Horton v. Arkansas Department of Human Services ( 2017 )


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  •                                Cite as 
    2017 Ark. App. 633
    ARKANSAS COURT OF APPEALS
    DIVISION IV
    No. CV-17-561
    KARESHA HORTON                                Opinion Delivered:   November 15, 2017
    APPELLANT
    APPEAL FROM THE SCOTT
    V.                                            COUNTY CIRCUIT COURT
    [NO. 64JV-15-39]
    ARKANSAS DEPARTMENT OF
    HUMAN SERVICES AND MINOR      HONORABLE TERRY SULLIVAN,
    CHILD                         JUDGE
    APPELLEES
    AFFIRMED
    WAYMOND M. BROWN, Judge
    Appellant appeals from the termination of her parental rights to E.H., born
    09/01/2015. 1 On appeal, she argues that the circuit court erred in (1) terminating her
    parental rights based on the failure-to-remedy ground, (2) finding that DHS had shown the
    subsequent-factor ground, and (3) denying her motion for a second psychological evaluation
    as untimely. We affirm.
    I. Facts
    The hotline was called on October 7, 2015, due to concerns that E.H. was not being
    fed properly. According to family service worker (FSW) Laura Case, appellant could explain
    how to mix E.H.’s formula, but “could not do it in practice.” Appellant reported that she
    fed E.H. four ounces of formula every two hours, which was appropriate. However, FSW
    1
    The parental rights of E.H.’s father, David Armstrong, were terminated in the same
    order. Armstrong is not a party to this appeal.
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    2017 Ark. App. 633
    Jennifer Williams reported “major concerns” regarding whether E.H. was being properly
    fed because she was being weighed regularly with no weight gain.
    Dr. Sara Robinson admitted E.H. to the hospital on October 14, 2015, for failure to
    thrive due to not being fed properly; she wanted to observe appellant feeding E.H. and
    wanted E.H. to be weighed daily. 2 There was “concern for [appellant’s] mental capacity as
    it relates to her ability to care for E.H.” Appellant was “on SSI for learning disabilities” that
    reportedly affected her ability to read and write. A seventy-two-hour hold was taken on
    E.H. on October 14, 2015, due to her failure-to-thrive diagnosis. Appellee Arkansas
    Department of Human Services (DHS) filed a petition for emergency custody and
    dependency-neglect on October 19, 2015, which was granted by the circuit court’s ex parte
    order for emergency custody entered on the same date.
    A probable-cause order was entered on October 21, 2015, finding probable cause
    that emergency conditions existed that necessitated E.H.’s removal and that those conditions
    continued. In its December 8, 2015 adjudication and disposition order, the circuit court
    adjudicated E.H. dependent-neglected “as defined in the Arkansas Juvenile Code” and made
    specific findings. Appellant was ordered to complete a number of standard duties, including
    submitting to a psychological evaluation and following any recommendations. DHS was
    ordered to provide “specialized parenting classes to [appellant] to focus on raising a baby.”
    Tammy Tolleson, appellant’s mother, was added to the case plan “since [appellant] lives
    2
    E.H. gained four ounces from one night in the hospital.
    2
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    2017 Ark. App. 633
    with her and [Tolleson] participated in caretaking for [E.H.] before the hold was taken.”
    The goal of the case was reunification.
    In its February 24, 2016 and August 12, 2016 review orders, the goal of the case
    remained reunification. In the latter review order, the circuit court found:
    That [appellant] has complied with the caseplan in that she has submitted to a
    psychological evaluation, completed specialized parenting classes and attended
    counseling. The psychological evaluation determined that [appellant] is functionally
    illiterate, that she cannot live independently and requires supervision of her child
    care. The maternal grandmother has agreed to act as a supervisor of [appellant’s] child
    care[.]
    DHS agreed to allow appellant to have visitation with E.H. “during the week, with the
    child to return to the foster home on weekends.” The circuit court gave DHS the authority
    to begin a trial placement if the visitation went well.
    On December 6, 2016, appellant filed a motion for a second psychological evaluation
    and a motion for a continuance. She requested that a second and independent psychological
    evaluation be performed as a reasonable accommodation pursuant to the Americans with
    Disabilities Act. 3 She asserted that the first psychological evaluation had been completed
    before she submitted to services and provided “little flexibility for [appellant] and DHS to
    achieve a form of reunification.” She asserted that it would be prejudicial to her to use only
    the initial psychological examination “[g]iven that [she] has submitted to services; given that
    she is a disabled individual entitled to a reasonable accommodation pursuant to the ADA;
    and given that the State has a policy that mental incapacity is a basis for termination of
    parental rights.”
    3
    Americans with Disabilities Act of 1990, 42 U.S. §§ 12101–12213 (2013).
    3
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    2017 Ark. App. 633
    On December 8, 2016, DHS filed a petition for termination of appellant’s parental
    rights, citing two grounds. The first ground was failure to remedy the cause for removal. 4
    DHS stated that “[a]lthough [appellant] completed the tasks in the case plan, she ha[d] not
    successfully utilized the skills she learned the parenting classes, counseling or from
    homemaker services.” It also noted that E.H. had a “continuous problem” with diaper rash
    that was “constant and worsening” and that appellant gave incorrect instructions on the
    application of the prescription provided for the rash, after DHS suggested—and she went—
    to the doctor. DHS’s second asserted ground was the other-factors ground. 5 It went on to
    state that during the trial home placement, appellant “did not provide the most basic care
    for her child resulting in circumstances that were contrary to the juvenile’s health, safety or
    welfare.”
    On December 9, 2016, the circuit court entered its permanency-planning order in
    which it changed the goal of the case plan to adoption. It noted testimony from Nancy
    Mondragon, employed by First Kids Daycare, that (1) E.H. would be brought to daycare
    “dirty”; (2) E.H. would “exude an odor” requiring workers to “wipe down her whole body
    with baby wipes”; and (3) appellant would bring bottles of “regular milk”—before E.H.
    turned one—in a bottle that would be “dirty and crusted with milk.” Mondragon stated
    that workers had spoken with appellant “several times about the cleanliness of the bottle and
    the fact that they could not give a child regular milk before the child’s first birthday,” yet
    4
    See Ark. Code Ann. § 9-27-341(b)(3)(B)(i)(a) (Repl. 2015).
    5
    See Ark. Code Ann. § 9-27-341(b)(3)(B)(vii)(a).
    4
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    2017 Ark. App. 633
    appellant “continued to bring a dirty bottle with regular milk.” The circuit court found
    Mondragon’s testimony “very credible.”
    It also noted testimony from FSW Carol Harp that appellant had complied with the
    case plan and court orders, leading to a trial home placement, but E.H. was removed from
    the placement on September 23, 2016. She noted visiting appellant’s home on that day—
    which was “very hot”—and seeing various safety hazards including a fan without a cover
    blowing on E.H. Appellant had claimed that the cover was only missing because she had
    washed it and it was drying, but FSW Bridget Warren had reported seeing the same safety
    hazard during her visit the previous day. Appellant had obtained a prescription-strength
    diaper cream for E.H. and had advised daycare workers—and stated to Harp—that it was to
    be applied at “every” diaper change, but the bottle said twice per day. Furthermore, she
    testified that appellant intended to give E.H. baby Orajel without consulting doctor, though
    the box advised not doing so for a child under two; and that she was concerned about
    Tolleson’s ability to supervise appellant’s parenting because Tolleson has a prescription for
    and was taking “multiple hydrocodone pills per day.” 6
    In the permanency-planning order, the circuit court found that appellant had
    complied with the case plan and its orders, stating specifically that she had done “everything”
    DHS or the circuit court had asked her to do, but went on to state:
    [E.H.] is not safe with her at this time. [Appellant] does not understand when
    medication should be administered. She is either not bathing [E.H.] or not bathing
    her properly. She was not properly cleaning the bottle she was taking to day care.
    She either does not understand or is ambivalent to the fact that piles of clothing, a
    very hot home, electrical wires, and exposed fan blades could be dangerous to a baby.
    6
    Warren also testified, but her pertinent testimony was duplicative.
    5
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    Despite these findings, and its order setting a termination hearing, it ordered DHS to
    continue to offer reunification services to appellant, “including looking for someone or
    some institution that would appropriately supervise [appellant’s] parenting.” It maintained
    that it was “very concerned about the condition of the home[.]”
    DHS responded in opposition to appellant’s motions for a second psychological
    evaluation and for a continuance on December 12, 2016, asserting that appellant’s requests
    had “no basis on law or in fact,” specifically arguing that “to the extent that [appellant]
    attempts to characterize her request for a continuance as reasonable accommodation, a
    second psychological examination is not a “reasonable accommodation as contemplated by
    the ADA” since appellant “ha[d] not argued that a second psychological evaluation would
    allow her meaningful access to services” and did not list any services that should be offered.
    DHS denied that the initial psychological evaluation limited its flexibility, but averred that
    DHS used the recommendations therein to develop further services for appellant, which it
    detailed therein.
    A status hearing was held on December 13, 2016, initially scheduled for purposes not
    pertinent to this appeal; however, the circuit court addressed appellant’s motions at the start
    of the hearing. Appellant argued that she was entitled to reasonable accommodations under
    the ADA and that she was seeking a second psychological evaluation because she did not
    have the “financial ability or the resources to provide [one] for herself in her defense.” She
    argued that a statement in the initial evaluation that appellant “cannot parent the child
    alone” was a limit that DHS relied on in providing services, visitation, and trial home
    placement to appellant. In pertinent and nonduplicative part, DHS argued that the motions
    6
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    2017 Ark. App. 633
    were untimely; the ad litem agreed. From the bench, the circuit court made the following
    findings:
    Well, I tend to agree with [DHS] and the ad litem. I think one thing we’re
    forgetting is about permanency for this child. We’re now, the best I can tell, this case
    was filed October 19, 2015. The child would’ve been taken a few days prior to that.
    We’re almost now 14 months into this case. The psychological that we’re talking
    about, as Mr. Landon said, was November 2015. I appreciate Ms. Standridge and
    she’s vigorously representing her client, but I don’t think it’s timely. It’s filed about
    13 months after the psychological. I think [DHS]—I’m certainly not—made up my
    mind what I would do on the termination hearing, but [DHS], I assume, is still
    continuing to provide services to the mother as I’ve ordered and they’ll do so. And
    I don’t know that there’s any prejudice under the ADA. I’d have to consider the best
    interest of this child and this child deserves permanency. So I am going to deny your
    motion. I don’t know if a second psychological would not say the same as the first.
    I don’t know. I don’t think it’s timely[.]
    The termination-of-parental-rights hearing was held on January 10, 2017. Where not
    duplicative of facts already given, pertinent testimony was as follows.
    Dr. Robert Spray, Jr., testified that he conducted appellant’s psychological
    evaluation. He diagnosed her with intellectual disability—based on her “low level of
    cognitive functioning”—and unspecified anxiety disorder—due to his inability to tell the
    nature of her self-reported “ongoing chronic anxiety.” He stated that appellant’s “ability to
    independently care for herself in that the low intellectual functioning in and of itself by itself
    does not suggest a problem[,]” but appellant “has some difficulty in carrying out”; “she
    could give strategies for doing things but she couldn’t explain how she could carry those
    strategies out in situations.” He recommended counseling as far as her ability to improve
    and understood that appellant had some parenting classes, but he stated that “there was no
    way for him to know based on [that] what the outcome would be.”
    7
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    As far as parenting E.H., Dr. Spray recommended that appellant “would need
    supervision by a competent adult living in the home” and he did not know for how long
    into the future. The supervising adult would have to be “competent and capable and be
    able to see to the child, because that adult will have to be as much of a caretaker” as
    appellant. 7 He would have concerns for E.H.’s safety if she was returned to appellant without
    adult supervision, including, but not limited to (1) appellant being able to pay attention
    consistently to what was going on with the child and what the child was doing, (2) issues
    with dosing medications because appellant has low math and verbal reasoning skills, and (3)
    appellant’s anxiety disorder, which he did not know the status of treatment for, but which
    “would play a role in being able to pay attention enough to [E.H.]” He believed appellant
    would know what a danger was, but would “maybe have difficulty following through with
    any plans that she would have to protect the child.”
    Dr. Spray did not have enough information available to him to give a prognosis for
    appellant in being able to improve to the point where she could independently care for her
    child. He stated that a second psychological evaluation “would not provide better insight as
    to whether she benefited from services” because the “issue is parenting and the parenting
    part of the evaluation was difficult” because of appellant’s low cognitive functioning.
    However, he admitted that “[i]t’s possible, [he] guess[ed]” that if appellant could
    comprehend and improve through more education and training, the psychological
    7
    This statement came from questioning by the circuit court regarding Dr. Spray’s
    questioning in appellant’s psychological evaluation of whether Tolleson’s supervision was
    inadequate, specifically stating “if they were living with her mother, why did her mother
    not see the problem and intervene?”
    8
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    evaluation “might” be different, but the “only way to know that is, in fact, a second
    psychological evaluation is conducted.”
    Mondragon testified that appellant or Tolleson would bring E.H. into daycare dirty
    “almost daily.” E.H. had dirt under her fingernails which “wasn’t normal for a child [E.H.’s]
    age”; she was not walking. She noted that when the facility told appellant it could not give
    whole milk to a child under one-year old, appellant “was bringing her own cup with whole
    milk” because she “thought if she brought the whole milk that would be okay.” She testified
    that she “never thought it necessary to call DHS or the hotline that [sic] E.H. wasn’t being
    cared for”; she was “never concerned that [E.H.] was unsafe in [appellant’s] home.”
    However, she admitted that the problems seen at the facility “were there since [they] started
    seeing E.H.” and they “lasted quite a while.”
    Holly Laird testified that appellant was bringing E.H. in for weight checks with the
    WIC program, which gives parents information on how to feed their baby for the first year
    of life. Though she was concerned about E.H., who was “very underweight,” she did not
    make a hotline call. The program was not sure if there was a medical issue or a feeding issue.
    E.H. was “clean, appropriately dressed” during her visits.
    Case testified that DHS was concerned early on with ADA, so it did early-childhood
    intervention for the baby. Appellant never asked for ADA accommodations; DHS was “just
    taking proactive steps in case that should happen,” to go “above and beyond so that it
    wouldn’t be an issue in the case.” While appellant progressed to unsupervised visitation and
    though DHS “very clearly” asked Tolleson to supervise appellant and let them know of any
    problems, she “didn’t see any improvements” in the behavior of appellant or Tolleson.
    9
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    Tolleson was giving E.H. table food at only four or five months old and smoking in the
    home. She continued to smoke in the vehicle she used to transport E.H. once she stopped
    smoking in the home, despite being told “from day one that there could be no smoking
    around [E.H.]” Case temporarily ended in-home visitations; appellant did improve some
    after resuming in-home visitations, but with additional requirements added to the visitations.
    She did not authorize the trial home placement, but someone after her did.
    Stephanie Holland, employed with the Department of Child and Family Services,
    testified to being the person who worked one-on-one with appellant for her parenting
    classes and worked with her up until the trial home placement. She assisted with
    applications, like for food stamps and “housing authority.” She helped appellant with a
    budget because appellant looked at the option of getting her own place but getting her own
    place “wasn’t feasible.” 8
    Holland stated that she referred appellant for nutrition classes and that she attended
    the first two classes, but not the last class; she never rescheduled. Likewise, with counseling,
    it was not being followed up on like it should have been. And after eight months of Literacy
    Council, when appellant and her mother were informed that they would have to transport
    appellant to the program once the trial home placement started, appellant “just quit”; she
    “didn’t have the support system to help her continue.” Despite budgetary issues, there was
    a plan to correct the issues between appellant and Tolleson; however, “appellant never
    8
    Tolleson had put some utility bills in appellant’s name and some overdue bills had
    not been paid. Tolleson was keeping all of appellant’s check except approximately $113 per
    month for appellant’s personal items. Despite one other adult sibling living in the home,
    appellant’s check was “kind of carrying half of the household.”
    10
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    followed through on it.” Appellant had no understanding of finances and “depend[ed] on
    [Tolleson] for that.” The “only problem” was that appellant “would want to do these things
    but she didn’t have the backing to do it.”
    Holland testified that she would have concerns with E.H. being returned to appellant
    due to “lack of support” and what happened in the trial home placement when the case
    “just went south.” Another issue she had was that it was her “understanding that [Tolleson]
    was supposed to be [appellant’s] support mechanism” and she knew Tolleson “had
    knowledge of this,” but issues were still arising. 9
    Appellant testified that she was twenty-three years old. E.H. had to be put in the
    hospital for lack of weight gain, and they put her on a “Similac-soy based formula and it
    was causing her to lose weight,” but “when [they] got in the hospital, they changed it and
    [E.H.] started gaining weight.” She stated that she had lived in an apartment by herself
    before and denied living with Tolleson since she was a baby, though she lived with her
    mother now in addition to her sister and her grandmother, who was sick but was “getting
    better sort of.” She paid her own rent from her $750.00 disability check; her mother would
    “hand the check to [her] and [she] would go pay everything.” She denied that DHS
    provided her any financial assistance to pay the bills that were in her name so she could get
    her own place and stated that “[w]hen [she] was in [her] own place HUD paid for it”; she
    just paid “whatever [she] had to pay.” DHS did not help her find another person “to take
    9
    Holland noted that appellant’s body odor was documented as a medical condition
    and an appointment was set, but appellant never went; there were two times E.H. had a
    double ear infection; and there were two times when Tolleson was gone “nearly a week at
    a time with a new boyfriend” leaving appellant with her sixteen-year-old sibling only.
    11
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    care of [her] social security money.” She stated that “[t]here could have probably been other
    services [DHS] could have offered [her],” but “[n]ot anything [she could] think of.” When
    people tell appellant to do something different with E.H., she “[tries] to do what [she] can”;
    she is “capable.” She would be willing to have a “24/7 aide,” if she qualified, and was
    willing to get help from places other than Tolleson. She thought she was “capable enough.”
    “With people’s help,” she so believed.
    Appellant asserted that the rash-cream instruction mistake was because she did not
    realize she handed the daycare worker both a “butt paste” and a prescription. On that
    particular morning, she asserted that E.H. did not have a diaper rash when she went to
    daycare, though she had one when she returned, so she went to the doctor. Regarding the
    whole milk before E.H. was one year old, she denied that it was a whole bottle of whole
    milk; “just with water and a little bit.” She first asserted that a “doctor told [her] to start
    introducing” whole milk to E.H., but then testified “[a]s to who told me how to do it, well,
    I went to parenting classes and stuff and I just try to do everything. I didn’t just do that on
    my own, someone told me something that I thought was okay.”
    Appellant acknowledged that Tolleson “was supposed to be there to help” her during
    her trial home placement. While she denied that Tolleson was with her boyfriend—
    eventually admitting that Tolleson would go to be with her boyfriend—she stated that
    Tolleson “was there but she wasn’t there.” She acknowledged discussing with her attorney
    that Tolleson “might not be the right person for [her] to be with and [Tolleson is] not.”
    When asked if she planned to continue to live with Tolleson and appellant’s grandmother,
    she stated that she looked into some places, “but the care that everybody wants is not what
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    they have.” 10 She had recently had a family friend take her to check out some services in
    Mena; she did not notice he was drunk “until someone said something.”
    Harp, appellant’s current caseworker, testified to giving appellant information for
    First Steps Pregnancy and Resource Center in Mena because they “have more intensive
    one-to-one parenting as well as life skills[,]” and the Polk County Developmental Center
    “was taking a little bit longer and [DHS] wanted to get [appellant] some services quicker”
    because time was “critical.” When Harp spoke to the director of the program about
    appellant’s needs, the director “didn’t realize” that appellant needed “a continual process”
    as the program was a 12- to 18-month program that “transitions out,” so they would not
    be able to help appellant “as far as 24-hour, you know, live in somewhere and stay there.”
    Harp testified that there were concerns “along the way” of the trial home placement,
    but DHS was “kind of working with” appellant and fixing the problems as they arose. Those
    concerns included (1) appellant’s inability to discern that a person had been drinking and
    that it was a danger to get into car with that person driving; (2) that multiple dogs and
    puppies were in the home during the trial home placement and “[p]oop was everywhere,”
    and she “was not exaggerating”; and (3) appellant’s inability to recognize safety hazards. 11
    10
    She submitted a letter from her landlord verifying that she had housing, having
    moved in on December 1, 2016; however, the letter stated that she lived in the home with
    Tolleson, Della Garcia, and Kayla Horton.
    11
    Examples given included a wooden crate with wires sticking out of it being on the
    floor at a time when E.H. could begin crawling, appellant placing her bed so that the
    headboard blocked the only other exit in the room, and an “air conditioner with the front
    of it, exposed wires, a fan clipped to it.”
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    The “pattern for [appellant was] that [Harp] would confront her on something, if [appellant]
    realized that she hadn’t—she had said the wrong thing, she would change it.”
    Despite some potential options that had not been explored, Harp did not think it
    premature to recommend termination of appellant’s parental rights because they were fifteen
    months into the case, and even if there were other possibilities, there were no guarantees
    that they could be set up or that appellant would follow through. Appellant’s counsel advised
    Harp of a program in Van Buren that currently provides 24/7 care to a disabled gentleman
    and his two-year-old child; however, counsel admitted to the court that she had not brought
    up this program to Harp. Harp testified that no one ever suggested that she check any
    specific program and no one ever said “[appellant’s] disabled, we want this particular
    accommodation or we want you to accommodate her because she is disabled.” At the last
    hearing, an assisted-living place had been brought up as an option and Harp had researched
    that, finding no place that would take a client as young as appellant and none that would
    make an exception for her with the inclusion of E.H. Harp did not believe appellant was
    ready for reunification or to live on her own with E.H.
    Appellant moved for a directed verdict after Harp’s testimony; the circuit court
    denied the motion. From the bench, the circuit court made the following pertinent findings:
    This child has been adjudicated dependent-neglected due to failure to thrive. This
    case now is going on its 15th month. The Department has provided a myriad of
    services to the mother. The record is replete with all the services. The mother, based
    on the testimony of the psychologist, Dr. Spray, has a low level of cognitive skills.
    She would need supervision by a competent adult in order to parent her child. And
    Dr. Spray had indicated that he would be concerned about who that person was
    because the mother of the mother was in the home when the child was taken. The
    testimony is replete even from the mother today that her mother is not an appropriate
    caregiver for her. She needs an appropriate -- she needs a caregiver. She cannot read,
    she has no driver’s license, I believe she’s a very nice person but she is low
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    functioning. She has a low level of cognitive skills. And as Dr. Spray said she’d need
    supervision by a competent adult in order to raise her child.
    ....
    The child’s been outside the home -- we’re in the 15 months – for more than
    12 months. There’s been subsequent factors. . . . I know, ma’am, you love your baby
    very much. But I have to find what’s in the best interest of this child. And if I thought
    we could continue this case for another three months or six months or whatever, or
    a situation that you can parent the child, I would certainly consider it. But this child
    needs permanency.
    This child needs a safe environment, a place where the -- from both parents
    and where the child can be cared for. This child is, I believe about 14 or 15 months
    old. A little bit over that. This child needs permanency. I find reasonable efforts on
    behalf of the Department, more than reasonable efforts to accommodate. Especially
    to accommodate the mother with her disabilities. But I don’t know anything more
    that the Department could possibly do.
    It then found termination of appellant’s parental rights to be in the best interest of E.H.
    The circuit court entered an order denying appellant’s motions for a second
    independent psychological evaluation and a continuance on February 6, 2017. 12 The circuit
    court entered its order terminating appellant’s parental rights on April 6, 2017. Therein, it
    found that DHS had proven both grounds alleged in the petition. Appellant filed a motion
    for reconsideration and/or for a new trial on April 11, 2017, based on records from the
    Fresh Start program, which she “was engaged and participating in . . . at the time of the
    12
    This order was virtually identical to the circuit court’s status order entered on
    January 17, 2017; however, the February 6, 2017 order added a Rule 54(b) certificate.
    Neither party raises the issue of the Rule 54(b) certificate on appeal; however, this court
    addresses it here because, if valid, it would be a final order from which appellant failed to
    appeal. A review of the certificate shows that it was not valid because it merely tracked the
    language of the rule and did not make specific factual findings. See Albarran v. Liberty
    Healthcare Mgmt., 
    2013 Ark. App. 598
    , at 4 (citing Cruse v. 451 Press, LLC, 
    2010 Ark. App. 115
    ).
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    termination hearing,” and had since, “successfully completed” so that she can “safely and
    appropriately parent her child.” The accompanying documentation stated that appellant
    began the program on January 16, 2017. DHS responded in opposition to the motion on
    April 17, 2017. The circuit court denied the motion in its order entered on April 25, 2011.
    This timely appeal followed.
    II. Standard of Review
    The standard of review in appeals of termination of parental rights is de novo, but
    we reverse a trial court’s decision to terminate parental rights only when it is clearly
    erroneous. 13 A finding is clearly erroneous when, although there is evidence to support it,
    the reviewing court on the entire evidence is left with a distinct and firm conviction that a
    mistake was made. 14 Grounds for termination of parental rights must be proven by clear and
    convincing evidence, which is that degree of proof that will produce in the finder of fact a
    firm conviction of the allegation sought to be established. 15 The appellate inquiry is whether
    the trial court’s finding that the disputed fact was proven by clear and convincing evidence
    13
    Shaffer v. Ark. Dep’t of Human Servs., 
    2016 Ark. App. 208
    , at 3, 
    489 S.W.3d 182
    ,
    184 (citing Ullom v. Ark. Dep’t of Human Servs., 
    340 Ark. 615
    , 
    12 S.W.3d 204
    (2000);
    Mitchell v. Ark. Dep’t of Human Servs., 
    2013 Ark. App. 715
    , 
    430 S.W.3d 851
    ; Brewer v. Ark.
    Dep’t of Human Servs., 
    71 Ark. App. 364
    , 
    43 S.W.3d 196
    (2001)).
    14
    
    Id. (citing Wade
    v. Ark. Dep’t of Human Servs., 
    337 Ark. 353
    , 
    990 S.W.2d 509
    (1999); Knuckles v. Ark. Dep’t of Human Servs., 
    2015 Ark. App. 463
    , 
    469 S.W.3d 377
    ;
    Hopkins v. Ark. Dep’t of Human Servs., 
    79 Ark. App. 1
    , 
    83 S.W.3d 418
    (2002)).
    15
    Greenhaw v. Ark. Dep’t of Human Servs., 
    2016 Ark. App. 294
    , at 2–3, 
    495 S.W.3d 109
    , 111 (citing Hughes v. Ark. Dep’t of Human Servs., 
    2010 Ark. App. 526
    ).
    16
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    is clearly erroneous. 16 In resolving the clearly erroneous question, the reviewing court defers
    to the circuit court because of its superior opportunity to observe the parties and to judge
    the credibility of witnesses. 17
    Termination of parental rights is a two-step process requiring a determination that
    the parent is unfit and that termination is in the best interest of the child. 18 The first step
    requires proof of one or more statutory grounds for termination; the second step, the best-
    interest analysis, includes consideration of the likelihood that the juvenile will be adopted
    and of the potential harm caused by returning custody of the child to the parent. 19 Only
    one statutory ground is necessary to terminate parental rights. 20 Appellant does not contest
    the best-interest finding made by the trial judge, so if either ground found by the circuit
    court to be supported by clear and convincing evidence is not clearly erroneous, we are
    compelled to affirm.
    16
    
    Id. at 3,
    495 S.W.3d at 111 (citing J.T. v. Ark. Dep’t of Human Servs., 
    329 Ark. 243
    ,
    
    947 S.W.2d 761
    (1997)).
    17
    Houseman v. Ark. Dep’t of Human Servs., 
    2016 Ark. App. 227
    , at 3, 
    491 S.W.3d 153
    , 155 (citing Brumley v. Ark. Dep’t of Human Servs., 
    2015 Ark. 356
    , at 7; Dinkins v. Ark.
    Dep’t of Human Servs., 
    344 Ark. 207
    , 213, 
    40 S.W.3d 286
    , 291 (2001)).
    18
    
    Id. at 2,
    491 S.W.3d at 155 (citing Harbin v. Ark. Dep’t of Human Servs., 2014 Ark.
    App. 715, at 2, 
    451 S.W.3d 231
    , 233).
    19
    
    Id. (citing Ark.
    Code Ann. § 9-27-341(b)(3)(B), (b)(3)(A) (Repl. 2015); 
    Harbin, supra
    ).
    20
    Beard v. Ark. Dep’t of Human Servs., 
    2016 Ark. App. 467
    , at 7, 
    503 S.W.3d 89
    , 93
    (citing Sanford v. Ark. Dep’t of Human Servs., 
    2015 Ark. App. 578
    , 
    474 S.W.3d 503
    ).
    17
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    2017 Ark. App. 633
    III. Failure to Remedy
    Appellant’s first argument on appeal is that the circuit court clearly erred in
    terminating her parental rights based on failure to remedy because failure to thrive was the
    condition that caused the removal and that condition had been remedied. This court does
    not agree.
    The failure-to-remedy ground provides that termination is appropriate if the court
    finds, by clear and convincing evidence, that the juveniles have been adjudicated dependent-
    neglected and have continued to be out of the parents’ custody for at least twelve months,
    and despite meaningful efforts by DHS to rehabilitate the parents and correct the conditions
    that caused removal, those conditions have not been remedied. 21 “Dependent-neglected
    juvenile” is defined to include any juvenile who is at substantial risk of serious harm as a
    result of neglect 22 or parental unfitness. 23 “Neglect” is defined to include those acts or
    omissions of a parent that constitute:
    (ii) Failure or refusal to provide the necessary food, clothing, shelter, or medical
    treatment necessary for the juvenile’s well-being; [or] 24
    ....
    21
    Morton v. Ark. Dep’t of Human Servs., 
    2015 Ark. App. 388
    , at 7, 
    465 S.W.3d 871
    ,
    875 (citing Ark. Code Ann. § 9-27-341(b)(3)(B)(i)(a) (Supp. 2011)).
    22
    Ark. Code Ann. § 9-27-303(18)(A)(v) (Repl. 2015).
    23
    Ark. Code Ann. § 9-27-303(18)(A)(vi).
    24
    Ark. Code Ann. § 9-27-303(36)(A)(ii). This court notes that there is an inapplicable
    exception here.
    18
    Cite as 
    2017 Ark. App. 633
    (iv) Failure or irremediable inability to provide for the essential and necessary
    physical, mental, or emotional needs of the juvenile, including failure to provide a
    shelter that does not pose a risk to the health or safety of the juvenile[.] 25
    The circuit court’s December 8, 2015 adjudication and disposition order, adjudicated
    E.H. dependent-neglected, “as defined in the Arkansas Juvenile Code.” It specifically found
    that:
    [E.H.] failed to gain much weight in the seven weeks after she was born due to the
    failure by [appellant] to properly feed her child and the baby’s life was in danger due to
    lack of food. Dr. Sara Roberson, the family doctor who examined [E.H.] testified
    that [E.H.] failed to gain much through three check-ups at her clinic despite [Dr.
    Roberson and her nurses discussing with [appellant] how to properly feed the baby. After
    those three visits, Dr. Roberson diagnosed [E.H.] with failure to thrive after having
    concerns with [appellant’s] ability to feed her baby. . . . Through observation and
    testing, Dr. Roberson found no other medical reasons for [E.H.’s] failure to gain
    weight other than improper feeding. Holly [Laird] testified she also had concerns
    with [E.H.’s] weight and with [appellant’s] feeding of [E.H.] even though they instructed
    [appellant] multiple times on how to properly feed [E.H.] FSW Jennifer Williams testified
    that on October 14th, she met with [appellant] and [E.H.] at their home and asked
    [appellant] to make a bottle. [Appellant] made a bottle but shorted it a full scoop. . .
    . The Court finds Dr. Sara Robinson, Holly Laird, and FSW Jennifer Williams’
    testimony credible. 26
    It is clear from the circuit court’s order that the reason for E.H.’s removal was the acts and
    omissions of appellant which led to E.H.’s failure to thrive and which gave rise to concerns
    regarding her ability to care for E.H., even when properly instructed. DHS listed the
    following as services provided to appellant:
    [S]he was offered and provided with one-on-one parenting and homemaking
    services; arrangements were made for her to receive instruction at the Extension
    office in Waldron; [DHS] helped her with the admissions process to Polk County
    Developmental Services – Adult Services; she was provided with psychological
    testing and counseling; she was provided with transportation to and from instruction
    at the Literacy Council; she was provided with psychological testing and counseling;
    she was provided with family visitation, home visits, Family Centered Meetings and
    25
    Ark. Code Ann. § 9-27-303(36)(A)(iv).
    26
    (Emphasis added.)
    19
    Cite as 
    2017 Ark. App. 633
    a trial home placement in which [appellant’s] mother agreed to provide additional
    assistance as needed.
    Despite these services, termination-hearing testimony showed that appellant still was not
    showing an ability to properly apply instructions. She still was unable to recognize safety
    hazards. Additionally, she was unable to successfully treat E.H.’s “continuous diaper rash,”
    could not mix a proper bottle of formula, and could not provide proper instructions for
    medication usage. It was not only clear that she could not follow instructions, but also that
    she had to be instructed to make basic parenting decisions. Her inability to conform to the
    requirements of parenting—in addition to the failure of Tolleson to properly supervise
    appellant—led to an unsuccessful trial home placement.
    These continued displays of appellant’s inability to follow through and successfully
    apply instructions exemplify Dr. Spray’s psychological-evaluation findings that appellant had
    low cognitive function and could not care for E.H. without supervision. Holland testified
    that she would come up with a plan with appellant but appellant would “never follow
    through.” Appellant’s own testimony was that she was capable of caring for E.H. with the
    help of others; she never asserted that she could, or would ever be able to, do it alone.
    Finally, she admitted that Tolleson was not a good helper to her. The statute requires that
    “the conditions that caused removal” be remedied, not just the named basis for the
    dependency-neglect adjudication. 27
    27
    Rodgers v. Ark. Dep’t of Human Servs., 
    2016 Ark. App. 569
    , at 11, 
    506 S.W.3d 907
    ,
    914.
    20
    Cite as 
    2017 Ark. App. 633
    After fifteen months of services, the circuit court was still concerned that appellant
    had not reached a point where she could safely parent E.H. Even full compliance with the
    case plan is not a bar to termination of parental rights; the issue is whether the parent has
    become a stable, safe parent able to care for his or her children. 28 Appellant’s continued
    inability to apply instructions showcased a continued failure, refusal, or irremediable inability
    to make proper decisions for E.H.’s benefit. Accordingly, this court holds that the evidence
    shows that appellant failed to remedy the cause of E.H.’s removal, which was neglect.
    IV. Other Subsequent Factors
    Appellant’s second argument is that the circuit court erred in finding that DHS had
    shown the subsequent factors ground because DHS did not make reasonable
    accommodations in accordance with the ADA. This court has stated that the requirement
    that DHS make reasonable accommodations for a disability is not an overarching mandate
    applicable to all grounds for termination, but instead is one of the elements contained only
    in the “other factors” ground. 29   30
    Because we find that the circuit court did not err in
    terminating appellant’s rights pursuant to the failure-to-remedy ground, and only one
    28
    Bean v. Ark. Dep’t of Human Servs., 
    2017 Ark. App. 77
    , at 24, 
    513 S.W.3d 859
    , 874
    (citing Villasaldo v. Ark. Dep’t of Human Servs., 
    2014 Ark. App. 465
    , 
    441 S.W.3d 62
    ).
    29
    Bane v. Ark. Dep’t of Human Servs., 
    2016 Ark. App. 617
    , at 10, 
    509 S.W.3d 647
    ,
    654 (citing Anderson v. Ark. Dep’t of Human Servs., 
    2016 Ark. App. 428
    , 
    501 S.W.3d 831
    ).
    30
    This court notes DHS’s argument that the ADA does not apply as a defense to a
    termination proceeding because it is not a service, program, or activity; however, it provides
    no Arkansas authority stating the same. It is axiomatic that we are not compelled to follow
    the holdings of other jurisdictions. Progressive Eldercare Servs.-Chicot, Inc. v. Long, 2014 Ark.
    App. 661, at 5, 
    449 S.W.3d 324
    , 327. Our courts have yet to address this argument, and we
    do not address it here.
    21
    Cite as 
    2017 Ark. App. 633
    ground is required to support termination of parental rights, we do not address this
    argument. However, we do positively note DHS’s argument that appellant’s argument does
    not contend that she did not have meaningful access to services, but that she needed the
    second evaluation to determine the benefit of the services she received; to determine
    “whether she had improved.”
    V. Denial of Motions
    Finally, appellant argues that the circuit court erred in denying her motions for a
    second evaluation and continuance as untimely. DHS argues that the denial of appellant’s
    motions for a second evaluation and continuance were made in a separate order that was
    not appealed, and because that order was not listed in appellant’s notice of appeal, appellee’s
    argument is waived. We agree with DHS.
    Appellant’s motions for a second evaluation and continuance were made on
    December 6, 2016. They were denied in the circuit court’s February 6, 2017 status-hearing
    order. Because the order was not final, 31 it could not be appealed until entry of the circuit
    court’s April 6, 2017 order. Appellant designated the termination order and the order
    denying her motion for reconsideration in her notice of appeal. While a termination order
    might bring up all intermediate orders, appellant did not designate the February 6, 2017
    order; therefore, she effectively waived her arguments regarding the motions for a second
    evaluation and a continuance. 32
    31
    See footnote 11.
    32
    See Gyalog v. Ark. Dep’t of Human Servs., 
    2015 Ark. App. 302
    , at 7, 
    461 S.W.3d 734
    , 738 (citing Velazquez v. Ark. Dep’t of Human Servs., 
    2011 Ark. App. 168
    , at 5) (appellant
    22
    Cite as 
    2017 Ark. App. 633
    Affirmed.
    VIRDEN and KLAPPENBACH, JJ., agree.
    Brett D. Watson, Attorney at Law, PLLC, by: Brett D. Watson, for appellant.
    Andrew Firth, Office of Chief Counsel, for appellee.
    Chrestman Group, PLLC, by: Keith L. Chrestman, attorney ad litem for minor
    children.
    did not designate the permanency-planning order in his notice of appeal, effectively waiving
    his arguments related to the permanency-planning order).
    23