Opinion ID: 2382556
Heading Depth: 4
Heading Rank: 5

Heading: Barbara's case plan

Text: OCS developed a case plan for Barbara in late 2006, requiring that she obtain a substance abuse assessment and comply with its recommendations. After completing the substance abuse assessment in November 2006 with Alaska Family Services (AFS), Barbara was diagnosed with opioid abuse, alcohol abuse, sedative abuse, amphetamine dependence, and cannabis dependence. The assessment recommended an intensive outpatient substance abuse program, and Barbara was placed on the waiting list for treatment; she was dropped from the waiting list when she failed to attend two Alcoholics Anonymous (AA) meetings per week as required. After she tested positive for cocaine use in December 2006 and Michael was taken into OCS custody, Barbara returned to AFS asking to be reinstated on the waiting list. Barbara was unable to begin substance abuse treatment through AFS because her mother was currently receiving treatment at the same facility, although she was provided with alternative options for treatment, including Ascent Treatment and Counseling. Barbara tested positive for cocaine again in April 2007. In a meeting with a social worker, she denied using cocaine but admitted to selling cocaine during March and April because she could not find a job. Barbara participated in a new substance abuse assessment with AFS in May 2007. The assessment reaffirmed her dependency on and abuse of various drugs and again recommended intensive outpatient substance abuse treatment. She began substance abuse treatment through Ascent in August 2007. Barbara was at times inconsistent in taking her required urinalysis tests and tested positive for cocaine use again in October 2007, which she testified was the last time she used cocaine. At the time, she was pregnant with Gary. Barbara's substance abuse assessment also recommended that she complete a full psychiatric evaluation. Barbara completed a psychological evaluation with Dr. Grace Long consisting of five meetings between March and May 2007. [2] Dr. Long concluded that Barbara should obtain intensive outpatient treatment for her substance abuse and recommended that she seek long-term treatment for depression, possibly with psychotropic medications and participate[] in a dialectic/behavior therapy program including long-term individual therapy. Without such treatment, Dr. Long concluded that Barbara's parenting skills [were] likely to remain unchanged and compromised. Dr. Long reiterated this recommendation at trial. Barbara requested that she be allowed to see Megha Hammaker, a nurse practitioner whom she had seen before, as her mental health professional, and OCS approved of her request. At trial, Barbara testified that she had seen Hammaker at least every two weeks since February 2006 and spoke to her frequently. The superior court did not credit this testimony. According to Hammaker's own records and testimony, there were periods of months between visits and few phone calls. Barbara reinitiated counseling sessions with Hammaker after a ten-month lapse in August 2007, following a suicide attempt. She participated in three sessions and then stopped seeing Hammaker until February 2008, when Barbara resumed sessions for less than a month before missing another nine weeks. After Hammaker recommended in early June 2008 that Barbara have weekly appointments to work through issues related to domestic violence, Barbara attended three sessions, went thirteen weeks without a visit, attended one session in October and one in November, then went until late April 2009 before attending another session the day after she was questioned at trial about the frequency of her sessions. The case plan also required that Barbara attend parenting and domestic violence classes. After missing a number of parenting classes, she eventually completed the required course in October 2007. She had begun attending domestic violence classes with AFS but believed she had to stop taking those classes after she was asked to leave the shelter in December 2006. By mid-2007 she had not resumed the classes. Around that time, she spoke to a social worker and described a recent violent encounter with Leo, where he came to her apartment and accused her of seeing another person. Barbara did not terminate her relationship with Leo; rather, in August 2007 Barbara decided she wanted to become pregnant again by Leo because she wanted both her children to have the same father. Dr. Long's report described a well-established pattern for [Barbara] to enter into heterosexual relationships that are volatile, abusive, and drug-related. By late 2007 Barbara had completed only her parenting class and the required evaluations.