[Cite as State v. Heltzel,

.]

IN THE COURT OF APPEALS OF OHIO ELEVENTH APPELLATE DISTRICT TRUMBULL COUNTY

STATE OF OHIO, CASE NO. 2023-T-0088

Plaintiff-Appellee, Criminal Appeal from the - vs - Court of Common Pleas

PATRICK LAWSON HELTZEL, Trial Court No. 2013 CR 00219 Defendant-Appellant.

OPINION

Decided: May 6, 2024 Judgment: Affirmed

Dennis Watkins, Trumbull County Prosecutor, and Ryan J. Sanders, Assistant Prosecutor, Administration Building, Fourth Floor, 160 High Street, N.W., Warren, OH 44481 (For Plaintiff-Appellee).

John B. Juhasz, 7081 West Boulevard, Suite 4, Youngstown, OH 44512 (For Defendant- Appellant).

MATT LYNCH, J.

{¶1} Defendant-appellant, Patrick Lawson Heltzel, appeals from the judgment of

the Trumbull County Court of Common Pleas, denying Heltzel conditional release from

Heartland Behavioral Healthcare. For the following reasons, we affirm the judgment of the

lower court.

{¶2} On April 12, 2013, Heltzel was indicted by the Trumbull County Grand Jury

for two counts of Aggravated Murder, unclassified felonies, in violation of R.C. 2903.01(A),

(B), and (F), and Aggravated Robbery, a felony of the first degree, in violation of R.C.

2911.01(A)(1) and (3). {¶3} On August 14, 2014, the trial court issued an order finding Heltzel

incompetent to stand trial. He was subsequently restored to competence and a trial was

held. On June 1, 2016, the court issued a Judgment Entry, finding Heltzel not guilty by

reason of insanity. The court found that Heltzel went to the home of the victim while

suffering psychotic delusional beliefs, placed the victim in a chokehold, stabbed him

repeatedly, and beat him with a remote control, causing his death, and subsequently

removed from the victim’s home a Bible and a ring. The court noted a delusional belief

that the victim had previously sexually abused him in an alternate life. It concluded that

Heltzel suffered from schizophrenia at the time of the offenses and, as a result of that

disease, he did not know the wrongfulness of his actions. It ordered an evaluation by the

Forensic Psychiatric Center of Northeast Ohio to determine the least restrictive treatment

alternative.

{¶4} On June 23, 2016, the court found Heltzel was a mentally ill person subject

to court order and that the least restrictive alternative consistent with public safety and

Heltzel’s welfare was to be committed to Heartland Behavioral Healthcare. A six-month

review was conducted in 2017, where the court found that his commitment remained the

least restrictive alternative and ordered he remain on his current level of privilege, level

two.

{¶5} During review hearings held in 2019, 2021, and 2023, the court issued orders

that Heltzel continue on inpatient treatment for two years. During this time, the court also

issued orders granting requests to advance Heltzel to level three, four, and five privileges

relating to his movement and supervision.

{¶6} In 2023, a request that Heltzel be granted conditional release was submitted.

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Case No. 2023-T-0088 On August 23, 2023, a hearing was held on this issue. The parties stipulated to the

Conditional Release Plan and Evaluation, which was conducted by Kristi Lang, a

psychologist at Heartland Behavioral Healthcare.

{¶7} Dr. Lang testified that she has worked with Heltzel for over a year, seeing

him on a daily basis, and evaluated him for conditional release. She stated that he is a

“model patient” and consistently attended group sessions made available to him. His

participation “showed * * * he had very good insight into his mental health and need for

medication.” She stated that he had done well in his movement through the level system,

having no incidents in groups, outings, or weekend overnight visitations with his mother.

She testified that he consistently tested negative for drugs and alcohol and was compliant

with his medication. She testified that he understood the need for medication and to remain

sober. She testified that it was the opinion of herself and the treatment team that he is “at

his baseline,” i.e., having no symptoms, and has been for a number of years. She

recommended he be put on conditional release, with which the forensic monitor agreed.

She indicated that if he was released, Heltzel would be on a conditional release plan,

requiring him to receive outpatient mental health treatment, substance abuse treatment,

and continue with medication including a long-acting injectable.

{¶8} The prosecutor inquired, “Would you agree that you can’t predict with a

hundred percent certainty how he’ll behave * * * once he’s released,” to which she

responded in the affirmative. He inquired, “that’s why we have to put some of these

guardrails in place, right?” with which she also agreed. He inquired about the observation

in Heltzel’s evaluation that his family was unable to control him in the past when he was

spiraling, which Dr. Lang noted was prior to his hospitalization. Dr. Lang indicated,

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Case No. 2023-T-0088 pursuant to the court’s questioning, that Heltzel had been on the same medication for his

schizophrenia since 2016. A Second Opinion Evaluation by Dr. Jessica Hart was also

submitted, in which she recommended that Heltzel be granted conditional release. A

representative of the victim’s family spoke and stated that he should “stay in prison.”

{¶9} The trial court issued an October 19, 2023 Judgment Entry denying Heltzel

conditional release and ordering that he remain at Heartland Behavioral Healthcare at his

present level of confinement, with further review in two years. The court stated that it

considered the evidence, the treatments received by Heltzel, the likelihood of continued

compliance, the risk to public safety, and Heltzel’s welfare. It found “by clear and

convincing evidence that [Heltzel] remains a mentally ill person subject to court order

pursuant to O.R.C. Section 2945.401.” It further indicated: “In full and complete review of

the entire case, the Court would be remiss if it did not acknowledge the seriousness and

brutal nature of the underlying crime. Furthermore, the Court notes the possible

consciousness of guilt evidenced by [Heltzel] when he fled the state following the murder.

The Court finds that full conditional release at this time would demean the seriousness of

the offense and is premature.”

{¶10} Heltzel timely appeals and raises the following assignment of error:

{¶11} “The trial court abused its discretion when it denied the Appellant conditional

release in violation of U.S. CONST., amend. XIV and OHIO CONST., art. I, §§1, 2, and 16

and R.C. 2945.401.”

{¶12} Heltzel argues that the court erred in denying conditional release because

the evidence presented supported release and no contrary evidence was presented, that

the prosecutor’s burden to prove by clear and convincing evidence that the change to his

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Case No. 2023-T-0088 conditions of commitment will represent a threat to the public safety was not met, and that

the court’s comments and failure to grant the motion indicated that Heltzel was being

treated as though he was serving a criminal sentence for a conviction rather than being

held as an acquittee who was not guilty by reason of insanity.

{¶13} R.C. 2945.401 sets forth the procedure for terminating or changing

commitment conditions for a person who has been found not guilty by reason of insanity.

“R.C. 2945.401(A) and (J)(1) provide that if a defendant in a criminal case is found not

guilty by reason of insanity and then committed to a mental-health institution, the defendant

shall remain subject to the jurisdiction of the trial court until final termination of the

commitment.” State v. Stutler,

,

,

. “At any time after evaluating the risk to public safety and the welfare of the committed

person, the managing officer of the institution or the director of the facility or program to

which the person is committed may recommend to the trial court that the person’s

commitment be terminated or that the conditions of the person’s commitment be changed.”

citing R.C. 2945.401(D). After a hearing, “the trial court may approve, disapprove, or

modify the recommendation and shall enter an order accordingly.” R.C. 2945.401(I).

{¶14} “R.C. 2945.401(E) sets forth various factors that a trial court must consider

when ruling on a recommendation that a committed individual be granted ‘nonsecured

status’ or hav[e] his or her commitment terminated.” State v. Hickman, 11th Dist. Ashtabula

No. 2022-A-0114,

. “Nonsecured status” is defined, in relevant part,

as “any unsupervised, off-grounds movement * * * or any conditional release, that is

granted to a person * * * who is found not guilty by reason of insanity * * *,” which applies

in the present matter. R.C. 2945.37(A)(3). The statutory factors to be considered in

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Case No. 2023-T-0088 granting nonsecured status are:

(1) Whether, in the trial court’s view, the defendant or person currently represents a substantial risk of physical harm to the defendant or person or others;

(2) Psychiatric and medical testimony as to the current mental and physical condition of the defendant or person;

(3) Whether the defendant or person has insight into the defendant’s or person’s condition so that the defendant or person will continue treatment as prescribed or seek professional assistance as needed;

(4) The grounds upon which the state relies for the proposed commitment;

(5) Any past history that is relevant to establish the defendant’s or person’s degree of conformity to the laws, rules, regulations, and values of society;

(6) If there is evidence that the defendant’s or person’s mental illness is in a state of remission, the medically suggested cause and degree of the remission and the probability that the defendant or person will continue treatment to maintain the remissive state of the defendant’s or person’s illness should the defendant’s or person’s commitment conditions be altered.

R.C. 2945.401(E).

{¶15} At a hearing to change commitment conditions, the prosecutor represents the

State and public interest. R.C. 2945.401(H). In the case that a conditional release is

sought, the applicable burden of proof is found in R.C. 2945.401(G)(2). Hickman at ¶ 16.

Pursuant to that section, the prosecutor has the burden of proof to show by clear and

convincing evidence, in the case of “a recommendation for a change in the conditions of

the commitment to a less restrictive status, * * * that the proposed change represents a

threat to public safety or a threat to the safety of any person.”

{¶16} An abuse of discretion standard has been applied to appellate review of a

trial court’s ruling on a motion for conditional release. Hickman at ¶ 21. An abuse of

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Case No. 2023-T-0088 discretion is the trial court’s “‘failure to exercise sound, reasonable, and legal decision-

making.’” State v. Beechler, 2d Dist. Clark No. 09-CA-54,

, ¶ 62, quoting

Black’s Law Dictionary 11 (8th Ed. 2004). In applying this standard, this court noted the

recent clarification of the standard by the Ohio Supreme Court in Stutler,

,

,

. In Stutler, the court explained the following:

That a trial court has more discretion to disapprove or modify an institution’s recommendation for a committed person’s nonsecured movement or termination of the person’s commitment explains why the legislature chose to use the word “may” in R.C. 2945.401(I). R.C. 2945.401(I)’s statement that the trial court “may approve, disapprove, or modify” a recommendation made under R.C. 2945.401(D)(1) shows that the court has more discretion to disapprove or modify a recommendation for nonsecured status or termination of commitment based on its findings under R.C. 2945.401(E) than it does for other recommendations for changes that involve the person’s remaining supervised. In this context, the use of the word “may” is nothing more than a reflection of the trial court’s options, which are based on the type of recommended change in commitment status or conditions before the court.

Id. at ¶ 15. This court concluded: “the trial court in this matter, according to the Court in

Stutler, enjoyed broader discretion in reaching its conclusion [denying motion for

conditional release] than if the movant sought a change in commitment level, such as one

involving ‘off-grounds supervised movement.’” Hickman at ¶ 18.

{¶17} In the present matter, the lower court indicated that it had reviewed all of the

evidence, the treatments received by Heltzel, the likelihood of continued compliance, the

risk to public safety, and Heltzel’s welfare. It ultimately concluded that conditional release

should not be granted. In addressing the motion for conditional release, the court is to

consider the factors listed in R.C. 2945.401(E), outlined above. While the record indicates

that Heltzel had made progress in his treatment, had insight into his mental health

condition, and had not exhibited symptoms of his mental illness for a number of years, the

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Case No. 2023-T-0088 court was also required to consider his “past history that is relevant to establish the

defendant’s or person’s degree of conformity to the laws, rules, regulations, and values of

society.” R.C. 2945.401(E)(5). The trial court expressed concern with the seriousness of

the crime, which demonstrates its consideration of his past history relevant to conformity

to the law. See Hickman at ¶ 20 (observing that the severity of the defendant’s history of

violence, as well as the less rigorous monitoring of the defendant, were relevant

considerations by the court in denying the motion for conditional release). There is nothing

in the statute that requires the factors be equally balanced; the trial court has the discretion

to determine the proper outcome based on these factors, although its consideration is “not

limited to” such factors. R.C. 2945.401(E).

{¶18} While Heltzel argues that the entirety of the evidence supported conditional

release, additional facts in the record of the conditional release hearing further support

concerns relating to Heltzel’s history of violence, which weighed against granting his

motion. The record indicates that the crime giving rise to the present matter included the

choking, stabbing and beating of the victim, leading to his death. Prior to that crime, in

early 2013, Heltzel also slapped his father and threatened to kill him with a knife. Further,

the Conditional Release Evaluation completed by Dr. Lang indicated that Heltzel has a “risk

factor for violence” in that he has a “history of noncompliance with treatment in the

community.” The report indicates that he had previously been prescribed antidepressants

following a suicide attempt but was “noncompliant” with taking medication. Further, after

the incident with his father in early 2013, during which he experienced delusions, he was

admitted to Heartland. However, although his symptoms improved during treatment there,

“[a]fter his hospitalization, he was noncompliant with appointments, medication, and he

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Case No. 2023-T-0088 continued to use substances after discharge.” The record indicated that he had a prior

history of use of various illegal drugs recreationally, including LSD, cocaine, and

prescription medications. Given these circumstances, it is evident there were legitimate

concerns about Heltzel’s release into the community given his past history and the lower

court exercised its discretion to deny the motion consistent with these concerns.

{¶19} Hetzel argues that he is an “acquittee” since a finding of not guilty by reason

of insanity is “not a conviction of a criminal offense,” State v. Tuomala,

,

,

, ¶ 16-17, and, thus, the court could not consider the

seriousness of his criminal offense to continue to hold him. It has been held that “[u]nlike

criminal defendants who are confined for punishment, insanity acquittees are confined for

treatment and safety.” State v. Street,

,

(7th Dist.).

This, however, does not preclude the court from considering his past violence and

noncompliance with the laws in denying a request for conditional release, as discussed

above. While his progress and improvement of his mental health condition are factors to

take into account, the past conduct is also a significant factor as it helps to evaluate the

threat posed to the public. While the trial court may have used inartful language in

discussing “demeaning the seriousness of the offense” rather than referencing the factors

under R.C. 2945.401(E), it is still permitted to consider his past record and offenses in

ruling on the motion.

{¶20} Heltzel raises arguments regarding how Ohio’s civil commitment statute has

been applied by various courts and whether such application violates the Equal Protection

Clause. This issue was not raised at the below hearing. Arguments regarding equal

protection are waived when no objection is made at the trial court. State v. Dudas, 11th

9

Case No. 2023-T-0088 Dist. Lake Nos. 2006-L-267 and 2006-L-268,

, ¶ 106. Nonetheless, we do

not find an equal protection violation.

{¶21} Equal protection “analysis begins with the rebuttable presumption that

statutes are constitutional.” State v. Peoples,

,

,

. “We need not even reach the equal protection issue if all offenders in a

class are treated equally.” Id. at ¶ 6. Under the statute at issue here, the legislature sets

forth requirements for all offenders who are found not guilty by reason of insanity. This

applies to all offenders in the same manner. That Heltzel takes issue with the court’s

application of the factors to be considered and the burden applied does not mean that the

law violates the Equal Protection Clause.

{¶22} Heltzel also argues that there was a violation of the separation of powers

doctrine when the prosecutor was not required to meet his burden in the present matter.

This really amounts to a challenge that there was a lack of evidence presented by the

prosecutor to support denial of Heltzel’s motion. As noted above, there was evidence in

the record, through the jointly admitted exhibits, showing concerns with Heltzel’s release,

specifically his history of violence and noncompliance with treatment for mental health

concerns in addition to use of illegal drugs that may compromise treatment.

{¶23} In its brief, the State concedes that the trial court “did not make the

appropriate findings under R.C. 2945.401,” noting the lack of a finding regarding the least

restrictive alternative and the court’s finding that conditional release would demean the

seriousness of the offense. However, Heltzel does not argue that the court failed to make

the proper findings or make findings relating to the least restrictive alternative but only that

the findings were not supported by the record: “the finding that conditional release was not

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Case No. 2023-T-0088 the least restrictive environment consistent with treatment goals and public safety was

against the manifest weight of the evidence.” While the State contends that the court did

not comply with R.C. 2945.401, this statute does not reference findings that the court is

required to make in granting a conditional release but states that, after a hearing on a

request for change in the terms of commitment, the “trial court may approve, disapprove,

or modify the recommendation and shall enter an order accordingly.” R.C. 2945.401(I).

Further, while the trial court must consider the factors listed in R.C. 2945.401(E) when

ruling on a request for nonsecured status, it has been held that “R.C. 2945.401(E) does

not mandate findings on the factors.” State v. Tanner, 12th Dist. Butler No. CA2021-12-

167,

; State v. Henderson, 5th Dist. Fairfield No. 16-CA-23, 2017-

Ohio-2620, ¶ 29. The statute also does not limit consideration to the six factors only.

Henderson at ¶ 29. While it is accurate the court used wording that conditional release

would “demean the seriousness of the offense,” which is typically related to criminal

sentence sentencing, as discussed above, the court’s choice of wording does not change

that it expressed concern about Heltzel’s history, a relevant consideration that supported

denying the motion for conditional release.

{¶24} The sole assignment of error is without merit.

{¶25} For the foregoing reasons, the judgment of the Trumbull County Court of

Common Pleas, denying Heltzel conditional release from Heartland Behavioral Healthcare,

is affirmed. Costs to be taxed against appellant.

EUGENE A. LUCCI, P.J.,

MARY JANE TRAPP, J.,

concur. 11

Case No. 2023-T-0088