Opinion
NOT TO BE PUBLISHED
Solano County Super. Ct. No. P43355
Margulies, Acting P.J.
After a trial, the court found defendant Joseph B. (conservatee) to be “gravely disabled” and ordered his civil commitment under the Lanterman-Petris-Short Act (Welf. & Inst. Code, § 5000 et seq.) (LPS Act). The decision was based on the testimony of a psychiatrist who diagnosed the conservatee as suffering from schizophrenia and said he was suffering from serious delusions, refused to cooperate in his treatment or acknowledge his mental illness, and engaged in physically and sexually aggressive behavior. The conservatee contends the court’s decision to appoint a conservator and impose special disabilities was not supported by the evidence and fell short of constitutional requirements. We affirm.
All statutory references are to the Welfare and Institutions Code.
I. BACKGROUND
On September 30, 2008, the Solano County Public Guardian (Public Guardian) filed a joint application for a temporary conservatorship and petition for the appointment of an LPS conservator for the conservatee, a 46-year-old man. The court appointed a temporary conservator in an order filed September 30, 2008, and extended the temporary conservatorship several times thereafter. The conservatorship investigation report, prepared in October 2008, stated the conservatee was diagnosed as schizophrenic, had a long history of psychiatric hospitalizations beginning in 1982, and abused a variety of illegal drugs. He suffered from delusions about his property and employment, and denied having a mental illness. After an interview, the investigator recommended in favor of a conservatorship, concluding the conservatee “ ‘is incapable of formulating any rational plan for his self care.’ ”
Trial was held on May 7, 2009. The primary witness was the clinical supervisor for the Mental Health Division of Solano County Health and Social Services, Dr. Michael Pena, who was responsible for evaluating patients and determining their proper level of care at Napa State Hospital, where the conservatee was being housed. Pena had visited the conservatee twice at the hospital and had evaluated him again immediately prior to trial, as well as examining written records and discussing the conservatee with professionals involved in his care at the hospital. Pena diagnosed the conservatee as suffering from schizophrenia, paranoid type, characterized by persistent delusions that, in three years of treatment at the hospital, had not been controlled. The conservatee continued falsely to believe he is a pharaoh, works for NASA, is a “Clan God” of the Ku Klux Klan, owns mansions, and had been judicially declared free of mental illness in 1996. Since the onset of his symptoms, the conservatee had been hospitalized more than 25 times and arrested “numerous” times. Over the prior five years, he had spent little time outside psychiatric facilities. He also had a history of crack cocaine abuse. At the hospital, the conservatee interacted little with other persons, primarily preoccupied with his thoughts and delusions. He had exposed his genitals to staff and other patients and had assaulted another patient with a chair.
Pena said the conservatee was being treated with an injectable form of Haldol, but it had not been possible to treat him with the most effective psychoactive drug for his condition, Clauseril, because Clauseril is an orally administered medication. The conservatee refused to take oral medications, concerned that accepting such medication would constitute an admission of mental illness.
Pena believed the repeated hospitalizations and arrests and the conservatee’s resistance to treatment demonstrated the conservatee was unable to “maintain himself in the community [or] provide for himself.” He opined that if released, the conservatee likely would stop taking medication and refuse to participate in therapy. Because the conservatee believed falsely he has several houses, he would be unlikely to seek out rental housing, and the hospital had been unable to find any family members who might help care for him if released. He had no known source of income and likely would spend any funds he acquired for illegal drugs. Upon release, Pena believed, the conservatee would find temporary shelter with a community organization, begin to suffer ever more severe delusions as the Haldol wears off, and eventually commit a criminal act resulting in his return to custody.
Near the conclusion of Pena’s testimony, the court began to question him about the special disabilities requested by the Public Guardian, asking whether it would be appropriate for the conservatee to be denied the right to refuse treatment. Given the conservatee’s history of refusing medication, Pena opined, the disability would be appropriate. After that response, the court discontinued its examination, and there was no other testimony specifically directed to the special disabilities.
The conservatee also testified briefly, largely confirming Pena’s testimony. The conservatee said he understood the nature of the hearing and opposed the appointment of a conservator, contending he knows how to cook and provide food. When asked if he had a source of income, the conservatee testified he not only had a bank account but was a musician and was employed as a designer of computer chips for NASA. When asked if he could provide his own shelter, the conservatee testified he had several homes, located in New York, Napa County, and Solano County. He noted the department of mental health had broken into his home in New York and “stole several artifacts and several paintings.” The conservatee denied he had a mental illness, contending an appellate court had granted him “a full restoration of sanity” at some time in the past. He believed the conservatorship proceedings were an attempt to get at his money.
At the conclusion of the trial, the court held the conservatee was unable to provide for his food, clothing, and shelter, and was therefore “gravely disabled” under the LPS Act. The court made no findings during the hearing about the special disabilities requested by the Public Guardian, but each of the disabilities permitted by section 5357, other than denial of the right to vote, was included in the court’s written order issued after the hearing.
II. DISCUSSION
A. LPS Conservatorship
“The LPS Act governs the involuntary detention, evaluation, and treatment of persons who, as a result of mental disorder, are dangerous or gravely disabled. (§ 5150 et seq.) The Act authorizes the superior court to appoint a conservator of the person for one who is determined to be gravely disabled (§ 5350 et seq.), so that he or she may receive individualized treatment, supervision, and placement (§ 5350.1). As defined by the Act, a person is ‘gravely disabled’ if, as a result of a mental disorder, the person ‘is unable to provide for his or her basic personal needs for food, clothing, or shelter.’ (§ 5008, subd. (h)(1)(A).)” (Conservatorship of John L. (2010) 48 Cal.4th 131, 142.)
This LPS conservatorship proceeding was commenced under section 5352, which permits “the professional person in charge of an agency providing comprehensive evaluation or a facility providing intensive treatment” to recommend that a county begin such proceedings when the professional person “determines that a person in his care is gravely disabled as a result of mental disorder... and is unwilling to accept, or incapable of accepting, treatment voluntarily.” The matter is referred to an investigator, who must prepare a written report evaluating the various options for the proposed conservatee and recommending a course of action. (§§ 5354, 5356.) If a conservatorship is recommended after investigation, the conservatee is entitled to a court or jury trial on the issue of whether he or she is gravely disabled. (§ 5350, subd. (d).) The Public Guardian is the conservator of last resort, if “the court finds that no other person or entity is willing and able to serve as conservator.” (§ 5354.5.)
The trial court may also impose a number of special disabilities on the conservatee, including the surrender of a driver’s license and loss of the rights to enter into contracts, vote, possess a firearm, and refuse medical treatment. (§ 5357.) A finding of grave disability is not alone sufficient for the imposition of special disabilities; a conservatee may be incapable of providing for the daily needs listed in the statute and yet sufficiently able in other respects that imposition of the special disabilities is inappropriate. (Riese v. St. Mary’s Hospital & Medical Center (1987) 209 Cal.App.3d 1303, 1313 (Riese).) The conservatee therefore retains the rights and privileges covered by the special disabilities unless the court separately determines they are justified. (Ibid.; Conservatorship of George H. (2008)169 Cal.App.4th 157, 165 (George H.).)
B. Grave Disability
The conservatee contends there was insufficient evidence to support the trial court’s finding he is gravely disabled. Although the trial court was required to make the finding of grave disability beyond a reasonable doubt, we apply the substantial evidence test in reviewing that finding. (Conservatorship of Walker (1989) 206 Cal.App.3d 1572, 1577 (Walker).) The testimony of a single witness can constitute substantial evidence. (Conservatorship of Johnson (1991) 235 Cal.App.3d 693, 697.)
The Public Guardian contends the conservatee’s appeal was untimely filed by one day. The conservatee does not deny that his appeal was untimely, but he contends he relied on counsel to file the notice of appeal and urges us to construe his appeal as a petition for habeas corpus. (See People v. Byron (2009) 170 Cal.App.4th 657, 666.) To assure the conservatee of timely judicial review of his detention and avoid a claim of ineffective assistance of counsel, we avoid the issue by construing this appeal as a petition for habeas corpus.
Pena’s testimony provided substantial evidence to support the trial court’s conclusion the conservatee is unable to provide for his “basic personal needs for food, clothing, or shelter.” (§ 5008, subd. (h)(1)(A).) According to Pena, the conservatee suffers from substantial, debilitating delusions. Even medicated in the psychiatric facility, he spends most of his time absorbed in his own thoughts. Suffering from the illusion he is already employed, the conservatee would be unable, or disinclined, to support himself financially outside the hospital. If released, he would be forced to rely on public charitable services for food, clothing, and shelter. As Pena testified, however, the limited mental health the conservatee has attained in the hospital would begin to deteriorate as the effects of his psychoactive medication wore off, and he would become ever more absorbed in his own delusions and less able to care for himself. Even assuming he was able to continue to acquire basic necessities, the delusions eventually would make it difficult for him to control his behavior sufficiently to avoid police custody, and thereby to continue living independently. The fact that the conservatee has been unable to avoid continual readmittance to the hospital also strongly supports Pena’s opinion. The foregoing constitutes substantial evidence the conservatee is unable to provide for his basic needs. (See, e.g., Conservatorship of Guerrero (1999) 69 Cal.App.4th 442, 447; Conservatorship of Law (1988) 202 Cal.App.3d 1336, 1342.)
The conservatee argues there is no question he can provide for his own food and clothing because the evidence demonstrated he can feed and dress himself. There is, however, much more to providing for one’s own food and clothing than the ability to convey food from plate to mouth and put on clothes. It also requires obtaining the food and clothing on a sustained, consistent basis. Because the conservatee is unable to earn the money necessary to purchase food and clothing, he would have to rely on family or public charity. He has no known supportive family. While he could take advantage of charity over the short term, eventually the delusions associated with his illness would overcome even his ability to take advantage of public help. Identical reasoning supports the finding he would be unable to provide for his own shelter.
The conservatee argues it was inappropriate for the court to consider his propensity for violence and sexually inappropriate behavior. While it is true the conservatee was not committed under statutes designed to protect public safety, there is no indication the court considered the conservatee’s propensity for inappropriate conduct for this reason. Rather, the conservatee’s violent and sexually inappropriate behavior was presented as evidence of his inability to care for himself. Providing for one’s own food, clothing, and shelter necessarily requires sufficient conformance with society’s standards of behavior to avoid frequent arrest. As Pena testified, the conservatee’s untreated delusions are sufficiently absorbing they are likely to result in his violent or sexually inappropriate behavior within a relatively short time after release. Putting aside its effect on others, this compulsive conduct demonstrates the conservatee’s fundamental inability to care for himself. Because the evidence was relevant to this issue, there was no error in its admission.
In arguing the evidence was insufficient to support his commitment, the conservatee relies on Conservatorship of Smith (1986) 187 Cal.App.3d 903. The differences between the circumstances of the appellant in Smith and the conservatee, however, simply underline his grave disability. The Smith appellant was also diagnosed as having paranoid schizophrenia, which led her to camp on the steps of a church, occasionally disturbing services. (Id. at pp. 906–907.) Despite her disorder, a psychiatrist testified “her cognitive intellect and most of her personality was intact and, despite the disorder, she could feed and clothe herself and provide for her own place to live.” (Id. at p. 907.) She had lived successfully on the steps, maintaining herself in good health, and feeding herself by accepting food and money from family and well-wishers. Although her behavior was unconventional, it was not a threat to her or others. (Id. at p. 910.) The contrast with the conservatee here is marked. No psychiatrist was presented to testify the conservatee could care for himself. Unlike the Smith appellant, the conservatee has no history of maintaining a stable, successful living situation.
The conservatee also argues the Constitution requires a finding that his disability is so severe as to “present a physical danger” in order to justify his civil commitment. While it is true a person must threaten “probable dangerousness to self or others” to justify civil commitment under the Constitution (Addington v. Texas (1979) 441 U.S. 418, 426), the term “dangerousness” does not mean solely the threat of violence or injury. The risk may be not only to others, through the individual’s aggressive behavior, but also to the committed person himself or herself. The latter standard is, in effect, California’s statutory standard, which focuses on the potential conservatee’s inability to care for himself or herself, thereby placing his or her well-being at risk. It is simply unrealistic to contend, as the conservatee does, that a person can be unable to provide for the necessities of life and yet not present a danger to self. That degree of mental disability surely places a person’s health, if not life, at risk.
Conservatee contends the disability “must... be beyond the capacity of the subject to control, ” citing In re Howard N. (2005) 35 Cal.4th 117. Howard N., however, concerns the detention of a youth under a statute permitting civil commitment of a person whose release “would be physically dangerous to the public because of the person’s mental or physical deficiency, disorder, or abnormality.” (§ 1800.) This statute and the LPS Act have wholly different purposes and requirements. Commitment under section 1800 is intended to protect the public from the detained person, while the LPS Act is intended to protect the detained person from the consequences of his or her own illness. As a result, the two are subject to different constitutional requirements. There is no suggestion in Howard N. that the constitutional requirement of difficulty in controlling conduct extends to persons committed under the LPS Act, and the conservatee makes no persuasive argument for such an extension.
C. Special Disabilities
The conservatee also argues the imposition of special disabilities was not supported by the evidence. As noted above, the court asked Pena about only one of the special disabilities, the forcible administration of medication. The conservatee argues the imposition of special disabilities was not supported by the evidence because Pena’s testimony never specifically addressed the remaining special disabilities, which include deprivation of the rights to hold a driver’s license, enter into contracts, possess firearms, and refuse treatment.
In essence, the conservatee’s argument is that the imposition of special disabilities must be supported by the opinion of an expert. The argument is without legal support. Because the statute contains no such requirement, the court is permitted to impose special disabilities on the basis of its own deductions from the evidence, without the need for expert opinion. Here there is no question the imposition of special disabilities finds substantial support in the evidence. The conservatee is a person who cannot distinguish reality from his delusions. If he were permitted to enter into contracts, he would be subject to victimization. He is subject to uncontrolled aggressive behavior, making it dangerous for him to have weapons or drive, and his inability to acknowledge his illness makes it necessary for the hospital to control the administration of medication for his mental illness. Finally, because of his delusions, the conservatee lacks the ability to determine his own best medical interests and therefore should not be permitted to refuse routine medical treatment.
In Riese, the court outlined the factors to be evaluated by a trial court in considering whether a gravely disabled person is incapable of making medical treatment decisions: “(a) whether the patient is aware of his or her situation (e.g., if the court is satisfied of the existence of psychosis, does the individual acknowledge that condition); (b) whether the patient is able to understand the benefits and the risks of, as well as the alternatives to, the proposed intervention...; and (c) whether the patient is able to understand and to knowingly and intelligently evaluate the information required to be given patients whose informed consent is sought (§ 5326.2) and otherwise participate in the treatment decision by means of rational thought processes.” (Riese, supra, 209 Cal.App.3d at pp. 1322–1323.) Under these criteria, imposition of this special disability was adequately supported here.
Although the imposition of special disabilities is supported by substantial evidence, we agree with the conservatee the testimony could have been presented more clearly. “The better practice is for the conservator to disclose, by the questions asked or the argument made, the evidence relied upon to support special disabilities under section 5357.” (Walker, supra, 206 Cal.App.3d at p. 1578.) It is also better practice for the court to make specific findings in imposing special disabilities. (George H., supra, 169 Cal.App.4th at p. 165.) Nonetheless, because the trial court expressly addressed the issue of refusal of medication during the trial, thereby demonstrating an awareness of the need for the separate consideration of special disabilities, and because of the strength of the evidence supporting the other special disabilities, the failure to follow these best practices was not reversible error here. (Ibid.) Significantly, the trial court did not enter a stipulated judgment but expressly approved a form of order submitted by the conservator. (Compare Conservatorship of Christopher A. (2006) 139 Cal.App.4th 604, 612.)
III. DISPOSITION
The judgment of the trial court is affirmed.
We concur: Dondero, J. Banke, J.