Opinion
D060604
01-13-2012
ROSA R., Petitioner, v. THE SUPERIOR COURT OF SAN DIEGO COUNTY, Respondent; SAN DIEGO COUNTY HEALTH AND HUMAN SERVICES AGENCY, Real Party in Interest.
NOT TO BE PUBLISHED IN OFFICIAL REPORTS
California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.
(San Diego County Super. Ct. No. EJ3261A,B)
PROCEEDINGS in mandate after referral to a Welfare and Institutions Code section 366.26 hearing. Ronald F. Frazier, Judge. Petition denied. Request for stay denied.
Rosa R. seeks review of a juvenile court order setting a hearing under Welfare and Institutions Code section 366.26. Rosa contends the court erred when it found that reasonable services were provided to her. She asserts she did not receive a court-ordered evaluation for psychotropic medication. We deny the petition.
Further statutory references are to the Welfare and Institutions Code.
FACTUAL AND PROCEDURAL BACKGROUND
Rosa R. is the mother of A.R., born December 2006, and N.R., born January 2010 (together, the children). Rosa is also the mother of a nondependent child. On June 25, 2010, the San Diego County Health and Human Services Agency (the Agency) detained the children in protective custody and alleged the children were at substantial risk of serious harm because Rosa was mentally ill, and she threatened to kill herself and N.R., attacked a maternal aunt while holding N.R. and threw N.R. on a bed where he collided with her three-month-old niece.
The identity of A.R.'s father is unknown. N.R.'s alleged father did not respond to a message to contact the Agency.
Rosa lost custody of this child to his father. She was not permitted to visit the child. Rosa did not comply with family court orders to obtain counseling, abstain from drug use and comply with recommended psychiatric medications.
The children's maternal grandmother (Grandmother) said Rosa had a history of mental illness. At one point in time, Rosa's mental health condition was stabilized on psychotropic medications. In 2008 Rosa's mental health condition was diagnosed as bipolar affective disorder, mixed state with psychiatric features, and polysubstance abuse, in partial remission. She was considered to be "chronically medication noncompliant." Rosa had a pattern of hospitalization, release and noncompliance with recommended mental health treatment. According to Grandmother, Rosa could be violent and aggressive. She threatened to kill her sister, G.R. Rosa's sister, R.R., said Rosa had a 10-year history of substance abuse, and had used methamphetamine and marijuana within the past three months.
Rosa had been arrested 10 times since 2006 on various charges, including being a fugitive from justice, being under the influence of a controlled substance, violating a restraining order, grand theft, vandalism, receiving stolen property, assault with a firearm and prowling.
In July 2010 Grandmother and G.R. obtained restraining orders against Rosa. A.R., then three years old, told the social worker that Rosa had hit her.
Rosa completed a substance abuse intake assessment on July 14. In-patient substance abuse treatment was recommended; however, Rosa could not be admitted until she resumed taking psychotropic medications. R.R. told the social worker she would try to have Rosa assessed for medication. She reported that Rosa resumed taking her previously prescribed medication but "it took a toll on her and she wasn't ready to have an in-take [at the in-patient substance abuse treatment program]." Rosa was hospitalized and released after an assessment but was soon arrested for fighting and probation violations.
On August 13 the juvenile court sustained the petitions, removed the children from Rosa's custody and ordered a plan of family reunification services. Rosa's case plan included weekly individual therapy, a psychotropic medication evaluation/monitoring and in-patient substance abuse treatment.
On September 22 Rosa appeared at the social worker's office and said she had been recently released from jail for violating a restraining order against a man she had been dating. She told the social worker she would test "dirty."
In October Rosa entered an out-patient treatment program on her own accord. In November the counselor reported that Rosa was doing well at the program. She tested negative for drugs in October, November and December.
On September 22, October 22 and November 16, Rosa told the social worker she was planning to see her former psychiatrist to be evaluated for psychotropic medications. She later reported she was unable to see that psychiatrist because she did not have medical insurance. The social worker then gave Rosa referrals to community clinics. On December 27 Rosa went to a clinic but did not meet their criteria for urgent walk-in services. On December 29 Rosa was denied services at another clinic because she did not have medical insurance. That clinic informed the social worker their medical staff could see Rosa after she had a medication evaluation and if it was determined Rosa needed medication, she could then obtain a prescription at the clinic.
On January 12, 2011, the social worker submitted a referral on Rosa's behalf for a psychiatric evaluation, including a psychotropic medication recommendation, with a court-approved evaluator.
Rosa started individual therapy in March. Her therapist said Rosa would benefit from a psychiatric medication evaluation.
On April 14 Rosa had a psychiatric evaluation with Michael Tramell, M.D., a psychiatric specialist. The social worker received the report in late May. Dr. Tramell diagnosed Rosa's mental health condition as Mood Disorder, NOS; rule out Bipolar Affective Disorder versus Substance-Induced Mood Disorder, Bipolar Type; cocaine abuse, methamphetamine dependence and cannabis abuse, status unclear; and rule out Posttraumatic Stress Disorder, Borderline Personality Disorder traits and Antisocial Personality Disorder. Dr. Tramell said long-acting formulations of medications such as Risperdal and Zyprexa might be appropriate for Rosa's mental health condition but the choice of medications should be left to her treating physician. He recommended Rosa participate in ongoing psychotherapy, including substance abuse treatment, a psychiatric medication evaluation and monitoring, and anger management services.
Rosa tested positive for methamphetamine and marijuana in May. After completing a detoxification program, Rosa missed a week of treatment and refused to submit to a drug test. In July Rosa was discharged from her out-patient substance abuse treatment program with the recommendation she enter an in-patient treatment program.
On September 22, at the 12-month status review hearing, the juvenile court found that returning the children to Rosa's care would be detrimental to their safety and well-being, and terminated reunification services. The court found that reasonable services were offered or provided to Rosa, and set a section 366.26 hearing.
Rosa petitions for review of the court's order under California Rules of Court, rule 8.452. She requests this court reverse the order setting a section 366.26 hearing. This court issued an order to show cause, the Agency responded, and the parties waived oral argument.
DISCUSSION
Rosa contends the juvenile court erred when it found that reasonable services were offered or provided to her. Rosa asserts the Agency did not provide reasonable services to her because she did not receive a psychiatric medication evaluation consistent with her court-ordered case plan and Dr. Tramell's recommendation. Rosa acknowledges she received parenting education services, individual therapy, substance abuse screening and
testing, visitation services and a "psychological" evaluation. She also acknowledges the Agency offered her in-patient substance abuse treatment. In addition to juvenile court services, Rosa was participating in a 52-week domestic violence treatment program through criminal court services.
Although Rosa refers to the evaluation as a "psychological" evaluation, the record shows that the evaluation was conducted by an M.D. specializing in psychiatry, and was labeled a "psychiatric examination."
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Family reunification services play a critical role in dependency proceedings. (§ 361.5; In re Alanna A. (2005) 135 Cal.App.4th 555, 563; In re Joshua M. (1998) 66 Cal.App.4th 458; see 42 U.S.C. § 629a(a)(7).) If reasonable services are not provided or offered to the parent, the court is required to continue the case for the period of time permitted by statute. (See § 366.21, subds. (e) & (g)(1).)
Reunification services should be tailored to the particular needs of the family. (David B. v. Superior Court (2004) 123 Cal.App.4th 768, 793, citing In re Alvin R. (2003) 108 Cal.App.4th 962, 972.) "The standard is not whether the services provided were the best that might be provided in an ideal world, but whether the services were reasonable under the circumstances." (In re Misako R. (1991) 2 Cal.App.4th 538, 547.)
To support a finding reasonable services were offered or provided, "the record should show that the supervising agency identified the problems leading to the loss of custody, offered services designed to remedy those problems, maintained reasonable contact with the parents during the course of the service plan, and made reasonable efforts to assist the parents in areas where compliance proved difficult . . . ." (In re Riva M. (1991) 235 Cal.App.3d 403, 414.) The "adequacy of reunification plans and the reasonableness of the [Agency's] efforts are judged according to the circumstances of each case." (Robin V. v. Superior Court (1995) 33 Cal.App.4th 1158, 1164.)
We review the evidence most favorably to the prevailing party and indulge in all legitimate and reasonable inferences to uphold the court's ruling. (In re Misako R., supra, 2 Cal.App.4th at p. 545.)
The Agency identified Rosa's noncompliance with psychotropic medication as one of the problems that led to the loss of custody of her children. (In re Riva M., supra, 235 Cal.App.3d at p. 414.) Before the August 2010 disposition hearing, Rosa's sister told the social worker she was going to try to help Rosa obtain a medication assessment. The social worker talked to Rosa in September, October and November about having a medication evaluation. Rosa told the social worker she was planning to see her former psychiatrist. When Rosa told the social worker she was unable to see her psychiatrist because she did not have medical insurance, the social worker provided referrals to community clinics to Rosa. On December 29 clinic personnel told the social worker they could treat Rosa after she had a medication evaluation. Within two weeks, the social worker referred Rosa for a psychiatric evaluation, specifically asking the evaluator to provide "[d]iagnostic clarification and treatment recommendations, including psychotropic medication recommendations . . . ."
On April 14 Rosa had a psychiatric evaluation with Dr. Tramell. He said long-acting medications such as Risperdal and Zyprexa may be appropriate for Rosa's possible dual-diagnosis mood disorder and recommended that Rosa's treating physician select and monitor her medications. Dr. Tramell also recommended that Rosa receive substance abuse treatment services and drug testing to determine her ability to maintain her sobriety and to eliminate her substance abuse as a causative factor in episodes of mood or thought disorders.
The record shows that Rosa was offered or provided substance abuse treatment services and drug testing, individual therapy, parenting education and a psychiatric evaluation that included an assessment of psychotropic medications. The psychiatric evaluator reasonably left the choice of medications to Rosa's treating physician. The record does not indicate whether Rosa sought the services of a treating physician after she received a psychiatric evaluation. She had a history of chronic noncompliance with medication. However, the record shows that the Agency complied with the court-ordered case plan and provided Rosa with the referrals and evaluation she needed to obtain psychotropic medication. The services provided to Rosa were reasonable under the circumstances. (In re Misako R., supra, 2 Cal.App.4th at p. 547.) We conclude there is substantial evidence to support the juvenile court's finding that reasonable reunification services were offered or provided to Rosa.
DISPOSITION
The petition is denied. The request for stay is denied.
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BENKE, Acting P. J.
WE CONCUR:
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MCDONALD, J.
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O'ROURKE, J.