IN THE COURT OF APPEALS OF IOWA

No. 23-0618

Filed July 13, 2023

IN THE INTEREST OF M.M., J.M., and P.F.,

Minor Children,

M.M., Mother,

Appellant.

________________________________________________________________

Appeal from the Iowa District Court for Webster County, Joseph L. Tofilon, 

District Associate Judge.

A mother appeals the termination of her parental rights. AFFIRMED.

Alesha M. Sigmeth Roberts of Sigmeth Roberts Law, PLC, Clarion, for 

appellant mother.

Brenna Bird, Attorney General, and Mary A. Triick (until withdrawal) and 

Mackenzie Moran, Assistant Attorneys General, for appellee State.

Gregory H. Stoebe, Humboldt, attorney and guardian ad litem for minor 

children.

Considered by Schumacher, P.J., and Chicchelly and Buller, JJ.
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BULLER, Judge.

The mother appeals the termination of her parental rights to her three 

children. She argues she should receive a second six-month extension for 

reunification, termination is not in the best interests of the children, a permissive 

exception applies to preclude termination, and the State failed to make reasonable 

efforts for reunification. The record details the mother’s ongoing issues with mental

health, substance abuse, and parenting deficits, as well as her persistent refusal 

to engage in services. We affirm the termination of parental rights.

I. Background Facts and Proceedings

This appeal concerns termination of the mother’s parental rights to M.M. 

(born 2017), J.M. (born 2019), and P.F. (born 2021). The family came to the 

attention of the Iowa Department of Health and Human Services (HHS) in June 

2021, when the mother hit the father of one child with her car and that father then 

pulled the mother out of the car and physically assaulted her. Throughout the

assaults, the children were in the car and were not strapped in properly. Both 

parents were arrested, and the children were removed from the mother’s custody 

and adjudicated as children in need of assistance (CINA) in September 2021. The 

children have not returned to the mother’s custody since then. 

Concerns about domestic violence persisted after removal. In August 2021, 

the mother reported to the local hospital’s emergency department with bruising on 

her face, but she claimed the injuries were from a bar fight. HHS believed 

otherwise and thought the mother was hiding the abuser in her basement, despite 

a no-contact order from the previous attack. Later that month, both the mother 

and the same father were arrested after law enforcement was called to the home 
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on suspicion of domestic abuse; police located one of the fathers in the basement, 

as HHS suspected. When HHS and providers tried to discuss the domesticviolence issues with the mother, she “was generally dismissive of it and did not

understand how it could [a]ffect the children or how it could have an impact on 

them.” In other words, “she did not think [domestic violence in the home] was a 

concern.” The HHS worker opined that returning the children to the mother’s 

custody would have been dangerous, as the mother could not protect herself, let 

alone the children. Eventually, the same father abused the mother so severely 

that she had to be life-flighted to a Des Moines hospital for multiple days to treat 

her injuries. The abuser was arrested and remained incarcerated through the time 

of the termination trial. 

In addition to concerns about domestic violence, the mother’s substanceabuse history is significant. The mother tested positive for methamphetamine on 

at least six dates between March 2022 and March 2023. She admitted to smoking 

marijuana and tested positive for that substance in January 2023. She also tested 

positive for amphetamines in March 2022 and January 2023. And she missed 

“numerous” drug-testing appointments. Despite this well-documented history of 

substance abuse, the mother did not successfully complete any treatment regimen 

to the degree that she can stay clean and sober. Multiple substance-abuse 

evaluators (including the most recent) recommended inpatient treatment, and the 

mother has yet to engage in such a program. 

Both related to and independent of her drug use, the mother also has 

significant mental-health problems. Her diagnoses include post-traumatic stress 

disorder, dissociative identity disorder, obsessive compulsive disorder, and a mild 
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intellectual disability. The mother reports having an alternate “bad personality” 

named “Ms. Nitro” who is “aggressive.” Again, despite this well-documented 

history, the mother’s attendance at therapy has been inconsistent at best. She 

similarly resisted attending the Iowa Domestic Abuse Program (formerly known as 

the Batterers Education Program), which was required by terms of her probation. 

The mother struggled, up to the time of termination, with basic parenting 

tasks. She was unable to handle scheduling or transporting children to 

appointments, even after providers “went to extraordinary lengths to help her 

organize her life,” such as by creating and writing in a calendar for her. When the 

mother had supervised visits with the children, she sometimes failed to engage 

with them and needed significant redirection from providers. She repeatedly 

attempted to provide the youngest child with cereal that led to severe vomiting, 

even though a pediatrician and court proceedings directed her to stop feeding the 

cereal. One time, an HHS worker observed one of the preschool-age children with 

a “marijuana pipe” in his mouth and access to firecrackers, a lighter, and 

“something that either looked like a gun clip or like a novelty knife.” To the extent 

the mother made any significant improvement working with providers on parenting 

skills during the life of these cases, there was “back-sliding” soon after her 

“sporadic” improvements. The mother never progressed beyond supervised visits,

and even those had issues as recently as the month of the termination trial. 

The mother also engaged in “triangulation” and “manipulation” with regard 

to the HHS caseworkers and their supervisors, ultimately leading to changes in 

personnel working the case. A caseworker also described attempts to interfere 

with drug-testing, including the mother’s claim that one patch “had fallen off” and 
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the mother’s admission that she took off another “because she was upset.” On 

another occasion, the mother claimed to be unable to urinate on her testing date. 

On still other occasions, she refused to let workers into the house for home 

assessments. During the termination trial, the mother declared she was going to 

“put [the HHS caseworkers] on blast” for allegedly lying about all manner of things. 

In June 2022, all of the parents involved in the case, including the mother, 

were granted six-month extensions to work toward reunification. Nearly all of the 

issues discussed in this opinion persisted past that extension.

The juvenile court accurately, although bluntly, summarized the record 

evidence concerning the mother’s willingness to rehabilitate and work toward 

reunification:

It is apparent that the mother only does what she wants to do 

and only when she wants to do it. She resists requests from 

providers and frequently rebuffs attempts by providers to help her.

She believes that she knows better than everyone else. [The mother]

did not heed multiple recommendations to engage in inpatient 

substance abuse treatment, simply because she did not want to. 

Earlier in the case, she put cereal in her baby's bottle even after she 

was repeatedly told that it caused him to vomit profusely afterwards. 

[The mother]’s stubbornness has been the main obstacle to 

reunification. The mother spent the vast majority of the case thinking 

she was too good and too cool to meaningfully engage in services.

These observations track those of three different HHS workers, who opined that

the mother “feigned ignorance so we would not be able to help her,” “didn’t like to 

hear feedback from other people,” “believed she knew how to parent and her way 

of parenting was the right way,” and “believes what she believes and I can’t tell her 

otherwise.” Those observations are in turn consistent with the mother’s failure to 

complete any mental-health, substance-abuse, or parenting-skills programs. 
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The mother’s unwillingness to use services also carried over to the children. 

The mother told HHS that “she doesn’t believe in therapy and [the children] don’t 

need services.” She denied permission for one of the children to receive 

necessary speech therapy through an area education agency, as the mother does 

not believe the child needs those services despite a completed assessment to the 

contrary. And she refused to consent to the school’s recommendation for another 

child to be placed on an Individualized Education Plan because she believes “[the 

child] don’t need it.” 

Both HHS and the children’s guardian ad litem recommended termination 

of parental rights. The juvenile court terminated the mother’s rights to all three 

children, and this appeal follows.

II. Standard of Review

“We review termination proceedings de novo.” In re C.B., 611 N.W.2d 489, 

492 (Iowa 2000). “The primary interest in termination proceedings is the best 

interests of the child.” Id.

III. Discussion

The mother makes four arguments on appeal: (1) she urges she should 

have received another six-month extension to work toward permanency; (2) she 

challenges whether termination is in the best interests of the children; (3) she 

claims the permissive bond exception precludes termination; and (4) she alleges 

HHS failed to make reasonable efforts in the services she was provided. We reject 

each of these claims for the reasons that follow.
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A. Another Six-Month Extension

“[T]he juvenile court may deny termination and give the parent an additional 

six-months for reunification only if the need for removal ‘will no longer exist at the 

end of the additional six-month period.’” In re W.T., 967 N.W.2d 315, 323 (Iowa 

2021) (emphasis added) (quoting Iowa Code § 232.104(2)(b) (2021)).

As the State correctly points out, the mother received a six-month extension 

in the summer of 2022 and did not use that time to meaningfully address her 

underlying problems. In looking at the totality of the record, nothing convinces us 

the need for removal would no longer exist after another six-month extension. 

Before and after receiving the extension, the mother continued to test positive for 

controlled substances and, as of termination, she failed to make significant 

progress in substance-abuse or mental-health treatment. At the termination trial, 

an HHS worker testified that she did not believe it likely the children could return 

to the mother’s custody in six months. The mother’s treating therapist offered a 

similar view when questioned by HHS. And perhaps most telling, when the record 

was left open at the end of the second day of the termination trial for the mother to 

submit results from new drug tests, the test came back positive for both 

methamphetamine and amphetamine—after the mother testified under oath that 

the test would come back clean. 

The juvenile court denied the request for more time, reasoning that the 

mother was “no closer to reunification than she was on the date of the removal. 

Indeed, she may be further away.” We agree.
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B. Best Interests of the Children

“We have long recognized that an unresolved, severe, and chronic drug 

addiction can render a parent unfit to raise children.” In re A.B., 815 N.W.2d 764, 

777 (Iowa 2012). All of those descriptors—unresolved, severe, and chronic—

apply to the mother here. We also give weight to the “numerous” missed drugtesting appointments. “Under our case law, we presume that the numerous missed 

drug tests would have been positive for illegal substances.” In re C.G., No. 22-

1948, 2023 WL 1809988, at *2 (Iowa Ct. App. Feb. 8, 2023) (citing In re R.A., 

No. 21-0746, 2021 WL 4891011, at *1 (Iowa Ct. App. Oct. 20, 2021) (collecting 

cases)). We consider this evidence in light of the children’s safety, the best 

placement for their long-term nurturing and growth, and their physical, mental, and 

emotional needs. Iowa Code § 232.116(2) (2023).

On our de novo review, we agree with the juvenile court that termination is 

in the best interests of the children. The children are well cared for by their foster 

parents in a home that is safe, clean, and loving. The children’s needs cannot be 

met by the mother, and they deserve permanency—particularly after being out of 

the mother’s custody for some twenty-one months at the time of termination. 

C. Permissive Bond Exception

“The court may exercise its discretion in deciding whether to apply the 

factors in section 232.116(3) to save the parent-child relationship based on the 

unique circumstances of each case and the best interests of the children.” In re 

A.R., 932 N.W.2d 588, 591 (Iowa Ct. App. 2019). Here, the juvenile court said it 

well: “[The children] undoubtedly will be sad if they stop seeing [the mother], but 

the long-term benefits of permanency and living in a stable home far outweigh 
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those concerns.” A parent resisting termination has the burden to prove this 

permissive exception by clear and convincing evidence, and our case law 

recognizes that neither a parent’s love nor the mere existence of a bond are

enough to prevent termination. See In re A.B., 956 N.W.2d 162, 169–70 (Iowa 

2021); In re D.W., 791 N.W.2d 703, 707 (Iowa 2010). Assuming without deciding 

that the mother adequately preserved this issue, whatever bond may exist between 

the mother and children does not outweigh the need to provide the children with a 

permanent, safe, and stable home. The mother’s history convinces us she cannot 

provide such a home now or at any time in the immediate future. We, like the 

juvenile court, decline to apply this permissive exception.

D. Reasonable Efforts

Last, the mother contests whether HHS made reasonable efforts toward 

reunification. “[W]hat constitutes reasonable services varies based upon the 

requirements of each individual case.” In re C.H., 652 N.W.2d 144, 147 (Iowa 

2002). 

The parent must “object to services early in the process so appropriate 

changes can be made.” C.B., 611 N.W.2d at 493–94. “In general, if a parent fails 

to request other services at the proper time, the parent waives the issue and may 

not later challenge it at the termination proceeding.” C.H., 652 N.W.2d at 148. 

During the CINA phase, the mother requested—and the juvenile court granted—

additional drug testing. Otherwise, the permanency orders show the court 

consistently found the State provided reasonable efforts toward reunification and 

“[n]o party has requested additional services or assistance.” Because the mother 
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did not timely challenge the adequacy of the services offered, she waived any 

challenge to those services on appeal. See C.H., 652 N.W.2d at 148.

Nevertheless, the mother briefly challenged the services offered in a filing 

after conclusion of the termination trial. Even if this were sufficient to preserve the 

issue for appeal, we would again agree with the juvenile court’s blunt but accurate

assessment of the record evidence: 

The evidence shows that [HHS] and its social workers bent over 

backwards to help accommodate the mother. They met with her 

frequently to review the expectations, they combined appointments 

to help her accomplish multiple tasks at the same time, they offered 

solution focused meetings (which she declined), and they helped her 

maintain a calendar with her obligations on it. Even with all of this 

assistance and handholding, the mother could not meet 

expectations.

The Court believes that [the mother’s] inability to meet 

expectations was caused primarily by her stubbornness and not her 

lack of intellectual ability. The mother failed to complete her

assignments because she thought they were stupid and a waste of 

her time, not because she did not understand them.

The Court also notes that [HHS] did not ask the mother to 

build a rocket from scratch or complete another Herculean task. The 

social workers simply asked her to go to substance abuse treatment, 

attend mental health treatment, and work on becoming a better 

mother. Parenting three children is much more complex and 

exhausting than anything [HHS] asked her to do.

We also note the record includes examples of efforts by HHS to condense or 

combine services, in an attempt to better serve the mother. The mother’s 

reasonable-efforts argument provides no basis for relief.

IV. Disposition

Having rejected the mother’s contentions on appeal, we affirm the 

termination of parental rights.

AFFIRMED.