P.N. (Father) and S.S. (Mother) Appellants-Respondents v. Indiana Department of Child Services, Appellee-Petitioner (2025)

MEMORANDUM DECISION

[1] P.N. (“Father”) and S.S. (“Mother”) (collectively “Parents”) appeal the termination of their parental rights to J.N. and G.N. (collectively “Children”). Parents present multiple issues for our review, which we revise and restate as:

1. Whether the trial court's findings support its conclusion that the conditions under which Children were removed from their care would not be remedied; and

2. Whether the trial court's findings support its conclusion that termination of Parents’ parental rights is in Children's best interests.

We affirm.

Facts and Procedural History

[2] Parents are the biological parents of J.N., born in November 2020, and G.N., born in August 2022. J.N. was born prematurely and diagnosed with cerebral palsy. She was also born drug-exposed because Mother used marijuana during her pregnancy. G.N. has been diagnosed with fetal alcohol syndrome and was also born drug addicted because Mother used marijuana during her pregnancy. Children lived with Parents prior to the conditions prompting the intervention of the Department of Child Services (“DCS”).

[3] After J.N. was born, her small intestine became infected and the majority of it had to be removed. After that removal, Parents were required to regularly complete several tasks at home to ensure J.N. remained healthy, such as empty and measure the contents of her ostomy bag, maintain her IV fluids, and administer nutrition through her TPN bag.¹ Parents did not consistently complete these tasks, did not regularly attend medical appointments, and had frequent conflicts with medical staff. As a result, J.N. experienced several medical complications, such as recurrent infections, and she was unable to gain weight. Eventually, J.N.’s primary physician, Dr. Kanika Puri of Riley Children's Hospital (“Riley”), recommended J.N. receive an organ transplant. Parents did not agree with that course of action, and in July 2021, transferred J.N.’s care to Peyton Manning Children's Hospital (“PMCH”).

[4] From July 2021 until May 2023, Dr. Eric Tibesar of PMCH was J.N.’s primary physician. He also recommended an organ transplant, but Parents refused, insisting TPN treatment was a long-term solution for J.N.’s medical condition. Dr. Tibesar disagreed with Parents’ assessment, indicating “TPN is a treatment, not a cure” and the “only potential cure ․ is a total intestinal transplant.” (App. Vol. II at 128.) While J.N. was under Dr. Tibesar's care, J.N. needed frequent medical tests and appointments. Parents missed seven appointments, “which led to significant gaps in [J.N.’s] treatment.” (Id.) Dr. Tibesar's concerns about Parents’ lack of ability to properly care for J.N. “were so significant that he reported his concerns about possible neglect to the hospital social worker.” (Id. at 129.)

[5] On March 16, 2023, Parents were arrested for trying to sell fentanyl while having Children and 150 fentanyl pills in their car. As a result of Parents’ arrests, DCS removed Children from Parents’ care and placed J.N. in foster care and G.N. in relative care with Maternal Grandfather. Children have remained in those placements throughout these proceedings. On March 17, 2023, DCS filed petitions alleging Children were Children in Needs of Services (“CHINS”) based on Parents’ arrest and their lack of ability to provide a safe and healthy environment for Children. Parents admitted Children were CHINS. The trial court adjudicated Children as CHINS and ordered Parents to participate in several services with the goal of reunification with Children. These services included submitting to random drug screens; participating in services recommended by DCS such as parenting classes and substance abuse treatment; and attending supervised visits with Children.

[6] On September 20, 2023, Father pled guilty to Level 5 felony neglect of a dependent,² Level 3 felony dealing in a narcotic drug,³ and Level 6 felony maintaining a common nuisance.⁴ Father was sentenced to incarceration with an earliest release date in December 2029. On August 21, 2024, Mother pled guilty to Level 5 felony neglect of a dependent and Level 6 felony maintaining a common nuisance. Mother was sentenced to probation.

[7] During the CHINS case, Parents were inconsistent with services. Mother did not engage in DCS-recommended services, missed approximately 200 drug screens, and frequently tested positive for drugs including cocaine, fentanyl, and methamphetamine. Mother did not successfully complete substance abuse rehabilitation services and tested positive for illegal substances during pregnancy with her third child, E.N. Mother did not consistently visit with Children and eventually visitation was terminated. Father participated in some substance abuse and parenting classes while incarcerated and communicated with the FCM once a month but did not engage in other services or visit with Children due to his incarceration.

[8] On May 15, 2024, DCS filed its petitions to terminate Parents’ parental rights to Children. The trial court held three fact-finding hearings in November 2024.⁵ During those hearings, DCS presented evidence of Parents’ noncompliance with services and Children's progress in placement. Dr. Puri testified J.N. was being considered for an organ transplant and that J.N.’s foster mother (“Foster Mother”) provided sufficient care to address J.N.’s medical needs. Regarding G.N., the Court Appointed Special Advocate (“CASA”), Sara Turner, testified that G.N. was delayed in her development by several months when removed from Parents’ care and had achieved age-appropriate developmental milestones since being placed in relative care with Maternal Grandfather. CASA indicated termination of Parents’ parental rights to Children was in Children's best interests. The social worker who was part of J.N.’s transplant team, Joshua Sumner, testified J.N. would not be able to get an organ transplant if Parents’ parental rights were not terminated because Parents lacked the ability to address her post-transplant needs. On February 7, 2025, the trial court issued its order terminating Parents’ parental rights to Children based, in part, on Parents’ lack of participation in services, Parents’ unwillingness to properly care for J.N.’s medical needs, Father's incarceration, and Mother's substance abuse.

Discussion and Decision

[9] Parents appeal the termination of their parental rights to Children. “The Fourteenth Amendment to the United States Constitution protects the traditional right of parents to establish a home and raise their children.” K.T.K. v. Ind. Dep't of Child Servs., 989 N.E.2d 1225, 1230 (Ind. 2013) (quoting Bester v. Lake Cnty. Off. of Fam. & Children, 839 N.E.2d 143, 147 (Ind. 2005)). However, a trial court “must subordinate the interests of the parents to those of the child and need not wait until a child is irreversibly harmed before terminating the parent-child relationship.” A.L., 223 N.E.3d 1126, 1140 (Ind. Ct. App. 2023), trans. denied. “If ‘parents are unable or unwilling to meet their parental responsibilities,’ termination of parental rights is appropriate.” Id. at 1137 (quoting Bester, 839 N.E.2d at 147). The “termination of the parent-child relationship remains an ‘extreme measure’ and should only be utilized as a ‘last resort when all other reasonable efforts to protect the integrity of the natural relationship between parent and child have failed.’ ” K.E. v. Ind. Dep't of Child Servs., 39 N.E.3d 641, 646 (Ind. 2015) (quoting Rowlett v. Vanderburgh Cnty. Off. of Fam. & Child., 841 N.E.2d 615, 623 (Ind. Ct. App. 2006), trans. denied).

[10] To terminate a parent-child relationship in Indiana, DCS must allege and prove “one (1) or more” of the circumstances listed in Indiana Code section 31-35-2-4(d). Ind. Code § 31-35-2-4(c). As relevant here, DCS can prove:

(3) That there is a reasonable probability that the conditions that resulted in the child's removal or the reasons for placement outside the home of the parents will not be remedied.

(4) That there is a reasonable probability that the continuation of the parent-child relationship poses a threat to the well-being, safety, physical health, or life of the child.

Ind. Code § 31-35-2-4(d) (2024). In addition, DCS must prove that termination is in the children's best interests, Ind. Code § 31-35-2-4(c)(3) (2024), and that there exists a satisfactory plan for the children's care following termination. Ind. Code 31-35-2-4(c)(2) (2024). “DCS must prove the alleged circumstances by clear and convincing evidence.” In re T.W., 135 N.E.3d 607, 612 (Ind. Ct. App. 2019), trans. denied. “[I]f [DCS] fails to prove any one of these ․ statutory elements, then it is not entitled to a judgment terminating parental rights.” In re G.Y. 904 N.E.2d 1257, 1261 (Ind. Ct. App. 2009). “Because parents have a constitutionally protected right to establish a home and raise their children, the Indiana Department of Child Services ‘must strictly comply with the statute terminating parental rights.’ ” In re Q.M., 974 N.E.2d 1021, 1024 (Ind. Ct. App. 2012) (internal citations omitted) (quoting Platz v. Elkhart Cnty. Dep't of Pub. Welfare, 631 N.E.2d 16, 18 (Ind. Ct. App. 1994)).

[11] When reviewing a trial court's termination of parental rights,

we do not reweigh the evidence or judge witness credibility. We consider only the evidence and reasonable inference that are most favorable to the judgment and give due regard to the trial court's unique opportunity to judge the credibility of the witnesses. We will set aside the trial court's judgment only if it is clearly erroneous.

In re V.A., 51 N.E.3d 1140, 1143 (Ind. 2016) (internal quotations and citations omitted). “When ․ the trial court has made findings of fact and conclusions of law, we apply a two-tiered standard of review: ‘we must first determine whether the evidence supports the findings and second, whether the findings support the judgment.’ ” In re Adoption of T.L., 4 N.E.3d 658, 662 (Ind. 2014) (quoting In re Adoption of T.W., 859 N.E.2d 1215, 1217 (Ind. Ct. App. 2006)). “Findings of fact are clearly erroneous when the record lacks any evidence or reasonable inferences from the evidence to support them.” Steele-Giri v. Steele, 51 N.E.3d 119, 125 (Ind. 2016) (quoting In re Paternity of Winkler, 725 N.E.2d 124, 126 (Ind. Ct. App. 2000)). “We accept unchallenged findings as true.” Henderson v. Henderson, 139 N.E.3d 227, 232 (Ind. Ct. App. 2019).

1. Conditions Will Not Be Remedied

[12] Parents contend the trial court's findings do not support its conclusion that the conditions under Children were removed from their care would not be remedied. When considering whether the trial court's findings support its conclusion that the conditions under which a child is removed from a parent's care would not be remedied, “we ‘engage in a two-step analysis.’ ” In re E.M., 4 N.E.3d 636, 642-3 (Ind. 2014) (quoting K.T.K., 989 N.E.2d at 1231). “First, we identify the conditions that led to removal; and second, we ‘determine whether there is a reasonable probability that those conditions will not be remedied’ ” Id. at 643 (quoting K.T.K., 989 N.E.2d at 1231). When hearing the evidence at a termination of rights hearing, “[t]he trial court should judge a parent's fitness as of the time of the termination hearing and take into consideration evidence of changed conditions.” Stone v. Daviess Cnty. Div. of Child. & Fam. Servs., 656 N.E.2d 824, 828 (Ind. Ct. App. 1995), trans. denied. “In judging fitness, a trial court may properly consider, among other things, a parent's substance abuse and lack of adequate housing and employment” as well as “a parent's failure to respond to services.” A.L., 223 N.E.3d at 1139 (internal citations omitted). “[H]abitual patterns of conduct must be evaluated to determine whether there is a substantial probability of future neglect or deprivation.” Id. (quoting Stone, 656 N.E.2d at 828) (brackets in original). “The trial court need not wait until the children are irreversibly influenced by their deficient lifestyle such that their physical, mental and social growth is permanently impaired before terminating the parent-child relationship.” Stone, 656 N.E.2d at 828.

[13] Parents ask us to reverse the termination of their parental rights because they have addressed the issues that led to Children's removal.⁶ To support their argument, Parents direct us to several parts of the record that they contend illustrate their progress in services. Father points to his testimony during the November 8, 2024, fact-finding hearing in which he told the trial court he had completed several substance abuse and parenting services while incarcerated and had earned sentencing credits for their completion. Mother asks us to focus on her attempts to address her substance abuse issues by attending several rehabilitation and sober living programs. She also highlights testimony from Shannon Cora, the visitation supervisor, who told the trial court that, based on her interactions with Mother two years prior to the termination fact-finding hearing, she had no concerns about Mother's interactions with J.N. during supervised visitation.

[14] Parents’ arguments, however, ignore the plethora of unchallenged findings that support the trial court's conclusion that the conditions under which Children were removed from their care would not be remedied. Regarding Mother's participation in services, the trial court found:⁷

106. [Mother] enrolled for inpatient recovery with Avenues of Recovery. However, [Mother] checked in on September 11, 2023 and checked herself out six (6) days later on September 17, 2023, not completing the program.

107. At various other times, [Mother] has claimed to be attending substance abuse treatment programs at Wooded Glenn Recovery in southern Indiana; TruHealing Sober Living also believed to be in southern Indiana; and Saint Elizabeth facility (location unknown).

108. None of these facilities or programs in Paragraph [107] came through a DCS referral.

109. [Mother] never provided any proof of completing an intake or evaluation, nor completing any services or treatment that may have been recommended, from any of these programs identified in Paragraph [107].

110. [Mother] continued and continues to test positive for illegal substances.

* * * * *

112. Despite referrals by DCS, [Mother] never enrolled in the Medication Evaluation program required in the Dispositional Order.

113. Despite referrals by DCS, [Mother] never enrolled in the Substance Use Assessment program required in the Dispositional Order.

114. Despite referrals by DCS, [Mother] enrolled in (twice) but never attended the Parenting Assessment program required in the Dispositional Order. On September 11, 2023 and January 11, 2024, she “no called, no showed” and each referral was cancelled.

115. [Mother] completed [the] Diagnostic Evaluation on March 29, 2023; however, she failed to complete the recommended follow up programs for Psychiatric Evaluation, Individual Therapy, and an Intensive Outpatient Program for Substance Use.

116. [Mother] scheduled the required Parenting Class ․ provided by Radiant Health. She attended one (1) class, but then “no called, no showed” three (3) subsequent classes, and the referral was closed due to noncompliance.

(App. Vol. II at 121-122.) The trial court also found that Mother was inconsistent with other efforts to reunify with Children:

123. [Mother] has also not called in with Cordant [the company conducting drug testing] regularly regarding random drug screens per the compliance report from Cordant.

124. From the period between May 19, 2023 and November 18, 2023, [Mother] missed 110 required Call-Ins, 25 random tests, and 24 unforgiven missed tests.

125. From the period between January 8, 2024 and June 16, 2024, [Mother] missed 85 required Call-ins, 24 random tests, and 18 unforgiven missed tests.

126 [Mother] also failed to comply with the Dispositional Order requiring that she obey the law.

127. On June 5, 2023, she was arrested for one (1) felony – possession of a narcotic drug (cocaine), and two (2) misdemeanors – possession of marijuana and possession of paraphernalia under Cause Number 27C01-2306-F6-000458.

128. On July 12, 2023, [Mother] was driving and was stopped for a traffic stop. She was in possession of packages that tested presumptively for methamphetamine; however, she was not charged in the matter.

129. On August 25, 2023, [Mother] was again stopped for a traffic violation and found to have methamphetamine and marijuana in her vehicle; however, again, she was not charged in the matter.

* * * * *

136. Regarding visitation, [Mother] has not seen [J.N.] since September 5, 2023.

137. As for [G.N.], on March 1, 2024, [Maternal Grandfather] notif[ied] DCS that because [Mother] was so inconsistent regarding her visitation with [G.N.] that he no longer wanted to supervise the visitation nor did he want it to take place in his home.

138. At the Permanency Hearing on March 21, 2024, [Mother's] visitations were suspended with [Children].

(Id. at 123-124) (internal citations to the record omitted) (footnote omitted). In addition, Finding 80 of the trial court's order contained a number of findings regarding Mother's participation in J.N.’s medical care:

i. CASA, Sara Turner ․ has been involved in the case since March 23, 2023, and has attended all or nearly all of [J.N.’s] medical appointments;

j. Despite being notified in advance of every appointment, [Mother] has failed to attend any of [J.N.’s] numerous medical appointments, with the exception of one (1) Riley appointment (which she attended by phone) and a liver biopsy (for which she was three (3) hours late);

k. [Mother] has never followed up with [the] CASA to ask about how such appointments went or to request information on the well-being of [Children.]

(Id. at 114) (internal citations to the record omitted). Finally, the trial court found “[Mother] does not have safe housing, as she is currently homeless” (id. at 116), and “[Mother] has not reported a source of income.” (Id. at 117.)

[15] Regarding Father's participation in services, the trial court found in Finding 84:

i. [Father] has partially complied with Children's case plans.

j. [Father] is currently incarcerated and only has contact with [the] FCM through monthly phone calls.

k. [Father] has not enrolled in services at this time; however, he stated in court he is taking classes offered through [the Indiana Department of Correction].

(Id. at 116.) The trial court also found Father was “incarcerated at the Putnamville Correctional Facility with a release date of December 15, 2029.” (Id.) (footnote omitted). In a footnote to the finding regarding Father's incarceration, the trial court found that, despite Father's testimony that he had completed several programs while incarcerated, earning him a sentence reduction, “such time cuts are not reflected in the official Indiana Department of Corrections [sic] (IDOC) database, which is regularly updated by IDOC.” (Id. at n.2)

[16] In sum, the trial court found:

[Parents] have done nothing to remedy the issues that led to [Children's] removal, nor the issues that were exposed as a result of the removal – failure to provide adequate housing, transportation, and income necessary to meet the basic needs of [Children], no true effort to be sober caregivers, i.e., seemingly perpetual substance abuse – in [Mother's] case even when she knew she was being monitored by DCS and continuing when she became pregnant a third time and was placed on probation – and also acting to delay the hope of, not even to mention actual progress toward – including even going so far as making the ridiculous and biologically impossible claim that they wanted to see if [J.N.’s] organs would regenerate or grow back if she gained weight – getting [J.N.] the lifesaving organ transplant she needed. It was all these things, and more, that prevented [J.N.] from even being considered as an organ transplant recipient by the Riley transplant team while under the custody of [Parents]. This is not just neglect; it is also heartless and reckless.

These were obstacles [Parents] created for [J.N.] just pretransplant. As for any shot of reaching the post-transplant stage, [Parents] did not even make the slightest effort to build a trained care team; instead suggesting that ․ [because they were provided] the basic TPN training[,] they were prepared and able to move forward. In reality, that is the absolute smallest step in a life-long journey. This lunacy, incompetence, and inability or unwillingness to make the simplest, most basic and obvious decisions for [J.N.’s] benefit, would have dramatically increased, probably almost guaranteed, the chance of [J.N.’s] post-transplant organ failure and almost certain death.

(Id. at 158) (emphases in original). Based thereon, the trial court concluded the conditions under which Children were removed from Parents care would not be remedied.

[17] As the trial court's findings outline in detail Parents’ lack of participation in services, failure to visit with Children, inability to obtain or maintain appropriate income and housing, and lack of interest in learning how to properly care for J.N., we hold those findings support its conclusion that the conditions under which Children were removed from Parents’ care would not be remedied.⁸ See, e.g., In re C.S., 190 N.E.3d 434, 439 (Ind. Ct. App. 2022) (mother's continued drug use, pending criminal charges, and inability to demonstrate she could care for her child supported the trial court's conclusion that the conditions under which child was removed from her care would not be remedied), trans. denied.

2. Children's Best Interests

[18] Parents argue the trial court's findings do not support its conclusion that termination of their parental rights to Children was in Children's best interests. When considering whether termination of a parent's rights is in a child's best interests, “the [trial] court is required to look at the totality of the evidence.” Z.B. v. Ind. Dep't of Child Servs., 108 N.E.3d 895, 903 (Ind. Ct. App. 2018), trans. denied. “In doing so, the [trial] court must subordinate the interests of the parents to those of the children involved.” Id. “The [trial] court need not wait until a child is irreversibly harmed before terminating the parent-child relationship.” Id. Moreover, the testimony of service providers may support a finding that termination is in the child's best interests.” Id.

[19] As indicated above, Parents did not complete services and did not demonstrate an ability to properly parent Children. Mother routinely tested positive for illegal substances and missed over 200 random drug screens; Mother did not visit with Children; and Mother did not participate in services. Father was incarcerated throughout the proceedings and his release date was listed as December 2029. Additionally, Parents did not take steps to learn the complex care regimen required to address J.N.’s significant medical issues.

[20] Further, the trial court findings outlined Foster Mother's efforts to ensure J.N. received proper care, including assembling a care team, attending all appointments, and receiving training for all at-home treatments. Foster Mother supported Dr. Puri's recommendation that J.N. receive an organ transplant and understood the importance of post-transplant care. Also, G.N. met developmental milestones while in Maternal Grandfather's care, in contrast to when she was under Parents’ care and significantly behind her peers. Finally, the trial court found: “It is CASA's unqualified position that the termination of parental rights of [Parents] is appropriate and in the best interests of [Children] and that adoption is a satisfactory plan for the care and treatment of Children.” (App. Vol. II at 155.) Based thereon, the trial court concluded the termination of Parents’ parental rights to Children was in Children's best interests. We agree and hold the trial court's findings support its conclusion that it was in Children's best interests for the trial court to terminate Parents’ parental rights to Children. See, e.g., In re N.G., 51 N.E.3d 1167, 1173 (Ind. 2016) (trial court's findings that parents had not benefitted from services and that the CASA and Guardian ad Litem testified termination was in children's best interests supported its conclusion that termination of parents’ parental rights was in the children's best interests).

Conclusion

[21] The trial court's findings support its conclusions that the conditions under which Children were removed from Parents’ care would not be remedied and that termination of Parents’ parental rights to Children was in Children's best interests. Therefore, we affirm the trial court's termination of Parents’ parental rights to Children.

[22] Affirmed.

FOOTNOTES

1.   Dr. Kanika Puri testified “TPN” was the acronym for “Total Parenteral Nutrition.” (Tr. Vol. II at 178.) Dr. Puri indicated the TPN is a process by which nutrition is administered intravenously instead of through the gastrointestinal tract.

2.   Ind. Code § 35-46-1-4(a).

3.   Ind. Code § 35-48-4-1(a)(1).

4.   Ind. Code § 35-45-1-5(c).

5.   Sometime prior to the termination fact-finding hearings, Maternal Grandfather initiated separate proceedings to adopt Children. Parents signed consent forms allowing Maternal Grandfather to adopt Children. DCS did not object to Maternal Grandfather adopting G.N. but did not agree Maternal Grandfather should adopt J.N. due to her medical conditions. The case was still pending at the time of the termination fact-finding hearings.

6.   Parents spend a substantial portion of their brief arguing that the trial court erred when it terminated their parental rights to Children because Mother was able to retain custody of E.N., the child born during these proceedings. However, the fact that Parents’ rights to E.N. were not at issue does not require reversal of the termination of their parental rights to Children, especially considering J.N.’s significant medical needs. See In re I.A., 903 N.E.2d 146, 156 (Ind. Ct. App. 2009) (affirming termination of mother's parental rights to I.A. despite the fact that the trial court did not terminate mother's parental rights to her four other children, in part because I.A. had special needs and mother was unable to address those needs).

7.   The trial court's order is 67 pages long and includes 377 findings. We appreciate the trial court's attention to detail, as it significantly aided our review.

8.   Parents also argue the trial court's findings do not support its conclusion that the continuation of the Parent-Children relationship posed a threat to Children's well-being. However, as DCS is required to prove only one of the factors alleged in Indiana Code section 31-35-2-4(c), we need not address Parents’ argument. See, e.g., In re J.S., 183 N.E.3d 362, 369 (Ind. Ct. App. 2022) (statute regarding factors required to terminate parental rights is written in the disjunctive and, thus, DCS need prove only one of the enumerated elements therein), trans. denied.

May, Judge.

Altice, C.J., and Foley, J., concur.