John W., In re, 95-448-A

• Decision Date: 10 September 1996
• Docket Number: No. 95-448-A,95-448-A
• Citation: 682 A.2d 930
• Parties: In re JOHN W. ppeal.
• Court: Rhode Island Supreme Court

Page 930

682 A.2d 930

In re JOHN W.

No. 95-448-Appeal.

Supreme Court of Rhode Island.

Sept. 10, 1996.

Frank P. Iacono, Jr., CASA, Regina M. Gibb, DCYF, for Plaintiff.

Catherine Gibran, Asst. Public Defender, Paula Rosin, Asst. Public Defender, Christine Ariel, for Defendant.

OPINION

PER CURIAM.

This matter came before the court pursuant to an order directing the parties to appear and show cause why the issues raised in this appeal should not be summarily decided. In this case the mother appeals from a Family Court judgment terminating her parental rights to her ten-year-old son, John W. ¹ After hearing oral argument and examining the memoranda submitted by the parties, we are of the opinion that cause has not been shown and that the issues raised by this appeal should be decided at this time.

In October of 1992, John, then six years old, was removed from his mother's care following the filing of an abuse-and-neglect petition by the Department of Children, Youth and Families (DCYF). On February 25, 1993, the mother admitted to dependency, and John was placed in the custody of DCYF. John's removal was prompted by his mother's inability to provide him with adequate medical care. John was diagnosed with Type I (juvenile) diabetes, in May of 1992. According to Dr. Philip Gruppuso, ² juvenile diabetes is a controllable disorder provided the patient receives daily insulin injections and proper management of diet. If the disorder is not properly controlled, long-term consequences such as blindness, kidney disease, and heart failure may result.

Immediately after John's condition was diagnosed, Rhode Island Hospital began working with the mother to instruct her on how to care for her son's diabetes. Nonetheless, after three weeks in a training program geared toward accommodating the mother's intellectual limitations, she failed to grasp the importance of managing her son's diabetes. ³ Despite assistance seven days a week from either a visiting nurse or a parent aide, John's mother continued to have trouble administering his insulin and controlling his access to foods that caused elevated sugar levels. Doctor Gruppuso testified that John "was out of control when under his mom's supervision." Once John was removed from his mother's care, John's medical condition improved measurably.

Testimony presented by social workers, doctors, and a visiting nurse established that the mother has borderline intellectual function and lacks the parental and management skills necessary to care for her son and his condition. One DCYF social worker testified that the mother had difficulty parenting despite services provided to her, ⁴ such as Comprehensive Emergency Services, Child, Inc. (daycare), the Visiting Nurses Association, and a parent aide. In an attempt to reunify John with his mother, a second social worker referred the mother to several programs, including the Kent County Reunification Program and the Sophia Little Independent Living Program, but the mother either refused to participate or never fully utilized the services provided to her.

Further, the visiting nurse stated that she was gravely concerned about the mother's inability to contact medical personnel when needed, to rotate the sites of John's insulin injections, and to control her son's diet and behavior. ⁵ She concluded that, in order for John to reside safely with his mother, a program providing twenty-four-hour supervision would be needed, but no such program existed. After DCYF placed him in foster care, the nurse added, both John's behavior and his diet improved substantially.

The clinical psychologist who conducted a parent-child evaluation concluded that the mother was mildly retarded and lacked not only the motivation but also the capacity to adapt to changing circumstances. The evaluation report indicates that the mother does not understand her child's medical needs, is incapable of differentiating serious from mild diabetic reactions, and cannot recognize the actions she must take to counter these adversities. The report concludes that the mother fails to understand the significance of her role in managing her son's care, not to mention, how she should perform that role. The psychologist testified that "this boy's life would be in danger if he were simply permitted to be in [his mother's] care without continual daily supervision * * * and I am not even sure that would suffice."

After a thorough review of the evidence, the trial justice found that, despite efforts to educate the mother about John's medical needs and to reunite the family, the mother's inability to provide adequate medical care posed a threat to John's life. ⁶

When this court reviews a case involving the termination of parental rights, the record is examined to determine if legally competent evidence exists to support the findings of the trial justice. In re Jennifer R., 667 A.2d 535, 536 (R.I.1995). The findings of a trial justice are entitled to...