Filed 7/28/22 In re the Domestic Partnership of von Dorrer-Hildebrand and Veccia 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NOT TO BE PUBLISHED IN OFFICIAL REPORTS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 This opinion has not been certified for publication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

In re the Domestic Partnership of 

CHRISTINA VON DORRERHILDEBRAND and ELLEN M. 

VECCIA.

 H045095

 (Santa Clara County

 Super. Ct. No. 2012-1-FL-162814)

CHRISTINA VON DORRERHILDEBRAND,

Appellant,

v.

ELLEN M. VECCIA,

Respondent.

Appellant Christina von Dorrer-Hildebrand (Christina) and respondent Ellen M. 

Veccia (Ellen) share joint legal and physical custody of two children through a stipulated 

judgment. Christina appeals the trial court’s order giving Ellen final decision-making 

authority over whether to vaccinate either or both children. (Order)

On appeal, Christina contends the trial court erred by modifying legal custody 

without requiring Ellen to show a significant change in circumstances before granting her 

request. She further argues Ellen failed to show the modification was in the children’s 

best interests. Finally, she claims the trial court erroneously denied her request for a 

long-cause hearing to present expert medical testimony on the issue of whether 

immunization was appropriate for the children. For the reasons set forth below, we 
2

conclude Christina has not established prejudicial error occurred. We therefore affirm

the Order.

I. FACTUAL AND PROCEDURAL BACKGROUND

Christina and Ellen, who entered into a domestic partnership in 2005, have two 

children, I. (born 2005) and O. (born 2008). In 2013, the couple sought to dissolve the 

partnership. They entered into a Domestic Partnership Settlement Agreement (DPSA), 

and the trial court entered a stipulated judgment dissolving the partnership and 

incorporating the DPSA. Pursuant to the DPSA, Christina and Ellen agreed to share joint 

legal and physical custody of the children. The DPSA expressly provides that Christina 

and Ellen would share access to information about the health of the children and would 

have joint control over, and cooperate regarding, the children’s healthcare provider and 

medical care.

When the children were born, Christina and Ellen agreed they would not vaccinate 

them. When the couple first enrolled the children in preschool, they chose to file 

personal belief exemptions that permitted the children to attend school without the 

immunizations otherwise required by law at that time.1 The children remained 

unimmunized until the couple separated. After the separation, however, Ellen asked that

the children be vaccinated against tetanus. Then, during the measles epidemic in 2015,

Ellen decided she wanted the children to receive every vaccine for which they were 

eligible. 

After the 2015 measles outbreak, California passed Senate Bill No. 277. (Health 

& Saf. Code, § 120325 et seq.) This bill eliminated the personal belief exemption that 

Christina and Ellen had relied on, and mandated that children be immunized to attend 

1 Because the trial court’s order only addressed the question of vaccinating the 

children, we limit our discussion of the facts to that issue.
3

school in California, unless the child had a medical exemption.2 As a result, the 

children’s pediatrician, Dr. Vukicevic, stopped seeing patients who were not fully 

vaccinated, causing the children to lose access to their doctor. 

By this time, I. was preparing to enter seventh grade in middle school and O. was 

entering the fourth grade at the private school both children had been attending. I. either 

needed to be vaccinated or needed a medical exemption to enroll, so Ellen sought to 

revisit the vaccination issue.

3 Ellen expressed concern that the children remained 

unvaccinated, putting them at risk for “unnecessary diseases,” including measles. 

Christina continued to object to vaccinating the children despite the change in the law and 

the children’s exclusion from their pediatrician’s practice. 

Without consulting with Ellen, Christina worked with a medical researcher in 

Israel, Yehuda Shoenfeld, to genetically test the children using a home administered test. 

Christina hoped the genetic testing would determine whether the children had any of the 

genetic mutations that Dr. Shoenfeld was working on related to vaccines. With the 

results of the test and several articles, Christina first sought a medical exemption for the 

children from Dr. Vukicevic. The pediatrician referred the results to the genetics 

2 Under Health and Safety Code section 120335, subdivision (b), the governing 

authority of a public or private elementary or secondary school cannot unconditionally 

admit any person as a pupil, unless he or she has been fully immunized prior to his or her 

first admission. Where a pupil, prior to January 1, 2016, had on file a letter or affidavit 

stating beliefs opposed to immunization, he or she can remain enrolled without 

immunization until enrollment in the “next grade span”; the specified grade spans are 

“[b]irth to preschool,” kindergarten through grade 6, and “[g]rades 7 to 12, inclusive.” 

(Health & Saf. Code, § 120335, subd. (g)(1) & (2).) Health and Safety Code 

section 120370 sets forth the conditions for obtaining a medical exemption from the 

immunization requirements. Senate Bill No. 277 modified provisions of the Health and 

Safety Code to eliminate the personal belief exemption from the then-existing 

immunization requirements, and modified the procedure for obtaining a medical 

exemption, among other things. (Sen. Bill No. 277 (2015-2016 Reg. Sess.) §§ 1, 2, 5.)

3 O. was allowed to remain in school based on the personal belief exemption until 

she entered the “next grade span.” (Health & Saf. Code, § 120335, subd. (g)(1) & (2).) 
4

department at Stanford University Medical Center, which opined that there was no basis 

to believe vaccines would cause the children any medical problems. Christina rejected 

these conclusions because she did not believe either Dr. Vukicevic or Stanford were “upto-date on the latest research” regarding vaccinations. Based on her own medical 

research, she did not agree with any physician who recommended vaccinations, except 

the experts with whom she had consulted. 

When Dr. Vukicevic refused to provide a medical exemption, Christina, without 

Ellen’s knowledge or consent, obtained medical exemptions for both children from a 

doctor who had neither examined the children nor treated them, doctor John Hicks, M.D. 

In his brief exemption letters, Dr. Hicks stated that the children have a family history of 

and genetic predisposition for autoimmune disease. He concluded that the state of their 

immune systems was such that any vaccination could trigger the start of autoimmune 

disease, and he recommended that neither child receive vaccines. The letters did not set 

forth the basis for any of these conclusions, nor did the letters state that he had examined 

either child or reviewed any of their medical history. Christina then submitted the 

medical exemptions to the children’s school, again without Ellen’s knowledge or consent. 

After Ellen discovered the actions Christina had taken, and the two remained at an 

impasse despite private mediation, Ellen sought an order modifying legal custody to grant 

her medical decision-making power, including the “ability to vaccinate the children.”

Ellen asked that the court allow her “the exclusive ability to follow the course of 

treatment recommended by the children’s doctors without Christina having the ability to 

block or delay [Ellen’s] decisions.” Ellen represented that she would “agree to keep 

Christina informed, post hoc, of every appointment and every procedure,” and to 

“consider [Christina’s] position regarding any necessary vaccinations or procedures. . . .”

Ellen stated she would rely on their pediatricians’ recommendations for the treatment of 

the children, rather than “try to backdoor the issue,” by going to a doctor and/or obtaining 

treatment that was not agreed upon by the parties, as Christina had done. 
5

Christina opposed Ellen’s request, arguing that Ellen was seeking to modify legal 

custody, and thus needed to show a significant change of circumstances, but had not done 

so. Christina acknowledged her opposition to vaccinating the children but argued that it 

was well founded based on her own research and on the recommendation of Dr. Hicks,

who agreed that the children should not be vaccinated because of the risk of provoking an 

auto-immune disease. She asked the court to hold a “long-cause” hearing so she could 

present the testimony of expert medical witnesses, as well as “her own expertise”

regarding the risks associated with vaccinating the children. She did not provide a list of 

proposed witnesses or identify any expert witnesses.

The court denied Christina’s request to present expert testimony. The court stated 

that it would not be deciding whether to vaccinate the children; rather, it would decide 

which parent would have the authority to make that decision if the parents could not 

reach an agreement. The court confirmed it “full[y] inten[ded] to retain a joint legal and 

joint physical custody as between the parties.” The parties would have a “continuing 

obligation . . . to meaningfully meet and confer over medical decisions involving the 

minor children . . . .” The court stated it would only decide who would be the “tie 

breaker” in the event the parents reached an impasse.

The court held a hearing where Ellen and Christina presented evidence. Ellen 

testified, through an offer of proof by her attorney, that the declaration she submitted in 

support of her request for orders was true and correct. Christina testified through an offer 

of proof and on the witness stand regarding her position on vaccinating the children. The 

court examined her regarding her purported expertise on the subject of vaccination.

After ordering the parties to meet and confer about a process going forward, the 

trial court issued its final order. The court found that Christina had “subverted the letter 

and spirit of the parties’ DPSA and the grant of joint legal custody” by obtaining genetic 

testing of the children, by using the genetic tests to obtain a medical exemption for the 

children from a physician of “unknown credentials who neither examined the children 
6

nor reviewed their medical histories,” and by submitting the medical exemptions to the

children’s school without Ellen’s knowledge or consent. 

In addition, the court found that Christina demonstrated “inflexibility on the issue 

of decision-making regarding the children’s medical care” by “categorically dismissing” 

Dr. Vukicevic and any other medical providers who disagreed with the vaccination 

position espoused by Dr. Shoenfeld, by stating her intention to reject any future medical 

opinion in favor of vaccinations unless provided by Dr. Shoenfeld, Dr. Hicks, or someone 

whose opinion was comparable to those two doctors,4 and by justifying her unwillingness 

to consider Dr. Vukicevic’s opinions and Ellen’s position on the grounds that she is a 

medical and market researcher with experience based on “self-directed lay reading of 

medical literature . . . .” 

The trial court further found Ellen had “demonstrated her willingness to co-parent, 

not least by accommodating for several years [Christina’s] steadfast opposition to 

vaccination until the measles outbreak[,] Dr. Vukicevic’s termination of her clinical 

relationship with the children, [I.’s] scheduled matriculation into middle school and the 

failure of private mediation brought the parties’ disagreement to a head. The court rejects 

as unsubstantiated [Christina’s] assertion that [Ellen] has made an issue of vaccination in 

bad faith.” 

Based on these findings, the court denied Ellen’s request for sole decision-making 

authority over all medical issues but granted her final decision-making authority over 

whether to vaccinate the children, and the scope and timing of such vaccinations “if 

vaccination is appropriate.” The court directed the parties to jointly consult with

Dr. Vukicevic regarding the propriety of vaccinating the children if she was willing to 

continue treating the children. The court also made specific orders about how the parties 

would choose a new medical provider if Dr. Vukicevic was unavailable to treat the 

4 The court noted Dr. Shoenfeld does not practice in the United States and 

Dr. Hicks had been deceased since 2016. 
7

children. The court ordered that “the parties shall jointly consult the selected pediatrician 

regarding the genetic issues raised by [Christina]” and the “propriety of vaccination of 

the parties’ children under Health & Safety Code sections 120325 et. seq.”

Christina timely appealed the Order.

5

 

II. DISCUSSION

A. Any Failure to Require a Showing of Changed Circumstances is Harmless

Christina contends that granting Ellen final decision-making authority over 

whether to vaccinate the children modified legal custody, and therefore the court erred in 

granting the request without requiring that Ellen show a significant change in 

circumstances. We conclude that even if granting Ellen final decision-making authority

over immunizations could be construed as a modification in legal custody, any failure to 

require an express showing of changed circumstances was harmless.

There is no dispute that the trial court did not require Ellen to show a change of 

circumstances. Despite Christina’s objection, the court held that no such showing was 

needed because it expressly rejected the notion that it was modifying legal custody, and 

stated that it fully intended to retain joint legal custody. We are not bound by the trial 

court’s characterization however. The question of whether the change amounted to a 

modification in legal custody is a question of law, which we review de novo. (Enrique 

M. v. Angelina V. (2004) 121 Cal.App.4th 1371, 1378 (Enrique M.).)

Under the terms of the DPSA, Christina and Ellen share joint legal custody, which

means that both parents share the rights and the responsibilities of making decisions 

relating to the child’s health, education, and welfare. (Fam. Code, § 3003.)6 Conversely, 

5 The trial court stayed enforcement of the order until October 12, 2017. Prior to 

the expiration of the stay, Christina petitioned this court for a writ of supersedeas staying 

enforcement of the trial court’s order during the pendency of the appeal; we denied her 

petition. 

6 Undesignated statutory references are to the Family Code unless otherwise 

indicated.
8

sole legal custody grants those rights and responsibilities to only one parent. (§ 3006.) 

Although a trial court has continuing jurisdiction to modify custody orders throughout a 

child’s minority whenever it is in the best interest of the child (§§ 3022, 3087, 3088), a 

parent who seeks to modify a final custody order must demonstrate “ ‘a significant 

change of circumstances’ indicating that a different custody arrangement would be in the 

child’s best interest. [Citation.]” (In re Marriage of Brown and Yana (2006) 37 Cal.4th 

947, 956 (Brown & Yana), citing Montenegro v. Diaz (2001) 26 Cal.4th 249, 256 

(Montenegro) and Burchard v. Garay (1986) 42 Cal.3d 531, 535.) The policy 

considerations underlying this requirement—continuity and stability—are well settled.

7

(Brown & Yana, at p. 956.)

Not every request to revise a final custody order requires a showing of significant 

changed circumstances. A parent who seeks a modification that is not tantamount to 

changing joint custody to sole custody, or vice versa, need not demonstrate a significant 

change of circumstances. (Enrique M., supra, 121 Cal.App.4th at pp. 1379-1381 [change 

in visitation schedule and school “did not amount” to a request to modify joint custody];

In re Marriage of Birnbaum (1989) 211 Cal.App.3d 1508, 1512-1513 [alteration of 

parenting schedule did not constitute modification of physical custody requiring material 

changed circumstances].) Thus, the appellate court in In re Marriage of Furie (2017) 16 

Cal.App.5th 816 (Furie), upheld a trial court order granting mother’s request for “sole 

authority” over the children’s orthodontic care, despite a stipulated judgment awarding 

the parents joint legal custody. In Furie, mother alleged father refused to coparent on 

orthodontic issues and the trial court granted mother sole decision-making authority 

without requiring a showing of changed circumstances. (Furie, at pp. 820, 822.) There

the court found that the change allowing mother sole decision-making authority over 

orthodontic issues amounted to something less than a change of legal custody. The court 

7 The parties do not dispute that the DPSA was a final order under Montenegro, 

supra, 26 Cal.4th at pages 258-259.
9

held that on those facts, a showing of changed circumstances was not required. (Id. at p. 

827.) 

Ellen contends, as in Furie, the change allowing her sole decision-making 

authority over immunization issues amounts to something “less than a change of legal 

custody.” (Furie, supra, 16 Cal.App.5th at p. 827.) Christina responds that the “legal 

basis for the Furie court’s holding is mistaken,” because it rests on appellate decisions 

that address changes in physical, rather than legal, custody. She also argues that these 

cases were wrongly decided.8 Under the circumstances here, however, we need not 

decide whether the court in Furie was correct in concluding that some changes in 

decision making authority are so minor that they do not change the legal custody 

originally established. Nor do we need to decide whether granting Ellen final decisionmaking authority over immunizations, while expressly directing the parties to jointly 

consult with Dr. Vukicevic, and setting up a cooperative process for selecting a new 

provider if Dr. Vukicevic was unwilling to continue treating the children, was a minor 

enough change that it did not change legal custody, as in Furie. 

Even if, despite the express continued obligation to cooperate, the order granting 

Ellen final tie-breaker decision making authority was tantamount to a change in legal 

custody, any failure by the trial court to require a showing of changed circumstances was 

harmless. (See Darab Cody N. v. Olivera (2019) 31 Cal.App.5th 1134, 1145.) There 

were in fact material changes in circumstances since the parties signed the DPSA that 

were detrimental to the children. (Ragghanti v. Reyes (2004) 123 Cal.App.4th 989, 996

(Ragghanti).) New legislation after the 2015 measles outbreak codified California public 

policy requiring vaccinations for school age children but eliminated the personal belief 

8 Although we are not bound by decisions of other appellate courts, we ordinarily 

follow them out of respect for stare decisis, absent good reason to disagree. (People v. 

The North River Ins. Co. (2019) 41 Cal.App.5th 443, 454-455.) These cases have been 

applied in the family divisions of California’s superior courts for over three decades. We 

find no good reason to revisit their holdings.
10

exemption the couple had relied on to enroll the children in school. Christina’s continued 

objection to vaccinating the children jeopardized the children’s continued enrollment in 

school. Additionally, the children’s pediatrician terminated their care because they were 

not vaccinated, and the children were without a pediatrician. These changes occurring 

since Christina and Ellen signed the DPSA were “ ‘of a kind to render it essential or 

expedient for the welfare of the child that there be a change.’ [Citation.]” (Ibid.)

Intervention was needed to ensure that the children could remain enrolled in school and 

had access to medical care. 

The court considered these recent developments and changes in the law with great 

particularity in reaching its conclusions. Just because the court did not believe it was 

modifying legal custody, and therefore did not frame its consideration in terms of 

“changed circumstances,” does not mean that Christina suffered any prejudice from this

failure. Because we are not bound by the trial court’s characterization, because there 

were substantial changes in circumstances necessitating a change for the benefit of the 

children, and because the court did actually consider evidence of these changed 

circumstances, any failure by the trial court to characterize its analysis in terms of 

“change in circumstances” was harmless. (Ragghanti, supra, 123 Cal.App.4th at p. 996.) 

B. The Trial Court Did Not Err in Denying a Hearing to Receive Live Medical 

Testimony

Christina next contends that the trial court erred in denying her request for a “longcause hearing.” She contends that pursuant to section 217 the court was required to hold 

a hearing so that she could present expert medical testimony supporting her objections to 

vaccinating the children.

9

 Citing Evidence Code sections 210 and 351, she argues that

9 Section 217 requires the court hold a hearing to “receive any live, competent 

testimony that is relevant and within the scope of the hearing and the court may ask 

questions of the parties.” (§ 217, subd. (a).) There is no reference to the type of hearing 

the court is supposed to hold. The reference to a “long-cause” hearing originates in the 

Santa Clara County Superior Court Local Family Rules, rule 5.H., which states in 
11

the opinions she intended to offer were relevant to the issues raised by Ellen’s request

and admissible, and, thus, should have been allowed.

10

“We review a trial court’s evidentiary rulings for abuse of discretion. [Citation.] 

This is particularly so with respect to rulings that turn on the relevance of the proffered

evidence. [Citation.] This standard is not met by merely arguing that a different ruling 

would have been better. Discretion is abused only when in its exercise, the trial court 

‘exceeds the bounds of reason, all of the circumstances before it being considered.’ 

[Citation.] There must be a showing of a clear case of abuse and miscarriage of justice in 

order to warrant a reversal. [Citation.] A trial court will abuse its discretion by action 

that is arbitrary or ‘that transgresses the confines of the applicable principles of law.’ 

[Citations.] In appeals challenging discretionary trial court rulings, it is the appellant’s 

burden to establish an abuse of discretion. [Citations.]” (Shaw v. County of Santa Cruz

(2008) 170 Cal.App.4th 229, 281.)

In her request, Ellen sought, among other things, that the court grant her exclusive 

medical decision-making authority for the children and order that the children be 

vaccinated without delay. Christina requested a hearing because she felt “the issues 

raised in Ellen’s motion . . . require expert medical opinions be provided to the Court and 

direct testimony by medical professionals well versed on . . . vaccination.” In denying 

her request to present medical expert testimony, the court stated that it would not be 

deciding whether to vaccinate the children, so expert testimony would be collateral. 

Christina argues that the trial court erred.

relevant part, “A ‘long cause’ hearing is any hearing other than a trial that will take 

longer than 30 minutes.” (Super. Ct. Santa Clara County, Local Family Rules, rule 5.H.)

10 Evidence Code section 210 states, “ ‘Relevant evidence’ means evidence, 

including evidence relevant to the credibility of a witness or hearsay declarant, having 

any tendency in reason to prove or disprove any disputed fact that is of consequence to 

the determination of the action.” Evidence Code section 351 states, “Except as otherwise 

provided by statute, all relevant evidence is admissible.”
12

Pursuant to section 217, “[a]t a hearing on any order to show cause or notice of 

motion brought pursuant to [the Family Code], absent a stipulation of the parties or a 

finding of good cause pursuant to subdivision (b), the court shall receive any live, 

competent testimony that is relevant and within the scope of the hearing.” (§ 217, subd. 

(a); accord Cal. Rules of Court, rule 5.113(a).) The court “may make a finding of good 

cause to refuse to receive live testimony and shall state its reasons for the finding on the 

record or in writing.” (§ 217, subd. (b).)

We first note that the court did hold a hearing where Christina testified both about 

her objections to vaccinating the children and about her research regarding vaccines. At 

the hearing, the court itself questioned Christina about her asserted expertise. Christina 

testified that, “I have had -- I’ve done medical research with various professionals, both 

doctors and Ph.D.’s, too, and -- and studied -- I’ve read probably thousands of medical 

research journals and I analyzed them and gone through them. And I’ve conferred with 

many experts as well . . . . [B]y profession I’m a market researcher. I have a degree in 

math and psychology. I don’t have a degree in market research yet I’ve got 20 years 

experience and the top Silicon Valley companies hire me to do market research for them.

So, in the same way that I have experience in that I have experience in medical research. 

And it’s mostly secondary research in the sense that I’m reading research and analyzing it 

and doing various things with it thereafter.” The court also asked Christina if she had 

training in medicine, biology, physiology, or immunology. Christina conceded that she 

did not have training in these fields. Although the court declined to receive additional 

evidence from unidentified experts Christina believed she could produce, the court did 

allow Christina to testify on the subject at the hearing.

Christina’s contention that she was entitled to an additional hearing involving 

medical experts fails. First, the evidence she sought to introduce was not relevant to the 

issue before the court. Christina contends that the medical testimony was relevant, but 

she incorrectly identifies the question before the trial court. The question was not 
13

whether it was or was not preferable to vaccinate the children. The court expressly 

limited the issue it would decide to, “whether to modify the existing orders to allocate 

final decision[-]making authority between the parents . . . . And it would be arrogant of 

me to pretend to dictate to the parents what course of medical treatment would be 

appropriate for the minor child.” To decide this issue, the court evaluated which parent 

was more likely to facilitate cooperative parenting in the course of the decision-making 

process, while including the other parent in the process and minimizing conflict between 

the parents. Medical testimony supporting Christina’s position that vaccines posed a risk 

to the children was not relevant to this question. The trial court stated that it would not

evaluate the merits of Christina’s belief that the children should not be immunized, 

because it would provide a mechanism for the parents to work with medical experts to 

make that decision. In granting Ellen final decision-making authority, the court was 

swayed by Christina’s actions that violated the DPSA—testing the children, obtaining 

medical exemptions, and submitting them to the children’s schools without Ellen’s 

knowledge and consent—not by the sincerity of Christina’s beliefs regarding vaccines. 

Neither the basis for, nor the merits of, her beliefs about vaccines was relevant to the 

issue the trial court decided.

Second, even if Christina could show relevance, the court had good cause to deny 

the hearing. In evaluating whether good cause exists to refuse live testimony, the court, 

in addition to the rules of evidence, must consider, among other factors, whether material 

facts are in controversy, whether live testimony is necessary for the court to assess the 

credibility of the parties or other witnesses, and the right of the parties to question anyone 

submitting reports or other information to the court. (Cal. Rules of Court, rule 5.113(b).) 

There were no material facts in controversy that the medical testimony could have 

resolved because the court was not deciding whether the children would be vaccinated, 

nor was it considering or evaluating the desirability or risks of vaccines. The only facts 

at issue concerned Christina’s actions that the trial court found violated the DPSA. Since 
14

Christina admitted testing the children, obtaining the medical exemptions, and submitting 

them to the school, those facts were not in dispute. Any proffered medical testimony, 

therefore, would not have helped to inform the court on any factual issue before it.

Similarly, since the court was not evaluating the merits of the proffered medical 

opinions of Dr. Hicks and Dr. Shoenfeld, and Christina did not identify any other experts, 

the court had no need to assess their credibility or to rely on their expertise. (Evid. Code,

§ 801, subd. (a).) Even if the vaccination issue had been before the court, it is not clear 

whether the proffered expert testimony would have been admissible, since achieving full 

vaccination is already the stated public policy in California, and neither doctor had 

personally examined or treated the children, or even reviewed their medical history.

11

 

However, since the court expressly did not decide whether the children should be 

vaccinated, we need not reach this issue here.

Nor was the right of the parties to question those submitting reports to the court 

implicated in this instance. Here, Christina claims she wanted to present live testimony 

in support of her own documentary evidence and testimony. However, she did not 

submit a witness list with her responsive papers or identify any other expert witnesses, 

prior to or during the hearing as required by section 217, subdivision (c). (Cal. Rules of 

Court, rule 5.113(e).) Since Dr. Hicks was deceased and Dr. Shoenfeld lives in Israel, 

and no other experts were identified below, Christina was not denied the right to present 

live expert testimony.

Further, section 217 is principally intended to allow a party an opportunity to 

confront witnesses and rebut evidence introduced by the opposing party, not to bolster 

their own documentary evidence. (See In re Marriage of Deamon (2019) 35 Cal.App.5th 

11 Health and Safety Code section 120325 sets forth the intent of the Legislature to 

provide, “[a] means for the eventual achievement of total immunization of appropriate 

age groups against [an enumerated list of] childhood diseases. . . .” (Health & Saf. Code, 

§ 120325, subds. (a) & (c).) 
15

476, 482.) Here, there is no indication that Ellen asked to challenge Christina’s medical

evidence or cross-examine Christina’s witnesses, and Ellen was provided an opportunity 

to cross-examine Christina herself. Since Christina did not provide a witness list and the 

court ruled that it would not be deciding whether the children should be vaccinated, Ellen 

had no reason to make that request. Absent a request by Ellen for an opportunity to 

question Christina’s experts and given the lack of relevance to the question before the 

court, no party’s right to question a declarant was infringed. The court had good cause to 

deny the request. 

Finally, Christina claims that allowing expert testimony regarding the risks of 

vaccinations would have likely “rehabilitated” her in the court’s eyes, revealing that she 

was not acting out of “uninformed stubbornness.” She also suggests the court would 

have made a different decision had it received the expert testimony. But even had the 

court received additional information about the potential risks associated with vaccinating 

the children, such testimony would not have altered the trial court’s finding that Christina 

violated the spirit of the DPSA by obtaining genetic testing and a medical exemption for 

the children without Ellen’s knowledge or consent. The court based its decision to give 

Ellen final decision-making authority on its finding, supported by substantial evidence, 

that Ellen would consider Christina’s opinions and cooperate with her in determining 

whether the children should be vaccinated. The court did not abuse its discretion when it 

ruled that it did not need expert testimony to make this decision.

C. The Trial Court Did Not Err in Granting Ellen Decision-Making Authority.

Whether or not the trial court’s order was a modification of legal custody, the trial 

court did not err in ordering the change. Any modification in parental authority requires 

a showing that the change is in the best interests of the child. (In re Marriage of Burgess

(1996) 13 Cal.4th 25, 32.) We review the trial court’s modification order for abuse of 

discretion. (See Montenegro, supra, 26 Cal.4th at p. 255.) Here, the trial court did not 

abuse its discretion because substantial evidence supports the order. 
16

At the time of this proceeding, to determine the best interest of the child, the court 

was required to consider, in relevant part, the health, safety, and welfare of the child, and 

the nature and amount of contact with both parents.”12 (§ 3011; Stats. 2012, ch. 258 

(A.B. 2365), § 1.) In setting up a process by which the parents could agree on a medical 

care provider moving forward and by granting Ellen tie-breaker authority, the court

determined that this change would benefit the children’s health, safety, and welfare. The 

court expressed concern that the elimination of the personal belief exemptions 

jeopardized the children’s continued enrollment in school, and their expulsion from their 

pediatrician’s practice left them without access to medical care. The court considered 

Christina’s inflexibility on the issue of decision-making regarding the children’s medical 

care, and her dismissal of any medical opinion that did not align with her views on 

immunization, as well as Ellen’s demonstrated history of cooperative parenting and 

openness to a broad range of medical opinions. This evidence supported the court’s 

conclusion that the ordered changes would be in the children’s best interest because the 

impasse that had developed between their parents on the critical subjects of school 

enrollment and medical care would be resolved.

Christina contends there is no nexus between the trial court’s findings and the 

children’s best interests, because the court did not focus on the propriety of vaccinations, 

but instead considered the inability of the parties to reach agreement regarding whether to 

vaccinate the children. As discussed above, the parent’s inability to agree regarding 

immunization was impacting the children’s access to medical care and jeopardizing their 

schooling. 

The way in which each parent chose to address this dispute was also directly 

relevant to the children’s best interests. The DPSA was designed to protect the children’s 

12 Nothing in the record suggests the other factors set forth in section 3011 at the 

time of trial—a history of abuse by one parent against specified persons, or a history of 

drug use or alcohol abuse by either parent—were relevant in this case.
17

health, safety, and welfare by requiring that the parents mutually schedule the children’s 

medical appointments and seek written consent from the other parent to engage any new 

healthcare provider. In violation of that agreement, Christina obtained a medical 

exemption for I., and then submitted it to the school, without Ellen’s knowledge or 

consent. Christina’s decision to retain a healthcare provider, found by the trial court to be

“of unknown credentials” who never saw the children and yet issued an exemption for 

them also was not in the children’s best interests.

As important, Christina’s lack of transparency put the children in the middle of 

parental conflict, which the trial court could properly consider in assessing the children’s 

best interest. Her insistence that the children not be vaccinated resulted in the 

termination of the children’s clinical relationship with the pediatrician who had treated 

them since birth. Christina’s decision to administer genetic testing by taking buccal

swabs from the children, who were certainly old enough to understand why they were 

being required by their mother to submit the samples, also highlighted for the children the 

growing conflict between the parents. In its findings, the trial court provided a record 

that Christina’s unwillingness to cooperate with Ellen and the ensuing impasse between 

the parents was detrimental to the health and welfare of the children. The trial court did 

not abuse its discretion when it addressed the ongoing conflict by authorizing Ellen, 

having found her to be the more cooperative parent, to make the final decision regarding 

whether to immunize the children if she and Christina reached an impasse after 

consulting with medical professionals.

III. DISPOSITION

The August 14, 2017 Order After Hearing is affirmed.
_______________________________

Greenwood, P.J.

WE CONCUR:

_________________________________

Grover, J.

________________________________

 Danner, J.

Von Dorrer-Hildebrand v. Veccia

No. H045095