Source: http://ca10.washburnlaw.edu/cases/2003/02/02-1135.htm
Timestamp: 2019-01-18 11:25:09
Document Index: 555583859

Matched Legal Cases: ['§ 2', '§ 290', '§ 2', '§ 2', '§ 2', '§ 2', '§ 2', '§ 290', '§ 2', '§2', '§ 10801', '§ 15043', '§ 794']

02-1135 -- Center for Legal Adocacy v. Earnest -- 02/25/2003
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CENTER FOR LEGAL ADVOCACY, doing business as Legal Center for People with Disabilities and Older People, also known as Legal Center, Colorado's Protection and Advocacy System, P&A System,
No. 02-1135
(D.C. No. 01-WY-642-CB)
Terry L. Fowler (Mark J. Ivandick with him on the briefs), Denver, Colorado, for Plaintiff-Appellant.
Sharon E. Caulfield (W. Stuart Stuller with her on the brief) of Caplan and Earnest, LLC, Boulder, Colorado, for Defendants-Appellees.
Before HENRY and McKAY, Circuit Judges, and OBERDORFER, Senior District Judge.(*)
When the Plaintiff Center for Legal Advocacy undertook to carry out its statutory mandate(1) to "investigate incidents of abuse and neglect of individuals with mental illness and to take appropriate action to protect and advocate the rights of such individuals," it was denied access to certain medical records by the Hospital. See Iowa Prot. and Advocacy Servs. v. Gerard Treatment Programs, 152 F. Supp. 2d 1150, 1158 (N.D. Iowa 2001) (internal quotes and citations omitted). While there were other disputes, the matter ultimately focused on the Hospital's belief that it was required to withhold the records pursuant to the confidentiality provisions of 42 C.F.R. § 2 et seq.
The Center sued to compel access to the information, and the Hospital countersued for a declaratory judgment that it was entitled to enforce the provisions of 42 U.S.C. § 290dd-2 (2001) and the accompanying regulations of 42 C.F.R. § 2 et seq. As those regulations explain, the confidentiality provisions "cover any information (including information on referral and intake) about alcohol and drug abuse patients obtained by a program (as the terms 'patient' and 'program' are defined in § 2.11) if the program is federally assisted . . . ." 42 C.F.R. § 2.12(e) (2001).
Patient means any individual who has applied for or been given diagnosis or treatment for alcohol or drug abuse at a federally assisted program . . . .
(c) Medical personnel or other staff in a general medical care facility whose primary function is the provision of alcohol or drug abuse diagnosis, treatment or referral for treatment and who are identified as such providers.42 C.F.R. § 2.11.
In holding that the Hospital's emergency room qualifies as a "program," the district court relied on United States v. Eide, 875 F.2d 1429 (9th Cir. 1989). In Eide, the Ninth Circuit was faced with facts similar to those here and with a prior version of the same confidentiality provisions, including a prior version of the definition of "program" in § 2.11. Applying the then-current regulations to the facts, the Ninth Circuit concluded that, for purposes of the confidentiality provisions, the emergency room at the Veterans Administration Hospital was a "program." See id. at 1436-37. In reaching this conclusion, the Ninth Circuit explained that "[a] hospital emergency room, while obviously also performing functions unrelated to drug abuse, serves as a vital first link in drug abuse diagnosis, treatment, and referral." Id. at 1436.
It is this very language from the Eide opinion that the district court in the instant case relied upon in concluding that the Hospital's emergency room was also a "program." See Center for Legal Advocacy v. Earnest, 188 F. Supp. 2d 1251, 1261 (D. Colo. 2002) (citing Eide, 875 F.2d at 1436). Applying reasoning similar to the Ninth Circuit's, the district court held that the emergency facility was an alcohol abuse program because (1) patients treated initially in the emergency room were often referred to Denver Cares, (2) the emergency department had access to the records held by Denver Cares, and (3) the emergency facility was closely integrated with Denver Cares and provided initial diagnosis and treatment for eventual patients of Denver Cares. See id.
Because the Eide court was applying a prior version of the confidentiality regulations, Appellant argues that the district court relied on immaterial facts and overturned law. We review de novo a grant of summary judgment, viewing the facts in the light most favorable to the non-moving party. See Sports Unlimited, Inc. v. Lankford Enterprises, Inc., 275 F.3d 996, 999 (10th Cir. 2002); Goodwin v. General Motors Corp., 275 F.3d 1005, 1007 (10th Cir. 2002).
In response to the Eide decision, the Substance Abuse and Mental Health Services Administration ("SAMHSA")­the agency charged with promulgating regulations under the confidentiality provisions of the Public Health Services Act, 42 U.S.C. § 290dd-2 (2002)­amended 42 C.F.R. § 2.12(e). SAMHSA explained the changes as follows:
The [Eide] court ruled that the [Veterans Administration Medical Center] was a "person" which is defined at §2.12 to mean "an individual, * * * Federal, State or local government or any other legal entity," and concluded that "(a) hospital emergency room, while obviously also performing functions unrelated to drug abuse, serves as a vital first link in drug abuse diagnosis, treatment and referral." [Citing Eide at 1438.]
The Department believes this interpretation too broadly defines the term "program.". . .
. . . Prior to the 1987 amendments, the regulations applied to any record relating to substance abuse whether the information was obtained from an emergency room, a general medical unit or a general practitioner so long as there was a Federal nexus. In 1987, however, it was the intent of the Department to limit the applicability of the regulations to specialized programs and personnel . . . .
59 Fed. Reg. 42,561, 42,562 (Aug. 18, 1994).
Not only have Appellees failed to provide any evidence that the Hospital has held itself out as such a program, but there is evidence to the contrary. While Dr. Cantrill testified that the emergency department holds itself out as being a fully staffed emergency department and that drug and alcohol abuse often includes medical emergencies, he admitted that the emergency department made no claim that it provided any ongoing care for "[t]he more chronic components of chronic alcohol or chronic drug abuse . . . ." Rec., Vol. II, at 530. Furthermore, Dr. Higgins, a nurse administrator in Behavioral Health Services at the Hospital, admitted in her deposition that the Hospital had never made significant efforts to market the emergency room as part of its drug and alcohol abuse treatment program. Finally, the testimonies of Dr. Casper and Mr. Snyder both point to the fact that neither the emergency room nor its personnel are licensed or identified to the public as part of an alcohol or drug abuse treatment facility.
In granting summary judgment in favor of Appellees, the district court awarded Appellees their costs. Since we now reverse the grant of summary judgment, Appellees are no longer considered the prevailing party on that motion and that order must be reversed. See Delano v. Kitch, 663 F.2d 990, 1001 (10th Cir. 1981); Amarel v. Connell, 102 F.3d 1494, 1523 (9th Cir. 1997) (citing Farmer v. Arabian American Oil Co., 379 U.S. 227 (1964)). Therefore, we reverse the award of costs to Appellees and remand the issue to the district court for proceedings consistent with this decision.
*.Honorable Louis F. Oberdorfer, United States Senior District Judge for the District of Columbia, sitting by designation.
1. The protection and advocacy system is primarily a creation of federal law, namely three federal statutes: 42 U.S.C. § 10801, et seq., the Protection and Advocacy for Individuals with Mental Illness Act; 42 U.S.C. § 15043, the Protection and Advocacy for Developmental Disabilities Act; and 29 U.S.C. § 794e et seq., the Protection and Advocacy for Individual Rights Act. Protection and advocacy organizations ("P&As") "are intended to investigate incidents of abuse and neglect of individuals with [disabilities] and to take appropriate action to protect and advocate the rights of such individuals." Iowa Prot. and Advocacy Servs. v. Gerard Treatment Programs, 152 F. Supp. 2d 1150, 1157 (N.D. Iowa 2001) (quotations and citations omitted). The Center is the designated P&A for Colorado.
URL: http://ca10.washburnlaw.edu/cases/2003/02/02-1135.htm.