Pub. Guardian of L. A. v. K.P. (In re K.P.)

• Citation: 489 P.3d 296,280 Cal.Rptr.3d 298,11 Cal.5th 695
• Decision Date: 28 June 2021
• Docket Number: S258212
• Court: United States State Supreme Court (California)
• Parties: CONSERVATORSHIP OF the Person and Estate of K.P. Public Guardian of Los Angeles, as Conservator, etc., Petitioner and Respondent, v. K.P., Objector and Appellant.

11 Cal.5th 695

489 P.3d 296

280 Cal.Rptr.3d 298

CONSERVATORSHIP OF the Person and Estate of K.P.Public Guardian of Los Angeles, as Conservator, etc., Petitioner and Respondent,

v.K.P., Objector and Appellant.

S258212

Supreme Court of California.

June 28, 2021

Christopher L. Haberman, Visalia, under appointment by the Supreme Court, and Christian C. Buckley, under appointment by the Court of Appeal, for Objector and Appellant.

Mary C. Wickham, County Counsel, Rosanne Wong and Joyce M. Aiello, Assistant County Counsel, Jose Silva, Principal Deputy County Counsel, and William C. Sias, Deputy County Counsel, for Petitioner and Respondent.

Opinion of the Court by Corrigan, J.

The Lanterman-Petris-Short Act (LPS Act or Act; Welf. & Inst. Code, § 5000 et seq. )¹ provides one-year conservatorships for those "gravely disabled as a result of a mental health disorder or impairment by chronic alcoholism

." (§ 5350.)² Those subject to a conservatorship petition are entitled to a court or jury trial to decide if they are "gravely disabled." (§ 5350, subd. (d)(1).) The question here is whether the trier of fact must find, in addition, that the individual is unwilling or unable to voluntarily accept treatment. This is an issue of statutory interpretation on which the Courts of Appeal have differed. We granted review to resolve the conflict and now hold that capacity or willingness to accept treatment is a relevant factor to be considered on the issue of grave disability but is not a separate element that must be proven to establish a conservatorship.

I. BACKGROUND

The Los Angeles County Superior Court established a conservatorship for 23-year-old K.P. in May 2008 and renewed it annually over the next nine years. In April 2018, the county's public guardian (Public Guardian) filed another renewal petition, alleging K.P. remained gravely disabled. This time, K.P. demanded a jury trial.

A psychologist from K.P.’s residential facility testified that he suffered from schizophrenia

, with auditory hallucinations and paranoid delusions. For example, on the morning of trial he asked to enter a witness protection program because he believed a fellow resident was planning to attack him. In another incident, K.P. chased and threatened someone he believed had intentionally hit him with a basketball. He could not be redirected and was hospitalized. K.P. also displayed "grossly disorganized behaviors," lack of motivation, and difficulty speaking and socializing. The psychologist concluded K.P. lacked significant insight into his disorder. He minimized his symptoms and believed they were caused by medications. His mother had expressed the same belief. K.P. resisted taking his prescriptions or participating in therapy and other services. The psychologist concluded K.P. could not provide for his basic needs without medication and did not believe he would take them consistently or correctly without a conservator's supervision. The day before trial, K.P. almost gave himself a double dose of one potentially toxic pharmaceutical. The psychologist believed K.P. needed round-the-clock supervision and lacked the initiative and insight necessary to obtain treatment himself. Although he had opportunities to do so, K.P. had never left the facility without his therapist or mother.

K.P.’s mother understood that he had a mental illness. If he were released from the conservatorship, she testified that she would help him take his medications and attend therapy appointments. She could not provide housing but would help him find a place to live.

K.P. also testified. He had not lived outside a hospital or treatment facility since 2013. After some conflicting answers, he agreed to stay in his current placement until he could find a place to live. K.P.’s mother had previously been his conservator but later became homeless and moved away. K.P. agreed he needed a psychiatrist and said he would see a therapist if released, but he denied having any mental illness. He thought his problems might stem from a childhood brain injury

. K.P. asserted he did better without his psychiatric drugs and said he would not take them if released from the conservatorship. To supplement his Social Security benefits, K.P. planned to become an entrepreneur.

The court gave two Judicial Council of California Civil Jury Instructions (CACI) relevant to the issue here. CACI No. 4000, as given, stated: "The Office of the Public Guardian claims that [K.P.] is gravely disabled due to a mental disorder and therefore should be placed in a conservatorship. In a conservatorship, a conservator is appointed to oversee, under the direction of the court, the care of persons who are gravely disabled due to a mental disorder. To succeed on this claim, the Office of the Public Guardian must prove beyond a reasonable doubt all of the following: [¶] (1) That [K.P.] has a mental disorder; and [¶] (2) That [K.P.] is gravely disabled as a result of the mental disorder."

CACI No. 4002, as given, explained the meaning of "gravely disabled": "The term ‘gravely disabled’ means that a person is presently unable to provide for his or her basic needs for food, clothing, or shelter because of a mental disorder. [¶] Psychosis

, bizarre or eccentric behavior, delusions or hallucinations are not enough, by themselves, to find that [K.P.] is gravely disabled. He must be unable to provide for the basic needs of food, clothing, or shelter because of a mental disorder. [¶] If you find [K.P.] will not take his prescribed medication without supervision and that a mental disorder makes him unable to provide for his basic needs for food, clothing, or shelter without such medication, then you may conclude [K.P.] is presently gravely disabled. [¶] In determining whether [K.P.] is presently gravely disabled, you may consider evidence that he did not take prescribed medication in the past. You may consider evidence of his lack of insight into his medical condition. [¶] In determining whether [K.P.] is presently gravely disabled, you may not consider the likelihood of future deterioration or relapse of a condition. [¶] In determining whether [K.P.] is presently gravely disabled, you may consider whether he is unable or unwilling voluntarily to accept meaningful treatment. " (Italics added.)

K.P. requested a modification of CACI No. 4000 to require, as a separate element, a finding that he was "unwilling or unable voluntarily to accept meaningful treatment." He argued the final sentence of CACI No. 4002 directing the jury's attention to this issue was inadequate because it was "thrown in at the bottom of [a] less consequential later jury instruction." The court denied the request, observing that resistance to voluntary treatment is appropriately considered as an aspect of grave disability but is not a separately required element that must be proven.

The jury found that K.P. was gravely disabled, and the reappointment petition was granted. On appeal, K.P. challenged the refusal to modify CACI No. 4000. The Court of Appeal concluded there was no error. We granted review and now reach the same conclusion.³

II. DISCUSSION

Although couched as a complaint about jury instructions, K.P. essentially claims that a finding of unwillingness or inability to accept voluntary treatment is required for a conservatorship to be established. This is a legal question subject to de novo review. ( John L. , supra , 48 Cal.4th at p. 142, 105 Cal.Rptr.3d 424, 225 P.3d 554 ; see Conservatorship of P.D. (2018) 21 Cal.App.5th 1163, 1167, 231 Cal.Rptr.3d 79.) Our goal in construing the LPS Act is to effectuate the Legislature's intent. ( John L. , at p. 143, 105 Cal.Rptr.3d 424, 225 P.3d 554.) We consider individual statutes in the context of the entire Act so that each part may be harmonized and given effect. (See Moyer v. Workmen's Comp. Appeals Bd. (1973) 10 Cal.3d 222, 230, 110 Cal.Rptr. 144, 514 P.2d 1224 ; Conservatorship of Joseph W. (2011) 199 Cal.App.4th 953, 963, 131 Cal.Rptr.3d 896.)

A. Overview of the LPS Act

The LPS Act has many purposes, including "end[ing] the inappropriate, indefinite, and involuntary commitment of persons with mental health disorders" ( § 5001, subd. (a) ), "provid[ing] prompt evaluation and treatment" (id ., subd. (b)), and "provid[ing] individualized treatment, supervision, and placement services by a conservatorship program" (id ., subd. (e)). The Act defines persons as " ‘gravely disabled’ " if they are unable to provide for basic personal needs of food, clothing, or shelter, as a result of a mental disorder. ( § 5008, subd. (h)(1)(A) ; see § 5350, subd. (e).)

The overall statutory scheme describes a detailed, calibrated system for intervention when circumstances indicate a person may be suffering from a mental health disorder. In addition to conservatorships, the Act permits 3-day, 14-day, and 30-day involuntary detentions for intensive treatment.⁴

1. Chapter 2: Involuntary Detentions

Under chapter 2 of the Act, those gravely disabled by a mental health disorder may be held for up to 72 hours for evaluation and treatment. ( § 5150, subd. (a).) Before such a detention can begin, a professional must assess whether the person "can be properly served without being detained." (Id ., subd. (c).) In such a case, services must be provided "on a voluntary basis."

(Ibid .) After 72 hours, the person may be detained for up to 14 days of intensive treatment if three conditions are met: (1) a professional has found that the person is gravely disabled due to a mental health disorder ( § 5250, subd. (a) ); (2) the facility providing treatment agrees to admit the person (id ., subd. (b)); and (3) the person "has been advised of the need for, but has not been willing or able to accept, treatment on a voluntary basis" (id ., subd. (c)). This 14-day period can be extended by up to 30 days if the professional staff finds that the person remains both gravely disabled and "unwilling or unable to accept treatment voluntarily." ( § 5270.15, subd. (a)(2).)

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