Court Opinion

ID: 9907415
Source: CourtListenerOpinion
Date Created: 2023-12-06 15:06:12.386199+00
Date Added: 2024-06-11T09:55:01.707848
License: Public Domain

RECORD IMPOUNDED

                                NOT FOR PUBLICATION WITHOUT THE
                               APPROVAL OF THE APPELLATE DIVISION
        This opinion shall not "constitute precedent or be binding upon any court ." Although it is posted on the
     internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3.

                                                        SUPERIOR COURT OF NEW JERSEY
                                                        APPELLATE DIVISION
                                                        DOCKET NO. A-0742-22

STATE OF NEW JERSEY,

          Plaintiff-Respondent,

v.

M.L.B.,1

     Defendant-Appellant.
_______________________

                   Argued October 31, 2023 – Decided December 6, 2023

                   Before Judges Smith and Perez Friscia.

                   On appeal from the Superior Court of New Jersey, Law
                   Division, Morris County, Indictment No. 19-12-0999.

                   Andrew Gimigliano argued the cause for appellant
                   (Mandelbaum Barrett PC, attorneys; Andrew
                   Gimigliano and Robert C. Scrivo, of counsel and on the
                   briefs).

                   Tiffany M. Russo, Assistant Prosecutor, argued the
                   cause for respondent (Robert J. Carroll, Morris County
                   Prosecutor, attorney; Tiffany M. Russo, on the brief).

1
 We use initials to protect the confidentiality of the parties in these proceedings.
R. 1:38-3(a)(2).
PER CURIAM

        M.L.B. appeals from an October 3, 2022 amended Law Division order

continuing his civil commitment at Greystone Park Psychiatric Hospital subject

to Krol2 status periodic review. We affirm.

                                         I.

        We summarize the facts and procedural history most pertinent to this

appeal from the record. On August 7, 2019, a female, later determined to be

L.K., called the Washington Township Police advising she had been shot twice

by M.L.B. and was located at a local residence in town. Upon arrival, officers

observed R.G. restraining M.L.B. and gunshot wounds to L.K.'s chest. M.L.B.

was arrested and charged. L.K. and R.G. were tenants residing on M.L.B.'s

property where he resided in a separate residence.       The parties had prior

incidents of discord, which resulted in police calls.

        On April 14, 2022, a jury found M.L.B. not guilty by reason of insanity

(NGRI) of attempted murder, N.J.S.A. 2C:5-1(a)(3) and N.J.S.A. 2C:11-3 (a)(1),

and possession of a weapon for an unlawful purpose, N.J.S.A. 2C:39-4 (a)(1).

M.L.B. also was found not guilty of separate charges of attempted murder and

2
    State v. Krol, 68 N.J. 236 (1975).
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                                         2
possession of a weapon for an unlawful purpose. He was transferred to the

custody of the Department of Health and placed inpatient at Ann Klein Forensic

Center for evaluation and treatment. M.L.B. was then scheduled for an initial

Krol review pursuant to N.J.S.A. 2C:4-8(b)(3).

      The Krol judge who had presided over the first hearing had conducted the

trial. Two psychiatric experts, Dr. Joanna Bajgier for the State and Dr. Steven

Simring for M.L.B., testified at the hearing. Both experts were qualified without

objection.

      Dr. Bajgier worked as a psychiatrist in the general psychiatric unit at Ann

Klein along with other medical professionals including psychologist Dr. Kim

Reeves. Dr. Bajgier testified in evaluating M.L.B. regarding commitment, she

reviewed Dr. Reeves's records and reports, including a risk assessment. She

testified that she considered Dr. Reeves's reports and incorporated the findings

into her own report.     Dr. Bajgier also reviewed M.L.B.'s progress charts,

psychiatric medical history including prior diagnoses, and other relevant

records, such as the report of M.L.B.'s trial psychiatric expert, Dr. Simring. Dr.

Simring had diagnosed M.L.B. with delusional disorder and persistent

depressive disorder.

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      Dr. Bajgier met with M.L.B. on "at least a weekly basis" and characterized

his inpatient hospitalization as "uneventful." Approximately three months after

arriving at Ann Klein, Dr. Bajgier spent two hours and fifteen minutes meeting

with M.L.B. for his evaluation. Dr. Bajgier relayed that during the meetings

M.L.B.: had a "cooperative" demeanor; demonstrated anxiety "[w]hen he talked

about the case"; and was "somewhat obsessive about the case." Regarding

M.L.B.'s diagnoses, Dr. Bajgier relayed that she "stuck with" the diagnoses

M.L.B. had "actually been treated for," which were "adjustment disorder with

anxiety and post-traumatic stress disorder and major depressive disorder."

When asked whether she witnessed "histrionic or narcissistic personality traits,"

Dr. Bajgier testified "[M.L.B.] bec[ame] very animated" and "dramatic" as that

was "his personality style." She stated that upon arriving at Ann Klein, M.L.B.

had stopped taking all medication at his own request.

      Dr. Bajgier relayed the violence risk assessment—conducted to ascertain

future violence—indicated "under relationships" there was a presence of

"relevance high [which] means that it's a protective factor." Further, M.L.B.

told Dr. Bajgier that he may not have shot L.K., "he [didn't] remember shooting

her," he was trying to "fill in the gaps," and "it's possible that it" did not occur.

Dr. Bajgier testified that there was no "active psychiatric diagnosis," and she

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                                         4
"didn't firsthand[] make any of the diagnoses." Further, "the more [she had]

worked at Ann Klein, the more [she had] seen those diagnoses just [got] carried

forward" and "may be inaccurate." After evaluating M.L.B., she did not change

any diagnoses, because she found he did not suffer any mental disease.

      Dr. Bajgier further testified that she included in her report that Ann Klein's

Special Status Patient Review Committee (SSPRC) recommended M.L.B.'s

continued commitment at Greystone. The committee included the Ann Klein

department chairpersons of psychiatry, social work, psychology, and security.

SSPRC reviewed M.L.B.'s patient's progress notes, risk assessment, and Dr.

Bajgier's "treatment team" reports in consideration of a step-down in treatment.

Dr. Bajgier included the information in her report to distinguish her

disagreement.   Dr. Bajgier determined M.L.B. "could be discharged to the

community" with outpatient treatment as he "carrie[d] [a] variety of diagnoses

from different times, so the outpatient provider" could manage recurring

symptoms.

      The Krol judge allowed the State to move into evidence, over objection,

Dr. Bajgier's and Dr. Reeves's reports. Defense counsel argued, "[t]he fact that

an expert might rely on something [wa]s a different question than whether it

bec[ame] admissible evidence."

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                                         5
      Dr. Simring testified he met with M.L.B. twice in preparing his

"recommendation as to [M.L.B.]'s ongoing status under Krol." In formulating

his opinion, Dr. Simring also reviewed and relied on Dr. Bajgier's and Dr.

Reeves's reports, new and old medical records, and the progress notes. Dr.

Simring conversed with M.L.B.'s "original therapist" and "other individuals who

had treated him." Dr. Simring recommended a "day hospital or partial hospital"

for M.L.B.'s "ongoing psychiatric treatment for . . . his long history of

depression" and the "great trauma" he had been through. He provided, the

"bottom line [wa]s he need[ed] a great deal of psychiatric therapy, not because

he's 'mentally ill' in terms of insane, but because he ha[d] a lot of life problems

that he need[ed] help with that unfortunately he [was] not getting." Dr. Simring

recommended "therapy five days a week," for approximately seven hours a day.

      When confronted on cross-examination regarding his recommendation

from August 2020 of inpatient treatment at Greystone, which was antithetical to

his current recommendation of release, Dr. Simring acknowledged that M.L.B.

would be confronting significant stressors—specifically, the civil lawsuit filed

by L.K. and the "re-establish[ment] of his career in the equestrian community."

Dr. Simring explained his prior recommendation for Greystone was "not a final

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                                        6
recommendation" and he had since determined M.L.B.'s "greatest need [wa]s

intensive psychotherapy" with treatment in a facility for six-to-eight hours a day.

      Dr. Simring acknowledged he had diagnosed M.L.B. with delusional

disorder. In response to the judge's inquiry regarding whether the diagnosis was

current, the doctor responded, it "[wa]s a chronic psychiatric condition that

never completely [went] away entirely and at best, delusional disorder [wa]s

kept under control so that it d[id] not rear its ugly head." Additionally, he added

that M.L.B. "still, at some level believe[d] that [L.K.] presented a real threat to

him . . . [t]here [wa]s no medication that really help[ed] with delusional disorder,

except in the very acute phases of it." Dr. Simring disagreed with "Dr. Bajgier's

position" that M.L.B. was "not suffering from anything," and concluded M.L.B.

"ha[d] a long-term chronic depressive disorder" that may require medication and

would "certainly [require] psychotherapy to get his life back together." Defense

counsel moved Dr. Simring's report into evidence without objection.

      In his oral decision, the judge credited Dr. Simring's testimony regarding

M.L.B.'s diagnoses over Dr. Bajgier's lack of diagnoses, finding M.L.B. suffered

from depression and delusional disorder. The judge reasoned Dr. Simring's

experience and greater knowledge about M.L.B.'s psychiatric history lent to his

credibility. The judge credited Dr. Simring's opinion that delusional disorder

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                                         7
was a chronic condition and found it relevant that he recommended therapy five

full days a week. The judge found M.L.B. "continue[d] to suffer from delusional

disorder." Additionally, the judge found it highly relevant that M.L.B. "still

believe[d] he was justified in his actions in shooting" L.K. and believed "he was

acting in self-defense," which demonstrated he "lack[ed] insight into his

condition." In determining that M.L.B. was a danger to L.K. and to others, the

judge noted the uncontroverted stressor of L.K.'s pending civil lawsuit and found

it was unknown what M.L.B. was "capable of dealing with."

       Lastly, the judge found Ann Klein was not appropriate for M.L.B.'s

treatment, ordering a transfer to Greystone for a more appropriate level of care.

The judge found Greystone provided the opportunity to be "moved from Level

1 . . . to Level 3," through less restrictive programs as his treatment progressed.

The judge advised M.L.B. that his progress would be addressed at the next

hearing and ordered that his treating physicians could approve a step-down unit

transfer within the facility without further appearance. The judge noted the

victim and her father had sent letters to the court, but the information was not

included in his decision.

       M.L.B. raises the following arguments for our consideration: the State

failed to carry its burden of proving M.L.B. had a mental illness; the State did

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                                        8
not establish that M.L.B. was a danger to himself, property, or others because

both experts testified he was not a danger; less restrictive treatment alternatives

were appropriate; and the judge improperly relied on hearsay evidence without

providing M.L.B. the opportunity to cross-examine.

                                        II.

      We are guided by well-settled principles of law which govern a Krol

hearing review of an NGRI commitment. A judge's determination is "subject to

modification on appeal only where the record reveals a clear abuse of

discretion." In re Civ. Commitment of J.M.B., 395 N.J. Super. 69, 90 (App.

Div. 2007), aff'd, 197 N.J. 563 (2009). It is recognized that judges who hear

commitment cases "generally are 'specialists' and 'their expertise in the subject'

is entitled to 'special deference.'" In re Civ. Commitment of R.F., 217 N.J. 152,

174 (2014) (quoting In re Civ. Commitment of T.J.N., 390 N.J. Super. 218, 226

(App. Div. 2007)). To the extent the questions presented are procedural or legal

ones, however, our review is de novo. In re Commitment of J.L.J., 196 N.J.

Super. 34, 49 (App. Div. 1984).

      Appellate review of a Krol order is "extremely narrow, with the utmost

deference accorded the reviewing judge's determination as to the appropriate

accommodation of the competing interests of individual liberty and societal

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                                        9
safety in the particular case." State v. Fields, 77 N.J. 282, 311 (1978). Our

Supreme Court has held, "Such sensitive decisions will be subject to appellate

modification only where the record reveals a clear mistake in the exercise of the

reviewing judge's broad discretion in evaluating the committee's present

condition and formulating a suitable order."      Ibid. "Accordingly, it is our

responsibility to canvass the record inclusive of the expert testimony to

determine whether the findings made by the trial judge were clearly erroneous."

J.M.B., 395 N.J. Super. at 89 (citing In re D.C., 146 N.J. 31, 58-59 (1996)).

      "We give deference to the findings of our trial judges because they have

the 'opportunity to hear and see the witnesses and to have the "feel" of the case,

which a reviewing court cannot enjoy.'" R.F., 217 N.J. at 174 (quoting State v.

Johnson, 42 N.J. 146, 161 (1964)). "So long as the trial court's findings are

supported by 'sufficient credible evidence present in the record,' those findings

should not be disturbed." Id. at 175 (quoting Johnson, 42 N.J. at 162). We

review expert testimony in the record for credible evidence to support the judge's

fact-findings before determining those findings were clearly erroneous. See

D.C., 146 N.J. at 58-59.

      When an accused is found NGRI, the criminal proceedings terminate

"unless the accused remains mentally ill and in need of involuntary

                                                                            A-0742-22
                                       10
commitment." In re Commitment of W.K., 159 N.J. 1, 4 (1999). Following an

NGRI verdict, "the accused can be involuntarily committed," and thereafter , the

court must conduct "periodic review hearings," known as Krol hearings, "to

determine if continued involuntary commitment is warranted." Ibid.

      Defendants "may be held in continued confinement if the person is a

danger to self or others and is in need of medical treatment." Id. at 2. The

purpose is not to punish, but "to protect society against individuals who, through

no culpable fault of their own, pose a threat to public safety." Krol, 68 N.J. at

246. After commitment, NGRI defendants "are reviewed on a periodic basis

under the same standards as those applied to civil commitments generally." In

re Commitment of M.M., 377 N.J. Super. 71, 76 (App. Div. 2005), aff'd, 186

N.J. 430 (2006) (citing Krol, 68 N.J. at 251). An NGRI defendant "may remain

under Krol commitment for the maximum ordinary aggregate terms that

defendant would have received if convicted of the offenses charged, taking into

account the usual principles of sentencing." W.K., 159 N.J. at 6.

      To continue involuntary commitment, the State must establish a defendant

poses "a substantial risk of dangerous conduct within the reasonably foreseeable

future." M.M., 377 N.J. Super. at 76 (quoting Krol, 68 N.J. at 260). The focus

is on whether the defendant "presently poses a significant threat of harm, either

                                                                            A-0742-22
                                       11
to himself or to others." Ibid. (quoting Krol, 68 N.J. at 247). The determination

of "dangerousness" is "a legal one, not a medical one." Krol, 68 N.J. at 261. An

"[e]valuation of the magnitude of the risk involves consideration both of the

likelihood of dangerous conduct and the seriousness of the harm which may

ensue if such conduct takes place." Id. at 260 (citing Cross v. Harris, 418 F.2d

1095, 1100-01 (1969)).

      N.J.S.A. 30:4-27.2(h) defines danger to self as: "by reason of mental

illness the person has threatened or attempted suicide or serious bodily harm, or

has behaved in such a manner as to indicate . . . that it is probable that substantial

bodily injury, serious physical harm, or death will result within the reasonably

foreseeable future." A danger to others is defined as: "by reason of mental

illness there is a substantial likelihood that the person will inflict serious bodily

harm upon another person or cause serious property damage within the

reasonably foreseeable future." N.J.S.A. 30:4-27.2(i). The required review for

a "[d]etermination of dangerousness involves prediction of defendant's future

conduct rather than mere characterization of . . . past conduct." Krol, 68 N.J. at

260-61. Yet, a "defendant's past conduct is important evidence as to his probable

future conduct."     Id. at 261.     As the statute directs, the dangerousness

determination "shall take into account a person's history, recent behavior, and

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                                        12
any recent act, threat, or serious psychiatric deterioration." N.J.S.A. 30:4-

27.2(h), (i).

      The determination requires a "delicate balancing of society's interest in

protection from harmful conduct against the individual's interest in personal

liberty and autonomy." Krol, 68 N.J. at 261. In ordering restraints to reduce the

risks an NGRI defendant poses, any "[d]oubts must be resolved in favor of

protecting the public, but the court should not, by its order, infringe upon

defendant's liberty or autonomy any more than appears reasonably necessary to

accomplish this goal." State v. Ortiz, 193 N.J. 278, 292 (2008) (quoting Krol,

68 N.J. at 261).

                                      III.

      We conclude the judge's finding that M.L.B. has a mental illness as he

suffers from depression and delusional disorder, is supported by sufficient

credible evidence in the record. The judge accepted Dr. Simring's testimony

regarding M.L.B.'s mental illness diagnoses and noted the expert's detailed

knowledge of M.L.B.'s medical history. While rejecting the experts' opinions

that M.L.B. should be released from inpatient care, the judge found relevant that

Dr. Simring testified M.L.B. needed "therapy five days a week" at a facility for

approximately seven hours per day. The judge accepted Dr. Simring's testimony

                                                                           A-0742-22
                                      13
that M.L.B. needed continued treatment and possible medication. Additionally,

as noted by the judge, Dr. Bajgier testified she witnessed M.L.B. demonstrate

anxiety and observed him to be "somewhat obsessive." M.L.B.'s argument that

the State failed to establish he has a present mental illness is without merit. See

State in the Int. of M.P., 476 N.J. Super. 242, 289 (App. Div. 2023) (finding "the

trier of fact is free to accept some portions of an expert's opinion and reject

others" (citing Sipko v. Koger, Inc., 251 N.J. 162, 188 (2022))).

          The judge reasoned the experts' testimony that M.L.B. still believed "he

was justified in shooting" L.K because it was in self-defense demonstrated

impaired judgment. A "mental illness" under Rule 4:74-7(f)(1)(2), as defined

by N.J.S.A. 30:4-27.2(r), is "a current, substantial disturbance of thought, mood,

perception, or orientation which significantly impairs judgment, capacity to

control behavior, or capacity to recognize reality." The judge found M.L.B.'s

mental illness impaired both his judgment and capacity to have "insight into his

condition." This finding is supported by substantial credible evidence in the

record.

      Nor are we persuaded by M.L.B.'s assertion that the State failed to prove

he was a danger. The judge determined M.L.B. was a danger to the community

and, more specifically, to L.K.       Again, the judge relied on Dr. Simring's

                                                                             A-0742-22
                                        14
testimony that M.L.B. at "some level believe[d] that [L.K.] presented a real

threat to him" and his actions in shooting her were in self-defense. Noting the

uncontroverted stressors M.L.B. would be confronting with the civil lawsuit

brought by L.K., which likely would require some level of interaction between

the parties, the judge found M.L.B. was a risk to L.K. The judge determined

M.L.B.'s delusional disorder could not be sufficiently addressed to prevent the

attendant risks from his inability to cope with stressors. We conclude the judge's

finding that M.L.B. presented a substantial danger for the foreseeable future is

sufficiently supported by credible evidence in the record.

      We observe the judge also considered the possibility of less restrictive

treatment in deciding to transfer M.L.B. to Greystone and entering a self-

initiating order permitting M.L.B.'s transfer to a step-down unit if medically

appropriate. The order provided: "[t]he treatment team at Greystone . . . [wa]s

allowed to change the privileges of [M.L.B.] between Level I – III . . . without

prior leave of this [c]ourt." Contrary to M.L.B.'s argument, the judge correctly

considered the less restrictive treatment alternatives but found, based on

sufficient evidence, that the State had proven the necessity for continued

commitment.

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                                       15
      "The State is, as a general matter, entitled to call experts on the subject of

commitment and, to the extent the information the experts relied upon is of a

type reasonably relied upon by experts in that field, the State can prove the

grounds for commitment without calling as a witness each person who provided

information upon which the expert relied." In re Civ. Commitment of A.Y., 458

N.J. Super. 147, 166 (App. Div. 2019); N.J.R.E. 703. The "[p]rior expert

opinions [relied upon] are admissible, not as substantive evidence, but as a basis

for the expert's opinion." A.Y., 458 N.J. Super. at 167 (citing In re Commitment

of E.S.T., 371 N.J. Super. 562, 576 (App. Div. 2004)).

      In his findings, the judge primarily relied on M.L.B.'s expert's credible

testimony. The judge reasoned Dr. Simring's testimony concerning M.L.B.'s

diagnoses was credible because the doctor had the greatest familiarity with

M.L.B.'s full medical history, which he relied upon in formulating his opinions.

Notably, Dr. Simring provided that in reaching his opinions, he relied on

uncontested diagnoses, medical charts, reports, and psychiatric information

relayed through conversations with other professionals.           Relevantly, Dr.

Simring's opinion and medical history testimony were introduced by M.L.B. and

were uncontested. See In re Civ. Commitment of A.E.F., 377 N.J. Super. 473,

492 (2005) (holding expert witnesses are not precluded from relying "in part[]

                                                                              A-0742-22
                                       16
on prior evaluations conducted for other purposes . . . and other psychiatric

evaluations conducted . . . as long as the opinion ultimately rendered . . . is that

of the witness based on his or her own evaluation"). We note Dr. Simring's

report was admitted without objection. M.L.B.'s argument that reversal and

release from commitment is warranted because the judge "improperly relied on

hearsay without the opportunity for cross-examination" is unavailing.

      Dr. Simring testified to the information he extracted from Dr. Bajgier's

and Dr. Reeves's reports, as well as from M.L.B.'s other previous therapists. Dr.

Simring relayed he reviewed M.L.B.'s medical history in the normal course of

conducting his evaluation and recommendation. Because the judge based his

findings almost exclusively on Dr. Simring's testimony, any reference to the

SSPRC recommendations outside of the background information upon which

both experts reasonably relied to distinguish their opinions, was harmless. See

In re Commitment of E.S.T., 371 N.J. Super. 562, 576 (App. Div. 2004) (finding

that while it is improper for a judge to consider "for their truth[,] any complex

diagnoses that may have been contained" in expert reports, "the admission of

the records [was] harmless under the circumstances" (quoting In re Commitment

of A.X.D., 370 N.J. Super. 198, 202-03 (App. Div. 2004))).

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                                        17
      Although we agree with defendant's argument that the blanket admission

of Dr. Bajgier's and Dr. Reeves's expert reports was improperly granted, we

recognize the judge delivered his opinion immediately at the conclusion of the

one-day hearing. While a judge may consider background information deemed

trustworthy in evaluating an expert's opinion testimony, the better course is for

a judge to make a "clearer [evidence ruling] by acknowledging the applicability

of N.J.R.E. 808." A.X.D., 370 N.J. Super. at 202-03; see R. 2:10-2 (noting that

a trial error or omission may be disregarded "unless it is of such a nature as to

have been clearly capable of producing an unjust result").

      It is recognized psychiatric evaluations and "hospital reports often

indicate that the author has recorded his or her observations of the patient's

relevant behavior in the course of performing his or her duties. Such reports are

admissible."    M.M., 384 N.J. Super. at 334 (citing N.J.R.E. 803(c)(6)).

Additionally, "[t]o the extent that such reports include statements made by the

patient for purposes of treatment or in explaining his or her present state of mind,

they are also admissible for the truth of those statements." Ibid. (citing N.J.R.E.

803(c)(3), (4); N.J.R.E. 805). With these considerations, we discern no basis to

disturb the judgment of commitment, which is amply supported by the sufficient

evidence.

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                                        18
      Lastly, M.L.B. argues the judge wrongfully set the next Krol hearing date

for "six months after the initial hearing, despite Rule 4:74-7(f)(2) requiring the

second hearing to be held three months after the initial hearing." Defense

counsel objected to the ordered March 2023 date and requested compliance with

the Rule. While we recognize the date has passed, M.L.B. is correct that the

hearing should have been scheduled within three months . M.L.B. has an

absolute right to have timely Krol status reviews. Rule 4:74-7(f)(2) provides for

"inpatient treatment, periodic reviews should be no later than (i) three months

from the date of the first hearing, and (ii) nine months from the date of the first

hearing, and (iii) [twelve] months from the date of the first hearing, and (iv) at

least annually thereafter." Accordingly, future Krol hearings shall be scheduled

in compliance with the Rule.

      To the extent we have not addressed M.L.B.'s remaining arguments, we

determine they lack sufficient merit to warrant discussion in a written opinion.

R. 2:11-3(e)(2).

      Affirmed.

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                                       19