People v. Shadan CA6

Filed 2/7/23 P. v. Shadan CA6
NOT TO BE PUBLISHED IN OFFICIAL REPORTS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 This opinion has not been certified for publication or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
SIXTH APPELLATE DISTRICT
THE PEOPLE, H049426
(Santa Clara County
Plaintiff and Respondent, Super. Ct. No. CC513277)
v.
CYRUS LAWRENCE SHADAN,
Defendant and Appellant.
I. INTRODUCTION
Defendant Cyrus Lawrence Shadan appeals from the trial court’s order revoking his
outpatient mental health status (Pen. Code, § 1608),1 after he was found not guilty by reason
of insanity in 2006 to several charges.
Defendant raises three challenges to the trial court’s revocation order. First, he
challenges application of section 1608 to his revocation hearing, asserting that “[t]o the
extent section 1608 permits incarceration instead of outpatient treatment for a patient who
was once deemed safe for the community, without additional proof of dangerousness, it is
not in accord with Supreme Court precedent and is a violation of [defendant’s] due process
rights.” Second, defendant asserts that the trial court’s ruling was “based on an erroneous
interpretation of material facts,” asserting that the trial court gave too little weight to the
1 All further statutory references are to the Penal Code unless otherwise indicated.
defense witness’s testimony and too much weight to testimony from the prosecution’s
witnesses. Finally, defendant alleges that his constitutional equal protection right was
violated, contending (as he did in his first issue) that patients found not guilty by reason of
insanity should not have their outpatient status revoked unless the trial court finds the
patient represents a danger to others.
For reasons that we will explain, we affirm the trial court’s order.
II. BACKGROUND
A. The Charges and Pleas
In December 2005, Santa Clara police responded to a report that defendant stabbed
his mother in the shoulder. As a result of this incident, d efendant was charged by complaint
with assault with a deadly weapon (§ 245, subd. (a)(1); count 1), battery causing serious
bodily injury (§§ 242-243; count 2), criminal threats (§ 422; count 3), attempting to dissuade
a witness (§ 136.1, subd. (b)(2); count 4), and misdemeanor resisting arrest (§ 148,
subd. (a)(1); count 5). The complaint also alleged that defendant personally used a deadly
and dangerous weapon as to counts 1, 3, and 4 (§§ 667, 1192.7, 12022, subd. (b)(1)) and
that he personally inflicted great bodily injury as to counts 1 and 2 (§§ 667, 1192.7, 1203,
subd. (e)(3), 12022.7, subd. (a)). The complaint further alleged that defendant had suffered
a prior strike conviction. (§§ 667, subds. (b)-(i), 1170.12.) Defendant pleaded no contest
and admitted the allegations, and also pleaded not guilty by reason of insanity to these
charges. After defendant was evaluated by mental health practitioners, he withdrew his no
contest pleas to counts 2 and 4, and on motion of the prosecutor, the court dismissed these
counts. The trial court found defendant not guilty by reason of insanity on the remaining
counts, and it referred defendant to the South Bay Conditional Release Program (CONREP)
for an evaluation.
B. Defendant’s Mental Health Treatment
On October 17, 2006, the trial court, acting on South Bay CONREP’s
recommendation, found that defendant had not fully recovered his sanity and ordered
2
defendant committed to the State Department of Mental Health (now the State Department
of State Hospitals) for placement, care, and treatment pursuant to section 1026.2 The trial
court also set defendant’s maximum term of commitment under section 1026.5.
Defendant remained in inpatient care at a state hospital until 2008. At that point, the
hospital director certified that defendant had improved such that he would no longer
represent a danger to the health and safety of others while in outpatient status, and that
defendant would benefit from being in outpatient status. Accordingly, the trial court granted
defendant outpatient status under section 1604, under the supervision and treatment of South
Bay CONREP. The trial court later ordered defendant transferred from South Bay
CONREP to Sonoma County CONREP. For the next several years, the trial court approved
one-year extensions to defendant’s outpatient commitment, each time finding that defendant
continued to suffer from a mental illness and would represent a danger to the health and
safety of others without involuntary outpatient treatment.3
In May 2014, however, the trial court temporarily revoked defendant’s outpatient
status and ordered defendant placed in a state hospital. The trial court took this action on
the recommendation and request of Sonoma County CONREP, with the agreement of
defendant’s counsel. Later that year, CONREP petitioned the trial court to fully revoke
defendant’s outpatient status, alleging that defendant’s mental health condition had not
stabilized and he remained uncooperative with outpatient treatment and supervision. The
2 In pertinent part, section 1026 provides: “Prior to making the order directing that
the defendant be committed to the State Department of State Hospitals or other treatment
facility or placed on outpatient status, the court shall order the community program director
or a designee to evaluate the defendant and to submit to the court within 15 judicial days of
the order a written recommendation as to whether the defendant should be placed on
outpatient status or committed to the State Department of State Hospitals or other treatment
facility.” (§ 1026, subd. (b).)
3 Outpatient status “shall be for a period not to exceed one year.” (§ 1606.)
Following the one-year period, the trial court may extend a person’s outpatient commitment
for up to an additional year following notice and a hearing. (Ibid.)
3
trial court granted the petition in November 2014, fully revoking defendant’s outpatient
status and committing defendant to Napa State Hospital.
In 2018, defendant petitioned the trial court to transfer him back to outpatient status.
Following a hearing, the trial court granted defendant’s petition for transfer to outpatient
treatment, ordering defendant released to South Bay CONREP. In July 2020, however, the
trial court approved a request to temporarily revoke defendant’s outpatient status again,
ordering defendant committed to Napa State Hospital. South Bay CONREP made this
request because it determined defendant had shown “increased paranoia, delusional
thinking, anxiety, rumination, agitation and sleep irregularities” over several weeks, because
he “engaged in aggressive communication (i.e. yelling and cursing) at housemates and room
and board staff,” because defendant had “limited insight into how his mental illness impacts
his aggressive acts,” and because defendant had violated CONREP conditions by
communicating with his father outside of supervised contacts and then lying about it and by
visiting pornographic sites on his cell phone. Defendant was not actually placed in Napa
State Hospital until October 2020, where he remained in inpatient care until the revocation
hearing that is the subject of this appeal.
C. The Revocation Hearing
In January 2021, South Bay CONREP petitioned the trial court to fully revoke
defendant’s outpatient status, beyond the temporary revocation the court had already
approved. South Bay CONREP’s request asserted that defendant’s behavior warranted
continued hospitalization because defendant was “not responding well to the established
treatment modality resulting in further increasing risk of harm to others,” and defendant had
not successfully accomplished any of his established treatment goals.4 The request cited
4 South Bay CONREP’s request to revoke defendant’s outpatient status also cited an
incident in which defendant’s father allegedly made a threat over the telephone against Napa
State Hospital. Defendant moved at the revocation hearing to exclude any evidence of
defendant’s father’s statement, and the prosecution agreed not to elicit such evidence.
4
section 1608 as its basis. Section 1608 provides that an outpatient treatment supervisor may
file a request with the trial court to revoke a patient’s outpatient status if “the person
requires extended inpatient treatment or refuses to accept further outpatient treatment and
supervision . . . .”5 South Bay CONREP’s request alleged that defendant “remains a danger
to himself and can no longer be safely treated in the community,” and thus South Bay
CONREP requested the court revoke defendant’s outpatient status.
The hearing on the revocation request took place on June 17 and June 21, 2021.
During the hearing, the parties and the court repeatedly discussed the relevance of evidence
concerning defendant’s potential dangerousness. For instance, in preliminary discussions
regarding whether evidence of defendant’s criminal history could be introduced, the
prosecutor argued: “What I have to prove is that [defendant] either needs the extended
inpatient treatment, or that he does not want outpatient treatment. So is risk assessment is
[sic] relevant? I think it is.” Later, in ruling on a defense objection to a question about
whether defendant posed a risk of harm to others, the trial court suggested that defendant’s
5 In full, section 1608 provides: “If at any time during the outpatient period, the
outpatient treatment supervisor is of the opinion that the person requires extended inpatient
treatment or refuses to accept further outpatient treatment and supervision, the community
program director shall notify the superior court in either the county which approved
outpatient status or in the county where outpatient treatment is being provided of such
opinion by means of a written request for revocation of outpatient status. The community
program director shall furnish a copy of this request to the defense counsel and to the
prosecutor in both counties if the request is made in the county of treatment rather than the
county of commitment. [¶] Within 15 judicial days, the court where the request was filed
shall hold a hearing and shall either approve or disapprove the request for revocation of
outpatient status. If the court approves the request for revocation, the court shall order that
the person be confined in a state hospital or other treatment facility approved by the
community program director. The court shall transmit a copy of its order to the community
program director or a designee. Where the county of treatment and the county of
commitment differ and revocation occurs in the county of treatment, the court shall enter the
name of the committing county and its case number on the order of revocation and shall
send a copy of the order to the committing court and the prosecutor and defense counsel in
the county of commitment.” (§ 1608.)
5
risk could be relevant to the question of what type of treatment defendant required.
Additionally, in rebuttal argument, the prosecutor noted that while the question of whether
defendant presented a risk of violence was “definitely relevant,” “it’s not exactly what I
need to prove.” Despite this, defendant did not raise any constitutional concerns with the
fact that section 1608 does not require a showing that defendant was dangerous in order to
revoke his outpatient status.
Two South Bay CONREP witnesses testified: Eloy Jimenez, Jr., a group counselor
and coordinator; and Ramiro Carrillo, community programs director. Jimenez testified that
he worked with defendant and saw defendant three to four times a week while defendant
was in outpatient treatment in 2019 and 2020. Jimenez testified that defendant’s
presentation “[f]luctuated quite frequently,” and that defendant had to be removed from
therapy groups “[m]ultiple times” due to difficulty regulating his emotions in the group
sessions. Jimenez described a time when defendant called him using “pressured speech”
about wanting to start an intimate relationship with the only female in the board and care
facility. Jimenez also testified that although there were times when defendant was more
collected and participated productively in therapy groups, defendant would then regress.
Jimenez offered his opinion that defendant was not amenable to outpatient treatment
because he “self-victimizes” and “everything around him is triggering.”
On cross-examination, Jimenez stated that he had not interacted with defendant for
more than a year, that Jimenez had reviewed no records from defendant’s latest time in
inpatient treatment, and that Jimenez was not aware what progress defendant had made in
inpatient treatment or what defendant’s mental condition was at the time of the hearing.
Jimenez also testified on cross-examination that he was not actually present for several
interactions with defendant that Jimenez had testified to, and that Jimenez was just
conveying what others wrote in notes about these interactions. Based on this latter issue, the
trial court denied a motion to strike Jimenez’s testimony as hearsay, but the trial court stated
it would not give this portion of Jimenez’s testimony “much weight.”
6
Carrillo testified as an expert in the diagnosis and treatment of mental disorders, in
assessing the risk of harm that someone poses to others, and in determining amenability for
outpatient treatment and the appropriateness of revocation. Carrillo testified that defendant
was diagnosed with schizoaffective disorder, bipolar type, which can cause symptoms that
include hallucinations, delusions, paranoia, disorganized or rapid thoughts, and difficulty
with impulse control. Carrillo opined that defendant required extended inpatient treatment
as opposed to outpatient treatment, because defendant lacked insight into his mental illness,
because defendant violated “numerous” terms and conditions while in outpatient treatment,
and because defendant was unwilling to work with his treatment team.
On cross-examination, Carrillo acknowledged that he had never met defendant or
spoken to him, and that Carrillo’s knowledge of defendant was based solely on a review of
defendant’s records. Carrillo also testified that the most recent report he had reviewed
concerning defendant’s progress was from March or April 2021, and that Carrillo had not
spoken with any mental health professional at Napa State Hospital in the previous six
months about defendant’s present insight or willingness to work within the CONREP
system while in outpatient status.
Defendant called one witness, Amelia Hughes, a licensed clinical social worker at
Napa State Hospital. Hughes testified that defendant was one of the patients in Hughes’s
unit, and that she saw defendant at least two times a week in the hospital. She testified that
she saw no aggressive or high-risk behaviors, verbal or physical aggression, property
damage, need for seclusion or restraints, escape attempts, unit rule violations, sexually
inappropriate behavior, self-injury or suicidal behaviors, or intrusive or disruptive behavior
from defendant during that time. Hughes testified about several actions she observed that
indicated defendant could function in outpatient treatment. She testified that defendant
complied with taking his medication in the hospital. She stated that defendant showed an
improved understanding of how to interact with his family, including defendant’s father,
whose relationship with defendant had been “very turbulent” and a “huge trigger” for
7
defendant. Hughes testified that defendant had done well in substance abuse treatment for
his previous marijuana use. She also stated that defendant took ownership of the issues that
prompted his return to inpatient treatment. Hughes thus expressed her belief that defendant
“would be safe under the supervision of CONREP,” and that defendant does not pose a
“high risk” in the community.
On cross-examination, Hughes stated that as a social worker, her role is to
“advocate” for her clients at Napa to help them reach their goals, provided that the goals are
“within reason.” She stated that typically, a patient would need to be moved to a discharge
unit before Napa State Hospital would recommend the patient’s release to outpatient
treatment, and that defendant was not in a discharge unit. Hughes testified that defendant’s
treatment team believed that none of the objectives for defendant’s treatment were fully met,
with most of the objectives partially met and one objective not met at all. Hughes stated that
her opinion that defendant was ready for release to outpatient treatment was her own, not the
opinion of the Napa State Hospital treatment team. She testified that she did not disagree
with the treatment team’s conclusion that defendant’s discharge criteria were not fully met,
but added, “I certainly have my own [opinion], which I think was made clear, but I can have
both, right?”
Finally, defendant testified on his own behalf. Defendant stated that he has been
diagnosed with schizoaffective disorder, bipolar type, and that he has suffered from
paranoia, delusions, mania, and depression. He testified that while at Napa State Hospital,
he had been attending several group sessions, learning how to use his coping skills, and
developing a relapse prevention plan. Defendant stressed that he had not been cited for any
rule violations since joining Hughes’s inpatient unit, that he was clean from his previous
marijuana use and was attending Marijuana Anonymous, and that he had not committed any
violent acts during his previous outpatient treatment periods. He testified that if released to
outpatient care, he would reach out to his treatment team if he needed support, follow his
relapse prevention plan, obey outpatient terms and conditions, attempt to improve his
8
relationship with his father, and continue to remain compliant with his medication
instructions.
Defendant also described conditions that displeased him at two board and care homes
he had stayed at before returning to inpatient care, and stated that if he encountered similar
conditions upon being released to outpatient treatment, he would attempt to advocate for
himself to get the conditions improved. He testified that he was “optimistic” and hoped
“there is a change within the program.” On cross-examination, defendant stated that if
conditions were not better in some respects, he would “probably” not want to be in
CONREP, though he hoped living conditions would improve. He also acknowledged
breaking some curfew conditions of the board and care home.
The trial court granted the request to revoke defendant’s outpatient status. The court
noted that under section 1608, the prosecution was required to prove by a preponderance of
the evidence either that defendant required extended inpatient treatment, or that the
defendant refused to accept further outpatient treatment and supervision. The trial court
then issued the following findings: “Specifically, the [c]ourt finds [defendant] requires
extended inpatient treatment. Based on this finding, the [c]ourt did not find it necessary to
rule on whether [defendant] refuses to accept further outpatient treatment and supervision.
However, if necessary, the [c]ourt did not think that alternative was satisfied.” The trial
court also noted that Hughes testified that defendant was not in the discharge unit, that
Hughes had recently agreed with the treatment team that defendant was not ready for
discharge, and that defendant had only partially met his discharge criteria. The court
concluded concerning Hughes: “This testimony was inconsistent with her direct testimony
that she believed [defendant] was ready to be discharged. These inconsistences were not
specifically addressed or reconciled. This had an impact on her credibility and the weight of
her testimony.” The court also found the testimony from Jimenez and Carrillo credible.
9
Defendant timely filed a notice of appeal challenging the trial court’s order. 6
III. DISCUSSION
A. Due Process/Equal Protection Violation
Defendant challenges the application of section 1608 to his case on two constitutional
grounds. Both challenges concern the fact that section 1608 does not require a showing that
a patient represents a danger to others in order to revoke the patient’s outpatient status.
Defendant first challenges the statute on due process grounds. Defendant cites Foucha v.
Louisiana (1992) 504 U.S. 71 for the proposition that to be civilly committed, a person must
be shown to be mentally ill and to require hospitalization for the person’s own welfare and
the protection of others. He cites Jones v. United States (1983) 463 U.S. 354 in arguing that
a committed acquittee is entitled to release when the person has recovered his or her sanity
or is no longer dangerous. As we understand his argument, defendant states that these
authorities require a finding of dangerousness in order to revoke defendant’s outpatient
status, relying upon People v. Beck (1996) 47 Cal.App.4th 1676 for this position.
Defendant’s equal protection argument asserts that persons who are civilly
committed to a mental health institution and mentally disordered offenders are entitled to
treatment provided in ways “that are least restrictive of the personal liberty of the
individual.” (Welf. & Inst. Code, § 5325.1, subd. (a).) He argues that he is similarly
situated to persons facing civil commitment and mentally disordered offenders, and thus he
is entitled to treatment in the least restrictive environment. As part of his equal protection
argument, defendant also asserts that the trial court was required to make its own decision as
to whether to revoke defendant’s outpatient status, and the court should have declined to
revoke defendant’s outpatient status where there was no evidence that defendant presented a
danger to others.
6 “Orders denying outpatient status are appealable under section 1237,
subdivision (b) (orders after judgment affecting the substantial rights of a party).
[Citation.]” (People v. Sword (1994) 29 Cal.App.4th 614, 619, fn. 2.)
10
Section 1026 provides that if the trier of fact “finds the defendant was insane at the
time of the offense, the trial court shall commit the defendant to a state hospital or other
appropriate public or private facility for the care and treatment of the mentally disordered,
or place the defendant on outpatient status pursuant to section 1600 et seq. (§ 1026,
subd. (a); [citations.].” (People v. Dobson (2008) 161 Cal.App.4th 1422, 1431.)
“Subsequent release from a state hospital after an insanity commitment occurs upon
(1) restoration of sanity pursuant to section 1026.2, (2) expiration of the maximum term of
commitment under section 1026.5, or (3) approval of outpatient status under section 1600 et
seq. [Citation.]” (People v. Cross (2005) 127 Cal.App.4th 63, 72 (Cross).)
“[A] defendant may be placed on outpatient status upon the recommendation of the
state hospital director and the community program director with the court’s approval after a
hearing. (§ 1603; [citation].)” Cross, supra, 127 Cal.App.4th at p. 72. “However,
“ ‘[o]utpatient status is not a privilege given the [offender] to finish out his [or her] sentence
in a less restricted setting; rather it is a discretionary form of treatment to be ordered by the
committing court only if the medical experts who plan and provide treatment conclude that
such treatment would benefit the [offender] and cause no undue hazard to the community.”
[Citation.]’ [Citation.]” (Ibid.)
Once a person has been placed in outpatient status, that status may be revoked under
either section 1608 or section 1609. Section 1609 governs revocation proceedings initiated
by the prosecution, while section 1608 covers requests to revoke a person’s outpatient status
if the outpatient treatment supervisor “is of the opinion that the person requires extended
inpatient treatment or refuses to accept further outpatient treatment and supervision . . . .”
(§ 1608.) “Section 1608 requires a finding that the patient needs extended inpatient
treatment or refuses to accept further outpatient treatment. It does not require the court to
find that the patient is a danger to the health and safety to others.” (People v. DeGuzman
(1995) 33 Cal.App.4th 414, 420 (DeGuzman).)
11
Defendant did not present his due process and equal protection claims to the trial
court, despite raising several motions in limine to the court and even though the question of
whether dangerousness was relevant to these proceedings came up several times during the
hearing. As a general rule, “a party may forfeit [the] right to present a claim of error to the
appellate court if he did not do enough to ‘prevent[]’ or ‘correct[]’ the claimed error in the
trial court . . . .” (People v. Williams (1998) 17 Cal.4th 148, 161, fn. 6.) “The forfeiture
doctrine is a ‘well-established procedural principle that, with certain exceptions, an
appellate court will not consider claims of error that could have been—but were not—raised
in the trial court. [Citation]’ [Citations.] Strong policy reasons support this rule: ‘It is both
unfair and inefficient to permit a claim of error on appeal that, if timely brought to the
attention of the trial court, could have been easily corrected or avoided. [Citations.]’ ”
(People v. Stowell (2003) 31 Cal.4th 1107, 1114.) Defendant forfeited his constitutional
claims by not raising them in the trial court, despite the opportunity to do so and despite the
fact that the cases he cites on appeal in support of his position were all decided well before
his hearing. If defendant had raised these claims to the trial court and if the trial court had
found merit in defendant’s position, the trial court could have received evidence on the
question of defendant’s dangerousness and determined whether defendant presented a
danger to others. Because defendant did not raise these claims in the trial court, we do not
have the benefit of any record on this matter, and we will not consider these issues in the
first instance here.
B. Sufficiency of the Evidence
In reviewing an order revoking outpatient status under section 1608, we uphold the
trial court’s factual findings if supported by substantial evidence. (DeGuzman, supra, 33
Cal.App.4th at p. 420.) The prosecution bears the burden of proof at a revocation of
outpatient status hearing to demonstrate by a preponderance of the evidence that the patient
requires extended inpatient treatment or refuses to accept further outpatient treatment and
supervision. (Id. at pp. 419-420.) We review the trial court’s order regarding outpatient
12
status for an abuse of discretion. (People v. Bartsch (2008) 167 Cal.App.4th 896, 900.)
“Under that standard, it is not sufficient to show facts affording an opportunity for a
difference of opinion. [Citation.] . . . ‘[D]iscretion is abused only if the court exceeds the
bounds of reason, all of the circumstances being considered. [Citation.]’ [Citation.]”
(Cross, supra, 127 Cal.App.4th at p. 73.)
Substantial evidence supports the trial court’s decision to revoke defendant’s
outpatient status. Both CONREP witnesses (whom the trial court found credible) testified
about difficulties defendant had functioning in an outpatient setting and following rules set
forth by South Bay CONREP. While both prosecution witnesses lacked knowledge of
defendant’s subsequent progress in inpatient treatment, even Hughes, the defense witness
who stated her role was to advocate for defendant, acknowledged that Napa State Hospital
did not believe defendant was ready to transition to outpatient status because he was not in a
discharge unit and none of his discharge criteria were fully met.
Defendant contends that the trial court erred when it “failed to consider that the
[prosecutor’s] witnesses had minimal contact with [defendant]” since his outpatient status
was temporarily revoked a year before the hearing. However, the record reveals that the
trial court was aware of this fact and weighed the witnesses’ testimony accordingly. The
trial court articulated that it recognized limitations in the CONREP witnesses’ knowledge
along with issues concerning Hughes’s credibility. For example, the trial court stated it
would not give portions of Jimenez’s testimony that relied solely on case notes “much
weight,” and the trial court also recognized that Carrillo “didn’t talk about any specific
incidents or specific content . . .” concerning defendant. Nonetheless, the trial court found
the testimony from Jimenez and Carrillo credible. The trial court correctly articulated the
burden of proof, issuing findings that the prosecution satisfied its burden of demonstrating
that defendant required extended inpatient treatment, but that the prosecution did not
demonstrate that defendant refused to accept further outpatient treatment and supervision.
The trial court concluded: “Based on the totality of the circumstances and facts presented
13
and giving each witness the weight this [c]ourt finds their testimony deserves, the [c]ourt
finds, by a preponderance of the evidence, that the government has proven” that revocation
of defendant’s outpatient status was proper. The trial court’s findings are supported by
substantial evidence and we find no abuse of discretion in its revocation of defendant’s
outpatient status. (DeGuzman, supra, 33 Cal.App.4th at p. 420.)
IV. DISPOSITION
The order of the trial court granting revocation of defendant’s outpatient status under
Penal Code section 1608 is affirmed.
14
BAMATTRE-MANOUKIAN, ACTING P.J.
WE CONCUR:
DANNER, J.
LIE, J.
People v. Shadan
H049426