Opinion
2d Civil B326732
01-16-2024
Conservatorship of the Person of S.I. v. S.I., Objector and Appellant. PUBLIC GUARDIAN OF THE COUNTY OF SAN LUIS OBISPO, Petitioner and Respondent,
Jean Matulis, under appointment by the Court of Appeal, for Objector and Appellant. Rita L. Neal, County Counsel, and Chelsea K. Kuhns, Deputy, for Petitioner and Respondent.
NOT TO BE PUBLISHED
Superior Court County of San Luis Obispo Super. Ct. No. 17PR-0324, Donald G. Umhofer, Judge
Jean Matulis, under appointment by the Court of Appeal, for Objector and Appellant.
Rita L. Neal, County Counsel, and Chelsea K. Kuhns, Deputy, for Petitioner and Respondent.
GILBERT, P. J.
S.I., the conservatee, appeals a judgment reappointing the Public Guardian of the County of San Luis Obispo (Public Guardian) as the Lanterman-Petris-Short (LPS) Act conservator for S.I. (Welf. &Inst. Code, §§ 5350, 5358, 5361.) The trial court found that S.I. was gravely disabled, that he lacked the capacity to consent or refuse treatment for his mental disorder, and that he lacked the capacity to enter into contracts exceeding $50. The court's findings are supported by substantial evidence. We affirm.
FACTS
The Public Guardian was appointed as the LPS conservator for conservatee S.I. in 2017, after S.I. had engaged in selfdestructive behavior. In the present case, the Public Guadian filed a petition to be reappointed as conservator. The petition attached declarations from two doctors who determined that S.I. was gravely disabled because of his mental disorder, that he was not capable of participating in decisions about his medications, and that he was not capable of entering into contracts exceeding $50. S.I. waived his right to a jury trial.
Doctor Rose Drago, a psychiatrist, testified S.I. is gravely disabled and he "cannot provide for himself." He suffers from a schizoaffective disorder, bipolar type. When he becomes manic, he has psychotic symptoms and can "physically injure himself." He has delusions and believes he is the movie character Luke Skywalker. He has plans for how he would care for himself in the community. But they are "concerning" because they are not specific and he wants to be released with "no supervision." He has a plan to return to a place called Sunny Acres. The last time he was there he was "injuring himself severely, banging his head." Sunny Acres does not monitor medications. He could go off his medications, become "psychotic again," and become "out of control."
Drago testified S.I. is not capable of making medical decisions relating to his mental disorder. S.I. does not acknowledge his "psychosis" and his need for "antipsychotic medication." He is given Zyprexa to control his mania. He does not want to take this medication. He is not capable of entering into contracts that exceed $50.
Lisa Niesen, an official with the Public Guardian's office, testified that, before the LPS conservatorship, S.I. was homeless. S.I. also had lived at Sunny Acres. Sunny Acres has no staff to monitor medications, provide mental health services, or monitor residents, and no psychiatrists to see residents.
Niesen testified the Public Guardian is the representative payee for S.I. S.I. receives "social security retirement and . . . an SSI [Supplemental Security Income] benefit." He has a small savings account. The Public Guardian manages this money for S.I. S.I. repeatedly calls the office to ask about the amount of funds in his account. He disagrees with the amount of funds that are reported to be in his account. Two years ago the Public Guardian made a "spend down" of money received for him from "stimulus checks." The amount of $2,500 was deducted from his account and used to buy a burial trust insurance policy for him. The Public Guardian believed this spend down was required because of the public disability benefits S.I. receives.
S.I. testified he believed he had a mental illness "because we all get mad and we all get depressed." He was not a danger to anyone. "I hurt myself and that's what got me in here.... I disagree with some of the meds I'm taking, but the meds I'm taking do help me." He said he does not want to take Zyprexa. "I'm trying to stop taking it, but the doctors are very consistent about me taking it continually." (Italics added.) He said there are side effects of taking Zyprexa. It "ruined [his] teeth" and it is "ruining" his "health." If he was no longer a conservatee, he "would like to go to Sunny Acres." He said, "I like being manic."
S.I. disagreed with Drago's testimony that medications such as Zyprexa were necessary, because "[t]hese meds . . . are poison." When he was homeless in the past, his "medication" was "beer and smoking weed." He now goes to Alcohol Anonymous meetings. S.I. testified about an incident years earlier where he got out of a car and saw "Abraham." S.I. then looked at the sky for an hour and a half and "got programmed." S.I. said, "First thing [Abraham] said is, this is the Lord, which I met at his house, Paul and his wife, and you're Luke Skywalker, and I go, 'Okay.'. . . I finally found where I believe in God." "I'm a chief of Israel. I'm Chief Joseph too."
The trial court received into evidence a stipulation of facts and numerous medical records. The stipulation of facts was signed by the Public Guardian's counsel and S.I.'s counsel. Counsel attached copies of "medical records in support of" the facts stated in the stipulation.
The trial court reappointed the Public Guardian as the LPS conservator of S.I. and entered a judgment sustaining the petition. It found that due to a mental disorder S.I. is unable to provide for his food, clothing, and shelter. There is "not yet a suitable alternative to a conservatorship." S.I. lacks the capacity "to refuse treatment for his medical condition" and to "contract in excess of $50."
DISCUSSION
Sufficiency of the Evidence that S.I. is Gravely Disabled
A person may not be subject to a conservatorship order unless he or she is" 'gravely disabled' as a result of a mental disorder." (Conservatorship of Carol K. (2010) 188 Cal.App.4th 123, 134.) To be gravely disabled, the person, "due to mental disorder," is unable to provide for his or her basic needs of food, clothing, or shelter. (Ibid.)
On appeal we review the record to determine whether substantial evidence supports the trial court's findings. (Conservatorship of Walker (1989) 206 Cal.App.3d 1572, 1577.) We must draw all reasonable inferences in support of the judgment. We do not decide the credibility of the witnesses, weigh the evidence, or resolve evidentiary conflicts. Those are matters decided by the trial court. (People v. Ochoa (1993) 6 Cal.4th 1199, 1206.)
S.I. cites to evidence in the record that he claims supports his position. But the issue on appeal is not whether some evidence supports appellant, but only whether substantial evidence supports the judgment. (People v. Ochoa, supra, 6 Cal.4th at p. 1206.) S.I. points to portions of Drago's testimony he claims were inconsistent with other portions of her testimony. But resolving conflicts in the evidence and issues of credibility are exclusively decided by the trier of fact. (Ibid.)
Here there is substantial evidence to support the finding that S.I. is gravely disabled. Drago testified S.I. suffers from a mental disorder. S.I. has a "schizoaffective disorder, bipolar type." Drago testified S.I. is gravely disabled.
S.I. claims Drago did not mention his ability to find food or shelter. But she testified unequivocally that S.I. "cannot provide for himself" and he was unable to calculate his necessary monthly expenses. Drago said when he "gets manic, he also oftentimes dips into psychotic symptoms. They can be grandiose. They can be paranoid, and he can get into a lot of trouble." She said S.I. can "physically injure himself." In her interview with S.I., he was "a little bit hypomanic." When he "gets manic," he has very poor insight into "his illness and his need for treatment." In October 2022, he was "very manic." He engaged in "a lot of disruptive manic behavior." She said his symptoms have ranged from severe "auditory hallucinations" to less severe "delusional thinking." He believes he is the movie character Luke Skywalker.
Drago said S.I.'s plans for his "self-care" were "concerning" because he wanted to be released with "no supervision," and his plans lacked "specificity." His plan to live at Sunny Acres was not a good alternative. That facility does not have "monitoring of medications," which means he could go off his medications, become "manic and psychotic again," and get "out of control." He was living at that facility before his conservatorship. Drago said it "was probably the worst [she has] ever seen him, because [S.I.] was injuring himself severely, banging his head."
S.I. lacked any specific plan for his release. He told Drago that he intended to obtain housing from a person affiliated with a church. But at trial he said he would go to a homeless shelter or Sunny Acres. Drago testified he was unable to calculate his necessary monthly expenses. Her testimony showed his inability to care for himself and his denial and lack of insight about his schizoaffective disorder. (Conservatorship of Walker, supra, 206 Cal.App.3d at p. 1577.)
The stipulation of facts and medical records admitted into evidence confirmed that: 1) S.I. "at times endorses a bipolar" diagnosis, but he denies that he has a schizoaffective disorder and he denies that he hallucinates; and 2) he exhibited "symptoms associated with his mental health disorder over" the prior year, including grandiose delusions, "dumpster diving for food, hyper talkative and pressured speech, manic, anxious, poor boundaries," and poor insight and judgment.
S.I. contends this case is analogous to Conservatorship of Murphy (1982) 134 Cal.App.3d 15, where the court found speculative predictions about what a person would do if released could not support a conservatorship petition. But in Murphy, the experts agreed that Murphy was able to take care of himself, but they made a speculative prediction that if released he would revert to using alcohol. Here, by contrast, Drago testified S.I. was delusional, he lacked insight, and was not capable of taking care of himself. Her concern that if released he would stop taking Zyprexa and become manic was supported by his medical history and S.I.'s testimony where he said, "I'm trying to stop taking Zyprexa," and "I like being manic." Drago knew S.I.'s propensities. She had known him for "several years prior to his conservatorship," and she had interviewed him annually during the conservatorship. Moreover, the stipulation of facts and medical records admitted into evidence showed that S.I. "would cease his psychiatric medications if on his own."
S.I.'s Ability to Make Decisions about Medications
S.I. claims he was able to identify the side effects of one of his medications. He argues the trial court erred by not allowing him to make decisions about medications. We disagree.
The trial court may order involuntary medication for a conservatee if he or she is not competent to understand the benefits and risks of medication and the alternatives; and is not able to give informed consent and participate in treatment decisions (Riese v. St. Mary's Hospital &Medical Center (1987) 209 Cal.App.3d 1303, 1322-1323); or is "incapable of making rational decisions about his own medical treatment" (In re Qawi (2004) 32 Cal.4th 1, 20).
Drago said S.I. has poor insight into his need for treatment and he would not seek treatment if released into the community. S.I. was not capable of "making medical decisions related to his mental disorder." He does not "acknowledge" his "psychosis" and his need for "antipsychotic medication."
Drago testified S.I. was not able to manage the medications necessary to treat his mental disorders. S.I. told her that "he couldn't keep track of all [his medications]." She said he wanted to stop taking Zyprexa. But that was the medication necessary to control his "mania." His doctors increased the dosage of that medication to deal with his increasing mental health problems. If he stopped taking it, he could become "manic." When he becomes manic, he has poor insight into his illness and his need for treatment, which includes his need for medications. He had recent psychotic episodes, and medications were necessary to treat them. The stipulation of facts and medical records admitted into evidence confirmed that S.I. "would cease his psychiatric medications if on his own."
S.I. claims he was able to credibly testify about the side effects of Zyprexa. But the credibility of his testimony was decided by the trial court. Moreover, he has not shown why the court could not reasonably find that he was not able to rationally discuss medications with his doctors because he believed they were giving him "poison." His doctors initiated a medication plan to prevent him from becoming manic. But S.I. desired to become manic and stop taking Zyprexa, the anti-manic medication. That would undermine the medication plan created for his protection. Consequently, he lacked the ability to rationally weigh the benefits of his medication and understand its impact on his symptoms. (In re Qawi, supra, 32 Cal.4th at p. 20.)
S.I.'s Ability to Make Contracts
S.I. contends the trial court erred by ruling that he lacked the capacity to enter into contracts exceeding $50. We disagree.
The diagnosis that a person has a mental disorder does not automatically show he or she lacks the ability to contract. (In re Marriage of Greenway (2013) 217 Cal.App.4th 628, 640.) There must be additional evidence to show that inability. (Ibid.)
Drago testified about S.I.'s mental disorder. But she also said he was "not capable" of entering into contracts in excess of $50. S.I. contends she relied on the facts that he was "suspicious about his money and people taking it." S.I. argues, "There is no ground to deprive a person of the right to contract because he is too vigilant."
But Drago's testimony went beyond that. She said S.I. did not have "a good budgeting sense." She asked him how he would budget his money for his monthly expenses. But he was unable to do that. He could not describe "how his money would be allocated for the month other than $800 rent." That supports a finding of the inability to contract. (Algo- Heyres v. Oxnard Manor LP (2023) 88 Cal.App.5th 1064, 1071 [evidence that a person lacked the ability to budget a checking account supported "the conclusion that he was unable to manage his financial affairs"].) Moreover, Drago's testimony showed that he had delusions regarding money. S.I. believed he could buy a car "with $2,000 in oil money." But there was no evidence that he had an oil money account.
S.I. claims it was normal for S.I. to question how the Public Guardian managed his funds. But Drago's testimony shows this was not a normal or rational questioning of accounting practices. Instead, she said, as a result of his mental illness, he has "paranoia about money and where that's going." (Italics added.) The stipulation of facts and medical records admitted into evidence confirmed that S.I. had: 1) "paranoid delusions that his conservator is stealing from him"; 2) "grandiose delusions that he is owed money from the government and oil companies"; and 3) "grandiose delusions that he has large amounts of money available to him." (Italics added.) The evidence of his delusional beliefs about money and his resources supports the trial court's finding that he lacked the capacity to contract. (Estate of Martin (1969) 270 Cal.App.2d 506, 509; Estate of Nigro (1966) 243 Cal.App.2d 152, 160.)
Public Guardian's Error in Managing the Account?
S.I. claims his questions about his money in his conservatorship account were reasonable because the Public Guardian's staff mismanaged his account. He claims that as a result of the CARES Act (26 U.S.C. § 6428), he received stimulus checks called economic impact payments (EIP's) into his account. (See Scholl v. Mnuchin (N.D. Cal. 2020) 489 F.Supp.3d 1008, 1020.) He argues the Public Guardian improperly withdrew $2,500 of his EIP's to make an unnecessary "spend down" from that account.
But the Public Guardian as conservator had the power and duty to make sure that the amounts in S.I.'s account did not exceed the maximum resources limit for eligibility for his SSI benefits. (Conservatorship of Roulet (1979) 23 Cal.3d 219, 227; Hudson v. Bowen (9th Cir. 1988) 849 F.2d 433, 434; Gordon v. Secretary of Health &Human Services (9th Cir. 1986) 803 F.2d 1071, 1073-1074; Kushner v. Commissioner of Social Security (E.D. Mich. 2019) 354 F.Supp.3d 797, 803.) Where the account exceeds that limit, the conservator has the authority to spend down or take action to attempt to maintain eligibility. (Roulet, at p. 227; Brown v. Labow (2007) 157 Cal.App.4th 795, 814-815; Will v. Kizer (1989) 208 Cal.App.3d 709, 719; 20 C.F.R. § 416.1240.)
The parties agree that an "IRS alert" regarding EIP's provides that EIP's are not counted for a recipient's "resource" limits for SSI/Medicaid eligibility for "a period of 12 months from receipt" of those payments. (IRS alert: Economic Impact Payments belong to recipient, not nursing homes or care facilities (IR-2020-121, June 16, 2020) <https://www.irs.gov/newsroom/irs-alert-economic-impact-payments-belong-to-recipient-not-nursing-homes-or-care-facilities> [as of Jan. 16, 2024], archived at https://perma.cc/7P7S-YRY5 (hereafter IRS alert).) But the Public Guardian notes that beyond that 12-month period, EIP's become a resource that is counted and the funds are then subject to excess resource spend-down requirements. EIP's are not permanently exempt; they are only exempt for a limited 12-month "grace period." (See, e.g., Davis v. Lukhard (4th Cir. 1986) 788 F.2d 973, 983.)
Niesen testified, "[W]e only had a certain amount of time that those funds could remain in a fiduciary account until those assets" would be considered "an over-asset amount," and therefore a spend down was required to keep S.I.'s eligibility. (Italics added.)
There was no evidence about when the EIP's were received and how long they had been in S.I.'s account. Consequently, the record S.I. has produced is not sufficient to support his claim that the Public Guardian erred by deciding to make the spend down. Niesen testified a spend down was required, and her testimony is uncontradicted. Unless there is evidence to the contrary, we must presume that official duty has been regularly performed. (People v. Dunlap (1993) 18 Cal.App.4th 1468, 1477.)
S.I. contends the IRS alert for "representative" payees also states, "If the beneficiary wants to use the EIP independently, the representative should provide the EIP to the beneficiary." But the Public Guardian was not merely a representative payee. (Conservatorship of Roulet, supra, 23 Cal.3d at p. 227.) Here the Public Guardian is the LPS conservator of a mentally disordered conservatee. S.I. has not shown the IRS notice was intended to apply to give large EIP's to an LPS conservatee who is not competent to receive money in excess of $50. We may not interpret the IRS alert in a way that would lead to absurd results. (Chahine v. State Bd. of Equalization (1990) 222 Cal.App.3d 485, 490; Kornman &Associates, Inc. v. U.S. (5th Cir. 2008) 527 F.3d 443, 451.) We have reviewed S.I.'s remaining contentions and we conclude he has not shown grounds for reversal. DISPOSITION The judgment is affirmed.
We concur: YEGAN, J., CODY, J.