Conservatorship of J.D. CA5 ( 2022 )


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  • Filed 8/18/22 Conservatorship of J.D. CA5
    NOT TO BE PUBLISHED IN THE OFFICIAL REPORTS
    California Rules of Court, rule 8.1115(a), prohibits courts and parties from citing or relying on opinions not certified for
    publication or ordered published, except as specified by rule 8.1115(b). This opinion has not been certified for publication
    or ordered published for purposes of rule 8.1115.
    IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA
    FIFTH APPELLATE DISTRICT
    Conservatorship of the Person of J.D.
    TULARE COUNTY PUBLIC GUARDIAN,                                                           F083415
    Plaintiff and Respondent,                                         (Super. Ct. No. VPR048411)
    v.
    OPINION
    J.D.,
    Objector and Appellant.
    THE COURT*
    APPEAL from an order of the Superior Court of Tulare County. Nathan D. Ide,
    Judge.
    Linda J. Zachritz, under appointment by the Court of Appeal, for Objector and
    Appellant.
    Jennifer M. Flores, County Counsel, John A. Rozum, Chief Deputy County
    Counsel, and Jason Chu, Deputy County Counsel, for Plaintiff and Respondent.
    -ooOoo-
    *           Before Hill, P. J., Poochigian, J. and Snauffer, J.
    In conservatorship proceedings under the Lanterman-Petris-Short Act (the
    LPS Act) (Welf. & Inst. Code, § 5000 et seq.),1 the trial court found appellant, J.D., to be
    “gravely disabled” due to a mental disorder, whereupon the court granted the petition to
    continue appellant’s conservatorship and reappoint respondent Tulare County Public
    Guardian (respondent or county) as the conservator of appellant’s person. J.D. argues
    that (1) the trial court’s finding that he was gravely disabled was not supported by
    substantial evidence, and (2) the trial court erred in authorizing the county to consent to
    psychiatric treatment, including administration of medication, because substantial
    evidence did not support the finding that he lacked the capacity to give informed consent.
    The county disagrees on both accounts. We affirm.
    FACTUAL AND PROCEDURAL HISTORY
    J.D. is a 49-year-old male who has been on successive LPS Act conservatorships,
    on a temporary basis starting on June 13, 2017, and continuing on a permanent basis from
    July 11, 2017. The permanent conservatorship has been reviewed and continued by the
    trial court every six months since July 11, 2017. Each order continuing J.D.’s
    conservatorship has included imposition of disabilities,2 including a suspension of his
    right to refuse antipsychotic, neuroleptic, and/or psychotropic medication. Most recently,
    on July 2, 2021, the county petitioned for continuation of J.D.’s conservatorship and
    reappointment as conservator, alleging that J.D. was gravely disabled (§ 5008) and lacked
    the capacity to give informed consent to treatment of his grave disability, including
    through the use of antipsychotic, neuroleptic, and/or psychotropic medication.
    1      All statutory references are to the Welfare and Institutions Code.
    2      The LPS Act allows a trial court to impose “disabilities” upon a conservatee—i.e.,
    temporary suspensions of or limitations on a conservatee’s statutorily identified rights—
    as needed (§ 5357). For example, section 5357, subdivision (d), identifies “[t]he right to
    refuse or consent to treatment related specifically to the conservatee’s being gravely
    disabled” as one of the rights that may be suspended in imposing a disability. The power
    to exercise that right may then be granted to the conservator. (§ 5357.)
    2.
    As part of the six-month review process, and in anticipation of the July 2, 2021
    petition, the county filed declarations of J.D.’s case manager, conservatorship
    investigator, and two reviewing doctors, recommending reappointment of the
    conservator. The case manager and conservatorship investigator filed a declaration,
    opining that J.D. was gravely disabled “[a]s a result of a … mental disorder … and is[]
    [¶] [u]nable to provide for his … basic personal needs …; and is [¶] [u]nwilling … of
    accepting treatment voluntarily; and is [¶] [i]ncapable of consenting to receiving
    antipsychotic medications ….” The declaration further detailed that J.D. was previously
    diagnosed with schizoaffective disorder, bipolar type; cannabis abuse; other stimulant
    dependence; and anxiety disorder. It alleged J.D. exhibited a “[g]ross denial of illness,”
    “[p]oor judgement,” “[p]reoccupation,” and “[r]espond[ed] to auditory hallucinations.” It
    alleged further that J.D. “[l]ack[ed] capacity to consent to administration of antipsychotic
    … medications,” previously refused outpatient treatment, could not cook for himself, had
    no realistic plan for obtaining meals, clothing, or shelter, had been evicted from a prior
    residence due to inappropriate behavior, and “[s]plurge[d] on items leaving nothing for
    food or rent.” The declaration concluded that the least restrictive level of care required to
    treat J.D.’s condition was a community care facility empowered to consent to
    administration of antipsychotic, neuroleptic, and/or psychotropic medications on his
    behalf.
    Two medical doctors filed declarations concurring in the medical diagnoses set out
    in the case manager and conservatorship investigator’s declaration with one doctor noting
    that J.D.’s cannabis dependence and stimulant dependence were both in remission. Both
    doctors further opined that J.D. was gravely disabled as a result of a mental disorder and
    was incapable of accepting treatment voluntarily, consenting to receiving antipsychotic
    medications, or providing for his basic needs.
    On July 20, 2021, the trial court held an initial hearing on the reappointment
    petition. J.D.’s public defender requested a contested hearing on the petition. The
    3.
    contested hearing was set for September 14, 2021, and the conservatorship, the county’s
    guardianship, and the previously imposed disabilities were continued until that date.
    On September 14, 2021, the trial court held the contested hearing on the
    conservatorship petition. The parties stipulated that the court could consider a redacted
    psychodiagnostic report prepared by Elaine Guerrero Clar, Psy.D., dated August 16,
    2021. The report outlined J.D.’s disorders and conditions: schizoaffective disorder,
    bipolar type, cannabis dependence, stimulant dependence, and anxiety disorder. The
    redacted report explained that Clar relied upon J.D.’s psychosocial history,
    hospitalization records, prior conservatorship investigation, and notes from J.D.’s board
    and care facility. The summary of those records was the only portion of the report to be
    redacted. The report detailed Clar’s mental status examination of J.D. J.D. was advised
    of the nature and purpose of the interview, and he acknowledged his understanding and
    gave his assent to the interview.
    J.D.’s posture was appropriate, his hygiene was adequate, his attire was
    appropriate for the weather, and he was cooperative in nature. “He presented as confused
    at times, as he provided responses that were out of context to past, present, and future.”
    J.D. appeared to have difficulty understating questions and Clar “repeated … and
    re[]worded various inquiries on multiple occasions …” for his benefit. He did not always
    respond to inquiries without prompting and his responses were occasionally
    nonresponsive. For instance, when asked how he would get transportation, he responded,
    “ ‘yeah.’ ” Clar described his thought process as “circumstantial, for instance, he was
    able to name various foods he could make, and how much income he believed he had,
    however, [he] was unable to describe steps to obtaining food nor money for finances.”
    J.D. “demonstrated anxious behavior,” reported his mood as anxious, and stated
    that the previous day his anxiety was ranked a “7 out of 10, with 10 being the highest
    level of anxiety.” He denied auditory hallucinations but “reported having ongoing
    paranoia regarding someone wanting to strike him daily, due to a past assault. While he
    4.
    demonstrated fair insight into his mental illness, he evidenced poor judgment as seen in
    his lack of thoughtfulness into a future viable plan of self-care.”
    With regard to compliance with treatment, Clar reported that J.D.
    “was knowledgeable in the various psychotropic medications he is
    administered. He demonstrated understanding the purpose of the
    medication[s] and how they affect him. However, he was uncertain as to
    how to obtain the medications that are currently prescribed to him if LPS
    [c]onservatorship were to be terminated. He reported that he could go to
    the Veteran’s Affairs but was uncertain how to obtain transportation to the
    office. In addition, he was unsure how to obtain a pharmacy in order to
    refill medications. When discussing mental health treatment and
    therapeutic intervention, he was often quiet and did not participate in
    feedback regarding a future plan to comply with treatment. At one point,
    he was asked what a plan may be in order to take his medications as
    prescribed. He stated, he would ask his father to call him, however, he also
    mentioned that his father’s phone number is blocked, and he sometimes
    does not accept [J.D.]’s calls. Should [J.D.]’s LPS [c]onservatorship be
    terminated, it is unlikely that [he] would be successful in complying with
    treatment.”
    Clar further opined that J.D. was unable to articulate a viable plan for self-care.
    J.D. told Clar that he wanted to live at “an apartment, a men’s shelter, [his] family home,
    or [a] friend’s home and become his own payee.” However, J.D. was “uncertain as to
    steps in locating an apartment, nor was he able to identify a city he would like to live in.
    When he was asked how he would be transported, he was uncertain.” Clar further
    expressed doubt that J.D. could manage his own finances and related a report from the
    team leader of the board and care facility where J.D. lived: “there was a recent situation,
    where [J.D.] had requested funding from his public guardian for a mobile phone. It was
    later learned that he spent these designated funds on miscellaneous items, rather than the
    intended expense.” For those reasons, Clar opined that J.D. was “not capable of living
    independently due to his impaired functioning, poor judgment, and lack of a viable plan
    for self-care.”
    5.
    Clar summarized her findings and opinions regarding J.D.’s history and needs:
    J.D. was originally placed on an LPS conservatorship as a “result of nonadherence to
    psychotropic medications and subsequent[]ongoing psychotic symptoms to the point of
    aggression, paranoia[,] and suicidal intent. … [M]ost recently [he] ha[d] been very
    compliant with treatment.” The board and care facility was then working on an
    application to transfer him to a facility that offered increased independence while
    maintaining his psychiatric needs. Despite his progress, J.D. required the structure of an
    LPS conservatorship to care for his basic needs because he displayed “no insight into his
    mental illness or need for mental health treatment … [and] he was unable to provide a
    viable plan of self-care if released from his LPS [c]onservatorship.” Clar opined that J.D.
    appeared to be mentally ill and gravely disabled and is impaired in autonomous judgment
    and capacity. She recommended that J.D.’s conservatorship be continued, that he be
    committed to a community care facility, and that the conservator be granted the power to
    consent to treatment on his behalf, to include administration of antipsychotic, neuroleptic,
    and/or psychotropic medications.
    J.D. testified at the contested hearing.3 He had been living at a board and care
    facility for approximately one- and one-half years. At the facility, J.D. was permitted to
    come and go as long as he returned by 7:00 p.m. every night. He had never violated the
    curfew. If no longer subject to a conservatorship, J.D. would choose to live with his
    parents or “stay in a motel until [he could] get [his] own place.” He had not spoken to his
    3      Repeatedly during J.D.’s testimony, his responses appear to reflect that he had
    trouble understanding the question. For instance, when asked where he resided, if he was
    taking medication for mental illness, how long he had been in compliance with his
    medication, whether he had a mental illness, whether he had been hospitalized since his
    conservatorship began, and more, J.D. answered “I’m sorry?” or “I’m sorry, what?”
    before answering the question. County counsel commented on the issue: “One concern,
    however, and it may not be captured by the reporter’s transcript, is the hesitancy in—I
    interpret confusion, demonstrated by [J.D.] to answer simple questions asked by, both,
    counsel and myself.”
    6.
    parents about living with them and had never lived in a hotel before. To find a place to
    live more permanently, J.D. would get a “newspaper and look[] for an address for a
    realtor [to] see what they had.” J.D. understood that he would have to pay for housing.
    He planned to spend about $1,000 per month of his $3,100 veteran’s disability check on
    housing. J.D. had lived on his own for a couple years in the past and knew how to create
    a budget. He anticipated spending $200 per month on food and $200 per month on
    clothing. He knew that he could buy groceries at a supermarket and clothing at a
    department store. J.D. had previously grocery shopped and cooked for himself. He could
    cook pancakes, hot dogs, and hamburgers for himself. He understood that he needed to
    eat three meals per day.
    J.D. had not contacted the Department of Veterans Affairs since being subject to
    the conservatorship. However, he knew that he had been to the Fresno office once before
    and planned to go there using public transportation. J.D. did not currently have a bus
    pass but he understood that he could obtain a bus pass through the county’s mental health
    office.
    J.D. understood that he had a mental illness, specifically “bipolar schizoaffective”
    disorder. J.D. could recognize when his symptoms began to become overwhelming. He
    would get “kind of worked up.” But that symptom had not occurred frequently in the last
    year because he was taking the “good meds.”
    J.D. took medication for his mental illness. He took that medication twice per day,
    at 8:00 a.m. and 5:00 p.m. He had been voluntarily taking his medication for “a long
    time” and would continue to do so if no longer subject to a conservatorship. Prior to his
    conservatorship, J.D. was hospitalized “quite a few times.” Since he began his
    conservatorship, he had not been hospitalized pursuant to section 5150. If no longer
    subject to a conservatorship, he would take steps to keep himself stable. He would go to
    the county’s mental health office and talk to a psychiatrist to obtain a prescription for
    medication and fill the prescription at a supermarket that contained a pharmacy. He had
    7.
    gone to a supermarket to fill a prescription once before. He did not presently have an
    account at a pharmacy, but he expressed that “hopefully, [he was] going to get it going.”
    J.D. planned to walk or take the bus to the supermarket to obtain his medication.
    J.D. explained that he wanted to no longer be subject to the conservatorship
    because it had been ongoing for four years, he had done a good job at the board and care
    facility, and he was ready to move on. He explained that he originally accepted the
    conservatorship because he had been living on the street for 10 months.
    On that record, the trial court found that “[e]vidence beyond a reasonable doubt
    establishe[d] that [J.D. was] gravely disabled as a result of a mental disorder. [¶] And
    “[c]lear and convincing evidence establishe[d] that [J.D. did] not have the capacity to
    give informed consent to treatment specifically related to his grave disability ….” The
    trial court explained that J.D. had a mental disability that resulted in him being unable to
    take care of himself outside of a structured environment. The court was “not convinced
    that [J.D.] ha[d] a viable plan for self-care [and therefore concluded] [t]hat [J.D.]
    remain[ed] in need of … conservatorship” and that the care plan then in place was the
    least restrictive sufficient to meet his mental health needs. The court therefore extended
    J.D.’s conservatorship for one year and approved the individual treatment plan filed on
    May 28, 2021. The trial court’s written order further reappointed the county as
    conservator and granted the county the power to require J.D. to “[r]eceive treatment
    related specifically to remedying or preventing the recurrence of [J.D.’s] being gravely
    disabled, including antipsychotic/neuroleptic/psychotropic medication.” The trial court
    suspended J.D.’s right to refuse treatment for the same.
    DISCUSSION
    J.D. contends that substantial evidence does not support the trial court’s
    conclusions that he was gravely disabled and that he lacked the capacity to give informed
    consent to treatment of his mental health disorder with psychotropic medication. The
    county disagrees, as do we.
    8.
    I. Gravely Disabled
    Under the LPS Act, “[w]hen a treatment professional determines a person is
    gravely disabled and unwilling or unable to accept treatment voluntarily, the county’s
    public guardian may petition to establish a conservatorship.” (Conservatorship of Eric B.
    (2022) 
    12 Cal.5th 1085
    , 1095, citing § 5352.) A person is considered “ ‘gravely
    disabled’ ” when he or she, “as a result of a mental health disorder, is unable to provide
    for his or her basic personal needs for food, clothing, or shelter.” (§ 5008,
    subd. (h)(1)(A);4 see Conservatorship of Carol K. (2010) 
    188 Cal.App.4th 123
    , 134, 135
    [grave disability standard is disjunctive, meaning evidence of inability to provide food,
    clothing, or shelter suffices].) If the trial court concludes beyond a reasonable doubt that
    a person is gravely disabled, it appoints a conservator to provide individualized treatment,
    supervision, and placement (§§ 5350, 5350.1), imposes “disabilities” as needed (§ 5357),
    and determines the “least restrictive alternative placement …” (§ 5358, subd. (a)(1)(A)).
    (See Eric B., at pp. 1095–1096.)
    An LPS conservatorship of a gravely disabled person automatically expires after
    one year. (§ 5361.) Thereafter, the conservator may petition to reestablish the
    conservatorship for additional one-year periods. (Ibid.) The focus of an LPS
    conservatorship reappointment is “on a conservatee’s current needs and condition.”
    (Conservatorship of Ben C. (2007) 
    40 Cal.4th 529
    , 543; accord, § 5361 [to reappoint a
    conservator, “two physicians or licensed psychologists” must opine “that the conservatee
    is still gravely disabled as a result of [a] mental disorder”], italics added.)
    On review, “we apply the substantial evidence standard to determine whether the
    record supports a finding of grave disability. The testimony of a single witness may be
    sufficient to support such a finding. [Citation.] We review the record as a whole in the
    4     An alternate method of proving a person is gravely disabled is provided by statute.
    (§ 5008, subd. (h)(1)(B).) It is not at issue in this case.
    9.
    light most favorable to the trial court judgment to determine whether it discloses
    substantial evidence. Substantial evidence, which is evidence that is reasonable, credible,
    and of solid value, also includes circumstantial evidence.” (Conservatorship of Carol K.
    (2010) 
    188 Cal.App.4th 123
    , 134.) In reviewing the record for substantial evidence, we
    presume the existence of every fact that the trier of fact could have reasonably deduced
    from the evidence. (People v. Johnson (1980) 
    26 Cal.3d 557
    , 576.) But we do not
    resolve conflicts in the evidence or reweigh the evidence, nor do we reevaluate the
    credibility of witnesses, as “those functions are reserved for the trier of fact.” (People v.
    Riley (2015) 
    240 Cal.App.4th 1152
    , 1163.)
    As a preliminary matter, J.D. admitted below that he suffers from a mental
    disorder. He does not contest that portion of the trial court’s finding. Instead, he argues
    that Clar’s report is “flawed to the extent it cannot be considered credible” regarding
    J.D.’s ability to provide for his basic needs. Specifically, J.D. first contrasts the portion
    of Clar’s report that indicates J.D. demonstrated “fair insight into his mental illness” with
    her later conclusion in the same report that “[h]e display[ed] no insight into his mental
    illness or need for mental health treatment.” Second, he argues that Clar’s conclusion
    that J.D.’s “ ‘prognosis for improvement remains poor’ ” was inconsistent with her
    finding that J.D. had “fair insight into his mental illness” and was knowledgeable about
    his medications and their purposes and effects. Third and finally, J.D. argues that Clar’s
    opinions that J.D. was unable to provide food, shelter, and clothing for himself were at
    odds with J.D.’s presentation in the courtroom such that Clar’s report was not credible
    and could not constitute substantial evidence.
    The county responds that acceptance of J.D.’s argument would require us to do
    that which we are not permitted to do, reweigh the evidence and substitute our own
    judgment for that of the trial court.
    Again, our role is to determine whether the trial court’s conclusions were
    supported by substantial evidence—we determine whether, in the light most favorable to
    10.
    the court’s decision, the evidence in support of the decision was capable of being
    credited, if so, we affirm even if a rational trier of fact could have reached a different
    decision. Here, even though Clar’s report contained some inconsistency regarding J.D.’s
    level of insight into his mental illness, it was not so flawed as to be entirely unworthy of
    credit. Clar described J.D.’s ongoing paranoia, compromised judgment in financial
    matters, and inability to prepare a viable plan for self-care, including specific details
    regarding how he would obtain food or medication or how he planned to comply with
    future treatment needs. Beyond that which J.D. told Clar regarding his self-care plan
    upon release, his testimony regarding his self-care plan included his planned
    transportation method, but provided little additional detail. The trial court agreed, stating
    that “while [J.D.] was able to describe a general budget and what things would cost, …
    all of his answers were fairly vague.” The trial court acknowledged J.D.’s apparent
    increased capacity to respond to questions since the interview, but also noted J.D.’s
    symptoms in the past year and echoed Clar’s concern that J.D. would be “unable to
    actually follow through and take care of himself … outside of a structured environment.”
    Accordingly, the court was “not convinced that [J.D.] ha[d] a viable plan for self-care.”
    The trial court found Clar’s report to be reliable and credible. J.D.’s arguments
    provide no basis to disturb that finding. (See Conservatorship of S.A. (2020) 
    57 Cal.App.5th 48
    , 55 (S.A.).) The trial court’s conclusion that J.D. was gravely disabled
    was supported by substantial evidence.
    II. Powers and Disability Regarding Consent Psychiatric Treatment
    The trial court found by “[c]lear and convincing evidence … that [J.D. did] not
    have the capacity to give informed consent to treatment specifically related to his grave
    disability ….” It therefore granted the county “the power to require [J.D.] to … [¶] …
    [r]eceive treatment related specifically to remedying or preventing … recurrence of [his]
    being gravely disabled, including antipsychotic/neuroleptic/psychotropic medication” and
    imposed a disability on J.D., suspending his right to refuse the same. J.D. contends this
    11.
    order was not supported by substantial evidence “and … was not even recommended by
    the” county’s evidence. We disagree.
    “A competent adult has the right to refuse medical treatment, including the right to
    refuse psychotropic drugs. [Citation.] A court’s determination that a conservatee is
    gravely disabled does not, by itself, justify imposing an order allowing involuntary
    medication. [Citations.] [An LPS c]onservator[] may seek added authority over [a]
    conservatee[], including a limitation on the conservatee’s right to refuse medical
    treatment. The [LPS Act] refers to medication authority as imposing a ‘disabilit[y]’ on
    the conservatee. (§ 5357, subd. (d).)” (S.A., supra, 57 Cal.App.5th at p. 55.) In order for
    a trial court to impose a disability, suspending a gravely disabled conservatee’s right to
    refuse psychiatric treatment, the conservator must prove by clear and convincing
    evidence that the conservatee is incompetent to give or withhold informed consent.
    (Riese v. St. Mary’s Hospital & Medical Center (1987) 
    209 Cal.App.3d 1303
    , 1322–
    1323; S.A., at pp. 55–56.) The factors to be considered in determining a conservatee’s
    mental capacity to give or withhold consent include “whether the conservatee lacks
    mental capacity rationally to understand the nature of the medical problem, the proposed
    treatment, and its attendant risks.” (S.A., at p. 56.)
    On review of an order imposing an involuntary psychiatric treatment disability, we
    “must determine whether the record contains substantial evidence from which a
    reasonable trier of fact could have made the finding of high probability demanded by this
    clear and convincing standard of proof. [Citation.] We do not reweigh evidence.
    [Citation.] We presume in favor of the judgment the findings of fact necessary to support
    it.” (S.A., supra, 57 Cal.App.5th at p. 56.) “There is no statutory requirement the court
    make an express finding of decisional incapacity. [Citation.] If sufficient evidence
    supports the need for involuntary medication, the lack of express reasoning on the record
    is not enough to support reversal.” (Id. at p. 57.)
    12.
    First, regarding J.D.’s capacity to understand the nature of his mental health
    condition, the trial court had before it Clar’s report and J.D.’s testimony. As we noted
    above, Clar’s report somewhat inconsistently described that J.D. had “fair insight into his
    mental illness,” in one section of the report, but had “no insight into his mental illness or
    need for mental health treatment” in another section of the report. Beyond those
    characterizations of J.D.’s level of insight, the report described J.D.’s behavior and Clar’s
    observations and conclusions. For instance, it described that J.D. “presented as confused
    at times, as he provided responses that were out of context to past, present, and future”;
    required repetition and rewording of questions to understand; “demonstrated anxious
    behavior”; was at times not responsive to inquiries, in one instance responding, “yeah,” to
    a question that did not seek a yes or no answer; appeared unable to concentrate on
    inquiries; reported having ongoing paranoia; and was “often quiet and did not participate
    in feedback regarding a future plan to comply with treatment.” Clar opined that J.D.’s
    “autonomous judgment and capacity [we]re … impaired.” J.D.’s testimony demonstrated
    similar limitations, such as repeatedly answering questions with, “I’m sorry, what?” (or
    variations on that response) before giving a substantive answer. The trial court was in the
    best position to assess J.D.’s testimony and any limitations apparent from his responses.
    While the record contains evidence from which the trial court could perhaps have found
    that J.D. understood the nature of his conditions, the record before us contains sufficient
    evidence to support the trial court’s implied finding that there was a high probability J.D.
    lacked the capacity to understand his mental illness.
    Second and third, as to whether J.D. understood the nature of the proposed
    treatment and the attendant risks, again the trial court had before it Clar’s report which
    stated that J.D. “was knowledgeable in the various psychotropic medications he [was]
    administered[ and] demonstrated understanding the purpose of the medication[s] and how
    they affect him[,]” but also opined that J.D. was “incapab[le of] provid[ing] adequate
    informed consent to receive antipsychotic medication(s),” in the section of her report on
    13.
    “current indices of grave disability” and his “disabilities are such that capacity for
    informed consent and voluntary participation in treatment are significantly limited” in the
    section of her report entitled “recommendations.” (Capitalization modified.) Also
    relevant to J.D.’s capacity to understand the nature and risks of his treatment, Clar’s
    report opined that J.D.’s autonomous judgment and capacity are impaired; when Clar
    asked of J.D.’s plan for self-care upon release, J.D. “was often quiet and did not
    participate in [discussion] regarding a … plan to comply with treatment”; and “[h]e
    presented as confused at times, as he provided responses that were out of context to past,
    present, and future.” Further, J.D. testified regarding his medications and symptoms.
    With regard to his medications, he referred to taking “good meds” and that they reduced
    his symptoms, and the times each day that he took medication. With regard to his
    symptoms, J.D. described only that he “get[s] kind of worked up.” That understanding of
    his symptoms stands in contrast to Clar’s description of J.D.’s symptoms at the time of
    the interview—paranoia and anxiety; previously, when unmedicated, “psychotic
    symptoms to the point of aggression, paranoia[,] and suicidal intent.” In light of the
    evidence before the trial court and the court’s comment on the vagueness of J.D.’s
    answers at the hearing, sufficient evidence was contained in the record to support the
    court’s implied findings that a high probability existed J.D. did not have the capacity to
    understand the nature of the proposed treatments and the attendant risks. The fact that the
    record contains some evidence inconsistent with those conclusions does not compel a
    contrary outcome.
    In short, while the record contains some conflicting evidence, clear and
    convincing evidence supported the trial court’s finding that J.D. did not have the capacity
    to give informed consent to treatment of his grave disability. We find no error.
    DISPOSITION
    The order is affirmed. All parties to bear their own costs.
    14.
    

Document Info

Docket Number: F083415

Filed Date: 8/18/2022

Precedential Status: Non-Precedential

Modified Date: 8/18/2022