Opinion
D040841.
7-30-2003
Conservatorship of the Person of BEN C. SAN DIEGO COUNTY HEALTH AND HUMAN SERVICES AGENCY, Petitioner and Respondent, v. BEN C., Objector and Appellant.
Conservatee Ben C. appeals from a judgment reestablishing a one-year conservatorship of his person under the Lanterman-Petris-Short Act (LPS or LPS Act). The petition for reestablishment alleged that C. continued to be gravely disabled because he was still unable to provide for his basic needs of food, clothing and shelter as a result of a mental disorder.
The LPS Act is codified in Welfare and Institutions Code section 5000 et seq. All further statutory references are to this code unless otherwise specified.
A recommendation and declaration form signed by two physicians (physicians declaration form) and filed concurrently with the petition as required by the LPS Act ( § 5361, discussed, post) also stated that as a result of a mental disorder, C. was unable to provide for his basic needs of food, clothing or shelter. By means of checking boxes on the form, the physicians further asserted that if the LPS conservatorship were to be terminated, C. would (1) obtain food from inappropriate or unsanitary sources, (2) be unable to obtain ordinary shelter, and (3) be unable to dress himself. The physicians did not check another box on the same form that (if checked) would have indicated a belief that C.s eating habits would likely result in "malnutrition/dehydration" if the conservatorship were terminated.
The court entered a judgment reestablishing the conservatorship after a jury unanimously found true the allegations in the petition that as the result of a mental disorder C. was unable to provide for his basic needs for food, clothing and shelter, and thus was gravely disabled.
C. appeals, contending that the judgment reestablishing the LPS conservatorship must be reversed on due process grounds because (1) the contents of the physicians declaration form constituted part of, and narrowed, the factual allegations of the petition so that reestablishment of the conservatorship required proof beyond a reasonable doubt that as a result of the termination of that conservatorship C. would obtain food from inappropriate or unsanitary sources and would be unable to obtain ordinary shelter and dress himself; (2) he did not have adequate notice of the public conservators theory for reestablishing the conservatorship; and (3) the finding of grave disability is not supported by substantial evidence. We affirm.
FACTUAL AND PROCEDURAL BACKGROUND
C. has been diagnosed with schizoaffective disorder, depressed type. His first psychiatric episode or "break" occurred in 1998. At that time, C., a concert pianist, was working on his masters degree at the University of Utah. He was hospitalized and treated in Utah. During the six-month period before he was admitted to the Cresta Loma psychiatric facility in San Diego (Cresta Loma) in June 2001, C. was hospitalized three times for treatment of his mental problems.
On June 19, 2001, upon the petition of the San Diego County Public Conservator (the public conservator), a one-year conservatorship of C.s person (the LPS conservatorship) was established by court order under the LPS Act.
A. Petition To Reestablish the LPS Conservatorship and Physicians Declaration
In May 2002, the public conservator filed a petition to reestablish the LPS conservatorship (the petition). The petition alleged that C. remained gravely disabled because he was still unable to provide for his basic needs of food, clothing and shelter as a result of a mental disorder.
Two physicians signed the physicians declaration form that was filed concurrently with the petition as required by section 5361 (discussed, post). The physicians stated therein that as a result of a mental disorder, C. was unable to provide for his "basic needs of food, clothing or shelter," and he continued to be gravely disabled. The physicians further asserted (by checking boxes) that if the LPS conservatorship were to be terminated, C. would (1) "obtain food from inappropriate or unsanitary sources"; (2) be "unable to obtain ordinary shelter"; and (3) be "unable to dress himself." The physicians did not check another box on the physicians declaration form that (if checked) would have indicated a belief that C.s "eating habits" would be "likely to result in malnutrition/dehydration" if the conservatorship were terminated.
Following a contested hearing, the court found that C. was gravely disabled and ordered the reestablishment of the LPS conservatorship and the reappointment of the public conservator as the conservator of C.s person. C. requested a jury trial on the petition.
B. Trial
The jury trial commenced in August 2002. The public conservator called one witness, Dr. Robert Simmonds, a psychologist at Cresta Loma. Represented by counsel, C. testified on his own behalf.
1. Dr. Simmonds testimony
Dr. Simmonds testified he diagnosed C. with schizoaffective disorder, depressed type. Dr. Simmonds explained that schizoaffective disorder falls between schizophrenia and mood disorders. C.s symptoms included disorganized thought process with poor boundaries, poor insight, poor judgment, and assaultive and agitated behavior. Although C. did not hear voices or have visual hallucinations, he was paranoid and tended to become depressed.
Dr. Simmonds stated that C. had made verbal threats to others on five occasions during the previous month (July 2002), but those threats had not developed into altercations. However, he was involved in a fight on July 16, 2002, and he was almost involved in another one because he was following a person who had asked him not to.
C. also has a pattern of very poor sexual boundaries. He touches females on the breast, and one week prior to commencement of the trial he had approached a female staff member at Cresta Loma and said to her, "You have big boobs." He also grabs men in their crotches.
Dr. Simmonds also testified about C.s prescribed medications. C. takes Trileptal, a mood stabilizer; Depakene, a liquid form of Depakote, which is also a mood stabilizer that has antipsychotic properties; and Haldol, which is given to C. by injection if he refuses his other medications. Dr. Simmonds explained that a mood stabilizer helps a person avoid extreme "highs" and extreme "lows." When C. arrived at Cresta Loma, he was taking Risperdal, which is an antipsychotic medication.
Dr. Simmonds stated that C. has a history of refusing to take his medications and "cheeking" his pills. He explained that "cheeking" medication occurs when a patient puts a pill in his mouth and moves it over to his cheek, drinks water, leaves the area, and then takes the pill out of his mouth and throws it away.
C.s history is that when he fails to take his medication, his psychotic symptoms are exacerbated. He becomes extremely paranoid and agitated, and he assaults others. Dr. Simmonds explained that C.s failure to take his medications is the main reason for his hospitalizations. A patient who has insight into his mental illness knows how to take care of his treatment needs. Insight is the single variable that helps to explain whether a person who has left treatment will again end up in treatment.
Dr. Simmonds stated that when he asked C. whether he would continue to take his medication if he were off of conservatorship, C. responded that he would not take the Depakene. C. does not take his medication because he denies having a mental illness. C. also believes he should not have to attend group sessions. The purpose of the groups is to assist the person in being able to live in the community after completing the Cresta Loma program. C., however, believes the groups are for "really retarded people" and that he is educated.
Dr. Simmonds opined that C.s history indicated he was not able to provide for his basic personal needs for food, clothing or shelter. He explained that C. had lived with his aunt in Salt Lake City, but had become agitated and abusive and had to be hospitalized. He then lived with a close family member in San Diego, where he received outpatient treatment, but he was hospitalized three times and was finally admitted at Cresta Loma on June 5, 2001. C. has never lived on his own.
Regarding C.s ability to provide himself with shelter, Dr. Simmonds stated that when he asked C. where he would live if he were off of conservatorship, C. first answered, "My house." When Dr. Simmonds further inquired, "Are you talking about your fathers house?", C. replied, "I dont know."
Dr. Simmonds testified that C. would certainly have difficulties because of his mental disorder in dealing with apartment managers or landlords to obtain and maintain shelter. Dr. Simmonds described C.s symptoms, including paranoia and thought blockage. C. feels that people are plotting against him. When C. experiences thought blockage, "everything comes to a stop" in his mind, making it difficult for him to deal with neighbors and landlords. As a result of these problems, when someone tells C. to do something, the situation can turn into an assaultive incident. As an example, Dr. Simmonds testified that two weeks prior to trial, C. ended up in a physical fight with someone who had tried to change the channel on the television C. was watching. Dr. Simmonds opined that as a result of thought blockage, C. would be unable to sequentially look up addresses of vacant apartments, make a telephone call, travel to an apartment with money, understand and sign a contract, and follow through on other requirements for him to find an apartment.
Dr. Simmonds also explained some of the dangers that C.s mental illness could present with regard to shelter. He described C.s history of turning on the stove under a pot and then forgetting about it and leaving, creating the danger of burning down the house. Dr. Simmonds opined that C. could not maintain himself in the community in an apartment or hotel because he would have "a hard time taking care of business," as evidenced by C.s difficulty in going to groups every day at Cresta Loma, which is "extremely simple to do." Dr. Simmonds believed C. did not have the capacity to take care of routine tasks such as grocery shopping, having power turned on in the house or maintaining a bank account.
Regarding C.s ability to provide himself with food, Dr. Simmonds stated that as a result of his delusions C. goes for long periods of time without having any food and, when he does eat, he binges on a single food. Dr. Simmonds opined that C. does not know how to take care of his nutritional needs because of the psychotic process.
Dr. Simmonds stated that C. was capable of providing his own clothing.
2. C.s testimony
C. testified that he was 27 years of age, and he did not want to be on conservatorship. He stated he wished to make his own decisions about his life, but would defer to his father to make some of the decisions. He also stated he wished to live in a board and care facility because he still had "a little bit" of mental illness.
C. stated he thought his recent change in medication was helping him. When asked whether he would continue to take medication if he were no longer at Cresta Loma, C. answered, "Yeah, definitely." When asked why he would take his medication, he replied that he would get headaches when he stopped taking his medication. Referring to his mental illness, C. stated, "Its not curable, but . . . when I take medication, I will feel better."
On cross-examination, C. was asked whether he had attacked other people. He stated, "I never attack people at first. They always are asking me rude questions or then they attack me, then I protect myself, so I hit them back." He discussed the recent altercation in front of a television. He explained he and another person had been watching television. He asked the other person if he could watch a video, and the other person did not let him. The other person grabbed C.s hand and started a fight. C. testified he protected himself, but got a bloody nose.
C. also testified about an incident involving his father and grandmother. They were together in a car, and his father told him he could not turn on the air conditioning. C. testified he tried to cause an accident by turning the steering wheel because he was "really angry." He then hit his father. C. also hit his grandmother because she raised her voice and got in the way.
Jury verdict and judgment
The jury found that C. has a mental disorder and as a result of that mental disorder he is unable to provide for his basic personal needs for food, clothing or shelter, and is thus gravely disabled. The court entered a judgment reestablishing the LPS conservatorship and reappointing the public conservator and ordered that C. be placed in a locked treatment facility. C.s timely appeal followed.
The judgment granted C. the right to complete a voter registration affidavit, but denied him the right to possess a drivers license, to enter into contracts, to refuse or consent to treatment and medication related specifically to his grave disability, to refuse or consent to routine medical treatment unrelated to remedying or preventing the recurrence of his grave disability, to possess a firearm, and to have to pay attorney fees for the LPS conservatorship proceedings.
STANDARD OF REVIEW
"A judgment or order of a lower court is presumed to be correct on appeal, and all intendments and presumptions are indulged in favor of its correctness." (In re Marriage of Arceneaux (1990) 51 Cal.3d 1130, 1133, 275 Cal. Rptr. 797, 800 P.2d 1227.) An appellate court is required to view the evidence in the light most favorable to the respondent, giving him or her the benefit of every reasonable inference, and resolving all evidentiary conflicts in the respondents favor. (In re Marriage of Mix (1975) 14 Cal.3d 604, 614, 122 Cal. Rptr. 79, 536 P.2d 479.)
On appeals challenging sufficiency of evidence, appellate courts review the record under the substantial evidence rule, under which the trier of facts resolution of disputed factual issues must be affirmed if it is supported by substantial evidence. (Winograd v. American Broadcasting Co. (1998) 68 Cal.App.4th 624, 632.)
Substantial evidence is evidence of ponderable legal significance, evidence that is reasonable, credible and of solid value. (Kuhn v. Department of General Services (1994) 22 Cal.App.4th 1627, 1633.) Substantial evidence is not synonymous with "any" evidence; it is substantial proof of the essentials that the law requires. (Roddenberry v. Roddenberry (1996) 44 Cal.App.4th 634, 651.) "The focus is on the quality, rather than the quantity, of the evidence[, and] very little solid evidence may be "substantial," while a lot of extremely weak evidence might be "insubstantial."" (Ibid.) Although "inferences may constitute substantial evidence, they must be the product of logic and reason[, and] speculation or conjecture alone is not substantial evidence." (Ibid.) "The ultimate test is whether it is reasonable for a trier of fact to make the ruling in question in light of the whole record. [Citation.]" (Id. at p. 652.)
The testimony of a single credible witness, even if he or she is a party, may constitute substantial evidence. (In re Marriage of Mix, supra, 14 Cal.3d at p. 604.) Evidence will be disregarded on appeal for credibility reasons only if it is inherently improbable, i.e., it must appear that the truth of the testimony was physically impossible or its falsity must be apparent without resorting to inferences or deductions. (Evje v. City Title Ins. Co. (1953) 120 Cal. App. 2d 488, 492, 261 P.2d 279; Eisenberg et al., Cal. Practice Guide: Civil Appeals & Writs (The Rutter Group 2000) P 8:53, p. 8-20 (rev. # 1 2001).)
The issue of whether the petition provided C. with notice of the basis for seeking reestablishment of his LPS conservatorship is a question of law. Questions of law are reviewed de novo. (Duncan v. Department of Personnel Administration (2000) 77 Cal.App.4th 1166, 1174.)
DISCUSSION
C. appeals from the judgment reestablishing a conservatorship of his person under the LPS Act. We begin with an overview of the relevant provisions of the LPS Act.
A. Statutory Framework
The LPS Act governs the involuntary treatment of the mentally ill in California and is codified at section 5000 et seq.. (Conservatorship of Susan T. (1994) 8 Cal.4th 1005, 1008, 884 P.2d 988 (Susan T.).) Enacted in 1967 (Stats. 1967, ch. 1667, § 36, p. 4074), the LPS Act "includes among its goals ending the inappropriate and indefinite commitment of the mentally ill, providing prompt evaluation and treatment of persons with serious mental disorders, guaranteeing and protecting public safety, safeguarding the rights of the involuntarily committed through judicial review, and providing individualized treatment, supervision and placement services for the gravely disabled by means of a conservatorship program." (Susan T., supra, 8 Cal.4th at p. 1009, citing § 5001.)
"The Act authorizes the appointment of a conservator for up to one year for a person determined to be gravely disabled as a result of a mental disorder and unable or unwilling to accept voluntary treatment." (Susan T., supra, 8 Cal.4th at p. 1009, citing § 5350, fn. omitted, italics added.) The Act defines gravely disabled as "[a] condition in which a person, as a result of a mental disorder, is unable to provide for his or her basic personal needs for food, clothing, or shelter." ( § 5008, subd. (h)(1)(A), italics added.)
The definition of gravely disabled set forth in section 5008, subdivision (h)(1)(A) (discussed, ante) is limited, however, by the provisions of section 5350, subdivision (e)(1) (hereafter § 5350(e)(1)). With exceptions not applicable here, section 5350(e)(1) provides that a mentally disordered person is not gravely disabled for purposes of the LPS Act if he or she can "survive safely without involuntary detention with the help of responsible family, friends, or others who are both willing and able to help provide for the persons basic personal needs for food, clothing, or shelter."
See section 5350, subdivision (e)(4), which provides: "This subdivision does not apply to a person who is gravely disabled, as defined in subparagraph (B) of paragraph (1) of subdivision (h) of Section 5008." Section 5008, subdivision (h)(1)(B), in turn, provides in part: "(h)(1) For purposes of . . . Chapter 3 (commencing with Section 5350), gravely disabled means either of the following: [P] . . . [P] (B) A condition in which a person, has been found mentally incompetent under Section 1370 of the Penal Code and all of the following facts exist: [P] (i) The indictment or information pending against the defendant at the time of commitment charges a felony involving death, great bodily harm, or a serious threat to the physical well-being of another person. [P] (ii) The indictment or information has not been dismissed. [P] (iii) As a result of mental disorder, the person is unable to understand the nature and purpose of the proceedings taken against him or her and to assist counsel in the conduct of his or her defense in a rational manner."
Section 5350(e)(1) provides in its entirety: "Notwithstanding subparagraph (A) of paragraph (1) of subdivision (h) of Section 5008, a person is not gravely disabled if that person can survive safely without involuntary detention with the help of responsible family, friends, or others who are both willing and able to help provide for the persons basic personal needs for food, clothing, or shelter."
The proposed conservatee is entitled under section 5350, subdivision (d) to demand a jury trial on the issue of his or her grave disability; and has a right to counsel at trial, appointed if necessary, under section 5365. (See Susan T., supra, 8 Cal.4th at p. 1009.)
Subdivision (d) of section 5350 provides in part: "The person for whom conservatorship is sought shall have the right to demand a court or jury trial on the issue whether he or she is gravely disabled."
Section 5365 provides in part: "The court shall appoint the public defender or other attorney for the conservatee or proposed conservatee within five days after the date of the petition."
The California Supreme Court has explained that "the party seeking imposition of the conservatorship must prove the proposed conservatees grave disability beyond a reasonable doubt and the verdict must be issued by a unanimous jury. [Citation.]" (Susan T., supra, 8 Cal.4th at p. 1009.)
Procedure for reestablishment of an LPS conservatorship
Section 5361 provides that an LPS conservatorship shall automatically terminate after one year (Conservatorship of Delay (1988) 199 Cal. App. 3d 1031, 1035, 245 Cal. Rptr. 216), and sets forth the procedure for reestablishing an LPS conservatorship after its original one-year term expires (Conservatorship of Scharles (1990) 220 Cal. App. 3d 247, 250, fn. 3, 269 Cal. Rptr. 398). That section provides in part:
"If upon the termination of an initial or a succeeding period of conservatorship the conservator determines that conservatorship is still required, he may petition the superior court for his reappointment as conservator for a succeeding one-year period. The petition must include the opinion of two physicians or licensed psychologists who have a doctoral degree in psychology and at least five years of postgraduate experience in the diagnosis and treatment of emotional and mental disorders that the conservatee is still gravely disabled as a result of mental disorder." ( § 5361; italics added.)
B. Analysis
C. contends the judgment reestablishing the LPS conservatorship must be reversed on due process grounds because (1) the contents of the physicians declaration form constituted part of, and narrowed, the factual allegations of the petition so that reestablishment of the conservatorship required proof beyond a reasonable doubt that as a result of the termination of that conservatorship, C. would obtain food from inappropriate or unsanitary sources and would be unable to obtain ordinary shelter and dress himself; (2) he did not have adequate notice of the public conservators foregoing theory for reestablishing the conservatorship; and (3) the finding of grave disability is not supported by substantial evidence. We reject these contentions.
1. Notice and due process
The petition expressly alleged that C. remained gravely disabled because he was still "unable to provide for his basic needs of food, clothing and shelter" as a result of a mental disorder. Two physicians signed the physicians declaration form required by section 5361 (discussed, ante), and stated therein that as a result of a mental disorder, C. was unable to provide for his "basic needs of food, clothing or shelter," and he continued to be gravely disabled. The physicians also expressed their opinion, by checking boxes, that if the LPS conservatorship were to be terminated, C. would (1) "obtain food from inappropriate or unsanitary sources"; (2) be "unable to obtain ordinary shelter"; and (3) be "unable to dress himself."
C. contends his right to due process was violated because he did not have notice that the public conservator would attempt at trial to establish grave disability "on any theory other than to sustain the above allegations" set forth in the physicians declaration form, i.e., that if the LPS conservatorship were to be terminated, C. would "obtain food from inappropriate or unsanitary sources," he would be "unable to obtain ordinary shelter," and he would be "unable to dress himself." He also contends that (1) section 5350, which sets forth the procedure for the appointment of a conservator under the LPS Act, incorporates Probate Code procedures for establishing a conservatorship; Probate Code section 1821, subdivision (a) requires a proposed conservator, who is not a bank or trust company, to file "supplemental information" to "state the reasons why a conservatorship is necessary"; and thus, in the case of the reestablishment of an LPS conservatorship, the physicians declaration form (discussed, ante) is the functional equivalent of the Probate Code section 1821, subdivision (a) "supplemental information." We reject these contentions.
Section 5350 provides in part: "A conservator of the person, of the estate, or of the person and the estate may be appointed for any person who is gravely disabled as a result of mental disorder or impairment by chronic alcoholism. [P] The procedure for establishing, administering, and terminating a conservatorship under this chapter shall be the same as that provided in Division 4 (commencing with Section 1400) of the Probate Code." (Italics added.)
Probate Code section 1821, subdivision (a) provides: "(a) The petition shall request that a conservator be appointed for the person or estate, or both, shall specify the name, address, and telephone number of the proposed conservator and the name, address, and telephone number of the proposed conservatee, and state the reasons why a conservatorship is necessary. Unless the petitioner is a bank or other entity authorized to conduct the business of a trust company, the petitioner shall also file supplemental information as to why the appointment of a conservator is required. The supplemental information to be submitted shall include a brief statement of facts addressed to each of the following categories: [P ](1) The inability of the proposed conservatee to properly provide for his or her needs for physical health, food, clothing, and shelter. [P] . . . [P] (5) . . . The facts required to address the categories set forth in paragraphs (1) to (5), inclusive, shall be set forth by the petitioner when he or she has knowledge of the facts or by the declarations or affidavits of other persons having knowledge of those facts. [P] Where any of the categories set forth in paragraphs (1) to (5), inclusive, are not applicable to the proposed conservatorship, the petitioner shall so indicate and state on the supplemental information form the reasons therefor. [P] The Judicial Council shall develop a supplemental information form for the information required pursuant to paragraphs (1) to (5), inclusive, after consultation with individuals or organizations approved by the Judicial Council, who represent public conservators, court investigators, the State Bar, specialists with experience in performing assessments and coordinating community-based services, and legal services for the elderly and disabled. [P] The supplemental information form shall be separate and distinct from the form for the petition. The supplemental information shall be confidential and shall be made available only to parties, persons given notice of the petition who have requested this supplemental information or who have appeared in the proceedings, their attorneys, and the court. The court shall have discretion at any other time to release the supplemental information to other persons if it would serve the interests of the conservatee. The clerk of the court shall make provision for limiting disclosure of the supplemental information exclusively to persons entitled thereto under this section." (Italics added.)
C. cites no decisional authority, and we are aware of none, that holds that the Probate Code section 1821, subdivision (a) supplemental information serves to limit the general allegations set forth in a petition for reestablishment of an LPS conservatorship. The physicians declaration form is required in such a case by section 5361, which (as already discussed) provides in part:
"The petition must include the opinion of two physicians or licensed psychologists who have a doctoral degree in psychology and at least five years of postgraduate experience in the diagnosis and treatment of emotional and mental disorders that the conservatee is still gravely disabled as a result of mental disorder." (Italics added.)
Here, the record shows that the physicians declaration form in question comports with the section 5361 requirement that "petition . . . include the opinion of two physicians or licensed psychologists . . . that the conservatee is still gravely disabled as a result of mental disorder." The physicians checked the box indicating that, in their opinion, C. continued to be gravely disabled in that, as a result of his mental disorder, he "is unable to provide for [his] basic personal needs for food, clothing or shelter."
In Conservatorship of Delay, supra, 199 Cal. App. 3d 1031, 1036, this court explained that "all section 5361 does is establish the threshold requirements for presenting to the court the petition to reappoint the conservator." (Italics added.) We also explained that "satisfaction of the requirements for presenting the petition does not satisfy the requirements for establishing the reappointment if it is challenged by the conservatee. At the reestablishment trial, [San Diego] County must prove continued grave disability beyond a reasonable doubt. [Citation.]" (Conservatorship of Delay, supra, at p. 1036.)
Here, the two physicians opinions in their physicians declaration form satisfied the statutory requirement for presenting the petition, but did not limit the evidence that the public conservator could present at trial to establish C.s continuing grave disability. (Conservatorship of Delay, supra, 199 Cal. App. 3d at p. 1036; see also this courts decision in Conservatorship of Scharles, supra, 220 Cal. App. 3d 247 [upholding the reestablishment of an LPS conservatorship where the public conservator at trial presented the testimony of a psychiatrist who had not signed the section 5361 physicians declaration form, and the conservatee did not expressly waive the presence of the doctors who had signed that form].)
2. Waiver of C.s due process claim
As this court held in In re Grayden N. (1997) 55 Cal.App.4th 598, 605, a due process claim of inadequate notice is waived by failure to raise it below. Here, even were we to assume both that the physicians declaration form narrowed the allegations in the petition and that the public conservator established C.s continuing grave disability on a specific theory other than one set forth in the physicians declaration form, C. waived any due process claim by not raising it below. The record shows that C.s counsel acknowledged prior to trial that the issue in the case was whether, as a result of a mental disorder, C. was unable to provide for his basic personal needs of food, clothing or shelter. Respondent argues, and C. does not contest, that C.s counsel did not object to the petition or argue that the issues were limited to whether C. would (1) "obtain food from inappropriate or unsanitary sources," (2) be "unable to obtain ordinary shelter," or (3) be "unable to dress himself," as the physicians who signed the physicians declaration form opined he would if the LPS conservatorship were to be terminated.
The record also shows that C. did not object to the jury instructions, which advised the jury that it was to determine whether C. was gravely disabled because his mental disorder prevented him from providing for his "food, clothing or shelter." C. also did not oppose the verdict forms submitted by the public conservator, the language of which mirrored the language contained in the jury instructions. On this record, we conclude C. waived any due process claim based on a lack of notice of the issues to be defended against at trial.
3. Substantial evidence
C. complains that the physicians declaration form specifically asserted that C. was gravely disabled because as a result of a mental disorder he would "obtain food from inappropriate or unsanitary sources" if the LPS conservatorship were to be terminated, but at trial the public conservator presented no such evidence, and thus the judgment reestablishing his LPS conservatorship is not supported by substantial evidence.
We conclude the judgment is supported by substantial evidence. Dr. Simmonds testified that C. suffers from schizoaffective disorder, depressed type,and opined that C.s history indicated he was not able to provide for his basic personal needs for food, clothing or shelter. Dr. Simmonds explained that C.s symptoms included disorganized thought process with poor boundaries, poor insight, poor judgment, and assaultive and agitated behavior. He also stated that C. has a history of refusing to take his medications and cheeking his pills and, when he fails to take his medication, his psychotic symptoms are exacerbated, he becomes extremely paranoid and agitated, and he assaults others.
With regard to food, Dr. Simmonds testified that as a result of C.s delusions, C. goes for long periods of time without having any food and, when he does eat, he binges on a single food. Dr. Simmonds opined that C. does not know how to take care of his nutritional needs because of the psychotic process.
With regard to shelter, Dr. Simmonds testified that C. had lived with his aunt in Salt Lake City, but had become agitated and abusive and had to be hospitalized. C. then lived with a close family member in San Diego, where he received outpatient treatment, but he was hospitalized three times and was finally admitted at Cresta Loma. C. has never lived on his own.
Dr. Simmonds also testified that C. would certainly have difficulties, because of his mental disorder, in dealing with apartment managers or landlords to obtain and maintain shelter. C. feels that people are plotting against him, and when C. experiences thought blockage, "everything comes to a stop" in his mind, making it difficult for him to deal with neighbors and landlords. As a result of these problems, when someone tells C. to do something, the situation can turn into an assaultive incident. Dr. Simmonds opined that as a result of thought blockage, C. would be unable to sequentially look up addresses of vacant apartments, make a telephone call, travel to an apartment with money, understand and sign a contract, and follow through on other requirements for him to find an apartment.
C. testified about an assaultive incident that involved his father and grandmother. He stated that on one occasion, when they were all together in a car, his father told him he could not turn on the air conditioning. C. admitted he tried to cause an accident by turning the steering wheel because he was "really angry." He also admitted he hit his father, and he hit his grandmother because she raised her voice and got in the way.
The foregoing substantial evidence supports the jurys findings that C. has a mental disorder and as a result of that disorder he is still unable to provide for his basic personal needs for food or shelter, and thus continues to be gravely disabled within the meaning of the LPS Act. Accordingly, the judgment reestablishing the LPS conservatorship must be affirmed.
Dr. Simmonds stated that C. was capable of providing his own clothing.
DISPOSITION
The judgment is affirmed.
WE CONCUR: HALLER, J., McDONALD, J.