IN RE: M.R.S. (Child in Need of Services) (2025)

MEMORANDUM DECISION

[1] M.M.S. (“Mother”) and M.S.S. (“Father”) (together, “Parents”) each appeal the trial court's determination that their minor child, M.R.S. (“Child”), is a child in need of services (“CHINS”). We affirm.

Facts and Procedural History

[2] Child was born to Parents in June 2023. On November 16, 2023, the Department of Child Services (“DCS”) received a report alleging that Child was “a victim of neglect in the maltreatment type of exposure to inadequate food, or signs of malnutrition.” Appellant Mother's Appendix Volume II at 101. Specifically, there were concerns that Child had been seen by multiple health care providers who noted “Failure to Thrive” due to poor nutrition and lack of weight gain. Id.

[3] Child was removed from Parents’ care on December 29, 2023. DCS filed a CHINS petition on January 3, 2024. The petition included allegations that: Child had been labeled by doctors as “Failure to Thrive and as having mild malnutrition;” Parents had failed to transport Child “to follow-up doctor appointments to monitor her growth;” Child had gained little weight since September; doctors had concerns that Mother is not understanding how to make special weight-gaining formula for Child or is not feeding her frequently enough; and Child was able to gain weight when she had a short stay in the hospital but is not doing the same at home. Id. at 22. The petition further alleged that Parents have another child who “is currently pending adoption due to an open Child in Need of Services matter regarding medical neglect and Failure to Thrive. Parents have not completed Court ordered services in that matter.” Id. Accordingly, the petition alleged that “the coercive intervention of the Court is necessary to ensure the safety and well-being of [Child].” Id. Following a detention and initial hearing held that same day, the court ordered Child's continued removal, entered denials on behalf of Mother and Father, and appointed counsel for each.

[4] The court held a factfinding hearing on April 29, 2024. DCS presented the testimony of Dr. Michael Keller, Nurse Practitioner David Johnson (“NP Johnson”), Dr. Cortney Demetris, Dr. Timothy Day, Nurse Practitioner Rebecca Anderson (“NP Anderson”), Family Case Manager Bailey Handley (“FCM Handley”), Family Case Manager Megan Hoath (“FCM Hoath”), and Family Case Manager Cloey Wright (“FCM Wright”). Mother testified on her own behalf. Father did not testify.

[5] Dr. Keller testified that he was Child and Mother's primary care physician for approximately three months beginning shortly after Child's birth in June 2023. He stated that Child was born at thirty-seven weeks and weighed 6.19 pounds at birth, which was considered a birth weight “within the realm of normal.” Transcript Volume II at 60. He testified that although infants lose weight after birth, they are usually back to birth weight by around fourteen days. Dr. Keller was concerned when Child was still not back to her birth weight at her seventeen-day appointment. Dr. Keller diagnosed Child with “failure to thrive” which is “essentially when an infant is small and not gaining weight.” Id. at 61. Dr. Keller testified that he discussed with Parents the need to “be very diligent with feeding” and engage in “more frequent feedings,” and Parents indicated that they understood. Id. at 62. Dr. Keller stated that, after he recommended “weight check[s]” every one to two weeks, Mother then “missed” many appointments. Id. at 63. Mother returned with Child to Dr. Keller in late August after thirty days and Child had only gained 4 ounces. Id. Dr. Keller again stressed the importance of frequent feedings to Mother. Mother returned to Dr. Keller's office for only one more appointment before changing providers.

[6] NP Johnson testified that he first saw Mother and Child as his patients on September 29, 2023. Mother informed him that Dr. Keller had filed a report with DCS so she stopped seeing him because she wished to “avoid entanglements” with DCS because she “had previous interactions with them.” Id. at 70. Child weighed 11 pounds and 7 ounces at her first appointment with NP Johnson. NP Johnson testified that this was not a typical weight for an almost four-month-old child, and that Child's weight placed her in “about the tenth percentile.” Id. NP Johnson stated that he was very concerned about Mother's statements that she wanted to avoid DCS. He testified that, when he observed that Child had lost 1.4 ounces after about five weeks in his care, he consulted with two pediatricians who recommended that Child be seen at a hospital for evaluation. He stated that Mother told him that she did not want to go to Riley Children's Hospital because she had a child pass away there, and that she did not want to go to Beacon Hospital because “she was told if she ever brought a child back the child would be taken into custody because of the previous child that had been taken into custody.” Id. at 72. NP Johnson testified that Mother took Child to Peyton Manning Children's Hospital in midOctober and she gained 0.26 ounces over the two days, “which is right on target for how the child should be feeding.” Id. at 72-73. NP Johnson stated that he contacted DCS because he “was concerned that something was happening in the environment outside the office ․ because it made no sense ․ that being observed feeding, [Child] gained weight, but [Child] couldn't gain weight any other way despite all the interventions we had tried.” Id. at 77.

[7] Dr. Demetris saw Child when Child was at Peyton Manning Children's Hospital. Following discharge, Child was to have weekly weight checks with the hospital's “child abuse monitoring team.” Id. at 89. Dr. Demetris testified, “We noticed a fairly flat, uh, weight trend from the hospital discharge until we started to actually see a loss, which did also place [Child] into a malnutrition category and that occurred on [December 1, 2023].” Id at 90. Dr. Demetris recalled that Mother canceled a weight check around December 15, 2023, Child was detained by DCS on December 29, and that Child then started “gaining weight in an alternative care environment.” Id. at 91. Dr. Demetris opined that Child's ability to gain weight while hospitalized and subsequent to being detained indicated that “her moderate malnutrition was secondary to neglect.” Id. at 94.

[8] Dr. Day testified that he began seeing Child as a patient on December 1, 2023. Dr. Day was concerned with Child's “weight gain, her size. She was undersized for her age.” Id. at 101. Dr. Day stated he advised Mother that it was necessary to make sure Child was not going “more than three hours without a feed ․ and to make sure she was getting at least two ounces ․ or offered at least two ounces per feed.” Id. at 102. After Child still did not gain “an adequate amount of weight” by the end of December 2023, Dr. Day recommended that Child be seen again at Peyton Manning Children's Hospital. Dr. Day noted that moderate malnutrition, with which Child was diagnosed while hospitalized, can cause “long-term consequences” for a child. Id. at 106.

[9] NP Anderson testified that Child became her patient in January 2024 after she was removed from Parents’ care. NP Anderson stated that Child gained almost 1 pound from December 28, 2023, to January 19, 2025, while in the care of a foster family. NP Anderson testified that since that January 19th appointment, Child has “grown leaps and bounds, she's done remarkably well ․ her last weight was up to 16 pounds, she walks, she babbles ․ she's certainly catching up.” Id. at 112.

[10] FCM Handley testified that DCS received a report on November 16, 2023, with allegations that then five-month-old Child had signs of malnutrition. FCM Handley met with Parents on November 18, 2023, at their home. FCM Handley advised Parents of DCS's concerns, but Parents made excuses regarding Child's failure to gain weight and Mother denied missing any of Child's medical appointments. Mother informed FCM Handley that she “was planning on changing primary care providers due to the current primary care provider calling DCS on them[.]” Id. at 120.

[11] FCM Hoath testified that DCS determined that detaining Child was necessary “when we were made aware that [Child] had entered the moderately malnourished category that raised significant concern for us in addition to the knowledge that the family has a previously medically fragile child that led to DCS involvement.” Id. at 127. FCM Hoath testified that she recommended Child should be adjudicated a CHINS because “up until the point of our detention, [Child] had not made appropriate progress with gaining weight per the conversations we've had with medical providers. We were aware of several missed appointments and concerns related to that.” Id. FCM Hoath stated that she believed that court intervention was necessary and that a CHINS adjudication was in Child's best interests.

[12] FCM Wright testified that she was assigned Child's case in December of 2023, and she was also the FCM for one of Parents’ other children who has now been adopted. She stated that Parents each lack adequate parenting knowledge and have never “really taken any accountability or admitted that there needs to be any change made.” Id. at 131. She stated that Parents lack housing and transportation stability, and “stability is super important when you have a medically fragile child.” Id. at 132. FCM Wright stated that both Parents have stated that they refuse to participate in any offered services “unless they're court ordered.” Id.

[13] On May 26, 2024, the court issued its order adjudicating Child a CHINS. Specifically, the court found that “it is in the best interests of the child to be removed from the home environment and remaining in the home would be contrary to the welfare of the child because the child needs protection and the child has special needs that require services for care and treatment that cannot be provided in the home.” Appellant Mother's Appendix Volume II at 98. The court further found that “reasonable efforts were made by DCS to prevent or eliminate the need for removal of the child.” Id. Following a dispositional hearing held on June 24, 2024, the court ordered Parents to participate in various reunification services.

Discussion

[14] Parents each challenge the sufficiency of the evidence to support the court's CHINS adjudication. In reviewing a trial court's determination that a child is in need of services, we do not reweigh the evidence or judge the credibility of witnesses and consider only the evidence which supports the court's decision and reasonable inferences drawn therefrom. In re S.D., 2 N.E.3d 1283, 1286-1287 (Ind. 2014), reh'g denied. We apply the two-tiered standard of whether the evidence supports the findings and whether the findings support the judgment. Id. at 1287. We will reverse a CHINS determination only if clearly erroneous. In re D.J., 68 N.E.3d 574, 578 (Ind. 2017). A decision is clearly erroneous if the record facts do not support the findings or if it applies the wrong legal standard to properly found facts. Id. Ind. Code § 31-34-1-1 provides:

A child is a child in need of services if before the child becomes eighteen (18) years of age:

(1) the child's physical or mental condition is seriously impaired or seriously endangered as a result of the inability, refusal, or neglect of the child's parent, guardian, or custodian to supply the child with necessary food, clothing, shelter, medical care, education, or supervision:

(A) when the parent, guardian, or custodian is financially able to do so; or

(B) due to the failure, refusal, or inability of the parent, guardian, or custodian to seek financial or other reasonable means to do so; and

(2) the child needs care, treatment, or rehabilitation that:

(A) the child is not receiving; and

(B) is unlikely to be provided or accepted without the coercive intervention of the court.

The statute does not require a court to wait until a tragedy occurs to intervene. In re A.H., 913 N.E.2d 303, 306 (Ind. Ct. App. 2009). Rather, a child is a CHINS when the child is endangered by parental action or inaction. Id.

[15] Before reaching the merits, we briefly address Mother's argument that the “findings of the trial court completely lacked addressing a critical element of the CHINS proceeding, in that there had to be a need for coercive intervention of the court.” Appellant Mother's Brief at 6. We note that it is generally and statutorily understood that the trial court is not required to issue findings in a CHINS proceeding, and we review any issues not covered by the trial court's findings under the general judgment standard, meaning we will affirm a judgment if it can be sustained on any legal theory supported by the evidence. In re S.D., 2 N.E.3d at 1286.

[16] Accordingly, we turn to address both Parents’ suggestions that insufficient evidence was presented to support the trial court's ultimate determination that Child is a CHINS. The required proof of the statutory CHINS elements “guards against unwarranted State interference in family life, reserving that intrusion for families ‘where parents lack the ability to provide for their children,’ [and] not merely where they ‘encounter difficulty in meeting a child's needs.’ ” In re D.J., 68 N.E.3d at 580-581 (quoting In re S.D., 2 N.E.3d at 1287). When determining whether the “coercive intervention” of the court is necessary, courts “ ‘should consider the family's condition not just when the case was filed, but also when it is heard.’ ” Id. (quoting In re S.D., 2 N.E.3d at 1290). “Doing so avoids punishing parents for past mistakes when they have already corrected them.” Id. (citing In re S.D., 2 N.E.3d at 1289-1290). The focus of a CHINS determination is on the status of the child, not on an act or omission of the parent. See, e.g., In re N.E., 919 N.E.2d 102, 105-106 (Ind. 2010); In re S.C., 96 N.E.3d 579, 585 (Ind. Ct. App. 2017).

[17] DCS presented ample evidence to support the trial court's CHINS adjudication. The record reveals that DCS has a history with this family and became involved again when Child was diagnosed initially with failure to thrive. DCS presented evidence from multiple health care providers that Parents were either unable or unwilling to follow clear instruction on how much and how often to feed Child which led to Child later being diagnosed with moderate malnutrition. The record demonstrates that Mother missed numerous medical appointments with Child and, rather than follow medical advice, Parents made excuses for Child's low weight and Mother admittedly continually changed providers to avoid DCS involvement.¹ Parents also indicated to service providers that they would not participate in offered services unless court ordered to do so. This evidence supports the conclusion that Child's physical or mental condition is seriously impaired or endangered and that she needs care or treatment that is unlikely to be provided or accepted by Parents without the coercive intervention of the court.

[18] In light of the evidence set forth above and in the record, we cannot say the trial court clearly erred in adjudicating Child a CHINS.

[19] For the foregoing reasons, we affirm the trial court's order.

[20] Affirmed.

FOOTNOTES

1.   Father states that, “Mother primarily handled [Child's] medical appointments with Father aiding in transportation.” Appellant Father's Brief at 15.

Brown, Judge.

Chief Judge Altice and Judge Tavitas concur. Altice, C.J., and Tavitas, J., concur.