On appeal from the Superior Court of New Jersey, Chancery Division, Family Part, Hudson County, Docket No. FG-09-120-07.
NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION
Submitted October 1, 2009
Before Judges Fisher, Sapp-Peterson and Espinosa.
Defendant C.C. appeals from a June 30, 2008, Family Part order terminating her parental rights to her two children: R.C., a female, born December 9, 2004; and R.A.J., Jr., a male, born December 20, 2006. We affirm.
On September 22, 2006, the Division of Youth and Family Services (Division) filed a complaint for guardianship seeking to terminate the parental rights of C.C. to R.C. The complaint was later amended in early 2008 to also seek termination of C.C.'s parental rights to R.A.J., Jr. The court conducted a trial over four non-consecutive days between March and June 2008. At its conclusion, the court rendered an oral decision, finding by clear and convincing evidence that the Division had proved all four prongs of the best interests standard governing termination of parental rights.
The Division presented its case through several witnesses, including Case Manager Clarastine Akbar; psychologists, Dr. Peter DeNigris and Dr. Elizabeth Smith; and psychiatrist, Dr. Vivian Shnaidman. Dr. Sonia Oquendo testified on behalf of the children. Defendant presented Dr. Arnaldo Apolito, a psychiatrist. No other witnesses were presented on behalf of defendant. The record disclosed that C.C. and R.A.J., Sr. are the biological parents of R.C. and R.A.J., Jr.*fn1 Both C.C. and R.A.J., Sr. suffer from paranoid schizophrenia. The Division's first involvement with C.C. occurred shortly after R.C.'s birth. At that time C.C. informed the hospital staff that she suffered from schizophrenia, was taking medication and participating in an outpatient mental health program. Dr. Carmelo Pingol of the Mount Carmel Guild Behavioral Healthcare System, where C.C. had been undergoing treatment since 2001, confirmed to the Division that C.C. was diagnosed with chronic paranoid schizophrenia and suggested she "be closely monitored periodically... to see if she is taking good care of her child."
Later, on February 22, 2005, Dr. Pingol wrote a letter to the Division explaining that C.C. was compliant with treatment and "psychiatrically stable and... fit to care for her child." The Division provided C.C. with homemaker services for the next three months, but terminated the services due to C.C.'s compliance. On May 11, 2005, the Division determined there were no concerns at that time and closed the case.
Over the next several months, the Division received three referrals about C.C. The first referral came from R.C.'s pediatrician, who reported that R.C. exhibited a failure to thrive.*fn2 He gave C.C. a referral to a nutritionist for three visits, but she only attended one. In response to the pediatrician's report, a Division worker visited C.C.'s home, at which time C.C. agreed to accompany the worker to the emergency room to have R.C. evaluated. Because the emergency room doctor did not have the benefit of medical records that included weight charts and other medical history, the doctor was unable to determine whether R.C. was failing to thrive.
On August 1, 2005, Dr. Pingol wrote to the Division informing it of C.C.'s "worsening agitation and irritability" and suggesting that C.C. could not take care of her child at that time. He also indicated that C.C. did not want to accept treatment recommendations.
The third referral came from another pediatrician four days later. C.C. had taken R.C. to a local clinic where efforts were undertaken to perform blood work because of R.C.'s low weight. The doctor reported that C.C. was hostile, uncooperative, and would not allow lab work needed to diagnose and treat R.C.'s malnutrition. Although loud and abrupt, C.C. eventually agreed to have R.C. treated at a hospital. Once at the hospital, C.C. became loud and hostile, until police and R.A.J., Sr. arrived. A hold was placed upon R.C. that prevented C.C. from removing R.C. from the hospital.
The Division placed R.C. with her paternal grandmother, S.J., on August 12, 2005, which placement was memorialized by a court order dated September 12, 2005. When S.J. passed away on October 31, 2005, R.C. was placed in a foster home until she was placed with her maternal aunt, R.T., in January 2007, where she resided at the time of the trial. Following R.A.J., Jr.'s birth in December 2006, he too was placed with R.T. and remained with her at the time of trial.
Clarastine Akbar testified that the Division provided homemaker services, transportation, a monthly bus card, parenting classes, furniture, a nutritionist, and psychological and bonding evaluations. Akbar explained that C.C. attended a treatment program at Christ Hospital but stopped going to a day program at Mount Carmel Guild. Akbar believed that C.C.'s participation in these programs did not successfully correct her parenting problems and testified that the Division's position was that C.C. could not take care of these children.
Dr. Shnaidman testified that she performed two psychiatric evaluations upon C.C. She indicated that C.C.'s mental health problems began when she was a junior in high school. She diagnosed C.C. as suffering from chronic paranoid schizophrenia and testified that the disorder is chronic and progressive in that the cognitive decline continues throughout time. Dr. Shnaidman opined that C.C. "has not shown an incredibly good response to medication throughout her years of compliance[,]... chances are that she will continue to decline cognitively over the years, and that her ability to take care of herself will decline as well."
Dr. Shnaidman also indicated that C.C.'s entire psychiatric treatment is inadequate and that if C.C. were her patient, she would try new generational atypical anti-psychotics and "a day program or a sheltered workshop where she would have constant socialization [and] activities." Ultimately, Dr. Shnaidman opined that in C.C.'s case, "the paranoid schizophrenia specifically affects her ability to parent[,]" and that "[i]n her current state she cannot parent her children."
Dr. DeNigris conducted a psychological evaluation of C.C. as well as bonding evaluations between the children and C.C. and between the children and their maternal relatives. Dr. DeNigris testified that there was no healthy bond between C.C. and the children and that C.C. refused to complete any of the psychological testing. He indicated that a secure, healthy bond existed between the children and their maternal relatives, and if the Division removed the children from their care, the children would suffer emotional, physical or psychological harm. Dr. DeNigris believed that even if C.C. received comprehensive medical treatment, she would be unable to assist the children with recovering from the harm they would experience from their removal from R.T.
Dr. Smith also conducted a psychological evaluation of C.C. as well as bonding evaluations. She too testified that C.C. was uncooperative and refused to take any psychological tests. Dr. Smith opined that "[C.C.'s] reasoning seemed very concrete and childlike, and, of course, most obviously, she appeared to be highly paranoid during my interview." Dr. Smith testified that C.C. "had no insight into her illness and the negative effects it would have on her parenting." After completing the bonding evaluations, Dr. Smith found that R.C. had familiarity and an attachment with C.C. but she did not believe C.C. was R.C.'s primary attachment. She indicated she found that R.A.J., Jr. seemed unresponsive, dull, and did not show any signs of a significant attachment to C.C. She did, however, describe the relationship between the children and their maternal foster parents as a very strong, secure and positive attachment. She noted that R.A.J., Jr. was animated and "in many ways seemed like another child." In her opinion, if the children were separated from their foster parents, there would be both short-term and long-term consequences for the children. Dr. Smith concluded that C.C. would be overwhelmed by the normal stresses of parenting and, even with assistance, would not be able to properly parent the children.
Dr. Oquendo testified that the children are at a higher risk for developing schizophrenia because both of their biological parents are schizophrenic. She explained that "child[ren] with [a] steady and stable home have a better prognosis than [children] that [are] being subjected to changes in care givers or changes in where they live, the school they attend, and the people who are stable in their life." By being raised in a stable environment, Dr. Oquendo believed the children would have a better chance of avoiding the illness. Dr. Oquendo determined that "allowing [C.C.] to care for the children without supervision would expose the children to an unnecessary risk of harm."
The parties stipulated to Dr. Apolito's qualifications as an expert psychiatrist but the Law Guardian objected to his qualifications as an expert in the area of bonding. The court agreed and did not allow Dr. Apolito to testify as an expert in the area of bonding due to his lack of specific knowledge and hands-on experience. After hearing defendant's motion for reconsideration, Judge Davis reiterated ...