1 Filed 12/2/14 CERTIFIED FOR PUBLICATION

IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA FOURTH APPELL ATE DISTRICT DIVISION TWO

THE PEOPLE, Plaintiff and Respondent,

v. WENONAH KARE N PARKER, Defendant and Appellant. E057890 (Super.Ct.No. FVI1010342)

OPINION

APPEAL from the Superior Court of San Bernardino County. Katrina West, Judge. Affirmed. Laurel M. Nelson, under appointment by the Court of Appeal , for Defendant and Appellant. Kamala D. Harris, Attorney General, Da ne R. Gillette, Chief Assistant Attorney General, Julie L. Garland, Assistant Attorney General, Kristine A. Gutierrez and Warren J. Williams, Deputy Attorneys Genera l, for Plaintiff and Respondent.2 In 2000, defendant and appellant Wen onah Karen Parker wa s found guilty, but not guilty of various crim es by reason of insanity . (Pen. Code, § 1026.) 1 Defendant was committed to Patton State Hospital (Patt on). In 2011, the trial court granted defendant outpatient status. (§ 1026.2.) The outpatient agencies refused to accept

defendant due to her behavior and mental c ondition. As a result, defendant remained hospitalized at Patton, in the inpatient prog ram. In 2012, the tr ial court revoked the order granting defendant outpa tient status. (§ 1608.)

Defendant raises three issues on appeal. First, defendant contends the Department of Mental Health and the outpatie nt treatment agencies acted unlawfully by refusing to admit defendant. Second, defend ant asserts the controlling statutes do not authorize revocation of outpatient status fo r a person who was not given the opportunity to participate in an outpatient program. Th ird, defendant contends collateral estoppel requires defendant’s outpatient status to remain in place because there were not material changes to defendant’s conditi on. In defendant’s Appellant’s Reply Brief, she also raises an issue concerning substantial evidence. We affirm the judgment. FACTUAL AND PROC EDURAL HISTORY

A. BACKGROUND In 1994, defendant had surgery to remove a cyst in her vaginal area. Defendant believes the surgeon intentionally disfigured her labia and cut her vaginal artery, which defendant believes is causing her to bleed inte rnally, despite the artery being four inches

1 All further statutory references are to the Penal Code unless otherwise indicated.3 from the surgery site and no in cisions being made in her va ginal wall. Defendant also

believes the doctor is a member of a cult that harms women. On August 20, 1999, defendant entered the doctor’s office with a .22-caliber

revolver and ordered the doctor to the floor. Defendant discharged two rounds into the ceiling and ordered the receptionist to assist with handcuffing the doctor. Defendant

then waited for the media to arrive so she could “‘expose’” the doctor. Law enforcement arrived, and defendant engaged in a standoff for approximately 20 minutes. Defendant was found guilty, but not guilty by reason of insa nity, of (1) two counts of false imprisonment by violence (§ 236); (2) two counts of assault with a firearm (§ 245, subd. (a)(2)); (3) second degree commercial burglary (§ 459); (4) one count of obstructing or resisting an execu tive officer (§ 69); and (5) one count of willfully discharging a firear m (§ 246.3, subd. (a)).

Defendant was admitted into Patton, in an inpatient program, in December 2000. In April 2006, defendant was granted out patient status, and released under the supervision of the San Bernardino/Riversi de Conditional Release Program (CONREP). In April 2009, defendant began showing signs of “psychiatr ic decompensation, including paranoid and rumina ting thoughts.” On April 24, defendant’s urine test reflected she had been drinking alcohol, wh ich violated the terms and conditions of her

release. An unannounced home visit re vealed an open contai ner of alcohol in defendant’s home and unopened containers of alcohol outside her apartment window. Defendant missed a CONREP appointment in May 2009. Defendant called her therapist and said she went AWOL from the pr ogram in order to seek medical attention4 for the “‘botched’” vaginal surgery. Defendant traveled to Oregon “in search of a clinic to perform her desired CT-scan”—a vaginal arteriogram. While in Oregon, defendant hit or attempted to hit her ex-boyfriend’s girlfriend with a vehi cle. Defendant was charged with recklessly endangering anot her person and was extradited back to California for absconding from CONREP. Defendant was ag ain admitted to Patton, on an inpatient basis, on June 6, 2009.

B. 2011 OUTPATIENT ORDER On December 14, 2011, th e trial court ordered defendant be immediately released to CONREP on outp atient status. The trial c ourt found defendant “met her burden of showing that she does not pose a dange r to the health and safety of others due

to her mental defect/disease or disorder while under supervision and treatment in the community.” The trial court ordered CONREP to “provide the court with a report indicating which placemen t is the best suit[ed] for [defendant].”

C. CONREP PL ACEMENT REPORT CONREP submitted its report to the trial court on January 27, 2012. The report reflected defendant was evaluated at Patton, by a clinical therapist, on January 9. In the report, CONREP wrote that, per the court’s or der, it would seek to place defendant “in a Statewide Transitional Regional Program (S TRP), such as Southpoint, Northstar, or Gateways.” However, CONREP warned that “[d]ue to [defendant’s] continued symptomology, it is an ticipated that it may be difficult to place [defendant] and this process may take several months.”5 CONREP noted that it had “serious misg ivings about [defendant’s] ability to be safely supervised in the community,” due to defendant “exhibit[ing] active symptoms of her mental illness, including pa ranoia, delusions, and mood in stability.” Defendant was difficult to supervise in Patton, displayed no insight into her me ntal illness, had poor judgment, and lacked a viable relapse prev ention plan. Despite the misgivings, the therapist wrote, “However, given that [def endant] has been ordered into CONREP by the court, we will make every effort to place her as ordere d in an expedient manner.”

D. AGENCY REPORTS Gateways Satellite (Gateways) is a Stat ewide Transitional Residential Program. On April 12, 2012, defendant was interviewed by Gateways ’s clinical director, for possible placement in the Gatewa ys program. Defendant initia lly expressed interest in being placed at Gateways. However, the clin ical director “pressed [defendant] on her verbal outbursts toward staff at [Patton],” a nd defendant then said “she actually did not want to go to Gateways.” De fendant said she heard a rumor that Gateways had a high rate of revocations, and therefore wanted to be placed in a different program. The clinical director encouraged defendant to discuss the issue with her (defendant’s) attorney, and then ended the interview “i n light of [defendant’s] refusal.” In the report, the clinical director not ed that defendant’s decision to decline placement in Gateways’s pr ogram precluded defendant fr om being placed in the program; however, the clinical director also had “clinical concerns regarding [defendant’s] suitability for [the] program.” The clinical director found defendant’s “rigid delusions persist and impair her judg ment and engagement in treatment. She6 lacks insight into her mental illn ess, and even denied having one. Instead she was intent on proving that her somatic delusions are inde ed real and she has been wronged by the system.” The clinical director opined defendant “would benefit from a continued placement at [Patton],” and concluded defendan t could not be accepted into the Gateways program “in light of the above information.” Southpoint is a Statewide Transiti onal Residential Program. Southpoint interviewed defendant on June 6, 2012, fo r possible placement in the Southpoint program. Southpoint found defendant “c ontinues to experience the same somatic delusions that were present at the time of her original offense and at the time of her AWOL from the CONREP program in 2009,” e.g., during the interview defendant yelled, “‘My vagina is black! I have pictur es.’” As the interview continued, it appeared defendant did not understand the dangers of ha ving discharged a fi rearm in the doctor’s office in 1994. Southpoint found defendant ha d failed to cooperate with treatment while in Patton. Due to the foregoing findings, So uthpoint’s clinical director wrote in the report, “I believe that the risk is too great to place her in Southpoint’s intensive but less

restrictive environment and that she contin ues to be a[] risk in general to the community. At this time, we cannot accept [defendant] for treatment in the Southpoint program.” The Northstar program reviewed defenda nt’s medical records and the denial letters from Gateways and Southpoint. Nort hstar found defendant “has no insight into her mental illness, or its symptoms, and has b een refusing treatment associated with her medication regimen. She also appears to lack impulse control.” Northstar declined to7 admit defendant into its program, and sugges ted defendant should once more be referred to Southpoint, if defendant were ag ain granted outpatient status. In a November 2012 report for the tria l court, a staff psychiatrist from the Department of State Hospitals recommended defendant “be retained and treated” at Patton. The psychiatrist noted the three out patient programs that evaluated defendant rejected her, and the psychiatrist also belie ved defendant did “not meet the criteria for outpatient treatment.” The ps ychiatrist found defendant “remain[s] actively ill with Delusional Disorder, Somatic Type.” The psychiatrist concluded, “This type of delusional thinking coupled with [defendant’s ] past violent behavior, her anger, and her extremely high likelihood for discontinuing her antipsychotic medication in a setting where her treatment is not mandatory suppor ts her significantly elevated risk for violence toward others in a less supe rvised and structured setting.” In a December 2012 report to the trial court, CONREP requested the trial court “rescind its decision” granting defendant outpa tient status. (§ 1608.) It was CONREP’s opinion “that, due to a mental disorder, dise ase, or defect, [defendant] would represent a substantial danger to the health and safety of the community if under treatment and supervision in the community.” A review of defendant’s chart reflected she “was not psychiatrically stable and displayed a pattern of aggressive and unpredictable behaviors.” When the clinical therapist ev aluated defendant in January 2012, defendant “presented with marked delusions and parano ia.” The therapist also found defendant “demonstrated poor insight, impaired judg ment, and impaired reality testing.”8 E. REVOCATION HEARING The court held a hearing on the revoca tion request on December 21, 2012. The prosecutor informed the court “it is impossibl e to place [defendant].” Defendant’s trial attorney, Mr. Gass (Gass), asse rted the court should “order CONREP to accept her, and

we’ll see how she does on CONREP.” Gass a sserted the agencies’ disagreement with the trial court’s findings and order “doesn’t mean the People get another shot at it.”

Gass asserted defendant was “still ready to go” into an outpatient program. The court explained the reports provided additional information that the court did not have when it granted defendant outpatient status. The court explained that if Gass submitted on the reports, without a hearing, the court would likely rescind its prior order. Gass responded, “I don’t know for sure what the problem is, and I certainly don’t know for sure what the remedy is. But I think what I would do is object to the issue being readdressed . . . . [I]t just doesn’t se em fair to make this ruling that she’s ready for CONREP, and then have CO NREP say, Well, we disagr ee with you, Judge, so why don’t you change your opinion.” The trial court explained, “it’s a bit mo re than that because there’s additional information that’s been glea ned from CONREP’s interactions with [defendant].” The court continued, “There are cases that are on point on this issue, and the Court does have discretion to change its ruling based on the additional in formation provided to it. So, again, my question is, does she wish to have a new hearing, or does she wish to proceed today?” Gass requested a restoration of sanity hearing, but also objected to the trial court “even reviewing the issue.”9 The court explained the hearing it c ould provide would focus on CONREP’s request for the court to revoke its prior orde r (§ 1608)—it would not be a restoration of sanity hearing (§ 1026.2). Th e court said defendant would need to file another petition for restoration of sanity (§ 10 26.2), if she wanted a restoration of sanity hearing. Gass said he would submit on the written reports, but defendant would file a new restoration of sanity petition. (§ 1026.2.) The court explained defendant “suffers fro m a rather rare mental illness.” In particular, the types of delusions defendant suffers may appear in only one percent of the population, and due to the rarity of the illness there are difficulties in treating her. At the prior hearing, it had appeared to th e trial court that Patton’s general treatment modality and CONREP requirements “would no t necessarily fit with [defendant] and

her mental illness such that if that typical standard were al ways applied to [defendant], she would never have an opport unity to be released into [CONREP].” The court said it still had the same concerns, but had to consider the additiona l information that had been provided about defendan t in the year since the trial cour t issued its outpatient order. The court found it “particularly troublesom e” that defendant was displaying signs of paranoia, because that wa s “new information.” The c ourt was also concerned with defendant refusing to cooper ate with medical treatment and suffering “‘[p]sychotic agitation.’” Based upon the new informati on, the court found defendant was “no longer suitable for release into [CONREP], and, theref ore, revoke[d] its prior order.” (§ 1608.) The court cited the danger defendant would po se to the community if released as the major factor affecting the court’s decision.10 DISCUSSION

A. DELAY IN PLACEMENT

Defendant contends CONREP and the thr ee outpatient agencies acted unlawfully by failing to place defendant in a program within 21 days of the court’s outpatient order. (§ 1026.2, subd. (h).) Defenda nt asserts she was prejudiced by the failure because she was denied “an opportunity to prove herself in a noninstitu tional setting.” We are not a trial court and cannot issue a ruling that CONREP and the agencies acted wrongfully. We cannot issue findings based upon evidence—t hat is the trial court’s domain. (See People v. Romero (1994) 8 Cal.4th 728, 740 [“appellate courts are ill-suited to conduct evidentiary hearings”].) Accordingly, we will interpre t defendant’s contention as asserting (1) the trial court erred by implie dly finding good cause existed to not place defendant in an outpatient pr ogram within 21 days; and (2 ) the trial court erred by allowing CONREP and the agen cies to have approximately seven months to conduct the placement process. We address the good cause issue. S ection 1026.2, subdivision (h), provides, in part, “If the court determines that the person should be transferre d to an appropriate forensic conditional release program, the co mmunity program dire ctor or a designee shall make the necessary placement arrangeme nts, and, within 21 days after receiving notice of the court finding, the person shall be placed in the commu nity in accordance with the treatment and supervision plan, unless good cause for not doing so is made

known to the court .” (Italics added.) We apply the abuse of discretion standard to a11 good cause finding. ( People v. Fernandez (1999) 70 Cal.App. 4th 117, 128, fn. 7 [“findings regarding good cause are genera lly reviewed for abuse of discretion”].) The court entered defendant’s outpatient order on December 14, 2011. In the order, the trial court ordered CONREP “to provide the court with a report indicating which placement is best suit[ ed] for [defendant].” CONREP interviewed defendant on January 9, 2012. CONREP submitted a report to the trial court on January 27, 2012. In the report, CONREP informed the trial court it had “serious misgivings about [defendant’s] ability to be sa fely supervised in the comm unity,” and “that it may be difficult to place [defendant] and this proce ss may take several months.” Gateways interviewed defendant on April 12. South point interviewed defendant on June 6.

Northstar submitted its letter c oncerning defendant in July. All three programs rejected

defendant.

Given that CONREP informed the trial court that it may take “several months” to place defendant, and the letters from th e different programs support CONREP’s reasoning regarding defendant not being suitable for outpatie nt treatment, we conclude

the trial court was within th e bounds of reason by implie dly finding good cause existed for the delay in placing defendant. The good cause finding was supported by the evidence that it was difficult to place defe ndant, and while attemp ts were being made within a reasonable timeframe, none of the attempts were successful. In sum, we

conclude the trial court did not err.12 Next, we address whether the trial c ourt erred by permitting CONREP and the agencies to have approximately seven months to conduct the placement process. As set

forth ante , section 1026.2, subdivision (h), requi res a defendant to be moved to an outpatient program within 21 days of noti ce of the court’s finding, unless good cause can be shown for a delay. In this case, C ONREP informed the trial court “that it may be difficult to place [defendant] and this pr ocess may take several months.” When the court received notice that the pr ocess would take “several months,” the

trial court should have set a status hearing in the case. A status hearing would have allowed the trial court to inquire into CONREP’s and the agencies’ progress and determine whether good cause still existed af ter the “several months” had passed. We conclude the trial court erred by not setti ng a status conference because “several months” became approximately seven months. A status hearing coul d have potentially caused the process to pro ceed in a timelier manner. Nevertheless, we conclude the er ror was harmless. As explained ante , the three agencies were unwilling to accept defendant. Th ere is nothing indicati ng that, if a status hearing had taken place in April, then defe ndant would have been more likely to be placed. Defendant ma y have had a more expedient resolution, but it appears the

resolution would have been the same. We not e the trial court offered to have a hearing on this issue, as to whether CONREP’s repo rt, which included reasons for defendant not being placed, was well-founded, but Gass subm itted on the report. Therefore, we must conclude CONREP’s reasons were properly supported. Since we conclude the result would be the same, we conclude th e error was harmless under both the Chapman and13 Watson standards. ( Chapman v. California (1967) 386 U.S. 18, 24 [harmless beyond a reasonable doubt]; People v. Watson (1956) 46 Cal.2d 818, 8 36 [reasonably probable a different result would occur].)

B. STATUTES Defendant asserts the statutory sche me does not provide for revocation of outpatient status when the defendant has no t actually been placed in an outpatient

program. “‘As in any case involving statutory inte rpretation, our fundamental task here is to determine the Legislature’s intent so as to effectuate the law’s purpose.’ [Citation.] ‘We begin with the plain language of the st atute, affording the words of the provision their ordinary and usual mean ing and viewing them in thei r statutory context, because the language employed in the Legislature’s enactment generally is the most reliable indicator of legislative intent .’ [Citations.] The plain mean ing controls if there is no ambiguity in the statutory language. [Cita tion.] If, however, ‘the statutory language may reasonably be given more than one inte rpretation, “‘“courts may consider various extrinsic aids, including the purpose of the statute, the evils to be remedied, the legislative history, public policy, and the st atutory scheme encompassing the statute.”’”’ [Citation.]” ( People v. Cornett (2012) 53 Cal.4th 1261, 1265.) Section 1608 provides, in relevant part, “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 sh all notify the superior court in either the14 county which approved outpatient status or in the coun ty where outpatient treatment is being provided of such opinion by means of a written request for revocation of outpatient status.” Defendant asserts the relevant porti on of the statute is “any time during the outpatient period.” Defendant contends this language reflects a revocation cannot occur unless a patient has been in an outpatient pr ogram. In other words, defendant asserts outpatient status cannot be revoked while a defendant is still an inpatient.

As set forth ante , we apply the words’ plain meaning. The words “at any time during the outpatient period” are broad due to the words “any time.” The words are not narrow, as defendant is presenting them . “Any time” can be understood to be synonymous with “any st age.” So at “any stage” or “any time” in the outpatient period,

revocation can occur. Defendant’s case was at the placement stage of the outpatient period. The court had ordere d defendant to have outpatie nt status, thus beginning the “outpatient period,” and CONREP was in th e process of finding defendant a placement. Again, the words of the statute are broad, not limiting. By usin g the words “any time,” the Legislature allowed a revocation request to be made at any time in the outpatient process. In this case, the revocation request was made during the placement stage. The statutory language does not bar revocation at the placement stage of the outpatient period. Accordingly, we conclu de the trial court did not err.

Defendant relies on People v. Dobson (2008) 161 Cal.App.4th 1422, to support her contention. In particul ar, defendant relies on the following language from the case, “While in the outpatient progr am, the applicant may be return ed to the state facility after15 a hearing if determined dangerous to others while in the program.” ( Id. at p. 1433.) Defendant emphasizes the language “[w]hile in the outpatient program,” to make the point that a defendant must be placed in an outpatient program before having outpatient

status revoked. We disagree with defendant’s use of Dobson to limit the language of section

1608. As set forth ante , section 1608 employs the language “at any time.” Therefore,

Dobson is correct that revocation may occur wh en a defendant is in an outpatient program. However, that is not the only stag e at which revocation may occur. Notably,

the statute does not use the language “w hile in the outpatient pr ogram,” the statute uses the language “at any time during the outpatient period.” Thus, a defendant need not be in an outpatient program prio r to outpatient status being re voked. Rather, the outpatient period begins with the court’s outpatient or der. Therefore, revocation can occur at the placement stage, as it did here, or in the program stage, as it did in Dobson

. C. COLLATERAL ESTOPPEL AND RES JUDICATA Defendant contends principl es of collateral estoppel and res judicata require the outpatient order be accepted as “law of the case.” 2 Defendant asserts the law requires

2 “The law of the case doctrine states that when, in deci ding an appeal, an appellate court ‘states in its opinion a principle or rule of law necessary to the decision, that principle or rule becomes the law of th e case and must be adhered to throughout its subsequent progress, both in the lower court a nd upon subsequent appeal . . . , and this although in its subsequent consideration this court may be clearly of the opinion that the former decision is erroneous in th at particular.’ [Citations.]” ( Kowis v. Howard (1992) 3 Cal.4th 888, 892-893.) Th e trial court’s outpatient or der and revocation order do not fall within the law of the case doctrine, since the law of the case doctrine is triggered by an appellate court opinion. Accordingly, we will not further discuss “law of the case.”16 there be “material changes” in a defendant’s mental condition in order for an outpatient

order to be revoked. Defendant asserts he r condition at the time of the revocation was essentially the same as her co ndition at the time the outpatient order was entered, except for a single incident of paranoia. Theref ore, defendant asserts the trial court was rehearing the same issue with e ssentially unchanged evidence. Collateral estoppel can operate to “p reclude a party to prior litigation from redisputing issues therein decided against him.” ( Vandenberg v. Superior Court (1999) 21 Cal.4th 815, 828.) As set forth ante , section 1608 permits the outpatient treatment supervisor to request revocation of an outp atient order “at any time” the supervisor believes a defendant needs “extended inpatient treatment or refuses to accept further outpatient treatment an d supervision.” The same issue was not being relitigated. At the restoration of sanity hearing, in 2011, the issue was whether defe ndant “would be a danger to the health and safety of others, due to mental defect, disease, or di sorder, if under supervision and treatment in the community.” (§ 10 26.2, subd. (e).) At the revocatio n hearing, in 2012, the issue was defendant’s current (2012) mental state. In particular, whether there was “evidence of a change of circumstances, i.e., that despite the fact [defendant] did not possess the requisite dangerousness in the earlier proceed ing, the circumstances have materially changed so that . . . she now po ssesses that characteristic.” ( Turner v. Superior Court (2003) 105 Cal.App.4t h 1046, 1060.)17 Approximately one year had elapsed fro m the time the trial court entered its outpatient order to the time the trial court re voked the order. During that year, three outpatient programs rejected defendant, defenda nt refused to cooperate with her medical treatment, defendant experienced paranoia, and defendant required a PRN/sedative to calm her psychotic agitation. Thus, the issu e at the revocation hearing was whether the outpatient treatment supervisor was corr ect in concluding de fendant now needed extended inpatient treatment based upon the new evidence of defendant’s condition. The issue was not the same as the prior hear ing, a year earlier—the revocation hearing required consideration of defendant’s curre nt condition based upon evidence gathered during the year between the two hearings. Accordingly, since the hearings involved different issues, we conclude the revocatio n order is not barred by principles of collateral estoppel.

D. SUBSTANTIAL EVIDENCE In defendant’s Appellant’s Reply Brief, sh e raises a substantial evidence issue.

Defendant asserts the finding of a material change in her condition is not supported by

substantial evidence. Although the issue was improperly ra ised for the first time in the reply brief, we will briefly address this issue. (See People v. Senior (1995) 33 Cal.App.4th 531, 537 [an argument raised for the first time in a reply brief is waived].) In a substantial evidence review, we “‘ex amine the whole record in the light most favorable to the judgment to determine whether it discloses substantial evidence— evidence that is reasonable, credible and of solid value—such that a reasonable trier of

fact could find the defendant guilty beyond a reasonable doubt.’ [Citation.]” ( People v.18 Ugalino (2009) 174 Cal.App.4th 1060, 1064.) At the revocation hearing, the issue is whether there has been “a change of circum stances, i.e., that despite the fact the [defendant] did not possess the requisite dangerousness in the earlier proceeding, the circumstances have materially changed so that [s]he now possesses that characteristic.” ( Turner v. Superior Court , supra , 105 Cal.App.4th at p. 1060.) At the outset, we note that defendant s ubmitted on the reports at the hearing. Defendant’s trial counsel said, “I’ll submit that issue [(the revocation)] on the written reports rather than taking live testimony. ” The revocation hearing took place on December 21, 2012. A December 11, 2012, report from CONREP reflected defendant was rejected from three outpatient programs. The report also reflected that on August 31, 2012, defendant was given a PRN for “‘psychotic agitation’” after a verbal

altercation with her roommate. On June 28 , 2012, defendant expressed concern that a janitor put something in her shoes to give her a foot fungus—displaying paranoia. Additionally, defendant had “been talking a bout being in a ‘spiritual warfare.’” At the prior hearing—the restoration of sanity hearing in December 2011—Dr.

Patel of Patton testified defendant had b een “violence-free in the hospital” and described defendant as “very respectful.” Dr. Patel also described defendant as suffering from delusional disorder; he did not say she was suffering from paranoia. In sum, the evidence at the revocation hearing (December 2012) reflected that during the year between the hearings, defendant suffered from paranoia and was becoming more agitated—n eeding PRN assistance to calm down—thus reflecting material changes in defendant’s condition. The trial court cited defendant’s paranoia19 and her psychotic agitation when finding defendant now posed a danger to the community—findings that were supported by the foregoing evidence. Given the information in the reports, and the test imony from the 2011 he aring, substantial evidence supports a finding of a materi al change in defendant’s condition. We note that while it does not appear testimony was given at the 2011 hearing regarding paranoia, there is evidence that defendant suffered from paranoia prior to 2012: (1) CONREP’s December 2012 re port reflects defendant suffered paranoid thoughts in April 2009, during her first outpatient release; (2) the Department of State Hospitals’ November 2012 report reflected that, at some point, defendant had been diagnosed with Schizophrenia, Paranoi d Type, among other illnesses; and (3) CONREP’s January 2012 report reflects defe ndant suffered paranoia— presumably defendant was suffering parano ia in 2011, since CONREP interviewed defendant on January 9, 2012 (very ear ly in the year) for the January 2012 report. The foregoing three reports were issued after the trial court entered its December 2011 order granting outpatient status. Also, as set forth ante , when Dr. Patel testified about defendant’s illness in 2011, he did not mention paranoia. Therefore, while defendant may have suffered paranoia prior to 2012, in this record it was not revealed that she suffered paranoia until the hearing in December 2012, when the three reports revealed the symptom/illness. Accordingly, for purposes of the trial court’s findings, defendant’s paranoia was new, i.e., a material change.20 DISPOSITION The judgment is affirmed.

CERTIFIED FOR PUBLICATION

MILLER J.

We concur:

HOLLENHORST Acting P. J.

KING J.