In re K.J... ( 2024 )


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    2024 UT App 47
    THE UTAH COURT OF APPEALS
    STATE OF UTAH, IN THE INTEREST OF K.J., M.J., AND K.J.,
    PERSONS UNDER EIGHTEEN YEARS OF AGE.
    D.F. AND K.J.,
    Appellants,
    v.
    STATE OF UTAH,
    Appellee.
    Opinion
    Nos. 20230102-CA and
    20230103-CA
    Filed April 4, 2024
    First District Juvenile Court, Logan Department
    The Honorable Bryan P. Galloway
    No. 1218130
    Alexandra Mareschal, Kirstin Norman, and Jason B.
    Richards, Attorneys for Appellant D.F.
    Emily Adams, Attorney for Appellant K.J.
    Sean D. Reyes, Carol L.C. Verdoia, and John M.
    Peterson, Attorneys for Appellee
    Martha Pierce, Guardian ad Litem
    JUDGE RYAN M. HARRIS authored this Opinion, in which
    JUDGES GREGORY K. ORME and JOHN D. LUTHY concurred.
    HARRIS, Judge:
    ¶1     In separate appeals that we consider together in this
    opinion, K.J. (Father) and D.F. (Mother) (collectively, Parents)
    challenge the juvenile court’s orders removing their three children
    (Children) from their home and, later, adjudicating the Children
    abused and neglected. Parents’ main challenge concerns the
    In re K.J.
    court’s adjudication that they abused and neglected the Children.
    Parents also assert that, in one respect, they received ineffective
    assistance of counsel. For the reasons discussed, we find Parents’
    arguments on these two topics unpersuasive.
    ¶2     But Parents also assert that, during the shelter hearing held
    at the beginning of the case, the juvenile court did not undertake
    a proper and complete analysis of the factors the governing
    statute required the court to consider. In this respect, Parents’
    arguments have merit, and we remand the case so that the
    juvenile court can conduct the proper statutory analysis.
    BACKGROUND
    ¶3     Parents are the legal and biological parents of three
    “medically complex” children: Kevin, Mia, and Kaleb. 1 The family
    moved to Utah in 2022, after having lived in Nevada and Arizona;
    at that time, Kevin was five years old, Mia was four, and Kaleb
    was not quite two. Parents believed that the Children suffered
    from a long list of various medical maladies; when the family
    arrived in Utah, all three Children—despite having largely
    different medical diagnoses—had surgically placed gastric
    feeding tubes (G-tubes), were developmentally delayed, and used
    wheelchairs for mobility.
    ¶4    In July 2022, Kevin was rushed to a local hospital by
    ambulance after Mother reported that he had suffered a seizure.
    Mia was hospitalized at the same time due to concerns about
    weight and dehydration. Kevin and Mia were transferred to
    Primary Children’s Medical Center (PCMC) in Salt Lake City;
    Kevin was treated with IV fluids to address “severe
    hypernatremia” due to dehydration. Kevin and Mia ended up
    1. For readability, we use pseudonyms (rather than initials) to
    refer to the Children.
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    staying at PCMC for nearly two weeks, and Kevin was even
    admitted to the pediatric intensive care unit. While Kevin and Mia
    were at PCMC, medical professionals there became concerned
    that they were being medically neglected. In particular, hospital
    personnel observed that Kevin and Mia were “severely
    underweight,” despite the presence of G-tubes, and “were
    considered a failure to thrive.”
    ¶5     After Kevin and Mia were discharged from PCMC, all
    three Children were referred to a pediatric nurse practitioner
    (Nurse Practitioner) for follow-up primary care. When the
    Children arrived at her medical clinic, Nurse Practitioner
    discovered that the Children—partly due to only recently having
    arrived in Utah—were not yet set up for medical insurance. But
    after examining the Children, Nurse Practitioner agreed to treat
    them anyway, despite their lack of insurance, because in her view
    “it was medically necessary to see them regardless of the
    insurance difficulties.” As she saw it, “these kids needed medical
    care whether [she] got paid” or not, because they were facing
    “significant medical issues” that she considered potentially “life
    and death” matters. The Children arrived at her clinic in
    wheelchairs and were developmentally delayed and nonverbal.
    None were toilet trained. Over the course of her treatment—
    which lasted several weeks—Nurse Practitioner also observed
    that the Children had not been “gaining [weight] as they [had
    been] in the hospital,” which made her wonder whether the
    Children might at some point need “to be rehospitalized.”
    ¶6     A few weeks later, a pediatrician (Pediatrician) was
    assigned to the Children. When he first saw the Children, he
    observed that they were all “nonverbal,” and while Kevin had
    some ability to walk on his own, Mia and Kaleb were
    “nonambulatory.” During the course of his treatment of the
    Children, he worked with them to improve their motor skills and
    their ability to walk, and he monitored their weight, which he
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    indicated was the thing he was “following most closely.” Soon
    after Pediatrician took over primary care of the Children, Kaleb
    came in for his “two-year well[ness] visit.” During that visit,
    Mother indicated that Kaleb had spina bifida, which is “a neural
    defect at the base of the spine” that can often be fixed with
    surgery. Mother insisted that Kaleb had already had the surgery
    to correct the spina bifida, and she even pointed to Kaleb’s back
    where she indicated there was a scar from the surgery. But
    Pediatrician saw no scar.
    ¶7     At some point after Kevin and Mia were released from
    PCMC, a physician at Nurse Practitioner’s clinic contacted the
    Utah Division of Child and Family Services (DCFS) to notify them
    about potential issues with the Children. Thereafter, DCFS
    assigned caseworkers to investigate the matter, and those
    caseworkers made some ten visits to Parents’ home, prior to
    removal, to check on the Children and to assess the situation.
    These visits occurred at different times of day, yet in every visit
    except for one, the Children were all confined in “Pack ‘n Play”
    playpens. Parents stated that the Children needed to be in the
    playpens so that their G-tubes could function properly, but
    caseworkers observed that Parents had—but were not using—
    portable devices that would have maintained a “continuous feed”
    from the feeding tubes without restricting the Children’s
    movement. On one visit, one of the caseworkers asked Mother to
    show her the Children’s medications, and in response Mother
    brought out a large “two feet by three feet” sized tote bag “full of
    prescription bottles and different ointments.” During this time,
    Kevin—who was five years old and eligible to begin
    kindergarten—was not enrolled in school and therefore was not
    receiving any of the services a school could potentially provide to
    a medically complex child.
    ¶8     In addition to receiving primary care from Nurse
    Practitioner and Pediatrician , the Children were also referred to
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    In re K.J.
    and treated by the Pediatric Complex Care Clinic at PCMC. They
    missed their first scheduled appointment with the clinic, which
    caused the lead physician there (Physician) a great deal of
    concern, because she knew that “it was critical that [PCMC]
    follow up with” the Children. Physician notified DCFS of the
    missed appointment, which was eventually rescheduled for about
    three weeks later.
    ¶9     At that rescheduled visit, Mother reported to Physician
    that the Children were all suffering from “dysphagia,” which is
    the “inability to swallow food properly.” Physician observed that
    Kevin and Mia had “continued to lose weight” since their
    discharge from the hospital. This was troubling, because the
    Children all had G-tubes, which exist primarily to make sure the
    Children are receiving enough nutrition; as one member of the
    PCMC team testified, “a child with a G-tube whose caregiver is
    fully responsible for that nutrition intake should not be
    experiencing failure to thrive in the absence of a disease or
    pathology that could cause failure to thrive.”
    ¶10 PCMC doctors investigated whether there could be any
    medical reason for the Children’s continued malnutrition and
    failure to gain weight, and eventually concluded that “none of the
    [C]hildren [had] a pathology consistent with a disease process
    that could cause failure to thrive.” Indeed, the PCMC team
    eventually determined that the Children’s “malnourishment and
    poor growth [were] directly related to insufficient caloric intake,”
    despite their G-tubes, and that the Children’s “failure to thrive
    was not due to their medical conditions but due to [Parents’]
    neglect . . . in feeding them appropriately.”
    ¶11 In addition, after her examination of the Children,
    Physician was concerned “that the [medical] history being
    provided by” Parents was “not consistent with what” she was
    “seeing on physical exam.” Given these concerns, the PCMC team
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    then set out to review the Children’s various medical diagnoses,
    as reported by Parents, with the goal of verifying or eliminating
    each of them. As reported by Parents, the Children suffered from
    the following medical maladies, among others:
    • Kevin had suffered a stroke either in utero or shortly
    after birth, and had Ehlers-Danlos syndrome, Erb’s
    palsy, a seizure disorder, hearing loss, premature birth,
    sleep apnea, and an “allerg[y] to the sun.”
    • Mia had DiGeorge syndrome, blindness, hearing loss,
    premature birth, cerebral palsy, and prediabetes.
    • Kaleb had spina bifida, gastroparesis, premature birth,
    clubfoot affecting both feet, urinary retention issues
    that required catheterization, and hydrocephalus.
    In an effort to confirm these diagnoses, the PCMC team requested,
    obtained, and reviewed over 7,000 pages of medical records
    regarding the Children, including records from Nevada and
    Arizona. After completing their review, and after examining the
    Children both before and after removal, the PCMC team was able
    to confirm some of the diagnoses. For instance, Kaleb does suffer
    from clubfoot in both feet, and Mia does have a genetic disorder
    similar to DiGeorge syndrome. But with regard to most of the
    diagnoses, the PCMC team concluded that Parents’ assertions
    were simply unsupported by any medical evidence. In particular,
    they eventually determined that Kevin does not suffer from
    Ehlers-Danlos syndrome or any seizure disorder, and that he did
    not have a stroke either in utero or shortly after birth; that Mia
    was not legally blind; and that Kaleb did not have spina bifida or
    hydrocephalus and did not need catheterization.
    ¶12 Based on these conclusions, and on their examination of
    the Children, the PCMC team determined that Kevin and Kaleb
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    “had been the victim[s] of” “medical child abuse,” 2 and that the
    team had “serious concerns” in that regard about Mia. They called
    for “hospital admission” for the Children to “de-escalate elements
    of [their] care that are unfounded” and to “restart crucial
    interventions that have been ignored,” with a focus on “nutrition
    and aiding age-appropriate development.” And they
    recommended “development of a long-term plan for trauma-
    informed counseling and adherence to broad therapies, including
    speech therapy, occupational therapy, and physical therapy.”
    ¶13 The PCMC team then met with DCFS caseworkers to
    explain their findings. Based in part on the information its agents
    learned at that meeting, the State determined to seek removal of
    the Children from Parents’ home, and the very next day the State
    sought and obtained a removal warrant.
    ¶14 After obtaining the warrant, DCFS caseworkers traveled to
    Parents’ home to remove the Children. When they arrived, the
    caseworkers again found the Children in their playpens. Parents
    were cooperative, however, and Mother changed the Children’s
    clothes in preparation for the drive to PCMC. One caseworker
    observed that the Children were “a little stinky” and “had an odor
    to them like they hadn’t bathed in a few days.” The drive to the
    2. In its reports regarding the Children, the PCMC team stated
    that “medical child abuse” is “a form of child maltreatment
    characterized by the fabrication or exaggeration of medical
    history, symptoms, and even exam findings and/or the induction
    of symptoms by a caregiver.” Medical child abuse “occurs when
    a child receives unnecessary and harmful or potentially harmful
    medical care at the instigation of the caregiver,” and it “results in
    manipulation of the medical system leading to child maltreatment
    in the form of unnecessary medical examinations, diagnostic
    testing . . . , imaging, and invasive procedures.” Medical child
    abuse, in the past, was called “Münchausen syndrome by proxy.”
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    hospital was uneventful; Kaleb “babbled . . . baby talk,” while
    Kevin and Mia were “lethargic” and had a “very flat affect.”
    ¶15 When the Children arrived at PCMC, hospital staff
    immediately noticed that the Children exhibited “very poor
    hygiene” and observed that the Children were each double or
    triple diapered and that the diapers were “sopping through.”
    After the wet diapers were removed, hospital staff discovered that
    the Children had “fairly extensive [skin] breakdown in the diaper
    area” that was severe enough to require the assistance of the
    hospital’s “wound clinic.” Hospital staff noted that these sorts of
    wounds do not occur “overnight” and were the result of “there
    being wetness on the skin without appropriate response for some
    period of time.” The Children also had “irritability and
    breakdown” around their G-tube sites; as with the diaper-area
    wounds, these wounds also required the assistance of the
    hospital’s wound clinic.
    ¶16 Medical personnel also observed that the Children were
    “malnourished and under expected weight for [their] ages.”
    Kevin was determined to be “severely malnourished,” while Mia
    and Kaleb were determined to be “moderately malnourished.”
    And blood tests on Kaleb “revealed abnormalities very
    concerning for chronic malnutrition.”
    ¶17 The doctors considered the Children’s malnutrition to be
    concerning, and they set about to discover why the Children were
    unable to regularly eat solid food. All three Children were
    administered “swallow studies” to determine their “ability to eat
    and drink by mouth.” Kevin had such a severe “oral aversion to
    food and drink” that hospital personnel were unable to complete
    the test, and he was referred to a “speech/language pathologist”
    to help him overcome the aversion. Mia was “found to have a
    significant oral aversion to liquids,” and was also referred to a
    “speech/language pathologist.” Kaleb, on the other hand, was
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    determined to have no oral aversion and was “eager to eat and
    engaged with all thicknesses of feeds.” Doctors concluded that
    Kevin and Mia’s oral aversion was “likely the result of not being
    provided with solid food” at home, and that Kaleb’s test results
    indicated a “serious concern” that he “did not need a feeding
    tube” at all.
    ¶18 Following removal, the Children stayed in the hospital for
    six days “to medically stabilize them and properly diagnose their
    conditions” through further examination and testing. During this
    time, the PCMC team was (as noted above) able to confirm the
    conclusions it had reached based on the earlier records review.
    ¶19 Upon discharge from PCMC, the Children were placed
    into foster care. Kevin and Mia were placed in the same homes, a
    temporary one at first for a few weeks before being moved to a
    more permanent placement. Kaleb was placed with a different
    foster family. Once in foster care, the Children showed rapid and
    measurable improvement. After having Kevin and Mia for only
    about a month, their foster mother reported that, while Kevin
    could only “scootch around the house on his hiney” when he
    arrived, he eventually learned not only to walk but to run, and he
    could often be seen doing “laps” around the kitchen island. He
    also began to allow his teeth to be brushed (something he had
    refused to allow at first), had become “a lot more personable” and
    affectionate, and began attending kindergarten and “loves
    school.” Mia had some ability to walk when she arrived but was
    “[v]ery unstable”; over time, however, she had learned to “run
    really fast.” The foster mother obtained glasses for Mia, which
    helped her navigate the world better. In the beginning, Mia
    refused to bathe, and would start “screaming and rocking and
    shaking” when asked to do so, but over time had become
    accustomed to it and “now she loves bath time.” And Kaleb’s
    foster mother reported that Kaleb could not crawl, walk, or talk
    when he arrived, but within a few weeks he learned how to not
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    only crawl but walk with the help of furniture, and he was able to
    say several words.
    ¶20 The foster parents also reported that they had enrolled the
    Children in appropriate schooling. Kevin was enrolled in
    kindergarten, where he began to receive speech and occupational
    therapy through the school. Mia was enrolled in preschool, where
    she was given an individualized education plan that included
    speech therapy. And Kaleb was enrolled in a state-run program
    known as “Up to Three,” where he was able to obtain physical
    and speech therapy.
    ¶21 With regard to nutrition and weight gain, all three
    Children demonstrated swift and marked improvement in foster
    care. It wasn’t long before the Children no longer required 24-
    hour G-tube feeding; soon, the Children were receiving feedings
    through the tube only at night and just two or three times during
    the day. All of them were soon eating solid foods; Kevin’s foster
    mother reported that he had “tried 20 new foods” and he liked
    “spaghetti and pasta and yogurt and ice cream.” Following an
    appointment about a month after foster placement, Physician
    noted that Kevin “looks to be doing great” and stated that, from
    “a weight perspective, he is gaining weight appropriately.” And
    she noted that Mia “looked to be in excellent physical health.”
    ¶22 Soon after the Children were removed from Parents’ care,
    Pediatrician set up a meeting to inform Parents of the Children’s
    condition and accurate diagnoses. Parents refused to accept the
    PCMC team’s conclusion that many of the previous diagnoses
    were inaccurate; indeed, Pediatrician described Parents’ reaction
    as one of “scoffing and disbelie[f] and unacceptance.” Pediatrician
    later stated that, because of Parents’ “blatant disregard of facts
    from medical tests and expert opinions from specialists,” he
    “would be very worried” about the Children if they were to be
    placed back in Parents’ care.
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    ¶23 In the meantime, legal proceedings began in the juvenile
    court. One week after removal, the court held a shelter hearing, at
    which it heard testimony from Mother, Father, and one member
    of the PCMC medical team. At the conclusion of the hearing, the
    court stated that it was “convinced by a preponderance [of the
    evidence] that the [C]hildren were being neglected” by Parents.
    The court noted that daily oversight of the Children had been
    Parents’ responsibility, and that this “oversight was done in a way
    that was neglectful.” It specifically mentioned that, upon arrival
    at the hospital after removal, the Children all had “soiled” diapers
    and “open sores” in the diaper area as well as around the G-tube
    sites. The court noted that the Children “needed a great deal more
    medical oversight” than they had been getting, and that “at the
    very least” the case presented “medical neglect” with a “strong
    indication” that there was also “medical abuse.” The court stated
    that it had been “up to [Parents] to identify [the issues] and care
    for these [C]hildren,” who “were not thriving.”
    ¶24 After making its findings of neglect, the court finished its
    shelter analysis with the following remarks:
    The [c]ourt does find that given the current state of
    the [C]hildren, exigent circumstances existed with
    regards to the removal. The removal was proper. At
    this particular time until there is a plan in place, the
    continued removal is necessary. Okay? At some
    point in time if a plan is in place and the parents
    have shown the ability to take into consideration the
    current medical condition of the [C]hildren and
    have shown the ability to work with the
    professionals that are providing that care for the
    [C]hildren, I don’t see why it cannot at least be
    considered that the ongoing continued removal
    would not be necessary. Okay?
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    At this point, I just don’t have enough with regards
    to that. The only thing I have is that there was
    testimony that if placed back in the care of [Parents],
    this is going to get worse and worse and worse. I
    don’t think that has to be the case really.
    So I do find removal proper, . . . [a]nd I do find that
    exigent circumstances, emergency circumstances
    did exist with relation to the removal at the time the
    [C]hildren were removed which absolved [DCFS] of
    the need to provide reasonable efforts to keep the
    [C]hildren in the home.
    ¶25 Later, the court issued an order memorializing its oral
    ruling. It found that “[t]he lack of physical care that the [C]hildren
    received by [Parents] constitutes neglect,” and that the Children
    were “clearly not thriving.” The court found that “[r]emoval of
    the [C]hildren from the home was proper and in [their] best
    interest,” and that it was “contrary to [their] well-being . . . to
    remain in the home.” And it found that, “because an emergency
    situation . . . existed at the time of removal, . . . any lack of pre-
    placement preventative efforts was appropriate and justified.”
    ¶26 About six weeks later, the juvenile court held an
    adjudication trial. Over three trial days, the court heard from
    thirteen witnesses, including the involved DCFS caseworkers,
    Nurse Practitioner, Pediatrician, the foster parents, and various
    members of the PCMC medical team. They all testified about the
    events described above. At one point during the trial, the Children
    visited the courtroom, an event the court noted for the record,
    stating that it “was able to” see the Children and “watch them
    interact with” Parents. At the conclusion of the trial, the court took
    the matter under advisement.
    ¶27 Some ten days later, the court issued a lengthy written
    ruling in which it summarized the evidence presented at trial and
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    then determined that the Children had been abused and neglected
    by both Parents. With regard to abuse, the court found that the
    Children had “suffered or been threatened with nonaccidental
    harm in that unnecessary medical interventions have been
    performed that have caused physical harm” to the Children. In
    support of this finding, the court pointed to six different
    “unnecessary medical interventions”: (1) a CT scan performed on
    Kaleb in 2022 that was against medical advice; (2) Mother’s
    “[i]ntermittent catheterization” of Kaleb; (3) various medical tests
    performed on Kevin that “expos[ed him] to radiation
    unnecessarily”; (4) various unnecessary blood draws on Mia;
    (5) “bronchoscopies and modified Barium swallow studies”
    performed on all three Children that “may not have been
    necessary”; and (6) Parents’ actions in “maintaining the
    [C]hildren on G-tubes” and “constant[ly] plac[ing]” them in
    playpens, actions the court found had “harmed the [C]hildren to
    the point that they became unable to eat food orally or develop
    the ability to walk.”
    ¶28 With regard to neglect, the court’s conclusion rested on
    two separate grounds. First, the court pointed to the Children’s
    condition upon arriving at the hospital, finding that they were
    “malnourished” without any “medical reason” and “[d]espite
    placement of feeding tubes and 24/7 feeding,” and that they were
    “nonverbal and unable to walk” because of parental neglect and
    not because of “their medical complexity.” Based on their
    condition at the time of removal, the court concluded that the
    Children were neglected because Parents had failed “to provide
    for their basic physical needs on a day-to-day basis.”
    ¶29 Second, the court pointed to Parents’ belief that the
    Children had various medical maladies, many of which did not
    appear to be borne out by medical evidence, noting by way of
    example that there is no evidence that Kaleb has spina bifida or
    hydrocephalus. In that same vein, the court found that the
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    Children “have not received appropriate interventions for their
    developmental needs,” noting specifically that Mia had not
    received appropriate medical treatment for certain neurological
    conditions and that none of the Children had been “enrolled in
    any physical therapy, occupational therapy, feeding therapy, or
    speech therapy since the family arrived in Utah.” Accordingly, the
    court concluded that the Children were neglected because Parents
    had “failed or refused to provide proper and necessary
    subsistence [and] medical care when required.”
    ¶30 After finding both abuse and neglect, the court concluded
    that “continued removal” was “in the best interest” of the
    Children, and that DCFS had “made reasonable efforts to prevent
    the removal,” but that those efforts had been “unsuccessful.” The
    court ordered that the Children “be placed in [DCFS’s] custody
    and guardianship for appropriate placement.”
    ISSUES AND STANDARDS OF REVIEW
    ¶31 Parents now appeal, and they raise three issues for our
    review. First, Parents challenge the juvenile court’s
    determination, made after the adjudication trial, that they had
    abused and neglected the Children. In this context, “we apply
    differing standards of review to findings of fact, conclusions of
    law, and determinations of mixed questions of law and fact.” In re
    M.S., 
    2023 UT App 74
    , ¶ 23, 
    533 P.3d 859
     (quotation simplified).
    The factual findings underlying an abuse or neglect adjudication
    are reviewed deferentially and are reversed only if clearly
    erroneous. See In re K.K., 
    2023 UT App 13
    , ¶ 21, 
    525 P.3d 519
    . But
    the court’s ultimate determination regarding abuse or neglect is
    reviewed for correctness, because making that determination,
    which involves applying a given set of facts to statutory criteria,
    “is primarily a law-like endeavor.” See In re M.S., 
    2023 UT App 74
    ,
    ¶ 23 (quotation simplified).
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    ¶32 Second, Parents assert that, in one respect, their attorneys
    rendered constitutionally ineffective assistance. “When a claim of
    ineffective assistance of counsel is raised for the first time on
    appeal, there is no lower court ruling to review and we must
    decide whether the [party] was deprived of the effective
    assistance of counsel as a matter of law.” State v. Kitzmiller, 
    2021 UT App 87
    , ¶ 14, 
    493 P.3d 1159
     (quotation simplified).
    ¶33 Finally, Parents challenge the juvenile court’s earlier order
    following the shelter hearing, asserting that the court failed to
    engage in the proper statutory analysis before issuing its order
    finding that removal was necessary. In particular, Parents assert
    that the court did not properly analyze whether DCFS had made
    reasonable efforts to prevent removal, and that the court did not
    properly analyze whether there were services available, going
    forward, that might have prevented removal. At root, Parents’
    assertion is that the juvenile court misapplied the shelter statute.
    “We review [a lower] court’s application of a statute for
    correctness.” Estate of Higley v. Utah Dep’t of Transp., 
    2010 UT App 227
    , ¶ 6, 
    238 P.3d 1089
     (quotation simplified).
    ANALYSIS
    I. Adjudication Order
    ¶34 Parents’ main challenge is to the merits of the juvenile
    court’s adjudication order, in which the court determined that the
    Children were abused and neglected as to both Parents. For the
    reasons discussed, we affirm the juvenile court’s determination
    that Parents neglected the Children. In light of that ruling, and
    given the posture of Parents’ arguments on appeal, we need not
    consider the merits of the court’s abuse adjudication.
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    A. Neglect
    ¶35 We first consider Parents’ challenge to the juvenile court’s
    neglect adjudication. In this context, “[n]eglect” includes parental
    “action or inaction causing” any one of six different results. See
    Utah Code § 80-1-102(58)(a). Yet not all six results are necessary
    for a neglect determination; when “the juvenile court [finds]
    neglect under several subsections, to affirm we need conclude
    only that neglect was established under one of the bases.” In re
    G.H., 
    2023 UT App 132
    , ¶ 28, 
    540 P.3d 631
    .
    ¶36 In this case, the juvenile court determined that Parents had
    neglected the Children under two of the six statutory subsections.
    First, based on the condition of the Children at removal, the court
    determined that Parents’ action or inaction caused a “lack of
    proper parental care of a child by reason of the fault or habits of
    the parent.” See Utah Code § 80-1-102(58)(a)(ii). Second, and
    alternatively, the court determined, based on the Children’s
    medical conditions, that Parents had failed or refused “to provide
    proper or necessary subsistence or medical care, or any other care
    necessary for the child’s health, safety, morals, or well-being.” Id.
    § 80-1-102(58)(a)(iii). For the reasons discussed, we conclude that
    the juvenile court’s first ground is supported by the evidence in
    this case, and we therefore need not reach the second.
    ¶37 In our view, the Children’s condition at removal alone was
    sufficient for the juvenile court to determine that the Children
    were neglected. The Children were all malnourished, one of them
    “severely” so. They were all underweight and failing to thrive.
    Moreover, they all had mobility problems; none of them could
    walk in an age-appropriate manner. And none were toilet-trained.
    In addition, they arrived at PCMC with open sores in their diaper
    areas and around their G-tube sites that were severe enough to
    require consultation with the hospital’s wound clinic.
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    In re K.J.
    ¶38 Even though the Children are medically complex, the
    juvenile court found that there was no medical reason for their
    malnourishment, failure to thrive, or open wounds. That finding
    was not clearly erroneous. It should go without saying that
    allowing open wounds to develop or remain untreated is not
    medically necessary; certainly, Parents make no assertion to the
    contrary. And with regard to malnourishment and failure to
    thrive, PCMC doctors investigated whether there could be any
    medical reason for the Children’s continued malnutrition and
    failure to gain weight, and eventually concluded that no such
    medical cause existed here. Absent a medical cause, children with
    G-tubes should not be malnourished. Following examination and
    testing, the PCMC team eventually determined that the
    Children’s “malnourishment and poor growth [were] directly
    related to insufficient caloric intake,” despite G-tubes, and that
    their “failure to thrive was not due to their medical conditions but
    due to [Parents’] neglect . . . in feeding them appropriately.”
    ¶39 Parents resist the court’s neglect determination by pointing
    to the neglect statute’s exception for “reasonable and informed”
    health care decisions. See 
    id.
     § 80-1-102(58)(b)(ii) (“Neglect does
    not include . . . a health care decision made for a child by the
    child’s parent or guardian, unless the state . . . shows . . . that the
    health care decision is not reasonable and informed.”). They
    assert, in essence, that their care of the Children has consisted of
    a series of health care decisions that the State has not shown to be
    unreasonable or uninformed. And on that basis they argue that
    the court’s neglect determination was incomplete and improper.
    ¶40 Parents’ arguments might have more force if the reason the
    State was asserting neglect had to do with a specific medical
    decision Parents made for the Children—say, for instance, their
    decision to place G-tubes in all three Children. But in this case, the
    juvenile court’s neglect determination was—at least in relevant
    part—not based on any specific health care decision but, instead,
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    In re K.J.
    on the Children’s condition at the time of removal. On that score,
    Parents—unlike the parents in In re M.S., 
    2023 UT App 74
    , ¶¶ 41–
    48, 
    533 P.3d 859
    , who asserted that their baby’s low weight was
    due to their decision to exclusively use breast milk rather than
    formula—make no effort to defend the Children’s malnutrition
    and failure to thrive by pointing to any particular health care
    decision, whether reasonable and informed or not. Indeed, as
    noted, PCMC doctors concluded, after examination and testing,
    that there was no medical justification for the Children’s
    malnutrition and failure to thrive. Under these circumstances, the
    statutory exception to “neglect” for “reasonable and informed”
    health care decisions simply has no application.
    ¶41 We therefore affirm the juvenile court’s determination that,
    based on the Children’s condition at removal, Parents—through
    their own “fault or habits”—had failed to provide “proper
    parental care” to the Children. See Utah Code § 80-1-102(58)(a)(ii).
    Because we affirm under subsection (a)(ii), we need not further
    discuss the court’s alternative neglect determination, made under
    subsection (a)(iii). See In re G.H., 
    2023 UT App 132
    , ¶ 28.
    B. Abuse
    ¶42 Moreover, because we affirm the juvenile court’s neglect
    determination, we need not—in this case—consider the merits of
    the court’s abuse determination. Juvenile court jurisdiction over a
    child can be based on, among other things, either abuse or neglect.
    See In re G.B., 
    2022 UT App 98
    , ¶ 32, 
    516 P.3d 781
     (“Importantly,
    jurisdiction could properly be based on either the abuse
    determination or the neglect determination.”). Our decision
    affirming the juvenile court’s neglect adjudication means that the
    court has continuing jurisdiction over the Children, regardless of
    the merits of Parents’ challenge to the court’s abuse adjudication.
    ¶43 In situations like this one, the propriety of the court’s abuse
    adjudication ends up being an inconsequential point, unless the
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    In re K.J.
    affected parent can demonstrate that there will be “collateral
    consequences associated with an abuse determination that do not
    follow from a neglect determination.” Id. ¶ 34. In this case, Parents
    make no effort to articulate any collateral consequences that might
    follow from an abuse adjudication that are not already present
    from a neglect adjudication. And when asked during oral
    argument if we would need to address abuse if we were to affirm
    on neglect, Parents agreed that, in that situation, we would not
    need to address abuse. We therefore have no occasion to consider
    the merits of Parents’ challenge to the court’s abuse adjudication.
    II. Ineffective Assistance of Counsel
    ¶44 Next, Parents assert that their attorneys provided
    ineffective assistance during the adjudication proceedings by
    failing to consult with or call an expert who could have testified
    about “medical child abuse” and about Parents’ state of mind and
    intentions regarding their care of the Children. Under the
    circumstances of this case, we reject Parents’ claim of ineffective
    assistance of counsel.
    ¶45 In child welfare cases, we employ the “Strickland test to
    determine a claim for ineffective assistance of counsel.” See In re
    E.H., 
    880 P.2d 11
    , 13 (Utah Ct. App. 1994) (citing Strickland v.
    Washington, 
    466 U.S. 668
     (1984)), cert. denied, 
    890 P.2d 1034
     (Utah
    1994). Under that test, Parents “must show that (1) counsel’s
    performance was deficient and (2) this deficient performance
    prejudiced the defense.” In re C.M.R., 
    2020 UT App 114
    , ¶ 19, 
    473 P.3d 184
     (quotation simplified). “To demonstrate deficient
    performance,” Parents “must persuade this court that,
    considering the record as a whole, [c]ounsel’s performance was
    objectively unreasonable.” In re R.G., 
    2023 UT App 114
    , ¶ 16, 
    537 P.3d 627
    . And to show prejudice, Parents “must demonstrate a
    reasonable probability that the outcome of [their] case would have
    been different absent counsel’s error.” In re C.M.R., 
    2020 UT App 20230102
    -CA
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    In re K.J.
    114, ¶ 21 (quotation simplified). “A reasonable probability is a
    probability sufficient to undermine confidence in the outcome of
    the proceeding.” 
    Id.
     (quotation simplified). In this case, Parents
    cannot meet either element of the Strickland test.
    ¶46 In support of their ineffective assistance claim, Parents
    have submitted a declaration from a forensic pathologist (Expert)
    who indicates that he has experience in cases of medical child
    abuse. Expert offers his view that, in most cases of medical child
    abuse, the “responsible parent . . . receives some form of
    secondary benefit, either financial or psychologic, from the
    inappropriate and unwanted medical care the child receives.” But
    he states that, in other cases, the unnecessary medical care is the
    result of “miscommunication between medical providers and
    patients” and of “the unsophistication and/or limited cognitive
    resources” of the parents. Expert states that, in order to offer a
    useful opinion in this case, he would need to undertake “an
    adequate psychologic and cognitive assessment” of Parents. He
    has not yet undertaken any such assessment, although he notes
    that he has reviewed the reports of another examiner who
    assessed Parents, and he offers his view that these reports “appear
    to endorse mental functioning deficits” on Parents’ part “that
    could lead to inaccurate conceptualizations of [the Children’s]
    medical conditions and treatment needs,” and that nothing he
    sees in those reports “implies [that Parents] are putting [the
    Children] at risk for selfish or self-aggrandizing motives.”
    ¶47 Under the circumstances presented here, a reasonable
    attorney could have decided not to consult Expert. The opinions
    Expert offers speak only to medical child abuse, and not to
    whether Parents neglected the Children by not feeding them
    enough and not enabling them to grow and thrive despite their
    medical maladies. As noted above, we affirm the juvenile court’s
    neglect determination without reaching the merits of any
    questions about the propriety of the Children’s various medical
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    In re K.J.
    diagnoses. Because Expert has nothing useful to say about
    Parents’ manifest neglect of the Children notwithstanding their
    diagnoses, a reasonable attorney could have determined that
    consultation with Expert was not necessary or helpful.
    Accordingly, we conclude that Parents have not demonstrated
    that their attorneys performed deficiently.
    ¶48 For much the same reason, Parents have also not shown
    prejudice. Even if their attorneys had consulted with and retained
    Expert, his testimony—given that it goes only to abuse and not to
    Parents’ neglect of the Children as evidenced by the Children’s
    condition at removal—would not have made a difference to the
    outcome of this case.
    ¶49 Thus, we conclude that Parents have not borne their
    burden of demonstrating that their attorneys rendered
    constitutionally ineffective assistance.
    III. The Shelter Order
    ¶50 Finally, we consider Parents’ challenge to the juvenile
    court’s earlier shelter order. Before considering the merits of that
    challenge, we address one preliminary issue: whether Parents
    have properly appealed the shelter order. After concluding that
    Parents have properly mounted an appeal from the shelter order,
    we proceed to address the merits of Parents’ arguments.
    A. Appealability
    ¶51 We do not see very many appeals from shelter orders. We
    suspect that this is because shelter hearings occur at the very
    beginning of any child welfare case, and because orders coming
    out of those hearings are not considered final orders that are
    immediately appealable as of right. We therefore take this
    opportunity to discuss the appealability of shelter orders, and we
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    In re K.J.
    conclude that Parents have properly appealed from the shelter
    order here.
    ¶52 “As a general rule, an appellate court does not have
    jurisdiction to consider an appeal unless the appeal is taken from
    a final order or judgment that ends the controversy between the
    litigants.” In re J.E., 
    2023 UT App 3
    , ¶ 17, 
    524 P.3d 1009
     (quotation
    simplified). And, at least conceptually, “the finality of an order in
    juvenile proceedings is determined the same way as the finality
    of an order in other courts.” Id. ¶ 18 (quotation simplified). “But
    it is fair to say that, in appeals from juvenile court, finality is
    viewed somewhat more flexibly than in the district court context.”
    Id. ¶ 19. In juvenile court cases, “the determining factor” as to
    finality “is whether [the order in question] effects a change in the
    permanent status of the child.” Id. (quotation simplified). Using
    this “pragmatic analysis of the order itself,” Utah appellate courts
    have concluded that, in juvenile court cases, “appeals may be
    heard from more than one final judgment.” Id. (quotation
    simplified). In particular, adjudication orders and termination
    orders are considered final orders that are appealable as of right,
    while “shelter orders” are “not considered final.” Id. ¶ 20; see also
    In re S.A.K., 
    2003 UT App 87
    , ¶ 13, 
    67 P.3d 1037
     (“An adjudication
    order is one such judgment that we have found to be final for
    purposes of appeal.”); In re M.V., 
    937 P.2d 1049
    , 1051 (Utah Ct.
    App. 1997) (per curiam) (holding that, because a shelter hearing
    only creates temporary orders, “a shelter hearing order . . . is not
    final and appealable as a matter of right”).
    ¶53 Because shelter orders are not considered to be final orders,
    they are not immediately appealable as of right.3 To properly
    3. Parties can, of course, request permission to appeal any
    interlocutory order (including shelter orders) under rule 5 of the
    Utah Rules of Appellate Procedure. But parties are not required
    (continued…)
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    In re K.J.
    appeal such orders as a matter of right, the party wishing to
    challenge the shelter order must wait until the court has entered
    a final appealable order. At that point, the party may take an
    appeal from the final order, which appeal “may include
    challenges to interlocutory orders” issued by the court prior to
    entry of the final order. Jensen v. Jensen, 
    2013 UT App 143
    , ¶ 2 n.1,
    
    304 P.3d 878
     (per curiam); accord U.P.C., Inc. v. R.O.A. Gen., Inc.,
    
    1999 UT App 303
    , ¶ 13, 
    990 P.2d 945
    .
    ¶54 In this situation, the adjudication order was the first final
    and appealable order issued by the juvenile court following entry
    of the shelter order. Thus, Parents’ opportunity to appeal the
    shelter order as of right presented itself upon entry of the court’s
    adjudication order. And Parents seized that opportunity by filing
    their notices of appeal. In each notice, Parents specified that they
    were appealing from the court’s adjudication order; they did not
    specify that they also wanted to appeal from the court’s interim
    shelter order, but parties are not required to include such
    to seek review under rule 5, and such review is in any event
    completely discretionary with the appellate court. See Utah R.
    App. P. 5(a), (g). In this case, Parents did not seek permission to
    appeal the shelter order under rule 5, but this fact does not affect
    their ability to later appeal the shelter order following the
    eventual entry of a final order. See State v. Troyer, 
    866 P.2d 528
    , 530
    (Utah 1993) (stating that “the scope of appellate review from a
    final judgment” is not “in any way affected or limited by the
    possibility that any one or more of the trial court’s rulings might
    have formed the basis of a petition for an interlocutory appeal”);
    see also In re S.F., 
    2012 UT App 10
    , ¶ 28, 
    268 P.3d 831
     (stating that
    the fact that a parent “could have elected to petition for
    interlocutory appeal” from an earlier nonfinal order “does not
    eliminate our authority to review” the earlier order “once the
    neglect and termination proceedings were completed and an
    appeal timely filed”), cert. denied, 
    280 P.3d 421
     (Utah 2012).
    20230102-CA
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    In re K.J.
    specification in the notice of appeal. See Wilson v. Sanders, 
    2019 UT App 126
    , ¶ 28, 
    447 P.3d 1240
     (“The language of rule 3(d) [of the
    Utah Rules of Appellate Procedure] does not require a party
    appealing from an entire final judgment to specify each
    interlocutory order of which the appellant seeks review.”
    (quotation simplified)), cert. denied, 
    456 P.3d 388
     (Utah 2019).
    Parents then indicated in their appellate petition, filed a few
    months later, that they were challenging not only the adjudication
    order but also the interlocutory shelter order.
    ¶55 Thus, Parents took all the right steps to appeal the juvenile
    court’s shelter order. Such orders are not immediately appealable
    as of right, but a challenge to such orders may be included in any
    appeal from the next subsequently entered final order. Parents
    properly included their challenge to the shelter order in their
    appeal from the next final order entered by the juvenile court: the
    adjudication order.
    B. Parents’ Challenge to the Shelter Order
    ¶56 Having concluded that Parents have properly mounted an
    appeal from the juvenile court’s shelter order, we proceed to
    consider the merits of Parents’ appellate challenge. In this case,
    Parents raise a very specific objection to the shelter order. They
    assert that the court did not properly address two of the required
    components of the statutorily mandated removal analysis:
    (1) “whether reasonable efforts were made to prevent or eliminate
    the need for removal,” and (2) “whether there are available
    services that would prevent the need for continued removal.” See
    Utah Code § 80-3-301(10)(a)(i). In considering the merits of
    Parents’ challenge, we first conclude that the juvenile court did
    indeed err in its application of the shelter statute. In a separate
    section, we then discuss the appropriate remedy in this situation.
    20230102-CA
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    In re K.J.
    1
    ¶57 Utah law requires juvenile courts, before removing a child
    from a parent’s home, to make several specific findings. At issue
    here are the requirements of subsection 10(a) of the shelter statute.
    That subsection states, in relevant part, as follows:
    (i) The juvenile court shall make a determination on
    the record as to whether reasonable efforts were
    made to prevent or eliminate the need for
    removal of the child from the child’s home and
    whether there are available services that would
    prevent the need for continued removal.
    (ii) If the juvenile court finds that the child can be
    safely returned to the custody of the child’s
    parent or guardian through the provision of the
    services described in Subsection 10(a)(i), the
    juvenile court shall place the child with the
    child’s parent or guardian and order that the
    services be provided by [DCFS].
    
    Id.
     § 80-3-301(10)(a).
    ¶58 Thus, this statutory provision requires juvenile courts to
    make, “on the record,” two separate but related determinations.
    See id. § 80-3-301(10)(a)(i). The first one is a backward-looking
    inquiry that asks whether, prior to removal, DCFS has made
    “reasonable efforts” to “prevent or eliminate the need for
    removal.” Id. However, if DCFS’s “first contact with the family
    occurred during an emergency situation in which the child could
    not safely remain at home,” the juvenile court need not engage in
    a traditional reasonable-efforts analysis but, instead, “shall make
    a finding that any lack of preplacement preventive efforts . . . was
    appropriate.” Id. § 80-3-301(11).
    20230102-CA
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    In re K.J.
    ¶59 The second—and related—determination requires analysis
    of “whether there are available services that would prevent the
    need for continued removal.” 
    Id.
     § 80-3-301(10)(a)(i). As we
    understand it, this inquiry is different from the reasonable-efforts
    analysis, in that it looks forward rather than backward. As
    relevant here, the question is not whether reasonable efforts have
    been made in the past, but whether services are available, going
    forward, that could “prevent the need for continued removal.” Id.
    ¶60 With regard to the first part of this inquiry, the court in its
    oral ruling offered its view that “emergency circumstances did
    exist” at the time of removal “which absolved [DCFS] of the need
    to provide reasonable efforts.” And in its later written order, it
    found that, “because an emergency situation and aggravated
    circumstances existed at the time of removal, and the [C]hildren
    could not safely remain in [Parents’] home, any lack of pre-
    placement preventative efforts was appropriate and justified.” 4
    4. There are other statutory provisions that, in specific cases, may
    operate to excuse or render irrelevant any lack of pre-removal
    reasonable efforts. See, e.g., Utah Code § 80-2a-201(6) (stating that,
    “in cases where sexual abuse, sexual exploitation, abandonment,
    severe abuse, or severe neglect are involved, the state has no duty
    to make reasonable efforts or to . . . maintain a child in the child’s
    home”); id. § 80-2a-302(4) (same); id. § 80-3-301(12) (same). No
    party asserts that any of these other Utah statutes are applicable
    here. In a supplemental authority letter submitted to us after oral
    argument, however, the guardian ad litem (GAL) asserts—for the
    first time—that the juvenile court’s allusion to “aggravated
    circumstances” was an implicit effort to resort to a provision of
    federal law, which provides that “reasonable efforts . . . shall not
    be required . . . if a court of competent jurisdiction has determined
    that the parent has subjected the child to aggravated
    (continued…)
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    In re K.J.
    ¶61 Parents assert that this analysis was erroneous because the
    “emergency” exception that absolves DCFS from making
    reasonable pre-removal efforts to prevent removal applies only in
    cases in which DCFS’s “first contact with the family occurred
    during an emergency situation,” see 
    id.
     § 80-3-301(11) (emphasis
    added), a situation not applicable here. The State advances a
    broader interpretation of this statutory exception, but in our view
    Parents’ interpretation is the correct one.
    ¶62 The State agrees with Parents that, in situations in which
    DCFS’s first contact with the family is in an emergency situation,
    the statute requires the court to make a finding that any lack of
    reasonable efforts was appropriate. See id. But it asserts that this
    provision does not prevent a court from “mak[ing] a finding of
    exigency in any case where [DCFS] has already been working
    with the parents,” and it posits that a juvenile court has the
    authority to dispense with the pre-removal reasonable-efforts
    inquiry anytime it believes the situation is emergent. We disagree.
    ¶63 The previous subsection requires that a pre-removal
    reasonable-efforts finding be made. See id. § 80-3-301(10)(a)(i).
    circumstances.” 
    42 U.S.C. § 671
    (a)(15)(D)(i). As an initial matter,
    we note that parties may not raise new legal theories in post-
    argument supplemental authority letters. Cf. State v. Seat, 
    2022 UT App 143
    , ¶ 39 n.4, 
    523 P.3d 724
     (stating that parties are “not
    permitted to raise a new question for the first time at oral
    argument” before this court). But more substantively, the GAL’s
    argument fails on its face; even if we assume, for purposes of the
    discussion, that the juvenile court’s comment was actually a
    reference to a federal statutory exception to the reasonable-efforts
    requirements, resort to the federal statute is unhelpful here
    because, at the time of the shelter hearing, no “court of competent
    jurisdiction” had made any determination that Parents had done
    anything wrong.
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    In re K.J.
    There are no exceptions built into this subsection. To be sure, there
    is an exception built into the next statutory subsection, but that
    provision, on its face, applies only to situations in which DCFS’s
    first encounter with the family occurred in an emergency
    situation. We decline the State’s invitation to read a broader
    emergency exception into the statute. See St. Jeor v. Kerr Corp., 
    2015 UT 49
    , ¶ 13, 
    353 P.3d 137
     (“[W]e will not read additional
    limitations into [a rule] that the language cannot bear.”); Greene v.
    Utah Transit Auth., 
    2001 UT 109
    , ¶ 15, 
    37 P.3d 1156
     (“[W]e will not
    disturb explicit legislative requirements and read into the statute
    an actual notice exception.”). We conclude that subsections (10)
    and (11) of the shelter statute, when read together, contemplate an
    exception to the reasonable-efforts requirement that is applicable
    only when DCFS’s first encounter with the family occurs during
    an emergency situation. 5
    ¶64 That narrow exception is not applicable here. DCFS was
    first notified of potential problems with the Children in August
    2022, some three months before removal. Between DCFS’s first
    notification (in August) and removal (in November), DCFS
    assigned caseworkers to the family, and those caseworkers made
    at least ten visits to Parents’ home. This is simply not a situation
    in which DCFS’s “first contact with the family” occurred in an
    emergency situation, and therefore the “emergency” exception to
    the reasonable-efforts inquiry does not apply here. The juvenile
    court therefore erred in applying that exception in this case, and
    it should have proceeded, at the shelter hearing, to consider
    5. We can certainly envision policy concerns that might support a
    broader exception to the reasonable-efforts requirement that
    could apply in any emergency situation, regardless of whether
    DCFS had already been working with the affected family. We note
    here, as we sometimes do, that our legislature is free to amend the
    statute if it believes we have misinterpreted legislative intent.
    20230102-CA
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    In re K.J.
    whether DCFS had made reasonable pre-removal efforts to avoid
    taking the Children out of Parents’ home.
    ¶65 The juvenile court’s error in this regard, however, appears
    to have been rendered moot by the court’s later finding, made
    after the adjudication trial, that DCFS had “made reasonable
    efforts to prevent the removal of the [C]hildren, but those efforts
    were unsuccessful.” While Parents complain that the court did not
    undertake this analysis after the shelter hearing, they do not make
    any effort to challenge the finding that the court eventually made
    just two months later after the adjudication trial. Under these
    circumstances, any error the court made by relying on the
    emergency exception at the shelter hearing, and by failing to make
    a “reasonable efforts” finding at that time, has been rendered
    inconsequential by the court’s later unchallenged finding that
    DCFS had indeed made reasonable efforts to prevent removal.
    ¶66 We turn now to the second part of the inquiry, the part that
    requires the court to determine, on a going-forward basis,
    “whether there are available services that would prevent the need
    for continued removal.” See Utah Code § 80-3-301(10)(a)(i). In this
    vein, the court stated, in its written order, as follows:
    If, at some point, there is a plan in place and
    [Parents] have shown the ability to take into
    consideration the current medical condition of the
    [C]hildren, and have shown the ability to work with
    the professionals providing that care for the
    [C]hildren, the [c]ourt would re-consider whether
    ongoing and continued removal would be
    necessary.
    This comment indicates that the court was of course aware that
    services do exist—such as physical, speech, and occupational
    therapy for the Children and medical education and in-home
    health care assistance for Parents—that are designed to improve
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    In re K.J.
    situations like the one presented here. And it indicates that the
    court was making an effort to apply the second part of the
    statutory analysis. 6 But the court, in its analysis, did not take the
    next analytical step and assess whether specific services could be
    provided to the family, in that moment and going forward, that
    might obviate the need for removal. See 
    id.
     Simply stating that, at
    some point in the future, the court might reconsider its removal
    order is not sufficient; indeed, in most child welfare cases, the
    initial permanency goal is reunification, and juvenile courts
    nearly always stand ready to reconsider removal orders in
    appropriate cases. The shelter statute requires a more exacting
    analysis prior to removal, and the court’s failure here to ask and
    answer the correct statutory question was error.
    ¶67 And unlike the court’s error regarding the backward-
    looking reasonable-efforts determination, this error was not later
    remedied by later findings made after the adjudication trial. The
    State points to no similar finding made after the trial, and we are
    aware of none.
    ¶68 We therefore conclude that the juvenile court made two
    errors in its attempt to comply with the shelter hearing statute.
    First, it misapplied the “emergency” exception to its obligation to
    make a backward-looking reasonable-efforts determination at the
    shelter hearing. Second, it failed to make a specific forward-
    looking determination about whether services could be provided
    6. On this basis, we reject the State’s assertion, also advanced by
    the GAL, that Parents failed to preserve any objection to the
    court’s application of the shelter statute. Our supreme court has
    made clear that there is no preservation problem where the trial
    court “not only had an opportunity to rule on the issue . . . but in
    fact did rule on it.” See Fort Pierce Indus. Park Phases II, III & IV
    Owners Ass’n v. Shakespeare, 
    2016 UT 28
    , ¶ 13, 
    379 P.3d 1218
    (quotation simplified).
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    In re K.J.
    to the family that would serve to obviate the need for removal.
    The first error was rendered inconsequential by later findings. But
    the second one wasn’t, and we must therefore consider what the
    proper remedy is, in this situation, to address the court’s error.
    2
    ¶69 Before doing so, we take the opportunity to emphasize the
    importance of completing the proper statutory analysis at the
    shelter hearing. While such hearings take place early in the case
    and are generally not comprehensive trials, they can assume a
    position of great importance in the arc of a child welfare case. To
    be sure, removal orders are temporary nonfinal orders that can
    be—and in many cases are, see, e.g., In re M.S., 
    2023 UT App 74
    ,
    ¶¶ 2–21, 
    533 P.3d 859
     (considering a situation where a child was
    placed back into the parent’s home at a later hearing, after initial
    removal)—amended or modified, but removal orders
    nevertheless memorialize a seminal moment in a child welfare
    case. Such cases often proceed much differently after the shelter
    hearing depending on whether the child was (or was not)
    removed. It is therefore vital that courts undertake the analysis
    required by the shelter statute, and that, before removal, they
    engage with both the backward-looking reasonable-efforts
    analysis as well as the forward-looking services analysis.
    ¶70 The importance of getting shelter hearings right the first
    time is highlighted by the difficulty of putting the removal genie
    back in the proverbial bottle. As this case illustrates, by the time
    appellate review of a shelter order can take place, the family’s
    situation will often look much different than it did at the shelter
    hearing. While post-adjudication events are not part of the record
    submitted to us on appeal, we are nevertheless aware that, while
    this appeal has been pending, significant events have taken place
    that might affect the way the juvenile court analyzes the question
    of whether services are available that could obviate the need for
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    In re K.J.
    continued removal. For instance, we are aware that criminal child
    abuse charges have been filed against Parents. In addition, we are
    aware that, since the adjudication hearing, Parents have received
    certain services, and the court has had the opportunity—at a
    permanency hearing held in January 2024—to assess the efficacy
    of those services. And there have doubtless been other
    developments that have occurred in the previous sixteen months
    of which we are appropriately unaware.
    ¶71 In this case, by way of remedy, Parents ask us to vacate the
    initial removal order and remand the case so that the juvenile
    court can conduct an entirely new shelter hearing. We do not view
    this as an unreasonable request; indeed, when an error is made at
    a hearing, a common remedy is to remand the case for the court
    to conduct a new hearing. But even though we do not view
    Parents’ request as unreasonable, in this situation the request is
    not entirely practical. After all, the situation is much different now
    from what it was in November 2022, and in cases involving
    children, our usual remand instructions include an admonition to
    the court to conduct any new hearing, on remand, in present-tense
    fashion, as of the date of the renewed hearing, taking into account
    all that has happened in the child’s situation since. See In re
    Z.C.W., 
    2021 UT App 98
    , ¶ 12, 
    500 P.3d 94
    .
    ¶72 Under the circumstances, we agree with Parents that the
    juvenile court’s error cannot go entirely unremedied, and that the
    case should therefore be remanded so that the juvenile court can
    complete the analysis required by the shelter statute and, in
    particular, consider “whether there are available services that
    would prevent the need for continued removal.” See Utah Code
    § 80-3-301(10)(a)(i). But this inquiry should not be undertaken as
    of the date of the initial shelter hearing; instead, this inquiry
    should, on remand, be conducted in present-tense fashion, taking
    into account all relevant existing developments. See In re Z.C.W.,
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    In re K.J.
    
    2021 UT App 98
    , ¶ 12. 7 Moreover, we offer no specific instruction
    to the juvenile court as to whether, and to what extent, it must
    hold an evidentiary hearing on remand; we conclude only that the
    court must properly complete the required statutory analysis and
    that it “must—in some manner—consider and appropriately deal
    with proffered new evidence.” See id. ¶ 15. And we do not, in this
    opinion, order that the removal order be vacated; the juvenile
    court may order that relief, if it deems such relief appropriate,
    only after completing its analysis on remand.
    ¶73 Finally, we wish to make clear that we harbor no opinion
    as to how the juvenile court’s renewed analysis should come out;
    given the realities of chronology, the juvenile court (conducting a
    present-tense analysis) will have a lot more information than we
    do now, on this record, about how the Children are doing and
    how Parents have responded to the situation during the period
    between the shelter hearing and the permanency hearing. It may
    well be that the court reaches the same result, after conducting a
    more complete shelter analysis, that it reached at the permanency
    hearing in January 2024. On the other hand, it may be that the
    court, after conducting the proper shelter analysis, finds it
    appropriate to vacate or amend one or more of its previous orders.
    But either way, it is important that courts conducting shelter
    7. In In re Z.C.W., 
    2021 UT App 98
    , 
    500 P.3d 94
    , our instruction
    that the renewed hearing be conducted, on remand, in present-
    tense fashion was a function of the applicable statute using a
    present-tense locution. See id. ¶ 13 (interpreting a statute requiring
    juvenile courts to assess “whether termination is in the best
    interest of the child” (quotation simplified)). The statute at issue
    here also uses a present-tense locution. See Utah Code § 80-3-
    301(10)(a)(i) (requiring assessment of “whether there are available
    services that would prevent the need for continued removal”
    (emphasis added)). We therefore conclude that, in this situation,
    a present-tense perspective is required on remand.
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    In re K.J.
    hearings, before they take the rather drastic step of removing
    children from a parent’s home, follow the requirements of the
    shelter statute. We remand the matter so that these requirements
    may be satisfied in this case, albeit belatedly.
    CONCLUSION
    ¶74 We discern no error in the juvenile court’s determination
    that, based on the condition of the Children upon removal, the
    Children were neglected by both Parents. And we reject Parents’
    assertion that their attorneys rendered ineffective assistance
    during the adjudication process.
    ¶75 However, we conclude that the juvenile court did not
    conduct the proper statutory analysis at the initial shelter hearing.
    We therefore remand this case to the juvenile court so that it can
    complete the required analysis and assess, in present-tense
    fashion, whether there are services available that can prevent the
    need for continued removal.
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Document Info

Docket Number: 20230103-CA

Filed Date: 4/4/2024

Precedential Status: Precedential

Modified Date: 5/24/2024