State v. Oxford ( 2020 )


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  •                  IN THE SUPREME COURT OF THE STATE OF IDAHO
    Docket No. 46608
    STATE OF IDAHO,                                      )
    )
    Plaintiff-Respondent,                           )        Boise, May 2020 Term
    )
    v.                                                   )        Opinion filed: October 1, 2020
    )
    CARI LEONE OXFORD,                                   )        Melanie Gagnepain, Clerk
    )
    Defendant-Appellant.                            )
    Appeal from the District Court of the Sixth Judicial District of the State of Idaho,
    Bannock County. Stephen S. Dunn, District Judge.
    The district court’s judgment of conviction is affirmed; the order of restitution is
    vacated.
    Eric Don Fredericksen, State Appellate Public Defender, Boise, for Appellant.
    Andrea Reynolds argued.
    Lawrence G. Wasden, Idaho Attorney General, Boise, for Respondent. Kale Gans
    argued.
    _______________________________________________
    MOELLER, Justice
    Cari Leone Oxford was arrested after she kidnapped her neighbor’s infant son. A Bannock
    County jury found Oxford guilty of burglary and kidnapping in the second degree. Oxford appeals
    from her judgment of conviction. On appeal, Oxford contends that the district court abused its
    discretion in (1) denying her the funds necessary to retain an expert witness to assist with her
    defense; (2) refusing to allow the doctor who examined her for purposes of her competency
    evaluation to testify at trial regarding her mental health condition; and (3) ordering restitution
    without any evidence supporting it. For the reasons stated below, we affirm the judgment of
    conviction and vacate the order of restitution.
    1
    I.      FACTUAL AND PROCEDURAL BACKGROUND
    On August 13, 2017, Oxford confronted her neighbor from across the hall as the neighbor
    was arriving home from work with her eighteen-month-old son in her arms. As the neighbor
    approached her apartment door, Oxford came out of her own apartment and began yelling at the
    neighbor “about not going into the laundry room.” The neighbor retreated into her own apartment
    and attempted to close the door, but Oxford stopped her and pushed the door open. Moments later,
    Oxford started punching and kicking the neighbor. Oxford then grabbed the neighbor’s infant son,
    fled with the baby into her own apartment, and shut the door.
    The neighbor called 911 and police were dispatched to the scene. Once the police arrived,
    they knocked on Oxford’s door until she opened it. One of the officers testified that Oxford was
    holding onto the baby and saying that she did not want the officers “to take her baby away.” Oxford
    kept shouting that the baby was her son. According to the officer, Oxford seemed “confused about
    the baby’s age,” at one point stating “he was a few months old” and at another point stating he was
    in “his twenties.” The officer also testified that Oxford “really seemed disoriented” and that “there
    was certainly something going on.” Finally, the officers “pried [Oxford’s] arms from around the
    baby” and returned him to his mother. The officers arrested Oxford.
    The State filed a complaint against Oxford, alleging she committed the crimes of Burglary,
    I.C. § 18-1401, and Kidnapping in the Second Degree, I.C. § 18-4503. Oxford moved to continue
    the preliminary hearing to allow for a competency evaluation pursuant to Idaho Code section 18-
    211. The magistrate court granted the continuance and ordered a competency evaluation.
    The magistrate court appointed Dr. Daniel Traughber to conduct the evaluation. The
    evaluation took place approximately seven weeks after the criminal conduct that is the subject of
    this appeal. Dr. Traughber found Oxford was not competent to stand trial. Dr. Traughber opined
    that Oxford “is currently [mentally ill], and has likely suffered from a mental illness for some
    time.” Although Dr. Traughber could not establish an exact diagnosis, he determined that “these
    problems affect [Oxford’s] cognitive processes, behavior, and certainly her impulse control.”
    Therefore, Dr. Traughber concluded that “Oxford does meet criteria for a mental illness and is in
    need of treatment/support.” Based on Dr. Traughber’s evaluation, the magistrate court found that
    Oxford “lacks the capacity to make informed decisions about treatment” and therefore, “is not fit
    to proceed” to trial. Accordingly, the court ordered Oxford into the custody of the Department of
    Health and Welfare for treatment and further evaluation.
    2
    A few months later, the magistrate court terminated Oxford’s order of commitment after
    Dr. Baker, Chief of Psychology at State Hospital South, filed a report with the court stating Oxford
    had been restored to competency and was now fit to proceed to trial. Following a preliminary
    hearing, Oxford was bound over to the district court where she pleaded not guilty to both counts.
    Prior to trial, defense counsel for Oxford filed a motion for the appointment of an expert
    witness. Defense counsel requested, based on Oxford’s “indigency status,” that the district court
    issue an order “approving the retention of a licensed psychiatrist or psychologist . . . to advise
    [Oxford] regarding her defense in this matter that her mental health situation on the date of the
    incident charged in this matter was such that she could not have possessed the requisite intent to
    have committed the offenses charged.” Defense counsel explained that he believed Oxford “has a
    defense to the specific intent portions of the charges brought against her.”
    After a hearing on the matter on January 22, 2018, the district court granted Oxford’s
    motion with one “exception”: “[T]he PD’s office does have, I think, an expert witness portion of
    their budget. So . . . I’m reluctant to order the district court to pay for it if there is a budget amount
    for that.” Defense counsel said “okay” and that he would ask the Public Defender’s Office about
    funds to pay for the expert witness. The minutes from the hearing confirm that the court “granted
    the Motion for Appointment of Expert Witness. The [c]ourt advised that the costs for the expert
    witness shall be paid for by the Public Defender’s budget.”
    On June 14, 2018, defense counsel filed a motion in limine. Defense counsel informed the
    district court that he had “made a request for funds to be allocated from the public defender’s office
    budget, but was denied because the funds were necessary for the defense of a capital case.” Rather
    than requesting that the district court allocate funds from a different public source, defense counsel
    sought a ruling that
    [Oxford] is allowed to produce evidence that she suffered from a mental illness
    which resulted in her inability to form the required intent to commit Burglary and
    Kidnapping [i]n [t]he Second Degree, and a ruling that Dr. Traughber will be
    allowed to testify at trial regarding his observations and conclusions about [Oxford]
    during his competency evaluation.
    Defense counsel clarified that “[i]t is the intent of the defense to call [Dr. Traughber] both as a fact
    witness regarding his observations of [Oxford] . . . [and] as an expert witness.”
    The State filed an objection to Oxford’s motion in limine. The State argued in part that the
    district court should not permit Dr. Traughber to testify at trial because Dr. Traughber’s evaluation
    of Oxford’s competency took place approximately seven weeks after the incident occurred and
    3
    does not go to show Oxford’s state of mind at the time of the burglary and kidnapping, which is
    the relevant state of mind.
    At the hearing on Oxford’s motion, the district court asked whether defense counsel had a
    report from Dr. Traughber regarding the opinions he intended to offer at trial. Defense counsel
    responded that “the 18-211 exam was the only evaluation and the only opinion [he had] ever gotten
    from Dr. Traughber.” The district court held that defense counsel would have to “lay a proper
    foundation” before Dr. Traughber’s section 18-211 exam could be admitted at trial.
    On September 7, 2018, eleven days prior to trial, the State filed a motion to exclude Dr.
    Traughber’s testimony under Idaho Rules of Evidence 401, 402, and 403 because his testimony
    was irrelevant and would confuse the jury. The State argued that Dr. Traughber’s section 18-211
    competency evaluation did not address Oxford’s ability to form the necessary intent to commit the
    charged offenses; rather, the evaluation solely focused on Oxford’s competency to stand trial. The
    State asserted that “[i]n order to determine whether or not [Oxford] could or could not form the
    intent to commit a crime[,] a mens rea evaluation needs to be completed,” which is different than
    Dr. Traughber’s 18-211 competency evaluation. The district court took the State’s motion under
    advisement.
    At trial, the district court provided defense counsel an “opportunity to make an offer of
    proof . . . as to the testimony that would have been offered by Dr. Traughber.” Once again, defense
    counsel only offered Dr. Traughber’s 18-211 evaluation of Oxford. Defense counsel explained its
    intent “to just have him testify as to his interview with [Oxford] and the contents of that report.
    Those were his observations, and those were his expert conclusions in terms of a diagnosis and
    what it was.” With that, the district court ruled that defense counsel failed to establish a “sufficient
    foundation and basis for allowing Dr. Traughber to testify as to [Oxford’s] mental health
    conditions or the specific intent requirements.” Accordingly, the district court concluded that Dr.
    Traughber could not testify at trial.
    At the conclusion of her trial, the jury found Oxford guilty of burglary and kidnapping in
    the second degree. The district court sentenced Oxford to concurrent unified terms of five years
    with two years fixed for the burglary charge, and ten years with three years fixed for the kidnapping
    charge. The district court then suspended Oxford’s sentence and placed her on probation for six
    years. The district court also ordered Oxford to pay $6,072.09 in restitution to the Idaho Industrial
    4
    Commission for payments made on behalf of the victim, Oxford’s neighbor, for the injuries she
    incurred on the night of the criminal conduct.
    Oxford’s counsel initially objected to the restitution order at the sentencing hearing because
    Oxford did not “have the ability to pay the restitution in the amount that’s been requested.” The
    district court ordered the entire requested amount of restitution, $6,072.09, but explained that
    Oxford could object at the restitution hearing to be held at a later date. The next day, Oxford filed
    a written objection to restitution, asserting that there is “no supporting information upon which the
    [c]ourt can find that the bills paid by the Industrial Commission relate to the offenses for which
    [Oxford] was found guilty or, if the bills are related to the charges in this matter, that such injuries
    were directly related to [Oxford’s] criminal conduct.” At the restitution hearing, the district court
    agreed with Oxford that “the [restitution] request is insufficient as far as providing adequate
    support” as to what amounts were actually paid by the Industrial Commission and what bills
    occurred at what times and for what circumstances. Nevertheless, the court overruled Oxford’s
    objection “with the caveat” that the State submit additional evidence supporting its restitution
    request within three weeks. The district court held that it would “make a final ruling” after the
    State provided such additional evidence. The State failed to submit any additional evidence as
    requested by the court; yet, the court’s conditional ruling granting full restitution remained in
    place. Oxford timely appealed.
    II.     STANDARD OF REVIEW
    This Court reviews a trial court’s evidentiary rulings, decision on a request for expert
    assistance at public expense, and restitution awards for an abuse of discretion. See Perry v. Magic
    Valley Reg’l Med. Ctr., 
    134 Idaho 46
    , 50, 
    995 P.2d 816
    , 820 (2000) (evidentiary ruling); State v.
    Brackett, 
    160 Idaho 619
    , 634, 
    377 P.3d 1082
    , 1097 (Ct. App. 2016) (expert or investigative
    assistance); State v. Straub, 
    153 Idaho 882
    , 887, 
    292 P.3d 273
    , 278 (2013) (restitution). This Court
    applies the familiar four-part test to determine whether a trial court has abused its discretion:
    whether the trial court “(1) correctly perceived the issue as one of discretion; (2) acted within the
    outer boundaries of its discretion; (3) acted consistently with the legal standards applicable to the
    specific choices available to it; and (4) reached its decision by the exercise of reason.” Lunneborg
    v. My Fun Life, 
    163 Idaho 856
    , 867, 
    421 P.3d 187
    , 198 (2018).
    5
    III.   ANALYSIS
    A. The district court did not abuse its discretion by directing that the funding for
    Oxford’s expert witness come from the Public Defender’s budget.
    Oxford contends that the district court violated her constitutional rights to due process and
    equal protection and violated Idaho Code section 19-852 when it denied her the funds needed to
    retain an expert witness to assist with her defense. The State requests that we not address this issue
    because it was not preserved for appeal. In the alternative, the State contends that Oxford, who
    “undoubtedly had a right to any necessary ‘expert assistance at public expense,’ ” has failed to
    show any error because she did in fact acquire an expert, i.e., Dr. Traughber. According to the
    State, Oxford’s “essential gripe is that she was unable to hire some other expert more to her liking.”
    i.     Oxford adequately preserved this issue for appeal.
    The State contends that Oxford’s claim—that the district court violated her constitutional
    rights when it denied her the funds needed to retain an expert witness—was not argued below and,
    therefore, is not preserved for appeal. According to the State, Oxford never cited any constitutional
    authority in her request for funding before the district court. Oxford contends that this issue was
    preserved for appeal because she argued in her briefing that the district court abused its discretion
    by denying her the funds needed to retain an expert witness, which resulted in a denial of her
    constitutional right to a fair trial. We hold that Oxford has adequately preserved this issue for
    appeal.
    “This Court will not consider issues raised for the first time on appeal.” State v. Garcia-
    Rodriguez, 
    162 Idaho 271
    , 275, 
    396 P.3d 700
    , 704 (2017) (quoting Mickelsen Const., Inc. v.
    Horrocks, 
    154 Idaho 396
    , 405, 
    299 P.3d 203
    , 212 (2013)). “Issues not raised below will not be
    considered by this [C]ourt on appeal, and the parties will be held to the theory upon which the case
    was presented to the lower court.”
    Id. (quoting Heckman Ranches,
    Inc. v. State, By & Through
    Dep’t of Pub. Lands, 
    99 Idaho 793
    , 799–800, 
    589 P.2d 546
    –47 (1979)).
    Here, Oxford filed a motion for the appointment of an expert witness at public expense.
    The district court granted Oxford’s motion and directed that the “public funds” come from the
    Public Defender’s Office if such funds were available. Oxford challenged the district court’s
    decision on appeal, citing the Court of Appeals’ decision in Brackett. As the Court of Appeals held
    in Brackett, “[d]enial of a request for expert or investigative assistance will not be disturbed absent
    a showing that the trial court abused its discretion by rendering a decision which is clearly
    erroneous and unsupported by the circumstances of the case.” 160 Idaho at 
    634, 377 P.3d at 1097
    .
    6
    If a court abuses its discretion by “den[ying a defendant] access to the basic tools of an adequate
    defense, then he has also been denied his due process right of a fair trial.” State v. Olin, 
    103 Idaho 391
    , 394, 
    648 P.2d 203
    , 206 (1982).
    Thus, it was implicit in Oxford’s underlying motion for funding to retain an expert witness
    that she had a constitutional right to such relief. Unless Oxford, who was represented by a public
    defender, had a constitutional right to obtain public funding for such a witness due to her indigency,
    there would have been no reason for the defense to request that the court authorize funding to
    retain one. Here, in light of the district court’s ruling on Oxford’s motion, there was no need for
    defense counsel to brief the issue and cite the constitutional authority for the request. Therefore,
    we hold that Oxford has not raised a new issue on appeal by arguing that she was denied her
    constitutional right to due process and equal protection when the district court allegedly denied
    her motion for public funds to retain an expert witness to assist with her defense. Accordingly, we
    will address the merits of this issue.
    ii.          The district court did not deny Oxford’s motion for funding to retain an expert
    witness, and did not abuse its discretion in initially directing that the funding for
    the witness come from the Public Defender’s budget.
    “Indigent defendants are entitled as a matter of due process and equal protection to the
    basic tools of an adequate defense, including the provision of expert assistance at public expense
    when such is necessary for a fair trial.” 
    Brackett, 160 Idaho at 633
    , 377 P.3d at 1096. These rights
    are safeguarded by Idaho Code section 19-852(1). Section 19-852(1) provides in part:
    (1) An indigent person who is . . . under formal charge of having committed, or is
    being detained under a conviction of, a serious crime, is entitled:
    ....
    (b) To be provided with the necessary services and facilities of representation
    including investigation and other preparation. The attorney, services and
    facilities and the court costs shall be provided at public expense to the extent
    that the person is, at the time the court determines indigency pursuant to
    section 19-854, Idaho Code, unable to provide for their payment.
    Idaho Criminal Rule 12.2 provides the requirements for obtaining such funds. See I.C.R. 12.2(a)
    (“A defendant may submit a motion requesting public funds to pay for investigative, expert, or
    other services that he believes are necessary for his defense. . . .”).
    Assistance is not automatically mandatory, “but rather depends upon [the] needs of the
    defendant as revealed by the facts and circumstances of each case.” 
    Brackett, 160 Idaho at 634
    ,
    
    7 377 P.3d at 1097
    (quoting State v. Powers, 
    96 Idaho 833
    , 838, 
    537 P.2d 1369
    , 1374 (1975)).
    Accordingly,
    [i]t is thus incumbent upon the trial court to inquire into the needs of the defendant
    and the circumstances of the case, and then make a determination of whether an
    adequate defense will be available to the defendant without the requested expert or
    investigative aid. If the answer is in the negative, then the services are necessary
    and must be provided by the state. . . .
    State v. Wood, 
    132 Idaho 88
    , 100, 
    967 P.2d 702
    , 714 (1998) (quoting Olin, 103 Idaho at 
    395, 648 P.2d at 207
    ). The grant or denial of assistance under section 19-852(1) is left to the sound discretion
    of the trial court.
    Id. Although section 19-852
    explains that the necessary services shall be provided at “public
    expense,” it does not explain where the “public expense[s]” shall come from, nor does any other
    section within the same chapter of the Idaho Code. However, Rule 12.2 does explain that if the
    motion for additional defense services is filed by private counsel for the defendant, “and the
    additional defense services are to be provided through funds budgeted to the public defender,” the
    public defender must be served with a copy of the motion. I.C.R. 12.2(f) (emphasis added).
    Accordingly, “public funds” may at times be allocated from the public defender’s budget.
    Here, the district court agreed with Oxford that an additional expert to help Oxford with
    her defense was necessary. Therefore, contrary to counsel’s repeated assertions at oral argument,
    the district court did not deny the motion. However, instead of merely ordering that the funds be
    paid at public expense, the court proposed the funds come from a specific source, i.e., the Public
    Defender’s Office’s budget, if funds were available. As it turned out, funds were available, but the
    Public Defender’s Office denied release of those funds because “the funds were necessary for the
    defense of a capital case.” At that point, defense counsel should have informed the court and
    requested that the county allocate additional funds from elsewhere, yet it did not. Instead, defense
    counsel offered to use Dr. Traughber as its expert witness, even though both the State and the
    district court pointed out on several occasions that Dr. Traughber might not be able to lay the
    necessary foundation at trial.
    Accordingly, we hold that the district court did not abuse its discretion in granting the
    motion and directing that the public funds for Oxford’s expert witness come from the Public
    Defender’s Office. In so holding, we recognize that the better practice would have been for the
    court to grant the motion and simply order that the funds be provided “at public expense.” It is not
    the court’s role to direct the details of a county’s expenditures and specify the source of its
    8
    disbursements. Notwithstanding the form of the district court’s order, it was not a de facto denial
    of funds because nothing in its order discouraged defense counsel from seeking an alternate source
    of funding. Additionally, defense counsel could have requested that the county provide additional
    funding to the Public Defender’s Office to pay for constitutionally required services if it felt
    obligated to allocate the budgeted funds to cases it deemed were a higher priority.
    B. The district court did not abuse its discretion in ruling (1) that the defense failed to
    establish a proper foundation to allow Dr. Traughber to testify at trial about Oxford’s
    mens rea at the time of the crime and (2) the testimony was not relevant under Rules
    401 and 403.
    Oxford contends that the district court abused its discretion by refusing to allow Dr.
    Traughber—the psychologist who conducted Oxford’s section 18-211 competency evaluation—
    to testify as an expert witness for the defense at trial. According to Oxford, Dr. Traughber’s
    testimony would have helped the jury understand the evidence and determine the key fact at issue:
    whether Oxford had the specific intent to commit burglary and kidnapping. The State contends
    that the district court properly excluded the testimony of Dr. Traughber because Dr. Traughber
    could not offer any testimony on the more relevant question: whether Oxford lacked the intent to
    commit the crimes at the time she committed them. We hold that the district court did not abuse its
    discretion in refusing to allow Dr. Traughber to testify at trial because defense counsel failed to
    lay proper foundation.
    Idaho Code section 18-207 provides that “[m]ental condition shall not be a defense to any
    charge of criminal conduct.” I.C. § 18-207(1). However, evidence of mental health is still expressly
    permitted to rebut the State’s evidence offered to prove criminal intent or mens rea:
    Idaho Code § 18-207 does not remove the element of criminal responsibility for the
    crime. The prosecution is still required to prove beyond a reasonable doubt that a
    defendant had the mental capacity to form the necessary intent. Idaho Code § 18-
    207 merely disallows mental condition from providing a complete defense to the
    crime and may allow the conviction of persons who may be insane by some former
    insanity test or medical standard, but who nevertheless have the ability to form
    intent and to control their actions. The statute expressly allows admission of expert
    evidence on the issues of mens rea or any state of mind which is an element of the
    crime.
    State v. Samuel, 
    165 Idaho 746
    , 770, 
    452 P.3d 768
    , 792 (2019) (quoting State v. Card, 
    121 Idaho 425
    , 430, 
    825 P.2d 1081
    , 1086 (1991)). “Whether the accused possessed the necessary intent to
    commit the offense is a question for the finder of fact.” State v. Matthews, 
    124 Idaho 806
    , 814,
    
    864 P.2d 644
    , 652 (Ct. App. 1993).
    9
    Here, Oxford was charged with Burglary, I.C. § 18-1401, and Kidnapping in the Second
    Degree, I.C. § 18-4501. Because burglary and kidnapping are specific intent crimes, state of mind
    is an element in both offenses. See I.C. § 18-1401 (criminalizing the act of entering a building
    when done “with intent to commit any theft or any felony.”); I.C. § 18-4501(1) (criminalizing the
    act of kidnapping another when done “with intent to cause [the victim], without authority of law,
    to be secretly confined or imprisoned within this state.”); I.C. § 18-4501(2) (criminalizing the act
    of taking a child under the age of sixteen when done “with intent to keep or conceal it from its
    custodial parent, guardian or other person having lawful care or control thereof.”). Accordingly,
    expert evidence addressing the issue of mens rea would be permissible in this case.
    Oxford sought to call Dr. Traughber as an expert at trial to testify concerning “his
    observations and his professional opinion . . . of what . . . mental illness [Oxford] was suffering
    from at the time [of the crime].” As noted, Dr. Traughber was initially appointed by the court to
    perform a competency evaluation of Oxford. According to defense counsel, Dr. Traughber would
    “offer the . . . evaluation on the 18-211, 18-212 exam” and would “testify as to his interview with
    her and the contents of that report.” The State objected to the admission of Dr. Traughber’s
    testimony under Idaho Rules of Evidence 401, 402, and 403 because his “evaluation doesn’t talk
    about what her state of mind was on the date in question.” The State explained that “[i]n order to
    be able to address the mens rea and bring that evidence before the jury, the defense would need to
    have an evaluation done that addresses that.” When the district court asked defense counsel
    whether Dr. Traughber intended to provide an additional opinion as to whether Oxford “did not
    have the specific intent to commit the crime,” defense counsel explained that he was not: “I didn’t
    hire [Dr. Traughber] as an expert to go in and give an opinion on that particular -- on that specific
    issue.” The district court ruled at trial that he would not allow Dr. Traughber to testify because
    defense counsel failed to lay “sufficient foundation and basis for allowing Dr. Traughber to testify
    as to [Oxford’s] mental health conditions or the specific intent requirements.”
    Oxford contends that, although the “district court was correct to conclude that Dr.
    Traughber could not testify that, based on his evaluation, Ms. Oxford ‘was unable to form the
    specific intent necessary to commit these crimes,’ . . . [t]hat does not make his testimony
    inadmissible.” According to Oxford, “Dr. Traughber could have testified regarding his clinical
    diagnosis of Ms. Oxford, which is a concept beyond the common experience of most jurors, and
    would have assisted the jurors in evaluating the evidence.”
    10
    Generally, evidence that has any tendency to make a fact more or less probable than it
    would be without the evidence is admissible. I.R.E. 401. However, even if evidence is relevant, it
    may be excluded if its “probative value is substantially outweighed by a danger of . . . confusing
    the issues [or] misleading the jury.” I.R.E. 403. Additionally, expert witness opinion is governed
    by Idaho Rule of Evidence 702, which provides:
    A witness who is qualified as an expert by knowledge, skill, experience, training,
    or education may testify in the form of an opinion or otherwise if the expert’s
    scientific, technical, or other specialized knowledge will help the trier of fact to
    understand the evidence or to determine a fact in issue.
    “[T]he trial court has the discretion to determine whether a proper foundation has been laid for the
    admission of expert testimony.” State v. Almaraz, 
    154 Idaho 584
    , 603, 
    301 P.3d 242
    , 261 (2013)
    (quoting Swallow v. Emergency Med. of Idaho, P.A., 
    138 Idaho 589
    , 593, 
    67 P.3d 68
    , 72 (2003)).
    After reviewing the record, we hold that the district court did not abuse its discretion in
    barring Dr. Traughber’s testimony. Oxford conceded in her opening brief on appeal that “[t]he
    district court was correct to conclude that Dr. Traughber could not testify that, based on his
    evaluation, Ms. Oxford ‘was unable to form the specific intent necessary to commit these crimes.’
    ” In the proceedings below, Defense counsel explained that Dr. Traughber would testify as to
    Oxford’s clinical diagnosis as contained in his report, which only addressed Oxford’s mental state
    at the time of the interview. Thus, the district court did not err by concluding that Dr. Traughber’s
    testimony would not have assisted the trier of fact in determining Oxford’s state of mind at the
    time of the criminal conduct. As the Court of Appeals emphasized in State v. Dryden, section 18-
    207 is “concerned with mental disease or defect at the time of [the] criminal conduct.” 
    105 Idaho 848
    , 850, 
    673 P.2d 809
    , 811 (Ct. App. 1983).
    Likewise, allowing such testimony for the general purpose of explaining Oxford’s “clinical
    diagnosis,” as suggested by Oxford’s trial counsel, would have also been improper. Absent
    additional testimony discussing Oxford’s state of mind at the time of the criminal conduct, Dr.
    Traughber’s testimony would only invite the jury to speculate about matters beyond the scope of
    Dr. Traughber’s opinion. Thus, Dr. Traughber’s testimony would have been irrelevant under Rule
    401, as it would not assist the trier of fact in determining whether Oxford had the necessary state
    of mind at the time of the criminal conduct. Likewise, the testimony would have been confusing
    and misleading to the jury under Rule 403, as there is a substantial likelihood that the jury might
    believe that Dr. Traughber’s testimony is being offered to prove Oxford’s state of mind at the time
    11
    of the criminal conduct since that is the only relevant state of mind. Moreover, Rule 702 requires
    that the expert’s testimony help the trier of fact determine a fact in issue, which in this case would
    be Oxford’s state of mind at the time of the criminal conduct. Dr. Traughber’s testimony would
    not assist the trier of fact in that regard. When dealing with this type of medical evidence, it is
    incumbent upon the defense to call a qualified expert witness to “connect the dots” for the jury by
    offering a competent medical opinion, rather than merely laying out the data and permitting the
    jury to reach their own conclusions. Here, admitting such evidence would essentially invite the
    jury to reach a medical conclusion that Oxford has conceded Dr. Traughber could not reach
    himself. Therefore, we hold that the district court did not abuse its discretion in excluding Dr.
    Traughber’s testimony at trial.
    C. The district court abused its discretion in ordering restitution over the defense’s
    objection without any evidence supporting it.
    Pursuant to Idaho Code section 19-5304(2), the State requested $6,072.29 in restitution
    payable to the Idaho Industrial Commission for payments it made on behalf of Oxford’s neighbor,
    the victim in this case. The State alleged that the funds expended by the Industrial Commission
    were for injuries she sustained on the night of the crime. Oxford objected to the request in part
    because the State failed to support its request with evidence showing the payments made on behalf
    of the victim actually related to the criminal conduct or that her injuries were directly related to
    the criminal conduct. Although the district court agreed that the requested amount of restitution
    was not supported by substantial evidence, the court overruled Oxford’s objection “with the
    caveat” that the State submit additional evidence to support the order of restitution by a specified
    date. The State failed to submit any additional evidence, yet the court kept the conditional
    restitution order in place.
    On appeal, Oxford contends that the district court abused its discretion in ordering
    restitution in the absence of substantial evidence supporting the request. The State contends that
    although it did not submit additional evidence to the district court upon its request, Oxford failed
    to renew her objection and request that the district court withdraw its conditional restitution order,
    thereby waiving her objection.
    The first issue we address is whether Oxford was required to renew her objection when the
    district court failed to vacate the restitution award in order to preserve this issue for appeal. We
    disagree with the State’s analysis and hold that Oxford’s objections were sufficient to preserve this
    issue for appeal.
    12
    The State fails to cite any authority wherein we have held that a renewed objection is
    necessary to preserve an issue regarding an order of restitution for appeal. In fact, we have held
    precisely the opposite. In State v. Villa-Guzman, we held that “defects in the documents admitted
    to support restitution are foundational errors, which require an objection at the time of the
    restitution hearing to preserve those arguments for appeal.” 
    166 Idaho 382
    , ___, 
    458 P.3d 960
    , 962
    (2020) (emphasis in original). Nowhere in that decision did we hold that multiple objections must
    be made until the district court issues a “final ruling,” as suggested by the State. Accordingly, for
    purposes of restitution, we hold that one objection is sufficient, if the final order grants the same
    relief objected to by the defendant.
    Here, defense counsel actually objected to restitution on three separate occasions. First,
    defense counsel objected at sentencing, contending that Oxford did not have the ability to pay
    restitution in the requested amount. Second, defense counsel followed up by filing a written
    objection to the order of restitution. In that objection, defense counsel argued that there is “no
    supporting information upon which the [c]ourt can find that the bills paid by the Industrial
    Commission relate to the offenses for which [Oxford] was found guilty or, if the bills are related
    to the charges in this matter, that such injuries were directly related to [Oxford’s] criminal
    conduct.” Finally, defense counsel orally objected to the order of restitution at the restitution
    hearing. Accordingly, we hold that Oxford’s objections were sufficient to preserve this issue for
    appeal.
    Having held that this issue is preserved for appeal, the next issue we address is whether the
    order of restitution is supported by substantial evidence. “[W]hether to order restitution, and in
    what amount, is within the district court’s discretion and is guided by consideration of the factors
    set forth in Idaho Code section 19-5304(7).” State v. Wisdom, 
    161 Idaho 916
    , 919, 
    393 P.3d 576
    ,
    579 (2017) (quoting State v. Corbus, 
    150 Idaho 599
    , 602, 
    249 P.3d 398
    , 401 (2011)). The district
    court must “base the restitution award on the preponderance of the evidence submitted by the
    prosecutor, defendant, victim, or presentence investigator.”
    Id. (citing I.C. §
    19-5304(6)). Finally,
    “[w]hat amount of restitution to award is a question of fact for the district court, whose findings
    will not be disturbed if supported by substantial evidence.”
    Id. Substantial evidence is
    “relevant
    evidence as a reasonable mind might accept to support a conclusion.”
    Id. (quoting State v.
    Straub,
    
    153 Idaho 882
    , 885, 
    292 P.3d 273
    , 276 (2013)).
    13
    In State v. Nelson, this Court vacated a restitution award because it was not supported by
    substantial evidence. 
    161 Idaho 692
    , 697, 
    390 P.3d 418
    , 423 (2017). In that case, we focused on
    how “the court may order restitution” to the State for prosecution expenses “actually incurred.” Id.
    at 
    695, 390 P.3d at 421
    (quoting I.C. § 37-2732(k)). The sole “evidence” supporting the restitution
    award was a one-paragraph form, the statement of costs.
    Id. This Court took
    issue with the
    statement of costs because it was a “boilerplate, fill-in-the-blank-style form” the State used in other
    cases.
    Id. The statement of
    costs did not contain itemized entries explaining the tasks performed
    or the expenditures made in the particular case, nor did it state that restitution was sought only for
    expenses actually incurred in prosecuting the charge. Id. at 
    695–96, 390 P.3d at 421
    –22.
    Accordingly, we held that “unsworn representations, even by an officer of the court, do not
    constitute ‘substantial evidence.’ ”
    Id. Here, the sole
    “evidence” supporting the order of restitution is a one-page, unsworn letter
    from the Crime Victims Compensation Program (CVCP). The letter states that it is requesting
    restitution “for payments made on behalf of [the victim].” The payment summary lists the
    “provider,” the “billed amount,” the “non allowed amount,” the “allowed amount,” the “CVCP
    payment to claimant,” and the “CVCP payment to provider.” The letter does not provide
    descriptions of the types of services provided, nor does it provide the date of such services. Similar
    to Nelson, this one-page, unsworn letter is insufficient to support an order of restitution under
    Idaho Code section 19-5304. The district court recognized this and ordered that “additional
    information would need to be obtained and/or provided so I can adequately review the request,”
    which the State conceded it failed to provide. Accordingly, we hold that the restitution award in
    this case is not supported by substantial evidence.
    Having held that the order of restitution is not supported by substantial evidence, the final
    issue we address is the appropriate remedy. Oxford contends that the proper remedy is to vacate
    the restitution award. The State contends that the proper remedy is “a limited remand for the state
    to provide that information to the district court.” We hold that under the circumstances of this case,
    the appropriate remedy is to vacate the restitution award.
    On appeal, when an order of restitution is not supported by substantial evidence, the
    appropriate remedy is to either vacate or remand the order, depending on the circumstances. In
    some circumstances, a remand is the appropriate remedy. For example, in State v. Cunningham,
    we remanded the district court’s restitution award because the State did not have multiple
    14
    opportunities to support its request. 
    161 Idaho 698
    , 702, 
    390 P.3d 424
    , 428 (2017) (Cunningham
    I). In other circumstances, however, vacating the order is the more appropriate remedy. For
    example, in Nelson, we vacated the district court’s restitution award without remanding it because
    “the State already had two opportunities to claim 
    restitution.” 161 Idaho at 697
    , 390 P.3d at 423.
    Similarly, in State v. Cunningham, we declined to remand to allow the State an opportunity to
    claim restitution because “[t]he State already had two opportunities to claim restitution, and
    remanding for a third opportunity would be improper.” 
    164 Idaho 759
    , 765, 
    435 P.3d 539
    , 545
    (2019) (Cunningham II) (quoting Nelson, 161 Idaho at 
    697, 390 P.3d at 423
    ).
    Here, we hold that the appropriate remedy is to vacate the order of restitution without
    remanding it. Similar to Nelson and Cunningham II, the State in this case has had multiple
    opportunities to support the restitution award, i.e., prior to sentencing when it made its initial
    request, at the sentencing hearing, at the restitution hearing, and after the restitution hearing during
    the three-week extension allowed by the district court for filing additional evidence. Under these
    facts, providing the State with yet another opportunity to get it done right would be improper.
    Accordingly, we vacate the order of restitution.
    IV.     CONCLUSION
    We affirm Oxford’s judgment of conviction, but vacate the order of restitution. The State’s
    motion for restitution shall not be reconsidered when the case is remitted to the district court.
    Chief Justice BURDICK, and Justices BRODY, BEVAN and STEGNER CONCUR.
    15