What now for Carlos Dominguez as state hospital awaits in Davis stabbing rampage?

The man held in the murderous rampage that paralyzed Davis for days this spring is bound for a state hospital, deemed unfit for trial.

But what comes next for Carlos Reales Dominguez, the 21-year-old former UC Davis student who suffered an apparent psychotic spiral before prosecutors say he committed three brutal stabbings that killed two people and seriously wounded a third.

“It’s a state hospital. They have one goal,” Mark Reichel, a criminal attorney and former federal public defender based in Sacramento, said. “Diagnose and treat the person and restore him to competence.”

Where that takes place — Napa, Atascadero or another facility — will likely be determined at a scheduled Aug. 17 placement review hearing in Yolo Superior Court. There, a judge will determine which hospital has room for him and can take him as quickly as possible.

The goal: “That they understand what’s going on, so they can truly, genuinely assist counsel,” Reichel said. “They’re going to do everything they can to restore him to competency.”

Diagnose, treat and restore. If treatment is successful and Reales Dominguez is restored to competency, the criminal case can resume. If not, “they keep trying,” Reichel said.

If in the rare instance that a person under state hospital care cannot be returned to competency, Reichel said, they are placed in what is known as a Murphy’s Conservatorship. The person facing criminal charges and deemed to be dangerous but not deemed competent within a statutory three-year time frame becomes a ward of the state.

A Murphy’s conservator after a judge’s approval, can place that person in a state hospital or state psychiatric facility — a secured lockdown facility, said Reichel — if they are:

▪ Gravely disabled as the result of a mental disease and/or disorder;

▪ Unable to provide for their basic personal needs for food, clothing or shelter; and

▪ Require placement in a state mental institution or other facility for psychiatric care.

In the meantime, Reales Dominguez, facing murder charges with special circumstances in the knife killings of 50-year-old David Breaux, 20-year-old graduating UC Davis student Karim Abou Najm; and attempted murder in a third attack that seriously wounded Kimberlee Guillory, 64, as she slept in her Davis encampment, remains isolated in medical custody at Yolo County Jail where he has been since his arrest.

Criminal proceedings in Reales Dominguez’s case remain suspended. The case has been put on hold since June when Dominguez’s attorney, Yolo County Deputy Public Defender Daniel Hutchinson, first declared doubt as to his fitness to stand trial.

The jury convened in July to decide Reales Dominguez’s mental fitness before Yolo Superior Court Judge Samuel McAdam will be formally excused Monday. It was unclear Friday whether Reales Dominguez would also appear in court Monday.

Restoring competency can take months or, sometimes, years, but the goal remains, Reichel said. At the hospital, the person will undergo therapy with mental health professionals that may include medication.

Medicating Reales Dominguez had surfaced as a critical issue in the competency trial now winding to an end and was a contributing factor in the prosecutors’ decision to agree that he is unfit to proceed to trial.

There were disagreements between jail medical staff and a telehealth psychiatrist, which delayed recommended emergency doses of antipsychotic medication for Reales Dominguez in the weeks following his May arrest. Judge McAdam last month suggested to attorneys that medical professionals caring for the former UC Davis student should petition the court to order emergency medication.

“We have overwhelming evidence he has a mental health condition,” McAdam told the attorneys.

McAdam and the jurors listened to days of testimony detailing Reales Dominguez’s slide as the disheveled defendant dressed in his daily uniform of green safety smock, shackles and waist restraints sat silently beside his attorney.

His grooming, once “pristine,” his girlfriend testified, had deteriorated. He began to hear voices, his friends said, and asked if others heard them, too. He stared at walls for minutes at a time, a co-worker testified. He hadn’t talked to his roommates in months but they were troubled enough to discuss a plan to confront him about his apparent mental illness, designating one of them to ask him to seek help and direct him to where he could find it.

“It was something to express our concerns about him being mentally ill,” former roommate Phillip Han testified. “We shared our personal observations that something needed to be done. We were trying to convince him to get checked out, to talk to someone, to open up.”

The last time roommate Sidney Slelecki saw him was May 3. David Breaux and Karim Abou Najm were already dead. Guillory was grievously wounded but slowly mending at a hospital.

“He didn’t acknowledge — he was kind of staring out into dead space,” Slesicki said from the witness stand. “He walked past me. He didn’t even look at me. He went into the street, made a super sharp turn into the roadway and walked down the middle of West Eighth Street.”

Reales Dominguez refused meals, dropped weight and was, on at least two occasions admitted to a hospital, while in Yolo County custody. At one point, he was 108 pounds, a jail medical professional testified. Experts testified that he showed signs of schizophrenia. Psychologist Juliana Rohrer called his a “textbook example” of the disorder.

A Sept. 29 hearing in Woodland will then serve as a progress report of sorts. McAdam will review the court’s emergency medication order, likely to determine whether Reales Dominguez is still receiving his medication while he remains in Yolo County Jail waiting to be transferred to the state hospital.