The opinion of the court was delivered by: Murray , J.
Conservatorship of Mary D. CA3
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 This opinion has not been certified for publication or ordered published for purposes of rule 8.1115.
Mary D. appeals from a judgment appointing a Lanterman-Petris-Short (LPS) Act mental health conservator. She contends there is not substantial evidence supporting the finding that she cannot provide for her basic needs for food, clothing, and shelter. We agree and reverse the order appointing the public guardian as Mary's conservator.
FACTUAL AND PROCEDURAL BACKGROUND
Mary, diagnosed as having schizoaffective disorder, was psychiatrically hospitalized four times between July 2008 and May 2010. Each time she was delusional and had not been taking her medications. In May 2010, Mary was again not taking her medications because she did not believe she was ill. She was observed walking down the street, naked from the waist down, masturbating in public. She also claimed her father had sexually abused her and later recanted those allegations. She believed she was Mother Earth, that God was her father, and her actual father was God. A temporary conservator was appointed.
A contested conservatorship hearing was held on October 12, 2010. By that time, Mary had been in transitional placement at Trinity Pines for four months.
Dr. Carolyn Kimura, a psychiatrist with Butte County Behavioral Health, testified as an expert. She became familiar with Mary shortly after Mary moved to Trinity Pines. Dr. Kimura testified that she thought she had met with Mary three or four times -- most recently, the day before Dr. Kimura's testimony.
Dr. Kimura had received no negative reports from the program staff, which the doctor found "hopeful." Mary was being medicated with oral Haldol, injectable Haldol (Decanoate), Depakote and Cogentin. The medications were working well and helped her maintain her stability. She was compliant with her medications, although the administration of medications was supervised. The symptoms of Mary's mental illness, including the delusions and inappropriate behaviors, occurred only when Mary was untreated.
When asked whether Mary was presently able to provide for her own food, clothing and shelter, Dr. Kimura responded, "Well, I think with this structure of the Trinity Pines staff and the day treatment staff, the nursing staff, the case management, I think with all that support she's successful. I would like to see that support continue for at least a year." Based solely on Mary's history of decompensating soon after psychiatric discharge, Dr. Kimura believed Mary would not be able to provide for herself without a conservatorship. When initially asked for her opinion about whether Mary would continue her medications if the court did not establish a conservatorship, Dr. Kimura responded, "with her history of multiple hospitalizations and with her trial a few months ago of not pursuing conservatorship and her failing within a few weeks, I think at this time I would feel much safer with her continuing conservatorship for at least a year just to ensure that she has someone to fall back on if things start to deteriorate for her." (Italics added.) When asked whether "as of right now . . . with the medication working" [Mary] would be able to provide for her own food, clothing, or shelter or obtain assistance to get those three items," Dr. Kimura testified, ". . . I've met with [Mary] . . . three times and maybe the fourth just yesterday. And the majority of the time she would like to have her meds decreased. She seems to not understand that she has a serious mental illness, and that is the piece that concerns me greatly with regard to future stability." Dr. Kimura testified that Mary's "lack of insight, denying that she had a mental illness[,] denying that she needed medication[,] thinking that the medications were street drugs" has been a "major concern." However, Dr. Kimura did not say how recently Mary had said she wanted to decrease her medications or otherwise had demonstrated a lack of insight into her mental health.
Case manager Holly Massie reported Mary was doing fairly well in the transitional program. Massie had been working with Mary for three months during the most recent temporary conservatorship and had worked with her for six months in 2009 when Mary was placed in a temporary conservatorship. In 2009, when Mary was discharged from the hospital, she was living in an apartment complex, had two jobs and was doing well. Conservatorship proceedings were dismissed. She started requesting a decrease in her medication, stopped taking her Decanoate shot and decompensated. Within a year, she lost her housing and was conserved again.
Massie testified that the Trinity Pines program involves working with patients on an individually tailored case plan involving independent living skills that includes self-care, care for the patient's housing, budgeting, and cooking. The patient must maintain the skills taught in each component for 30 days and continue to maintain those skills as he or she progresses through the remaining components of the program. While Mary was in the program, Massie received monthly progress reports on Mary and they met once a month.
Mary was currently compliant with her medications. She had not refused to take them. According to Massie, she was also compliant with her case plan and had completed and maintained three of the four program components.*fn1 She only needed to prepare an exit ...