reinstated turning first to roger and linda's claims there is no dispute that linda and roger disabled they are deaf and fairview is a place of public accommodation for eighty eight purposes and receive federal funding for rehabilitation purposes it is the third element of the discrimination claim whether fairview discriminated against him based on disability which is at issue and is and is the grounds on which the trial court committed err in granting summary judgment dismissal now roger and linda are what fairview refers to as stakeholders and a fair view patient that patient being roger and linda's son shaan who was initially in fairview i c u on may eighth two thousand and thirteen and died the next day on another floor one of the discreet advance which fairview denied the appellant's meaningful services were the care conferences one of the services that fairview provides to all stakeholders stakeholders are care conference i care conference was confused convene for sean duran stakeholders when clued sean's family and close friends on both may eighth and eighth and ninth by fairview advance practice nurse klopp a special a to a specialist  palliative care and dr malik nursed klopp a new through that through shawn's health care agent priscilla that shines parents were deaf and an interpreter was requested and needed contrary to fair views of surgeons in its brief no interpreter was provided for either care conference until after dr malloch had laughed and their care conference with all stakeholders had been completed so on like the meetings at issue in lloyd the purpose of a care conference is not simply to convey information although that's part of it these conferences are not mechanistic exercises and providing information they're emotionally charged they're highly personal group interactions and discussion among all the stakeholders recently the hamelin law review volume thirty six at page two twenty nine discusses the hospital service of the care conference for stakeholders which echoes the description of that by fairview nurse klopp care conferences give stakeholders a chance to voice their respective wishes hear from the other stakeholders and allows expressions of frustration one of the main purposes of these care conferences that someone no stakeholder feels left out or ignored by the decision making process even though the ultimate decision is by the health care agent and part of the care conference role is to act to have the stakeholders together rework their sense of h often shifting from hope to a cure or from hope for comfort and peace and it has a spiritual component the desire or goal for the stakeholders to stick come to some kind of group decision or agreement on what the patient want want by failing to provide an interpreter to stakeholders roger and linda in these care conferences they were deprived of the care conference service which fairview provided to all of the in view of the fact that the patient was an adult and the health care directive designated someone other than the parents as that as a decision maker and i'm wondering if what if the patient they're stakeholders in the patient life they're true that they're not the health care arrangements matter of fact nurse klopp met first with a health care agent who is persona and together the decision is made to have this care conference which is the benefit for all the stakeholders now the federal regulations hipaa is not of concern here because the health care or agent authorized the hospital the care providers to give the information to the parents and so i mean that occurred in other conference before he was hospitalized and then occurred actually during doctors rounds where other stakeholders were present so what we have what doesn't aren't they entitled to and i don't want to to diminish this interest but aren't they only entitled to really in this particular situation it's a situation they really a can to a visitor and what and what what right information what availability of information they access with any other visitor who is permitted by family to be present be entitled to know i disagree with that because what you have here is you have like i said they're called stakeholders but we had been involved in these care conferences all of the family members there are a number of siblings of sean there were close friends and the idea of the care conference is to provide information but also to have these group discussions and to weigh in so even though they're not the health care agent they have these right to a service which fairview provides a service to the to the non disabled they get to able to discuss here you have a situation because of the lack of an interpreter roger and linda are deprived of that service it would be like having a carer conference in a room that's not accessible to a wheelchair where the mother and father are wheelchair bound and so you have the care conference over here while they sit out in the hall and you come out later and you just tell them oh this is what we talked about this is what we decided i mean that is not meaningful access to the same service then the disabled persons are treated differently than the disabled and it's not effective communication so i think it's very important to look at the discrete of hanson that one of the discrete events are these care conferences for which there was no interpreter present and where it was after the fact an interpreter would show up and nurse klopp would go through but by then all the stakeholders to disperse and rich roger and linda were not allowed to wait in that group discussion setting another series of events is with regard to the doctor's rounds there was a request to have interpreters available when the doctors come around now what's interesting is about fair views on policies i might to refer the court to our denim an eight to twelve of our appendix which is where fairview in its materials sa interpreter is to be provided by a hospital staff if they recognized or had reason to believe a relative of a patient is deaf or hard of hearing and quote you must advise the person that  n aids and services will be provided free of charge fairview also had a policy to schedule interpreters in advance of scheduled rounds but no interpreter was provided to the d and nurse klopp admitted that priscilla who was the health care agent didn't limit the interpreter request to care conference again summary judgment is inappropriate on these facts using this court's analysis in our going in the trial court should have evaluated whether fairview provided linda duran the same opportunity to access its telephone service that it provided to others the facts of record permitted jury to find that it did not so when you look at the a vance in question you look at the care conferences you look at the nurse's rounds and you look at the fact that there was not in the veil of all working accessible t t y on this record the trial court committed err in granting summary judgment to linda and roger duran finally priscilla duran has standing to bring her own eighty a rehabilitation and claim now there is a split in the circuits between the science and an eleventh but what's interesting is even the eleventh circuit in the poem case recognized it was widely accepted that under the eighty eight non disabled persons can be personally discriminated against it deny and some benefit because of association with disabled concluded the threshold for associated standing was the same under both now in loffler the second circuit hadn't concluded the standing provision of the r a as distinct from the provision for discriminatory contact conduct the f o force enforcement provision extends relief to any person who is aggrieved by a violation of five affords nondiscrimination provision and the second circuit concluded the non disabled person is aggrieved when a hospital relies on them to interpret for a deaf person here priscilla requested interpreter for her parents and then when they were not provided she did her best to interpret for them because priscilla was treated differently than i would treat a daughter of a hearing parent with the same obligation as a health care agent the denial of an interpreter for the parents is also a denial of benefits to priscilla she is a person of aggrieved and is entitled to pursue her claim so what we're asking this court to do is viewing these fact acts of record and there are disputed facts but viewing them in a light most favorable durans are entitled to reversal and to proceed on the merits thank you court had asked about hipaa and whether or not roger and linda duran were in fact visitors the words stakeholders been used throughout the durans briefs and they were stakeholders and because of that they had some heightened right to information to a patient who was their son but who is an adult son who had specifically excluded them from his health care directive i would note that the phrase stakeholder does not equal decision maker the decision maker in this case when shawn duran was unable to provide or to communicate with his health care providers w that was one decision the second decision was to remove his defeat really are the reason they moved remove a defense related because they don't want to shock him as he's dying the only do that for dying patients certainly priscilla knew on may eighth during that meeting with amy klopp that her brother was dying in but priscilla didn't only know that her parents did as well roger and linda both briefs talk about what happened before may of two thousand and thirteen a ridge hospital going back to november december of two thousand and twelve roger and linda duran were involved in a conference with a hospice provider through fairview health services and there was an interpreter present for that meeting hospice is only provided to people who are dying on april eleventh of two thousand and thirteen roger linda duran and were present again at the hospital with the same nurse amy klopp about three weeks before the events at issue in this case again there was another conference with an interpreter discussing the dire prognosis of their son sean so when roger linda came to the hospital on may eighth two thousand and thirteen they knew their son was in very dire ely one thirty in the afternoon we know from the records that just after an hour somewhere around two forty or so fairview contacted a interpreter provider that interpreter i think was dispatched somewhere around two forty five got there at three forty four in the afternoon and was there until six o'clock we know that because we provided the court with their invoice they were there for two hours and sixteen minutes while it is true that conference with an interpreter and now there's been some some argument and some things in the briefs that the care conference took place before before the interpreter ever arrived amy klopp testified that as they're gathering people together there may certainly have been some discussion she may have there she had may have fielded questions from folks and done that before an interpreter came but she talked about what her practice was what she would have told roger linda duran with the benefit of an interpreter there is no disputed think there was a commenter in that during one of the depositions i believe was linda duran who said why didn't have any information so i didn't ask any questions well i think you should we can flip that on the head and say well if you would have asked questions you would have had more information fear of you provided during that may eighth conference with the interpreter fairview provided roger and linda duran with effective communication that provided meaningful access  duran had an opportunity to ask questions to obtain information with the benefit and of an interpreter go forward to may ninth again there's another care conference with amy chua again it's documented it's undisputed there was an interpreter available for roger and linda duran on may ninth taking this court's decision and lawyer i think it's completely analogous to the extent that there may have been other discussions conferences that  not involve roger and linda duran it's undisputed they were given the opportunity through the use of interpreters to have to communicate ask questions to obtain information i think there was a point made in one of the briefs at this second conference on may ninth was only about fifteen minutes long well it was only fifteen minutes long because it didn't sound like there are a lot of questions roger duran testified he never once asked the question during any of these conferences why because he didn't feel comfortable doing that given his relationship with his son in any event a fair few provided effective communication that provided meaningful access to those interpreters under lawyers i believe that dispositive the district court relying on lawyer rely on the fact that you can have interpreters talk have communication and subsequent meetings is all that is required of the a da in the act there is a claim that roger linda duran and their daughter priscilla wanted access to interpreters every time a medical provider came into that hospital room every time a nurse came in every time a doctor came in and although they want to admit it that constitutes twenty four seven round the clock interpret in services that's the martin case it's been cited in the briefs there is no requirement  the ira for continuous twenty four seven interpreter care they claim to have a standing request for interpreters but again that standing request amounts to twenty four seven round the clock care around the clock interpreter services which is not required under the law roger linda duran claimed that because some discussions may have happened outside the hearing of interpreters or happened before interpreters arrived that they didn't necessarily understand their son's condition didn't understand his prognosis didn't understand what was going to happen well the law doesn't require or guarantee does it require fear of you to guarantee comprehension under these circumstances we cite the cases that talk about that as well instead what the law requires is give them an opportunity to have equal access or give them opportunity to gain the same it's undisputed that linda duran asked for a t t y and two occasions on may ninth this is after her and her husband formulated a plan to leave the hospital roger said he had to go to work she would come back to the hospital sometime later that evening i think she arrived even clock at that point in time she realizes i need and my son is dying and i need to contact my husband i should note that before that time there was never a request made for a t t y ever by anybody linda duran or roger i forget who said well we didn't need one we never had a reason to call anybody as a judge as the district court noted they didn't request a t t while until they needed it right that minute sometime late in the evening on may ni came back give or take an hour later and this time ms hewitt agreed to provide the t t y there some time to go get it and now there's a question about whether or not fear of you actually provided all the equipment all the all the hookups the connections for this the deposition was taken of the ridges hospital interpreter person and she testified bought a box of equipment that's provided there's pictures of it in our a denim i think it's at one pages one twenty one two one twenty never until summary judgment did anybody ever claim that there wasn't a telephone i think the caller rotary phone provided that's the first time anyone ever said there was no telephone not during the depositions that any time what we is a box with a telephone in it they say it's the wrong kind of telephone well that doesn't make sense to me because the testimony was they in fact got it connected but they kept getting a busy signal how do they get a busy signal if they don't have a phone they had a phone understanding they didn't dial nine nine or so you it perhaps could have helped with that but she was kicked out of the room i think the district court was right and and ruled correctly in this case  not every denial of an auxilary service amounts to discrimination that be that first then i'll buy that nurse that doesn't necessarily make it discrimination they got the phone within an hour i think what's important to have any type of liability or for a finding of discrimination in this issue is you have to show causation and we cited that that line from the mccullum case you need to show some cause between alleged violation  at this voicemail both of them called got the voicemail and it sounds like they both hang up they didn't leave a message who hadn't addressed the circuits standing for no disabled persons i will your honor we've got  mccollum phone same standard the dissent in law fleur i think made a good point that if we go with the more broader approach from the loffler majority opinion this is going to open the floodgates to all types of of potential association a standing type claims i think there is something about you know if you want to gluten free meal and the the hospital burns the meal does that put them on  potential liability i think that's a little outlandish but i think the more the more narrow construction by the district court in this case by mccollum in that case is the right one because it makes the  and the a b a the same you need to be personally excluded personally denied benefits or person discriminated against i think the mccollum had a good point they said if the court held provision does that doesn't make any sense of the way that these laws are applied the regime between the eighty eight rehabilitation so for that for the my point i guess there would be the district court correctly found mccollum is the standard in this case and should applied here otherwise we've got it doesn't make sense i have fifteen seconds left unless the court has questions for me i'll be seated thank you thank you look at the record in this case roger and linda were present with an interpreter on april two thousand and thirteen care conference before hospitalization there is a men's been made between linda and roger with s and that is of record in this case a nurse klopp testified that they health care agent can orally change who has access to information and priscilla at all times was involved in those care conferences it gets down to what is the service that fairview is providing if the idea is it's just to relay information then it is like a lawyer but carer conferences are not just to relay information they're for discussions there are four of the ability to get comfort from each other the stakeholders talking about what is the the plan what is necessary what would show on want and so in that respect it is vastly different than low light and that goes back to this court's decision and are anywhere you look at what is the service provided and was the disabled person given the same service and on this record the answer to that is no with regard to priscilla's claim i refer the court to the mccollum and seven sixty two fed third at footnote five were  about the fact that at the time a column was decided the regulation was not in place that provided that you could not rely on an adult parent and i also would just like to briefly note that loffler was decided in two thousand nine and we have not seen the floodgate type of cases that was the assertion made by the respondent this morning so i asked for a reversal and reinstatement thank you well