Filed 6/30/26 Conservatorship of M.B. CA4/1
NOT TO BE PUBLISHED IN OFFICIAL REPORTS
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COURT OF APPEAL, FOURTH APPELLATE DISTRICT
DIVISION ONE
STATE OF CALIFORNIA
Conservatorship of the Person of M.B.
SAN DIEGO COUNTY HEALTH AND D085660
HUMAN SERVICES AGENCY,
(Super. Ct. No. MH121-777)
Petitioner and Respondent,
v.
M.B.,
Objector and Appellant.
APPEAL from a judgment of the Superior Court of San Diego County,
Albert Harutunian III, Judge. Affirmed.
Christian C. Buckley, under appointment by the Court of Appeal, for
Objector and Appellant.
David J. Smith, Acting County Counsel and Anjana Pottathil, Deputy
County Counsel, for Petitioner and Respondent.
INTRODUCTION
M.B. appeals from a jury verdict and order finding him gravely disabled
and establishing a conservatorship of his person under the Lanterman-Petris-
Short Act (LPS). (Welf. & Inst. Code,1 § 5000, et seq.) He contends the jury’s
verdict was unsupported by substantial evidence because he had a viable
plan to provide for his basic needs if released into the community. M.B.
concedes that his primary plan to take care of his needs had no chance of
success, but he contends the viability of his alternate plan was not subject to
dispute. Because we are not persuaded, we uphold the trial court’s order
placing his person into conservatorship.2
1 All undesignated statutory references are to the Welfare and
Institutions Code.
2 On June 11, 2026, M.B. asked us to take judicial notice that the one-
year conservatorship over his person had expired on February 4, 2026, and
the parties had stipulated to reestablish the conservatorship. In his motion,
M.B. briefly suggests that the appeal “may be moot” now that the original
conservatorship is no longer in place and that it should potentially be
dismissed.
We grant M.B.’s request for judicial notice, which the Conservator has
not opposed, pursuant to Evidence Code sections 452 and 459. And while we
agree the appeal is technically moot, we exercise our discretion to decide the
issue M.B. has raised on the merits. “Even if a case is technically moot, the
appellate court may nonetheless exercise its discretion to decide the case”
when “there is a distinct possibility that the controversy between the parties
may recur.” (Bullis Charter School v. Los Altos School Dist. (2011)
200 Cal.App.4th 1022, 1033, 1034.) We consider it to be reasonably likely
that the same controversy between the parties—whether the Conservator’s
evidence established that M.B. would be unable to provide for his essential
needs by relying on shelter services if released—will recur in future
proceedings to reestablish the conservatorship. (See generally,
Conservatorship of Joel E. (2005) 132 Cal.App.4th 429, 434.)
2
PROCEDURAL AND FACTUAL BACKGROUND
I.
Petition
On December 23, 2024, the San Diego County Office of the Public
Conservator3 (Conservator) petitioned to establish an LPS conservatorship of
the person of M.B. On January 8, 2025, after a contested hearing, the trial
court appointed a temporary conservator. A few days later, M.B. demanded a
jury trial.
II.
Motion to Exclude Evidence of Third Party Assistance
Section 5350, subdivision (e), provides, “[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 person’s basic personal needs. . . . [¶] However,
unless they specifically indicate in writing their willingness and ability to
help, family, friends, or others shall not be considered willing or able to
provide this help.” In accordance with this code section, the Conservator
moved before trial to exclude evidence that M.B. would be able to manage his
personal needs with third party assistance unless the availability of such
assistance was corroborated in writing. At the hearing on motions in limine,
M.B.’s counsel stated that M.B. did not plan to present evidence of third
3 San Diego County Health and Human Services Agency provides LPS
services through the Office of the Public Conservator under San Diego
County, Administrative Code section 234.
3
party assistance availability. The trial court granted the Conservator’s
motion without further discussion.
III.
Trial
Trial commenced on February 26, 2025. It lasted two and one-half
days.
A. The Conservator’s Evidence
The Conservator called two mental health professionals to testify about
M.B.’s mental health. Anna Litwak was a licensed marriage family therapist
who worked for the Conservator as an LPS investigator. Mohamad Khafaja
was an associate professor and clinical psychiatrist who worked as the
medical director at an inpatient psychiatric unit at the University of
California, San Diego (UCSD). Litwak and Khafaja both opined that M.B.
was gravely disabled as the result of a mental disorder.
Litwak testified she was assigned to M.B.’s case in December 2024
after UCSD referred him for a conservatorship investigation. She conducted
two interviews with M.B., one on December 16, and a second on January 31,
2025. She interviewed M.B.’s brother and his social worker. And she
reviewed M.B.’s medical records, including his previous hospital records.
Litwak described M.B. as a “very pleasant man,” with whom she “very
much enjoyed talking.” During the first interview, Litwak reported that M.B.
was “willing to answer [her] questions,” but noted “he was responding to his
voices during the whole conversation.”
M.B. told Litwak that he was evicted from an apartment in 2021 and
became homeless. A few years later, about two or three months before the
interview, he began hearing voices. M.B.’s ex-wife let him live with her, but
only for two weeks. M.B.’s brother then flew out from Europe, where he and
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the rest of M.B.’s family lived, and rented a Motel 6 room so M.B. would have
a place to stay. M.B.’s brother began providing M.B. with clothing and
support, but he “noticed that he was not doing well” and took him to the
hospital. M.B. was hospitalized about two weeks later.
M.B. told Litwak he heard 10 to 12 different voices on a daily basis.
The most important voice was Gloria, his fiancée. M.B. recounted that he
“mainly hear[d] Gloria’s voice, specifically from the tip of his penis.” To
communicate with her, “he often slouched down to his groin so he could speak
with her clearer.” M.B. told Litwak that he also heard voices from other body
parts, “but the main communication [was] through the tip of his penis.”
M.B.’s brother later spoke with Litwak and explained that the reason
he took M.B. to the hospital was that he discovered M.B. had been leaving
the food he bought for him “outside random doors at the Motel 6.” When
asked why he was giving away his food, M.B. told his brother he was giving it
to Gloria. M.B. “believed that Gloria was living in these different rooms,” and
that “he [was] helping her [by] giving away what he had.”
According to Litwak, M.B.’s plan for discharge from the hospital was
“to have his voice, Gloria, pick him up in her car. She would drive to
Los Angeles, and this was right before the holidays, so they would spend the
holidays together in Los Angeles with her sister, Rina. [M.B.] did not know
the address of the place in Los Angeles where they would stay, but he was
convinced that . . . Gloria, ha[d] a car that they would take to Los Angeles.
They would spend the holidays in Los Angeles with the sister and then move
down to La Jolla, . . . in San Diego. They would buy a house because Gloria
ha[d] billions of dollars that she ha[d] inherited from her father who [was] a
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very successful businessman.” About the plan, Litwak opined, “It’s not a
viable plan because Gloria does not exist.”4
Based on the medical records Litwak reviewed, M.B. was diagnosed
with schizophrenia by the referring psychiatrist at UCSD. Litwak opined
that M.B. did not “exhibit any insight into his diagnosis.” She explained, “He
felt . . . he did not belong in the hospital. . . . He felt that he could manage.
He felt ready to leave right . . . that minute and wanted to discharge. He did
not want to stay at the hospital or receive more treatment.”
As for his medications, M.B. “was not sure” he wanted to continue to
take them or continue seeing a psychiatrist after he was discharged even
though “he did not know what would happen” if he did not take them. And
even if M.B. were to commit to taking his medications, Litwak explained,
there is “a big difference” between a patient taking medication in a controlled
and monitored environment like a hospital, and an individual taking
medication “while they’re out in the world on their own.” She explained that
medications for schizophrenia must be taken at different times of the day and
“it’s important they are taken at the right time.” This is difficult for
individuals, like M.B., who are preoccupied by “internal stimuli.”
Litwak concluded that M.B. was gravely disabled and that a
conservatorship should be established. She determined he would be unable
to provide food, shelter, or clothing for himself because he planned to rely on
one of his voices, Gloria, for financial support and assistance. He was not
open to seeing a therapist or having a case manager assist him with
necessary medical care if he was to be released. As for his personal safety,
4 M.B. does not contend on appeal that “Gloria” is a real person who
could be relied upon for support.
6
Litwak opined, “It would definitely not be safe for [M.B.] to leave the hospital
and not have any plan, no money, nowhere to go, no support.”
Before coming to this conclusion, Litwak confirmed that M.B.’s family
all lived in Europe and he was not willing to move there to live with them.
Litwak also testified that it was her practice before deciding whether a
conservatorship should be established to consider “lesser-restrictive options,”
including whether the patient is willing and able to live in “boarding care”
and even whether the patient can take care of his basic personal needs while
homeless. She does not recommend that a conservatorship should be
established until she has “ruled out all of the other options.”
Litwak’s opinion did not change after the second interview. M.B. told
her he continued to hear voices, although he reported hearing only two or
three of them. Gloria’s voice was “still prominent,” but M.B.’s medication
made it more difficult to hear her. The medication’s effect on M.B.’s ability to
hear Gloria’s voice “annoyed” him. But he still spoke with Gloria and
planned to rely on her care if discharged from the hospital. According to
Litwak, M.B. was “constantly” talking with Gloria during the interview.
M.B. also reported that he and Gloria had married each other since the last
time he saw her.
Litwak agreed that M.B. was clean, dressed appropriately, and
appeared to be able to maintain his daily living activities while living in a
hospital setting. He consistently took his medication while in the locked
facility. He generally answered the questions he was asked and had never
been aggressive with Litwak during the interviews.
The Conservator’s second witness, Khafaja, testified that he was M.B.’s
treating psychiatrist from December 10, 2024, through February 4, 2025, at
the UCSD hospital where M.B. was admitted. Khafaja’s initial evaluation
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took between 45 to 60 minutes. After that, he saw M.B. about five days a
week for 10 to 15 minutes each day.
Khafaja reported that, during M.B.’s stay at the hospital, he had
difficulty engaging in reality. He suffered from “delusions, auditory
hallucinations, and disorganized behaviors.” M.B. believed he could talk to
other people through his body parts, including Gloria, whom he believed to be
his girlfriend. Khafaja would see M.B. on almost a daily basis “pacing in the
hallway [and] conversing with non-visible others.” M.B. needed prompting
from staff to eat his meals because of the disorganization generated by the
delusions. Despite approximately 56 days of treatment and medication, the
improvement to M.B.’s condition was minimal. While there was a reduction
in the number of voices he heard, there was no improvement in his delusional
beliefs about Gloria. In Khafaja’s view, M.B. remained “very impaired.”
Khafaja diagnosed M.B. with schizophrenia and opined that M.B. had
no insight into his condition. M.B. told Khafaja directly that he did not
believe he had schizophrenia because the voices he heard “d[id] not come
from his head, they [came] from his body parts only.”
Khafaja did not believe M.B. could provide for his needs in an
unstructured environment. In general, there is a very high risk of relapses
when schizophrenic patients leave the unit. Some patients who hear voices
can function safely in the community because they recognize the voices are
not real. But those patients, unlike M.B., either have more insight into their
situation or the voices they hear are minimal. In M.B.’s case, despite
repeated attempts to discuss an alternative plan for discharge, he was unable
to formulate one that was based on reality. He was “adamant” that his only
plan was to live with Gloria, an unreal person who manifest as one of the
several voices he was still hearing.
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Khafaja was also concerned that M.B. would stop taking his medication
if discharged to the community. Although he initially believed that M.B.
would continue to take most of it, he said his opinion would change if M.B.
was upset that the medication interfered with his ability to communicate
with Gloria.
Based on his discussions with M.B., as well as his daily observations
over the course of 56 days, Khafaja opined that M.B. was gravely disabled
due to a mental health disorder. Khafaja did not believe discharge would be
successful because M.B. had no insight into his condition and his plan for
living in the community was not based on reality.
B. M.B.’s Evidence
M.B. testified on his own behalf. He provided details about his living
situation before his brother brought him to the hospital in November 2024.
He confirmed that before his hospitalization he lived with his ex-wife for two
weeks and then stayed in a motel for a few weeks. And before then, he was
homeless for about five to six weeks.
M.B. testified that before he became homeless he lived in three
different shelters for about two years. The shelters provided meals, a place to
sleep, showers, and sometimes clothing. He was also employed at an
organization called “Life Events” as a gate checker for concerts by the
waterfront and San Diego State University sporting events.
M.B. acknowledged that he was evicted from the last shelter where he
resided. This was right before the five- to six-week period when he was
homeless. He said there was a misunderstanding and the shelter did not
receive a communication from him that he would not be there for three days
because of his work schedule.
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M.B. confirmed that his primary plan for attending to his basic needs,
if discharged, was still to rely on Gloria. He testified he met Gloria three and
a half years earlier. He said she had recently inherited in excess of $1 billion
from her father, who was a successful businessman. Initially, M.B. and
Gloria spoke in person and by phone. But about three to four months before
the trial, M.B. started speaking with her through parts of his body. He said
he could hear her voice through his penis “almost like a phone call.” He said
they were married in January 2025.
M.B. testified he had alternative plan in case he was not supported by
Gloria. He said he would “go back to a shelter,” specifically, St. Paul’s where
he had lived for a year and a half. As a backup plan, he would seek shelter at
Father Joe’s Village, where he had also lived. M.B. represented that neither
of these shelters had told him he could not come back. He said he would
“probably go back to work” and would try to get the job he had before at Live
Events. M.B. acknowledged that he did not tell Litwak or Khafaja about this
alternate plan to take care of his basic needs.5
M.B. said no matter where he lived he would take his medication. He
testified, “[I’d] rather not hear any voices. Telephone for that.” He thought
his current medication was working well to reduce the number of voices he
was hearing. He represented that he would continue to take his medication
even if that meant he could no longer speak with Gloria through parts of his
body. He explained that, once he was released, he would be able to speak
5 M.B. did not proffer evidence in writing that Father Joe’s Village and
Saint Paul’s were willing to assist him. Despite the trial court’s in limine
ruling that third party assistance testimony would not be permitted unless
corroborated in writing, the Conservator did not object or move to strike
M.B.’s testimony about his alternate plan.
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with Gloria in person and on the phone, and he would no longer need to do so
through body parts.
M.B. confirmed that he still disagreed with Khafaja’s diagnosis of
schizophrenia because the voices he hears come from his body and not his
head. He explained, “schizophrenia means it’s in your mind, and I don’t get
any voices in my head.”
IV.
Jury Instructions, Deliberations, and Verdict
The trial court instructed the jury with CACI No. 4007. The
instruction explains the requirement in section 5350, subdivision (e), that
jurors not consider evidence that a person can survive safely without
involuntary detention with the help of third parties unless the third parties
“specifically indicate in writing their willingness and ability to help.”
A few hours after retiring for deliberations, the jury sent a note asking,
“Whether a facility such as [Father] Joe’s [Village] or [Saint] Paul’s would or
would not be considered sufficient third-party assistance.” After hearing
argument from both parties, the court decided to respond to the question by
directing the jury’s attention to CACI No. 4007 as follows:
“1. If the jury is asking whether a shelter facility like
‘Father Joe’s’ [Village] could be considered ‘third party
assistance’ as defined in CACI [No.] 4007, the answer is the
jury is permitted to decide whether or not it meets the
definition.
“2. If the jury is asking if assistance that may be provided
by a shelter would be ‘sufficient’ to show a lack of grave
disability, that question would be a jury determination that
cannot be answered by the Court. As with all other
instructions, CACI [No.] 4007 should be read in its entirety
when being considered by the jury.”
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The next day, March 3, 2025, the jury found beyond a reasonable doubt
that M.B. was gravely disabled due to a mental illness. After excusing the
jury, the trial court confirmed the previous order imposing a conservatorship
on M.B.’s person.
DISCUSSION
M.B. contends the evidence was insufficient to support the jury’s
finding of grave disability. He concedes he has a mental illness and that “his
plan to rely on Gloria for support was not viable.” But he contends that
“nothing in the [Conservator’s] case proved beyond a reasonable doubt that
under his secondary plan to rely on shelter services, he would be ‘unable to
provide for essential needs due to a mental illness’ if released.” He argues,
“[T]he jury was presented with uncontested evidence that [he] previously
used the services of two specific San Diego shelters, knew how to access those
services, planned to do so if released, lived in those shelters successfully on
prior occasions when he was medicated or unmedicated, and acknowledged
that this was his only option if Gloria did not support him.” In his view, “The
jury was presented with no evidence rebutting [his] clear fallback plan. [He]
was clearly able to care for himself for a long period despite his mental
disability. There was no evidence that the mere existence of voices or
delusions rendered him incapable of using shelter services.” We are not
persuaded.
An LPS conservatorship may be established for any person who is
gravely disabled due to a mental disorder. (§ 5350.) A person is “gravely
disabled” if “unable to provide for their basic personal needs for food,
clothing, shelter, personal safety, or necessary medical care.” (§ 5008,
subd. (h)(l)(A), italics added.) Proof beyond a reasonable doubt is required to
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prove grave disability and establish an LPS conservatorship.
(Conservatorship of Carol K. (2010) 188 Cal.App.4th 123, 134 (Carol K.).)
“In reviewing a conservatorship, we apply the substantial evidence
standard to determine whether the record supports a finding of grave
disability.” (Carol K., supra, 188 Cal.App.4th at p. 134.) “We review the
record as a whole in the 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.” (Ibid.)
We agree with the Conservator that M.B.’s testimony that he could
provide for his basic needs with assistance from shelter services was
uncorroborated and therefore unreliable as a matter of law. Under
section 5350, subdivision (e)(1), “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 person’s basic personal needs for food, clothing, or shelter.”
(See generally, Conservatorship of Jesse G. (2016) 248 Cal.App.4th 453.)
That same provision, however, provides that to be “considered willing or able
to provide this help,” friends, family, and others must “specifically indicate in
writing their willingness and ability to help.” (§ 5350, subd. (e)(2), italics
added.) Here, M.B. made no attempt to comply with the statute’s clear
requirement that he corroborate his testimony about available third party
assistance with confirmation of that assistance in writing.
Regardless, even considering M.B.’s testimony about his “alternate
plan,” there was ample and compelling evidence sufficient to support a
finding beyond a reasonable doubt that he was “unable to provide for [his]
basic personal needs for food, clothing, shelter, personal safety, or necessary
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medical care.” (§ 5008, subd. (h)(1)(A).) M.B. may have lived without
incident for two years with assistance from shelter services, but this two-year
period, by his own admission, was before he began hearing voices from parts
of his body. According to M.B., he first began hearing voices from his body
parts about two or three months before his interview with Litwak and about
three or four months before the trial. This was around the same time he was
evicted from the third shelter. He was then homeless for five weeks until his
ex-wife allowed him to stay with her and his brother flew out to rent him a
motel room. M.B.’s brother was so concerned by his delusional behavior that
he took him to UCSD for testing. There, he was immediately admitted and
placed into a locked care facility. Two mental health professionals
interviewed him and concluded he was gravely disabled. Thus, we conclude
that no matter M.B.’s self-reported ability to care for himself earlier, there
was more than sufficient evidence for reasonable jurors to conclude that M.B.
became “gravely disabled” within the meaning of section 5008, subdivision
(h)(1)(A) once he began hearing and speaking to voices he believed to be
emanating from various parts of his body.
The jury’s verdict was supported by substantial evidence. We therefore
uphold the trial court’s order placing M.B.’s person into conservatorship.
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DISPOSITION
The judgment is affirmed.
DO, J.
WE CONCUR:
O’ROURKE, Acting P. J.
DATO, J.
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