCS should not have given  

                                                                                                                            



up on the possibility of [her] becoming a safe parent."  

                                                                                     



                    But the superior court's findings that Denny's mental health problems are  

                                                                                                                                



of long standing, and that she has done little to address them, are supported by the  

                                                                                                                                



record.  The court noted that Denny's delusions occasionally included her children and  

                                                                                                                               



that, because of her inconsistency with both medication and therapy, her poor prognosis  

                                                                                                                      



                                                               -11-                                                         7076
  


----------------------- Page 12-----------------------

 suggested that change in the near future was unlikely.                                                                                                                                                                                                In its discussion of the children's                                                                        



best interests the court found that they were bonded to their maternal aunt, not to Denny.                                                                                                                                                                                                                                                                                                                         



The court further found that "[t]he children require stability and consistency to overcome                                                                                                                                                                                                                                                                         



the emotional deficit created by their parents' conduct" and that they "should not wait                                                                                                                               



                                                                                                                                                                                                                                                                                                                                                                                                       22  

any longer for a permanent and loving home, a home that [Denny] cannot provide."                                                                                                                                                                                                                                                                                                                                 



                                                                                                                                                                                                                

We have repeatedly observed that a "child's need for permanence and stability should  



                                                                                                                                                                                                                                                                                                                                               

not be put on hold indefinitely while the child's parents seek to rectify the circumstances  



                                                                                                                                                                                                                              23  

                                                                                                                                                                                                                                                                                                                                                                                             

that cause their children to be in need of aid";                                                                                                                                                                                         the court appropriately applied that  



                                           

principle here.  



                               22                             Although OCS's primary concern was Denny's mental health, it had two                                                                                                                



others that could theoretically be addressed independently:  her parenting abilities and   

her financial stability.                                                                               The superior court made no findings about whether OCS helped                                                                                                                                                                                                              

Denny address her financial situation (other than paying for services) or whether it                                                                                                                                                                                                                                                                                                                    

actually referred her to a parenting class, and Denny cites OCS's failures in these areas                                                                                                                                                                                                                                                                                               

in her brief.   But OCS's priority was to manage Denny's mental health problems, for                                                                                                                                                                                                                                                                                                              

which she had come to OCS's attention twice before.                                                                                                                                                                                                          It is clear from the record, and                                                                                                  

Denny concedes, that her mental health was the major obstacle to improvement in other                                                                                                                                                                                                                                                                                                    

aspects of her life, and the superior court could reasonably accept OCS's prioritization                                                                                                                                                                                                                                                            

of its concerns.                                                             We have previously held that when a parent receives "a number of                                                                                                                                                                                                                                                         

referrals from the state for services," OCS's failure to make others need not be fatal.                                                                                                                                                                                                                                                                                                                            

 Thomas H. v. State, Dep't of Health & Soc. Servs., Office of Children's Servs.                                                                                                                                                                                                                                                                                    , 184 P.3d               

 9, 17 (Alaska 2008) ("[W]hile the trial court acknowledged that OCS should have                                                                                                                                                                                                                                                                                                        

referred Thomas to a mental health provider following its November 20, 2006 case plan,                                                                                                                                                                                                                                                                                                    

the court also found that Thomas's own actions . . . would have frustrated the success of                                                                                                                                                                                                                                                                                                              

any OCS services. Furthermore                                                                                                                     . . . Thomas received a number of referrals fromthe                                                                                                                                                                                      state  

 for services . . . .");                                                                        E.A. v. State, Div. of Family & Youth Servs.                                                                                                                                                                            , 46 P.3d 986, 990                                                    

 (Alaska 2002) (holding that OCS's failure to make active efforts for part of the case was                                                                                                                                                                                                                                                                                                     

"insignificant in light of the extensive remedial efforts the state has provided throughout                                                                                                                                                                                                                                                                   

its involvement").                                                                    



                               23                             Sherman B. v. State, Dep't of Health & Soc. Servs., Office of Children's  

                                                                                                                                                                                                                                                                                                                                                              

Servs., 310 P.3d 943, 954 (Alaska 2013) (quoting Kent V. v. State, Dep't of Health &  

                                                                                                                                                                                                                                                                                                                                                                   

Soc. Servs., Office of Children's Servs., 233 P.3d 597, 603 (Alaska 2010)).  

                                                                                                                                                                                                                                                                                                                                                              



                                                                                                                                                                                                -12-                                                                                                                                                                                      7076
  


----------------------- Page 13-----------------------

                              Dennyalsofaults OCS for passively relying on the                                                               services provided by the                       



mental health court without following up to make sure those services were working.                                                                                                                   



Denny's primary caseworker, Edwards, was unsure whether OCS ever communicated  



with Denny's therapeutic court providers apart from the staff at the assisted                                                                                                        living  



facility, though he testified he did receive some of their records.                                                                                 We have repeatedly     



stated that OCS's "efforts need not be perfect; they need only be reasonable under the                                                                                                      



                                   24  

circumstances."                                                                                                                                                                           

                                        Dennyreceived extensiveresources directly fromOCS,includingcase  



                                                                                                                                                                        

planning,  frequent  and  in-person  support  from  caseworkers,  monthly  therapeutic  



                                                                                                                                                                                        

visitation   with   her   daughters,   and   referrals   for   both   neuropsychological   and  



                                                                                                                                                                                

psychological evaluations.  Though our record lacks a full description of the services  



                          

ordered by the therapeutic court, Denny does not dispute that these services were also  



                                                                                                                                                                                        

provided.  And there is no evidence that any deficiencies in coordination between OCS  



                                                                                                                                                                  

and the court-ordered services damaged Denny's prospects as a parent.  



                                                                                                                                                                               

                              Denny also argues that many of the services the court cited as showing  



                                                                                                                                                                                 

OCS's active efforts - psychological assessments, cab fare, collecting medical records,  



                                                                                                                                                                                      

arranging  visitation  -  are  "unremarkable,"  because  those  are  the  services  OCS  



                                                                                                                                                                                   

ordinarily provides in these cases.  But regardless of whether OCS put in extra efforts,  



                                                                                                                                                                                          

what  matters  is  whether  its  efforts  were  reasonable  under  the  circumstances.                                                                                                    We  



                                                                                                                                                                                     

conclude that the superior court's decision of this issue was well supported by the record  



                                                                                                                                                          

and that it did not err in finding that OCS satisfied the active efforts requirement.  



V.             CONCLUSION  



                                                                                                                                                                        

                              For these reasons, we AFFIRM the judgment of the superior court.  



               24             Sylvia L., 343 P.3d at 432.  

                                                                                



                                                                                             -13-                                                                                              7076  

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