Jessica P. v. Dcs, H.P. ( 2020 )


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  •                                    IN THE
    ARIZONA COURT OF APPEALS
    DIVISION ONE
    JESSICA P., Appellant,
    v.
    DEPARTMENT OF CHILD SAFETY, H.P., Appellees.
    No. 1 CA-JV 19-0253
    FILED 7-28-2020
    Appeal from the Superior Court in Maricopa County
    No. JD 530589
    The Honorable Jeffrey A. Reuter, Judge
    AFFIRMED
    COUNSEL
    Gillespie Shields Goldfarb & Taylor, Phoenix
    By Kristina B. Reeves, April Maxwell
    Counsel for Appellant
    Arizona Attorney General’s Office, Mesa
    By Lauren J. Lowe
    Counsel for Appellee, Department of Child Safety
    Arizona Center for Disability Law, Tucson
    By Christian Carlsen, Rose A. Daly-Rooney
    Counsel for Amicus Curiae, Arizona Center for Disability Law
    Arizona Center for Law in the Public Interest, Phoenix
    By Anne Ronan, Daniel Adelman
    Counsel for Amicus Curiae, Arizona Center for Law in the Public Interest
    ACLU Foundation of Arizona, Phoenix
    By Victoria Lopez
    Counsel for Amicus Curiae, American Civil Liberties Union of Arizona
    Mills & Woods Law PLLC, Phoenix
    By Thomas A. Connelly
    Counsel for Amicus Curiae, the ARC, et al.
    NYU School of Law Family Defense Clinic, New York, NY
    By Amy Mulzer, Christine Gottlieb, Martin Guggenheim
    Counsel for Amicus Curiae, the ARC, et al.
    Disability & Civil Rights Clinic, Brooklyn NY
    Brooklyn Law School
    By Sarah Lorr
    Counsel for Amicus Curiae, the ARC, et al.
    OPINION
    Judge Jennifer B. Campbell delivered the opinion of the Court, in which
    Presiding Judge Paul J. McMurdie and Judge Kent E. Cattani joined.
    C A M P B E L L, Judge:
    ¶1            Jessica P. (“Mother”) appeals from the juvenile court’s order
    terminating her parental rights to her son, Hunter. On appeal, Mother raises
    an Americans with Disabilities Act (“ADA”) claim, a facial constitutional
    challenge, and a state statutory claim. She also challenges the sufficiency of
    the evidence supporting the court’s order terminating her parental rights
    on mental deficiency and fifteen months out-of-home placement grounds.
    For the following reasons, we affirm.
    BACKGROUND
    ¶2         Mother was 20 and living with her mother (“Grandmother”)
    when Hunter was born in April 2014. Mother has an intellectual disability.
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    JESSICA P. v. DCS, H.P.
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    Grandmother helped take care of Hunter, including taking him to medical
    appointments. Grandmother also helped Mother, who received Social
    Security disability benefits, with her finances.
    ¶3           In September 2016, Mesa Police were called to Banner Desert
    Hospital where Mother was being treated for a possible sexual assault.
    Mother tested positive for THC, opiates, and methamphetamine. She told
    police she sometimes spent time with a 61 year-old man and smoked
    methamphetamine with him. Hospital staff observed that Mother was
    “extremely altered” and displaying “twitching type behavior.”
    Grandmother reported that the man had been “grooming” Mother for the
    past month after meeting him at an extended stay motel where they were
    residing.
    ¶4            In November 2016, Mother’s grandparents feared for
    Mother’s safety and called Mesa Police to report that Mother was acting
    out, being combative, and “acting crazy.” Police observed that Mother
    appeared to be under the influence of drugs. They transported her to the
    hospital for evaluation.
    ¶5           In late December 2016, DCS received two reports that Mother
    was neglecting Hunter. Mother and Hunter were still living with
    Grandmother. The callers alleged that Mother used marijuana and
    methamphetamine around the child, she had left him home alone on
    multiple occasions, the home was dirty, and she had been observed giving
    Hunter drinks of beer and hard liquor. The reports further alleged that
    Mother spanked the child, physically fought with Grandmother and
    Mother’s significant other in front of the child, and she bit her own
    grandmother.
    ¶6             A DCS investigator went to Mother and Grandmother’s home
    and observed that other than a scratch on his cheek, the child was injury-
    free, and he was dressed appropriately. Aside from summarizing the two
    reports to DCS discussed supra ¶¶ 4-5, the investigator reported that the
    home was “free from any safety hazards.“ The investigator noted that
    Grandmother reported the child had previously received services from the
    Department of Developmental Disabilities (“DDD”) for an intellectual
    disability, but that she had discontinued his DDD services “because he was
    doing well.”
    ¶7            The investigator spoke with Mother, who reported she had
    consumed alcohol that morning. Mother told the investigator she believed
    the neglect reports had been made by a former boyfriend because she had
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    JESSICA P. v. DCS, H.P.
    Opinion of the Court
    refused to have sex with him. Mother told the investigator that she
    previously had taken medication for depression and anxiety but was not on
    medication currently. Mother agreed to drug testing and told the
    investigator she would test positive for “weed.” Mother also told the
    investigator that she had considered self-harm. After Grandmother agreed
    to be a safety monitor, the investigator left Hunter in the home pending
    Mother’s urinalysis testing. DCS offered Mother family-preservation
    services, drug testing, and substance-abuse treatment.
    ¶8            Mother’s urinalysis was positive for alcohol and marijuana.
    Her hair follicle test was positive for marijuana and “a high level [of]
    . . . methamphetamines.” DCS held a Team Decision Meeting in January
    2017. At that meeting Mother admitted to having used methamphetamine
    but said she had only done so one time. She told DCS that Hunter’s father
    was unknown. DCS expressed “concern that Hunter did not currently have
    DDD services and concern about Mother’s lack of understanding about
    DCS’s involvement.”
    ¶9             The next day, DCS removed Hunter from the home because
    1) Grandmother, his safety monitor, refused to provide a urinalysis test1; 2)
    Mother’s substance abuse; 3) Mother refused to participate in services; and
    4) “[t]he physical or mental condition of [Mother] endangers [the] child’s
    health or safety.” DCS placed Hunter in an unlicensed relative placement
    (a maternal cousin) and filed a dependency petition. DCS alleged Mother
    was unable to parent Hunter because of both substance abuse and her
    intellectual disability. The case plan was family reunification. Several days
    after Hunter was removed, Grandmother went in for urinalysis and was
    caught using a device to submit a false urine sample.
    ¶10           A behavioral health agency conducted a rapid-response
    assessment of the child. The cousin described Hunter as difficult to comfort
    when upset and told the agency therapist that Hunter would bang his head
    against walls to the point of injuring himself. The therapist observed that
    he became very upset when the cousin attempted to engage him in
    activities. The cousin said that she could not keep Hunter in her home
    because of his special needs. Two weeks later, DCS placed Hunter in a
    licensed DDD foster home.
    1   Grandmother claimed she could not test the first time DCS asked her
    to do so because of work responsibilities. About eight months later, in
    September 2017, Grandmother tested negative for substances.
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    JESSICA P. v. DCS, H.P.
    Opinion of the Court
    ¶11           When Hunter came into care, he was globally delayed, could
    barely speak, and was “very unsteady on his feet.”2 He had not had any
    immunizations, was underweight and his eating behaviors raised concerns
    about whether he had been getting enough nourishment. In addition, he
    had trouble feeding himself, shook when he was eating, and drooled
    excessively. Initially, he had frequent tantrums and violent outbursts
    towards other children in daycare. He displayed obsessive compulsive
    behaviors and appeared to be autistic. Hunter’s foster mother took him to
    a neurologist who diagnosed him with a seizure disorder and put him on
    medication. Hunter’s neurologist and pediatrician referred him to a
    developmental pediatrician because he was delayed in three or more areas.
    At the time of trial, Hunter had an Individualized Education Plan (“IEP”)
    and was attending a developmental preschool where he received speech,
    occupational, and physical therapies. He remained “significantly behind”
    his peers in preschool.
    ¶12           The juvenile court found Hunter dependent in late January
    2017. DCS asked Mother to complete services, including a substance abuse
    assessment and treatment at TERROS, random urinalysis testing, case aide
    services, parent aide services, therapeutic visits,3 individual counseling,
    2    Hunter was nearly three years old when he came into care. His delays
    were apparent much earlier, however. When he was five months old, his
    pediatrician referred him to the Arizona Early Intervention Program
    (“AZEIP”), where he was determined to have a moderate delay in motor
    skills, a significant delay in cognitive skills, a moderate delay in physical
    development and communication ability, and a mild delay in adaptive and
    self-help skills. AZEIP provided him with physical therapy. By February
    2016, it was apparent that Hunter was speech delayed, and at a visit to his
    pediatrician that month, Mother and Grandmother said Hunter would start
    speech therapy “soon.” He did not begin speech therapy until June 2016,
    however. Also in February 2016, Hunter’s pediatrician referred him to a
    neurologist to address his shaking and staring episodes. Hunter did not see
    the neurologist until June 2016. The neurologist suspected complex partial
    seizures and referred Hunter for an electroencephalogram (“EEG”) and a
    magnetic-resonance imaging scan (“MRI”). Neither Mother nor
    Grandmother took him for an EEG or MRI, leaving him untreated until he
    came into care.
    3   Therapeutic visitation was put into place because Hunter was exhibiting
    stress before and after visits, and because Mother was having difficulty
    responding to his cues and managing his tantrums during the visits. The
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    JESSICA P. v. DCS, H.P.
    Opinion of the Court
    and psychological evaluations. In 2018, DCS also provided Mother with
    several joint counseling sessions with Grandmother when considering the
    possibility of Mother and Grandmother co-parenting the child. DCS
    provided Mother with transportation to services and visits.
    ¶13            Mother was diligent and participated in services “to the best
    of her abilities.” She consistently tested negative for substances after the
    initial positive tests, successfully completed substance abuse services at
    TERROS, engaged consistently in both regular visitation and therapeutic
    visitation, completed parent aide services, and participated in
    psychological evaluations and individual counseling. At the time of trial,
    Mother was living in her own apartment and had a job as a caretaker for an
    18 year-old with special needs.4 Although the DCS case manager agreed
    that Mother had made behavioral changes and “was doing really well with
    maintaining her sobriety,” the case manager was still concerned that
    Mother did not understand Hunter’s medical and behavioral needs.
    ¶14           The case aide who supervised visits with Hunter, Mother, and
    Grandmother starting in June 2018, testified that Mother was consistent,
    prepared, nurturing, and loving. However, Mother and Grandmother
    bickered with one another during almost every visit, which upset the child.
    Hunter would cover his ears, ask why Mother and Grandmother were
    arguing, and tell them to be nice. The case aide testified that Grandmother
    acted in a controlling manner towards both Mother and the child.
    ¶15           In December 2018, the case aide received a phone call
    inadvertently originating from Grandmother’s phone that went to
    voicemail. The voicemail message was a recording of Grandmother
    “ranting and raving . . . [at Mother] with swear words.” The case aide heard
    Grandmother mention a lawyer and tell Mother “you haven’t tried.” She
    heard someone who sounded like Mother yelling back and crying. The case
    aide believed Grandmother was berating Mother about the dependency
    case. She reported the incident to Adult Protective Services. Subsequently,
    in part because of this incident, Grandmother and Mother’s visits with
    Hunter were separated. Mother continued to have weekly supervised visits
    in her home (visits Hunter appeared to enjoy), and Grandmother’s visits
    were reduced to once a month at a DCS office. An additional incident
    occurred at a meeting at DCS when Grandmother “scream[ed] at [Mother]
    therapeutic visit supervisor modeled appropriate parenting behaviors for
    Mother, provided her with parenting information and strategies, and gave
    her verbal feedback.
    4   Mother earned $150.00 per week at her job.
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    JESSICA P. v. DCS, H.P.
    Opinion of the Court
    about what a failure she was and how bad she had done to not get her son
    back.” The case manager warned Grandmother that if she spoke that way
    to Mother again, she would not be invited to any more meetings.
    ¶16            Mother underwent two psychological evaluations with
    Dr. James Thal. The first evaluation took place in July 2017. Mother’s IQ was
    determined to be 65, which placed her in the first percentile or in the
    intellectually disabled range. Dr. Thal diagnosed Mother with mild
    intellectual disability, alcohol use disorder in early remission,
    methamphetamine use disorder in early remission, and gave her a rule-out
    diagnosis of bipolar I disorder. Dr. Thal opined that Mother’s memory was
    “not intact and it was very difficult for [her] to recall basic information.”
    Further, Mother’s “insight [was] quite limited but consistent with her
    intellectual level.” He observed that Mother “seemed to take little
    responsibility for her own actions or her reported lack of adequate care of
    her son.” Dr. Thal opined that Mother’s intellectual disability would make
    it “exceedingly difficult for her to acquire, understand, retain, and
    implement basic parenting knowledge and skills.” He concluded that
    Mother’s prognosis for being able to demonstrate minimally adequate
    parenting skills in the foreseeable future was poor. Dr. Thal also concluded
    that the child could not be safely returned to Mother’s sole custody now or
    in the foreseeable future, and that he would be at risk in her care. Dr. Thal
    explained that “[Mother] would require ongoing supervision with a child”
    and that she could not “be relied upon to independently learn, retain, and
    implement safe and effective parenting practices.” He found that Mother
    was at risk for exploitation by predatory males and recommended
    individual therapy to assist her in decision making. Although mental health
    services “could improve [Mother’s] functioning,” they would be unlikely
    to raise her to a minimally adequate parenting level.
    ¶17           Dr. Thal re-assessed Mother in October 2018 to determine if
    Mother’s participation in services had improved her parenting abilities to a
    minimally adequate level. Mother continued to deny neglecting the child.
    Mother denied that Hunter had emotional or behavioral problems and
    stated that she believed he was developmentally on track. When discussing
    her completed drug treatment at TERROS, Mother stated “I honestly didn’t
    need those classes.” Dr. Thal again concluded that the prognosis that
    Mother would be able to demonstrate minimally adequate parenting skills
    was poor. He wrote:
    [Mother] has participated in a wide range of services but, not
    surprising given the nature of her mental deficiency, there are
    not significant changes in her parenting profile. This is an
    7
    JESSICA P. v. DCS, H.P.
    Opinion of the Court
    intellectually disabled young woman who has substantial
    difficulty with concepts, timeframes, and retaining factual
    information. She is more than willing to follow directives and
    she clearly loves [the child]. However, placing Hunter in
    [Mother]’s sole and independent care would likely place the
    child at risk for inadvertent neglect, impaired decision-
    making, and significant under-stimulation of the child’s
    already reportedly compromised learning abilities.
    ¶18           Dr. Thal recommended a bonding and best interests
    assessment for Hunter, Mother, Grandmother, and the child’s foster family.
    Dr. S. Bryce Bennett conducted the assessment in April and May 2018.
    Dr. Bennett noted that Mother “seemingly had no understanding of
    [Hunter’s] medical needs,” and that Grandmother lacked understanding of
    his medical needs beyond his developmental delays and did not seem to
    recognize how much support Mother would require if Hunter were
    returned to her. Both Mother and Grandmother had difficulty responding
    to the child’s cues. Grandmother’s failure to recognize his cues was of
    particular concern because Hunter required a “caregiver who is very
    responsive to his cues.” Dr. Bennett concluded that Hunter’s foster parents
    provided him with a safe and stable home and had the ability to meet his
    special needs. Dr. Bennett conducted an updated bonding assessment
    regarding Grandmother in October 2018. Dr. Bennett continued to have
    concerns about Grandmother’s ability to meet Hunter’s needs and
    concluded that it was not in his best interests to be placed with her.5
    ¶19             DCS filed a motion to terminate Mother’s parental rights in
    August 2018 pursuant to A.R.S. §§ 8-533(B)(3) (mental deficiency) and
    (B)(8)(c) (fifteen months out-of-home placement). At that time, Mother
    requested that Hunter be placed with Grandmother. The juvenile court
    denied the request.
    ¶20          A week before trial, Mother filed a motion to appoint
    Grandmother as a permanent guardian. In her petition, Mother stated,
    “[DCS] has made reasonable efforts to reunite Mother with the minor child.
    Reunification of the minor child and Mother is not in [his] best interest.
    5     Dr. Thal conducted a psychological evaluation of Grandmother in
    January 2018 and another evaluation in January 2019. He likewise did not
    recommend placing Hunter with Grandmother. At trial, Dr. Thal testified
    that it was concerning that Grandmother believed that Mother could safely
    parent the child and failed to recognize she had “some very significant
    intellectual limitations.”
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    JESSICA P. v. DCS, H.P.
    Opinion of the Court
    Mother is unable to properly care for [him] without the assistance of
    [Grandmother].” DCS opposed the guardianship motion.
    ¶21            A third psychological evaluation of Mother was conducted
    by Dr. Lee Underwood in March and April 2019, midway through trial.
    Dr. Underwood’s diagnosis of mild intellectual disability was consistent
    with Dr. Thal’s diagnosis. Dr. Underwood did not recommend that the
    child be returned to Mother’s sole care. Instead he concluded that she could
    parent in a co-parent model.
    ¶22           After a seven-day trial on both the guardianship and
    severance motions, the juvenile court denied Mother’s guardianship
    motion. The court granted DCS’s severance motion, terminating Mother’s
    parental rights to Hunter based on fifteen months out-of-home placement
    and mental deficiency.6 The court found that severance was in Hunter’s best
    interests even though Mother loved him and was clearly bonded with him,
    and that DCS made reasonable efforts to provide reunification services. The
    court denied the motion to appoint Grandmother as a permanent guardian,
    noting, among other things, that he had been neglected by Mother while
    they both resided with Grandmother. Mother timely appealed.
    DISCUSSION
    I.    Americans With Disabilities Act
    ¶23           Mother argues that the juvenile court erred by not
    considering whether DCS’s reunification efforts complied with ADA, 42
    U.S.C. §§ 12101-12213, and that DCS failed to prove that it provided her
    with services that reasonably accommodated her mental disability.7
    ¶24          The ADA prohibits public entities from discriminating
    against disabled persons by excluding them from participation in or
    denying them the benefits of public services and programs. 42 U.S.C.
    § 12132. The ADA imposes an affirmative duty on public entities to make
    “reasonable modifications in policies, practices, or procedures when the
    modifications are necessary to avoid discrimination on the basis of
    6    The court also terminated the parental rights of an alleged Father on
    abandonment grounds. He is not party to this appeal.
    7    Mother argues for the first time on appeal that DCS should have
    provided her with “enhanced,” “supplemental,” and more frequent
    training (presumably parenting training), either in her home or in another
    environment “more conducive to learning,” and that it should have
    provided “visual modeling or individualized techniques.”
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    JESSICA P. v. DCS, H.P.
    Opinion of the Court
    disability, unless . . . the modifications would fundamentally alter the
    nature of the service” provided. 28 C.F.R. § 35.130(b)(7)(i). A mental
    impairment that substantially limits one or more major life activities of an
    individual is a disability. 42 U.S.C. § 12102(1)(A). A mental impairment
    includes “intellectual disability, organic brain syndrome, emotional or
    mental illness, and specific learning disability.” 28 C.F.R. § 35.108(b)(1)(ii).
    ¶25             We agree with courts in other jurisdictions―child welfare
    agencies such as DCS, as public entities, must provide reunification services
    that comply with the ADA to disabled parents. See Lucy J. v. Dep’t of Health
    & Soc. Servs., 
    244 P.3d 1099
    , 1115-16 (Alaska 2010) (ADA requires family
    reunification services to be provided in a manner that takes a parent’s
    disability into account); In re S.K., 
    440 P.3d 1240
    , 1248, ¶ 25 (Colo. App.
    2019) (“ADA does not restrict a juvenile court’s authority to terminate
    parental rights when the parent, even after reasonable accommodation of a
    disability, is unable to meet his or her child’s needs,” but while the ADA “is
    not a defense to termination of parental rights, it applies to the provision of
    assessments, treatment, and other services that the Department makes
    available to parents . . . before termination.”); In re H.C., 
    187 A.3d 1254
    , 1265
    (D.C. 2018) (ADA’s requirement of reasonable accommodation is “entirely
    consistent with and perhaps subsumed within, [child welfare agency’s]
    general statutory obligation to expend reasonable efforts to make
    reunification possible”); In re Adoption of Gregory, 
    747 N.E.2d 120
    , 126 (Mass.
    2001) (reunification services must comply with the ADA); In re Terry, 
    610 N.W.2d 563
    , 570 (Mich. Ct. App. 2000) (same); In re K.C., 
    362 P.3d 1248
    , 1252,
    ¶¶ 19, 21 (Utah 2015) (ADA encompasses a plan for reunification services
    and a parent has the right to raise the ADA “while the reunification plan is
    being implemented . . . not just after the fact in a claim for money
    damages.”); In re A.J.R., 
    896 P.2d 1298
    , 1302 (Wash. Ct. App. 1995)
    (severance statute’s requirement that State provide reasonable services
    resulted in reasonable accommodation of parents’ disabilities). Arizona’s
    statutory requirement that DCS make reasonable efforts to provide
    reunification services is consistent with the ADA’s requirement that
    disabled parents be reasonably accommodated.
    ¶26           In general, any claim that DCS is failing to provide
    appropriate reunification services must be raised in the juvenile court or the
    issue is waived. Shawanee S. v. Ariz. Dep’t of Econ. Sec., 
    234 Ariz. 174
    , 175,
    ¶ 1 (App. 2014). Similarly, we agree with other courts concluding that any
    claim that the appropriate state agency (here, DCS) is violating the ADA in
    a dependency or severance matter must be timely raised or the issue is
    waived. See 
    Gregory, 747 N.E.2d at 124-25
    (parent may not raise
    noncompliance with the ADA with regard to reunification services for the
    10
    JESSICA P. v. DCS, H.P.
    Opinion of the Court
    first time at a termination proceeding). Accord 
    Terry, 610 N.W.2d at 570
    (disabled parent should claim a violation of the ADA before the termination
    hearing “either when a service plan is adopted or soon afterward” so that
    juvenile court can address the claim.). Accord In re Hicks/Brown, 
    893 N.W.2d 637
    , 642 (Mich. 2017) (raising claim that services did not accommodate a
    parent’s intellectual disability in court eleven months prior to termination
    hearing was sufficient). Cf. In re 
    K.C., 362 P.3d at 1252
    , ¶ 27 (parent may
    raise ADA violation at termination hearing, but “[a] parent who waits until
    the eleventh hour to request a modification under the ADA may thoroughly
    undermine her ability to establish that such a modification is reasonable”).
    ¶27           Here, Mother did not raise her claim that DCS violated her
    right to reasonable accommodations under the ADA in the juvenile court
    before or during the severance proceedings. Mother never asked the
    juvenile court to determine whether the services DCS provided Mother,
    which the court found were reasonable under A.R.S. § 8-533, also satisfied
    the ADA. Mother was represented by counsel throughout the case and
    could have timely raised the issue. Raising an ADA claim for the first time
    on appeal is untimely and we do not consider it.
    II.    Due Process and A.R.S. § 1-601
    ¶28            Mother argues that the juvenile court violated her due process
    rights. Alleged constitutional violations raised for the first time on appeal
    are reviewed for fundamental error. Brenda D. v. Ariz. Dep’t of Child Safety,
    
    243 Ariz. 437
    , 447, ¶ 37 (2018). Mother first argues that A.R.S. §§ 8-533(B)(3)
    and (B)(8) are facially unconstitutional under the federal constitution. We
    review the constitutionality of a statute de novo. State v. Maestas, 
    244 Ariz. 9
    , 11, ¶ 6 (2018). Under strict scrutiny analysis there is no presumption that
    a statute is constitutional. Martin v. Reinstein, 
    195 Ariz. 293
    , 309, ¶ 51 (App.
    1999).
    ¶29             Parents have a fundamental right in the care, custody, and
    management of their children and that interest is protected by the Due
    Process Clause. Santosky v. Kramer, 
    455 U.S. 745
    , 753, 758-59 (1982). “The
    maintenance of the parent-child relationship is a fundamental right, and the
    rationality of statutes which abridge it is subject to strict scrutiny.” Maricopa
    Cty. Juv. Action No. JS-7359, 
    159 Ariz. 232
    , 236 (App. 1988) (citing Santosky,
    
    455 U.S. 745
    ). Under strict scrutiny analysis, “proponents of a law bear the
    burden of showing that it furthers a compelling state interest, that it is
    narrowly drawn to serve that interest, and that the state’s interests
    outweigh” the fundamental liberty interests at stake. 
    Martin, 195 Ariz. at 309
    , ¶ 51.
    11
    JESSICA P. v. DCS, H.P.
    Opinion of the Court
    ¶30             Mother agrees that A.R.S. §§ 8-533(B)(3) and (B)(8) serve a
    compelling state interest. Nevertheless, she argues that Arizona’s severance
    statute fails strict scrutiny analysis because the compelling state interest is
    preventing harm to the child and the statute does not require DCS to prove,
    by clear and convincing evidence, that termination is necessary to prevent
    harm to the child.
    ¶31           The Arizona Supreme Court has held that Arizona’s
    severance statute satisfies due process because the statutory grounds are
    “synonymous with parental unfitness.” Alma S. v. Ariz. Dep’t of Child Safety,
    
    245 Ariz. 146
    , 150, ¶ 9 (2018) (“If a statutory ground were not synonymous
    with unfitness, a contested severance based on such a ground would be
    constitutionally infirm.”); see also 
    JS-7359, 159 Ariz. at 236
    (prior version of
    Arizona’s severance statute satisfied strict scrutiny because it incorporated
    a concept of parental unfitness).
    ¶32           Both A.R.S. §§ 8-533(B)(3) and (B)(8) require a finding of
    parental unfitness at the time of termination. To terminate parental rights
    based on mental deficiency under A.R.S. § 8-533(B)(3), the court must find,
    by clear and convincing evidence, that a parent is “unable to discharge
    parental responsibilities because of . . . mental deficiency” at the time of
    severance and that “the condition will continue for a prolonged
    indeterminate period.” Section 8-533(B)(8)(c) requires a finding that a
    parent “will not be capable of exercising proper and effective parental care
    and control in the future.”
    ¶33           Mother misidentifies the compelling state interest in
    termination proceedings, which is to promote and protect child welfare. See
    
    Santosky, 455 U.S. at 766
    (the State has an urgent “parens patriae interest in
    preserving and promoting the welfare of the child” and its “goal is to
    provide the child with a permanent home,” preferably with a fit parent);
    
    JS-7359, 159 Ariz. at 236
    (quoting 
    Santosky, 455 U.S. at 767
    ); Ariz. Dep’t of
    Child Safety v. Beene, 
    235 Ariz. 300
    , 306, ¶ 13 (App. 2014) (“DCS has a
    compelling interest in protecting child welfare.”) (internal quotation
    omitted).
    ¶34            Mother argues that A.R.S. §§ 8-533(B)(3) and (B)(8) are both
    unconstitutional because they do not require DCS to prove that termination
    is the least-restrictive means available for protecting the child. She argues
    that the State may not choose a single means of avoiding severance, such as
    family reunification, and then declare that severance is the least-restrictive
    means because reunification is not available. We disagree. DCS must make
    reasonable rehabilitative efforts before seeking severance under A.R.S.
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    JESSICA P. v. DCS, H.P.
    Opinion of the Court
    § 8-533(B)(3). Vanessa H. v. Ariz. Dep’t of Econ. Sec., 
    215 Ariz. 252
    , 255-56,
    ¶ 18 (App. 2007). And A.R.S. § 8-533(B)(8) requires DCS to make a diligent
    effort to provide appropriate reunification services. If reunification with a
    parent is not possible, however, due process does not require DCS to pursue
    “alternative means” such as guardianship in every instance before seeking
    to change the case plan to severance and adoption.8
    ¶35           Mother also argues that A.R.S. §§ 8-533(B)(3) and (B)(8) are
    overly inclusive because they “allow for the possibility that a fit parent may
    have their parental rights . . . terminated simply because, at some point,
    they were unfit.” As discussed supra ¶¶ 31-32, §§ 8-533(B)(3) and (B)(8)
    require the juvenile court to make an individualized finding of unfitness at
    the time of termination.
    ¶36           Mother next argues that the juvenile court had a statutory
    duty to apply A.R.S. § 1-601(B), and “find that DCS has met every burden
    that Arizona’s legislature has mandated, including those mandated under
    A.R.S. § 1-601(B),” and that its failure to do so violated her due process
    rights under the federal and state constitutions. Mother did not raise her
    statutory claim until her written closing argument.
    ¶37           The Parents’ Bill of Rights is codified at A.R.S. §§ 1-601 and
    -602. Section 1-601 (A) states that parents have a fundamental right “to
    direct the upbringing, education, health care and mental health of their
    children.” Section 1-601(B) says that the State shall not infringe on those
    rights “without demonstrating that the compelling governmental interest
    as applied to the child involved is of the highest order, is narrowly tailored
    and is not otherwise served by a less restrictive means.” Section 1-602
    defines a parent’s rights, and provides, in part:
    This section does not authorize or allow a parent to engage in
    conduct that is unlawful or to abuse or neglect a child in
    violation of the laws of this state. This section does not
    prohibit courts, law enforcement officers or employees of a
    government agency responsible for child welfare from acting
    in their official capacity within the scope of their authority.
    This section does not prohibit a court from issuing an order
    that is otherwise permitted by law.
    8    Here, DCS did pursue permanent guardianship by Grandmother but
    determined she was not an appropriate guardian for the child.
    13
    JESSICA P. v. DCS, H.P.
    Opinion of the Court
    Here, the juvenile court acted within its “official capacity within the scope
    of [its] authority” under Arizona’s severance statute, A.R.S. § 8-533, and
    that statute satisfies due process. The juvenile court made an individualized
    determination that Mother was unfit at the time of termination, and that
    severance was in child’s best interests. The court’s severance order was
    permitted by A.R.S. § 8-533. We find no error, fundamental or otherwise,
    nor do we find that Mother’s due process rights were violated.
    III.   Fifteen Months Out-of-Home Placement
    ¶38            Mother argues that insufficient evidence supported the
    juvenile court’s finding that severance was warranted pursuant to A.R.S.
    § 8-533(B)(8)(c). Under this statute, the court may terminate parental rights
    if DCS made diligent reunification efforts, the parent was unable to remedy
    the circumstances causing the parent’s child to be in an out-of-home
    placement for fifteen months or longer, and “there is a substantial
    likelihood that the parent will not be capable of exercising proper and
    effective parental care and control in the near future.” A.R.S.§ 8-533(B)(8)(c).
    We view the evidence and the reasonable inferences to be drawn from it in
    the light most favorable to affirming the juvenile court’s order. Jordan C. v.
    Ariz. Dep’t of Econ. Sec., 
    223 Ariz. 86
    , 93, ¶ 18 (App. 2009). We will not
    reverse the juvenile court’s order unless reasonable evidence does not
    support the juvenile court’s factual findings. Ariz. Dep’t of Econ. Sec. v.
    Matthew L., 
    223 Ariz. 547
    , 549, ¶ 7 (App. 2010). In assessing a parent’s ability
    to provide proper parental care and control, the juvenile court must
    “consider the discrete and special needs of the particular child.” Joelle M. v.
    Ariz. Dep’t of Child Safety, 
    245 Ariz. 525
    , 527, ¶ 12 (App. 2018).
    ¶39            Hunter was in an out-of-home placement for more than two
    years at the start of the severance trial and for two and one-half years when
    the juvenile court granted the severance. Mother argues that she remedied
    her substance abuse problem, which was the circumstance causing
    Hunter’s removal. However, in making a determination that a parent has
    been unable to remedy the circumstances causing the child to be in an out-
    of-home placement, we construe those circumstances to mean the
    circumstances existing at the time of the severance that prevented a parent
    from appropriately providing for the parent’s child. Marina P. v. Ariz. Dep’t
    of Econ. Sec., 
    214 Ariz. 326
    , 330, ¶ 22 (App. 2007). Moreover, Mother’s
    substance abuse was not the only circumstance leading to Hunter’s
    removal. See Donald W. v. Dep’t of Child Safety, 
    247 Ariz. 9
    , 17, ¶ 26 (App.
    2019) (court must consider “both the origin and any cause arising during the
    dependency”). DCS took Hunter into custody because of Mother’s substance
    abuse, because she initially refused to participate in services, and because
    14
    JESSICA P. v. DCS, H.P.
    Opinion of the Court
    “[t]he physical or mental condition of [Mother] endanger[ed] child’s health
    or safety.” In addition, Grandmother declined to take a urinalysis test when
    she was designated safety monitor for the child. The dependency petition
    alleged that Mother was unable to parent due to both substance abuse and
    her intellectual disability. At the time of the severance trial, although
    Mother’s substance abuse was no longer a concern, her intellectual
    disability was the circumstance causing Hunter’s continued out-of-home
    placement.
    ¶40           Here, the juvenile court found that “Mother has completed all
    services that have been asked of her to the best of her ability.”9 The court
    found that even so, Mother had been unable to remedy the circumstances
    leading to the child’s out-of-home placement because “[e]very professional
    who evaluated Mother has concluded that Mother, due to her limitations,
    cannot independently parent the child. Mother’s deficiencies are
    exacerbated by the special needs of the child. The professionals have
    concluded that the child cannot be safely returned to Mother’s care.” Citing
    Dr. Thal’s opinion, the court found that there was a substantial likelihood
    that Mother would not be capable of exercising proper and effective
    parental care and control in the near future.
    ¶41           Reasonable evidence supports the juvenile court’s findings.
    Dr. Thal evaluated Mother twice, and even after she had completed “a wide
    range of services,” Dr. Thal concluded that Mother’s prognosis for
    demonstrating minimally adequate parenting skills was poor, given the
    nature of her intellectual ability. Dr. Thal noted that Mother’s medical
    decision-making abilities were “significantly limited,” and opined that
    Mother’s intellectual disability “and the accompanying impact on her
    judgment and decision making” made her unable to meet Hunter’s special
    9   Mother complains that elsewhere in the court’s minute entry the court
    stated, “[DCS] made diligent efforts by providing an array of reunification
    services and had those services been successfully completed, reunification
    likely would have occurred.” This appears to be in conflict with other
    findings. The court specifically found that Mother completed all services to
    the best of her abilities and stated so twice in its minute entry order, which
    was consistent with the DCS case manager’s testimony. Further, the court
    outlined in great detail all of the services offered to Mother and noted that
    she participated in and completed each of them.
    15
    JESSICA P. v. DCS, H.P.
    Opinion of the Court
    needs. No evaluator or therapist concluded that Mother could safely parent
    child independently.
    ¶42            Mother argues that Dr. Thal recommended the child be
    returned to her in July 2017, and that DCS’s failure to do so extended his
    out-of-home placement past fifteen months. This misstates the record. After
    his first evaluation of Mother in July 2017, Dr. Thal made the following
    recommendations concerning placement:
    It is not recommended a child be placed in this [Mother]’s sole
    and independent care. . . . The best-case scenario for [Mother]
    would be for her to act as an assistant caregiver to a fully
    qualified caregiver. [Mother] would require ongoing
    supervision with a child and cannot be relied upon to
    independently learn, retain, and implement safe and effective
    parenting practices. . . . Alternative long-term placement
    planning is necessary to insure the welfare of [Hunter].
    ¶43            Mother also asserts that Dr. Thal testified that she could
    effectively co-parent, and that with assistance, she would be able to exercise
    proper and effective parental care and control. This misstates Dr. Thal’s
    testimony. Dr. Thal specifically testified that the child should not be in
    Mother’s sole and independent care, but that a goal might be for her to
    “function in an assisted capacity. Not to [be] the co-parent but to assist a
    capable and fully functioning parental figure.”
    ¶44          Mother argues that the juvenile court erred by finding that
    DCS made diligent efforts to reunify the family because DCS failed to
    “undertake even the minimum of the diligent efforts [it was] legally
    required to take.” Mother argues that DCS failed to obtain Hunter’s
    medical, DDD, and Head Start records, did not ask Mother or Grandmother
    about services they had obtained for the child, and did not speak with
    child’s grandfather or Mother’s aunts. She also argues that Dr. Thal
    recommended that the child “be returned to Mother, with Grandmother as
    guardian,” but “DCS did nothing for six months.”10
    ¶45         Before seeking to terminate a parent’s parental rights on
    grounds of out-of-home placement, DCS must make a diligent effort to
    provide appropriate reunification services. A.R.S. § 8-533(B)(8).
    “Termination of the parent-child relationship should not be considered a
    10  As noted supra ¶¶ 42-43, Dr. Thal did not recommend returning Hunter
    to Mother with Grandmother as his guardian.
    16
    JESSICA P. v. DCS, H.P.
    Opinion of the Court
    panacea but should be resorted to only when [a] concerted effort to preserve
    the relationship fails.” Ariz. Dep’t of Econ. Sec. v. Mahoney, 
    24 Ariz. App. 534
    ,
    537 (1975). DCS need not undertake rehabilitative measures that are futile,
    but it is obligated to undertake measures with a reasonable probability of
    success. Mary Ellen C. v. Ariz. Dep’t of Econ. Sec., 
    193 Ariz. 185
    , 192, ¶ 34
    (App. 1999). DCS need not provide every conceivable service, but it “must
    provide a parent with the time and opportunity to participate in programs
    designed to improve the parent’s ability to care for the child.”
    Id. at ¶ 37.
    DCS does not make reasonable reunification efforts if “it neglects to offer
    the very services that its consulting expert recommends.”
    Id. ¶46 As the
    juvenile court found, DCS offered Mother numerous
    reunification services, including random urinalysis testing, substance abuse
    treatment, more than 30 individual counseling sessions (exceeding the 20
    sessions recommended by Dr. Thal), two psychological evaluations, a
    bonding assessment, therapeutic visitation and supervised visitation, a
    parent aide, and transportation because she did not drive. DCS invited her
    to attend the child’s medical appointments so that she could understand his
    special needs. These services were offered to help Mother become sober,
    enhance her parenting skills, and assist her with “decision-making,
    employing sound judgment, staying safe, and coping with her disabilities.”
    Sufficient evidence supported the court’s finding that DCS made diligent
    efforts to provide reunification services.
    ¶47           DCS case manager Claudia Hoff testified that obtaining the
    child’s DDD and medical records at the outset of the case would not have
    changed the services offered to Mother. And whether or not DCS
    interviewed certain family members during its investigation is not relevant
    to the question of whether it made diligent efforts to provide appropriate
    reunification services.
    ¶48           Because sufficient evidence supported the juvenile court’s
    finding that severance was warranted pursuant to A.R.S. § 8-533(B)(8)(c),
    we need not consider Mother’s challenge to the alternate ground of mental
    deficiency. See Jesus M. v. Ariz. Dep’t of Econ. Sec., 
    203 Ariz. 278
    , 280, ¶ 3
    (App. 2002).
    IV.    Best Interests
    ¶49           Finally, Mother argues that the juvenile court erred by finding
    that termination of her parental rights was in Hunter’s best interests. We do
    not reweigh the evidence and will affirm the juvenile court’s factual
    findings if supported by reasonable evidence. Dominique M. v. Ariz. Dep’t of
    17
    JESSICA P. v. DCS, H.P.
    Opinion of the Court
    Child Safety, 
    240 Ariz. 96
    , 97, ¶ 6 (App. 2016). “Although fundamental,
    parental rights are not inviolate; a court may still sever those rights if it finds
    clear and convincing evidence of one of the statutory grounds for
    severance, and also finds by a preponderance of the evidence that severance
    is in the best interests of the child[].”
    Id. at 98, ¶ 7
    (citations omitted).
    Severance is in a child’s best interests if the child would “derive an
    affirmative benefit from termination or incur a detriment by continuing in
    the relationship.” Ariz. Dep’t of Econ. Sec. v. Oscar O., 
    209 Ariz. 332
    , 334, ¶ 6
    (App. 2004). A current adoptive plan is a well-established affirmative
    benefit to a child.
    Id. ¶50 The juvenile
    court found that the child was adoptable and that
    his foster parents were meeting all his special needs. Hunter’s foster parents
    wished to adopt him. He had lived with his foster parents for nearly two
    and one-half years and he was bonded to them. He was also bonded with
    Mother. The court also found that maintaining Mother’s parental rights
    would be detrimental to Hunter because Mother was “not equipped to
    provide the level of care that child needs.” The court concluded that “the
    facts dictate that it is in the child’s best interests that Mother’s parental
    rights be terminated despite her love for, and bond with, the child.”
    ¶51           Reasonable evidence supported the juvenile court’s best
    interests finding. Dr. Bennett concluded his bonding and best interests
    assessment by opining that returning Hunter to Mother was not in his best
    interests because she seemed to have little understanding of his medical
    needs and was not responsive to his cues regarding his needs.11 Dr. Bennett
    explained that the child would be at risk of neglect in her care, even for
    short periods of time. Hunter was adoptable and his current placement was
    willing to adopt him. Hunter was thriving in their care.
    ¶52          Mother argues that she was a “fit and loving” parent and that
    Hunter was bonded to her. As discussed above, reasonable evidence
    supported the severance ground of out-of-home placement and the court’s
    conclusion that Mother would not be a fit parent in the near future. And
    although the existence of a bond between a parent and child is a factor in
    11   Mother claims that the juvenile court erred by finding severance was
    in Hunter’s best interests because she was a single parent. The court did
    mistakenly refer to Mother instead of Grandmother when summarizing
    Dr. Bennett’s bonding/best interests assessment, wherein Dr. Bennett
    stated that Grandmother was a single parent. However, the court did not
    refer to Mother’s relationship status in its ultimate findings about best
    interests.
    18
    JESSICA P. v. DCS, H.P.
    Opinion of the Court
    assessing best interests, it is not dispositive. Dominique 
    M., 240 Ariz. at 98
    ,
    ¶ 12. “Even in the face of such a bond, the juvenile court is required to
    evaluate the totality of circumstances and determine whether severance is
    in the best interests of the children.”
    Id. at 99, ¶ 12.
    Here, the court
    considered the totality of the circumstances and found that severance was
    in Hunter’s best interests. Reasonable evidence supports that finding.
    CONCLUSION
    ¶53          For the foregoing reasons, we affirm the juvenile court’s order
    terminating Mother’s parental rights.
    AMY M. WOOD • Clerk of the Court
    FILED: AA
    19