Opinion ID: 794319
Heading Depth: 2
Heading Rank: 1

Heading: PAMII Preemption

Text: 4 PAMII, enacted in 1986, authorizes certain independent organizations (referred to in PAMII as eligible systems) such as MOPAS to monitor and protect the rights of the mentally ill. Eligible systems fulfill this role, in part, by accessing certain records in order to investigate incidents involving mentally ill individuals. 42 U.S.C. § 10805(a)(4)(A) (providing access to all records of . . . any individual). There is no dispute the records referenced in section 10805(a)(4)(A) include the medical peer review report at issue here. See id. § 10806(b)(3)(A) (`[R]ecords' includes reports prepared by any staff of a facility rendering care and treatment or reports prepared by an agency charged with investigating reports of incidents of abuse, neglect, and injury occurring at such facility that describe incidents of abuse, neglect, and injury occurring at such facility and the steps taken to investigate such incidents.); see also Houstoun, 228 F.3d at 426-27. 5 Under Missouri law, however, reports prepared by peer review committees ... concerning the health care provided any patient are privileged and shall not be subject to discovery, subpoena, or other means of legal compulsion for their release to any person or entity. Mo.Rev.Stat. § 537.035 (4). Thus, an actual conflict exists between PAMII and Missouri law regarding MOPAS's access to peer review reports. 6 The issue in this case, therefore, is whether PAMII preempts Missouri's law protecting healthcare facilities from disclosing peer review reports. PAMII's plain language affords the answer by specifically providing a grace period of up to two years before PAMII preempts such state laws: 7 If the laws of a State prohibit an eligible system from obtaining access to the records of individuals with mental illness in accordance with section 10805(a)(4) of this title and this section, section 10805(a)(4) of this title and this section shall not apply to such system before — 8 (i) the date such system is no longer subject to such a prohibition; or 9 (ii) the expiration of the 2-year period beginning on May 23, 1986, whichever occurs first. 10 42 U.S.C. § 10806(b)(2)(C). By limiting PAMII's application regarding records access in deference to state prohibitions only before an express period, section 10806(b)(2)(C) effectively indicates section 10805(a)(4) applies and requires access after the grace period has passed. 11 Despite this plain language, DMH argues Congress did not intend to preempt state laws protecting peer review documents. DMH claims this congressional intent is evidenced by House and Senate committee reports during PAMII's 1991 reauthorization, stating [i]t is the Committee's intent that the PAMII Act does not preempt State law regarding disclosure of peer review/medical review records relating to the proceedings of such committees. H.R.Rep. No. 102-319, at 6, reprinted in 1991 U.S.C.C.A.N. 777, 782; see also S.Rep. No. 102-114, at 5. (containing virtually identical language). DMH also relies on a Department of Health and Human Services (DHHS) 1998 regulation purporting to implement PAMII's reauthorization, stating that nothing in this section is intended to preempt State law protecting records produced by medical care evaluation or peer review committees. 42 C.F.R. § 51.41(c)(4). 12 Because PAMII's language is unambiguous, we see no reason to resort to congressional committee reports as interpretive devices. See United States v. Maswai, 419 F.3d 822, 824 (8th Cir.2005) (Only if the statute is ambiguous do we look to the legislative history to determine Congress's intent. (quoting United States v. Smith, 171 F.3d 617, 620 (8th Cir. 1999))), cert. denied, ___ U.S. ___, 126 S.Ct. 1418, 164 L.Ed.2d 115 (2006). Even were we to mine the 1991 reports for meaning, any unearthed nuggets would prove pyritical, for the reports' subject, the 1991 reauthorization bill, was enacted without amending PAMII regarding record access. See Protection and Advocacy for Mentally Ill Individuals Amendments Act of 1991, Pub.L. No. 102-173, 105 Stat. 1217; see also Houstoun, 228 F.3d at 427-28. 13 Regarding DHHS's PAMII regulatory implementation, like Judge Alito's unanimous Third Circuit panel, we conclude [t]he interpretation of PAMII set out in 42 C.F.R. § 51.41(c)(4) does not represent a reasonable interpretation of the statute, and we must therefore reject it. Houstoun, 228 F.3d at 427 (citing Chevron, U.S.A., Inc. v. Natural Res. Def. Council, Inc., 467 U.S. 837, 843-44, 104 S.Ct. 2778, 81 L.Ed.2d 694 (1984)); see also Ctr. for Legal Advocacy v. Hammons, 323 F.3d 1262, 1271 (10th Cir.2003). Reducing the statute's preemptive force would require a legislative change to the plain language of the statutory text. Such a change cannot be achieved by means of a regulation. Houstoun, 228 F.3d at 428. 14 For the reasons stated, we affirm the district court and hold, to the extent Mo. Rev.Stat. § 537.035(4) conflicts with PAMII, PAMII expressly preempts Missouri law. See Pac. Gas & Elec. Co. v. State Energy Res. Conservation & Dev. Comm'n, 461 U.S. 190, 203, 103 S.Ct. 1713, 75 L.Ed.2d 752 (1983) (declaring within Constitutional limits Congress may preempt state authority by so stating in express terms).