In re K.C., ___ N.C. App. ___ (August 20, 2024)
Held:
Affirmed
- Facts: Mother appeals the adjudication of her one-year-old child as neglected. DSS first became involved in this case due to the child’s meconium testing positive for amphetamines and methamphetamines at birth and Mother’s positive urine screen at the time of the child’s birth. During his first year of life, the child developed several serious health conditions that required medical care in addition to regular wellness visits including jaundice, an abscess, a hernia, and MRSA. DSS regularly communicated or attempted communication with Mother to engage Mother in substance use treatment and assist Mother in arranging transportation to some of the child’s necessary medical appointments. DSS filed a petition alleging the child neglected based on the child’s positive meconium test, unsuccessful attempts to engage Mother in substance use treatment, Mother’s failure to consistently communicate with DSS, and Mother’s failure to attend a substantial number of the child’s necessary medical appointments. The child was adjudicated neglected based on Mother’s failure to provide proper care, failure to provide or arrange necessary medical care, and allowing the creation of an injurious environment. Mother challenges the findings of fact relating to her attempts to obtain substance use and mental health assessments and her provision of necessary medical care, and argues the remaining findings do not support a conclusion of neglect.
- A neglect adjudication is reviewed “to determine (1) whether the findings of fact are supported by clear and convincing evidence, and (2) whether the legal conclusions are supported by findings of fact.” Sl. Op. at 6 (citation omitted). The determination of whether a child is neglected is a conclusion of law reviewed de novo.
- “The Juvenile Code defines a neglected juvenile as ‘[a]ny juvenile less than 18 years of age . . . whose parent . . .does not provide proper care, supervision, or discipline[,] . . .has not provided or arranged for the provision of necessary medical or remedial care[,] . . .[or] created or allowed to be created a living environment that is injurious to the juvenile’s welfare.’ ” Sl. Op. at 8-9, quoting G.S. 7B-101(15)a.,c., and e. A court must find “some physical, mental, or emotional impairment of the juvenile or substantial risk of such impairment as a consequence of the failure to provide ‘proper care, supervision, or discipline.’ ” Sl. Op. at 9 (quoting In re Stumbo, 357 N.C. 279 (2003)). For newborns, “the decision of the court must of necessity be predictive in nature, as the trial court must assess whether there is a substantial risk of future abuse or neglect of a child based on the historical facts of the case.” Sl. Op. at 9 (citation omitted). While the record must show clear and convincing evidence of “current circumstances that present a risk” to the child, the court has discretion in determining whether there is risk for a particular kind of harm given the child’s age and environment. “Health assessments of a parent can help the trial court determine the ‘current circumstances’ of a child’s environment.” Sl. Op. at 11. A parent’s mental health is a fixed and ongoing circumstance that is relevant in assessing the child’s environment and whether there is a substantial risk of harm to the child that may lead to an adjudication of neglect. “When an infant has substantial health concerns, sporadically attending necessary medical appointments and procedures can pose a ‘substantial risk’ of harm.” Sl. Op. at 13.
- The findings of fact are supported by clear and convincing evidence and the conclusion that the child was neglected is supported by the findings. The child was at substantial risk of harm based on Mother’s failure to provide proper care and arrange necessary medical care for the child, and the child living in an injurious environment. The evidence shows Mother never completed the requested substance use assessment and only completed a mental health assessment the week before the adjudication hearing, over a year since the child’s birth. Mother’s failure to complete a substance use assessment after the child and Mother tested positive for substances at the time of the child’s birth and her failure to timely complete the requested mental-health assessment impact her ability to provide adequate care for the child. The court determined that without these health assessments Mother cannot address her fixed and ongoing health issues and therefore poses a substantial risk of harm to the child. Additionally, the evidence shows that Mother cancelled or did not show up for 24 of the child’s 41 medical appointments within the child’s first year of life, including necessary surgical appointments to remove the child’s hernia, despite Mother qualifying for Medicaid and its transportation services and evidence that she was able to arrange transportation from family, a social worker, or EMS when necessary. Missing a substantial number of the child’s necessary medical appointments constitutes failure to provide necessary medical care. The combined evidence of the child’s positive meconium test, Mother’s failure to complete the substance use assessment or timely complete the mental health assessment, and Mother’s failure to ensure the child’s attendance for necessary medical appointments “fully convinces that [the child’s] environment was injurious to his welfare.” Sl. Op. at 14.
Category:
Abuse, Neglect, DependencyStage:
AdjudicationTopic:
Neglect