Center for Legal Advocacy v. Hammons, 01-1574.

Citation323 F.3d 1262
Decision Date27 March 2003
Docket NumberNo. 01-1574.,01-1574.
PartiesCENTER FOR LEGAL ADVOCACY dba The Legal Center for People with Disabilities and Older People aka The Legal Center, Colorado's Protection and Advocacy System, P & A System, Plaintiff-Appellant, v. Marva Livingston HAMMONS, in her official capacity as Executive Director of the Colorado Department of Human Services; Robert B. Rossi, in his official capacity as Manager, Office of Direct Services of the Colorado Department of Human Services; Robert L. Hawkins, in his official capacity as Superintendent of the Colorado Mental Health Institute at Pueblo; and Colorado Mental Health Institute at Pueblo, Defendants-Appellees. National Association of Protection and Advocacy Systems, Amicus Curiae.
CourtUnited States Courts of Appeals. United States Court of Appeals (10th Circuit)

Mark J. Ivandick (Terry L. Fowler with him on the briefs), Denver, CO, for Plaintiff-Appellant.

Beverly Fulton, First Assistant Attorney General, Human Services Unit, State Services Section, Denver, CO (Ken Salazar Attorney General, Denver, CO, with her on the brief), for Defendant-Appellee.

Sandra L. Gomez, Protection & Advocacy System, Inc., Albuquerque, NM, and Gary P. Gross, National Association of Protection and Advocacy Systems, Washington, DC, filed an amicus curiae brief for the National Association of Protection and Advocacy Systems.

Before BRISCOE, ANDERSON, and LUCERO, Circuit Judges.

STEPHEN H. ANDERSON, Circuit Judge.

This case involves the single issue of whether plaintiff, Center for Legal Advocacy ("CLA"), is entitled, under the Protection and Advocacy for Mentally Ill Individuals Act ("PAMII"), 42 U.S.C. §§ 10801-10851, to peer review and quality assurance records it seeks in connection with its investigation into the suicides and attempted suicide of mental health care patients, or whether such access is barred by Colorado statutes prohibiting access to such records. The district court held CLA was not entitled to those records. We reverse.

BACKGROUND

CLA is a non-profit Colorado corporation designated by the governor of Colorado as the state's Protection and Advocacy System ("P & A System") under the PAMII Act. Under the Act, P & A Systems like CLA are directed to "investigate incidents of abuse and neglect of individuals with mental illness," and to "protect and advocate the rights of such individuals." 42 U.S.C. § 10801(b)(2).

Defendant Colorado Mental Health Institute at Pueblo ("Institute") is a Colorado facility which treats individuals with mental illnesses. It is organized and operated under the Office of Direct Services of the Colorado Department of Human Services ("CDHS"). Defendant Robert Hawkins is the Institute's superintendent, defendant Robert Rossi is the manager of CDHS's Office of Direct Services, and defendant Marva Hammons is the executive director of CDHS.

After learning of the suicides of four patients at the Institute, and the attempted suicide of another Institute patient, CLA sought information under PAMII, including physician peer review and quality assurance/management materials, to assist in its investigation of those incidents.1 PAMII authorizes P & A Systems like CLA to have access to certain records in order to conduct its investigations into incidents involving mentally ill individuals. Colorado, however, has two statutes which bar disclosure of physician peer review and hospital "quality management" review records in certain situations.2 Defendants eventually provided CLA with all records relating to the patients under investigation, but refused to turn over peer review and quality assurance records.3

CLA seeks a declaratory judgment and an injunction requiring access to peer review and quality assurance records relevant to the suicides and attempted suicide it was investigating at the Institute, as well as a permanent injunction for future cases, along with attorney's fees.4 Plaintiff and defendants filed motions pursuant to Fed. R.Civ.P. 12(c) for judgment on the pleadings, and the matter was referred to a magistrate judge. The magistrate judge concluded that PAMII's disclosure requirements applied to the professional review records sought by CLA and recommended that defendants grant CLA access to them. The district court disagreed, concluding that PAMII does not compel the disclosure of the records at issue and does not preempt Colorado's statutes barring disclosure of them. It therefore held that CLA could not compel access to those records, and it accordingly vacated the magistrate judge's recommendation and dismissed CLA's claims. CLA appeals.

DISCUSSION

We review de novo the entry of judgment on the pleadings. Ramirez v. Dept. of Corrections, 222 F.3d 1238, 1240 (10th Cir.2000); Bishop v. Fed. Intermediate Credit Bank of Wichita, 908 F.2d 658, 663 (10th Cir.1990). We also review de novo the district court's interpretation of a federal statute. United States v. Quarrell, 310 F.3d 664, 669 (10th Cir.2002).

A brief history of PAMII is necessary to understand the arguments of each side in this case. PAMII was enacted in 1986. Section 10805 of the Act authorizes P & A Systems like CLA to "in accordance with section 10806 ... have access to all records of ... any individual who is a client of the system if such individual, or the legal guardian, conservator, or other legal representative of such individual, has authorized the system to have such access." 42 U.S.C. § 10805(a)(4).5 In 1988, PAMII was amended and reauthorized, and subsection (b)(3) to § 10806, providing a definition of "records," was added:

As used in this section, the term "records" 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, and discharge planning records.

42 U.S.C. § 10806(b)(3)(A). Section 10806 further provides that:

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 —

(i) the date such system is no longer subject to such a prohibition; or

(ii) the expiration of the 2 year period beginning on May 23, 1986, whichever occurs first.

42 U.S.C. § 10806(b)(2)(C).

PAMII was again amended and reauthorized in 1991, although none of the 1991 amendments to the text of PAMII are relevant to this case. All parties agree that, prior to the 1991 amendments and reauthorization, the legislative history of the Act did not address the issue of access to peer review or quality assurance records. All parties also agree that the issue was raised during the 1991 reauthorization process. They disagree strongly on what, if anything, we should derive from those facts.

The mention of access to peer review records in connection with the 1991 amendment and reauthorization appeared in both the House and Senate Committee Reports:

The Committee recognizes that almost all hospitals have established medical care evaluation or peer review committees as part of their Joint Commissions on Accreditation of Health Care Organizations (JCAHO) accreditation requirements. The purpose of these committees is to review and evaluate patient care in the facility in order to improve the quality of care.

The Committee has been made aware that 46 states have statutes that protect the records produced by such committees from disclosure. It is the Committee's intent that the PAMII Act does not pre-empt 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 (1991), reprinted in 1991 U.S.C.C.A.N. 777, 782. The Senate Report contains virtually identical language. However, the 1991 reauthorization bill, Senate Bill 1475, was passed by both the Senate and the House of Representatives with no discussion of access to peer review records, and no change relating to record access was actually made in the text of the Act when it was reauthorized.6

Additionally, when Congress reauthorized PAMII in 1991 it provided that "the Secretary [of Health and Human Services] shall promulgate final regulations to carry out this title." Protection and Advocacy for Mentally Ill Individuals Amendments Act of 1991, § 9, Pub.L. No. 102-173, 105 Stat. 1217 (1991). Pursuant to that authority, the United States Department of Health and Human Services enacted a regulation which states that P & A Systems shall have access to the following:

Reports prepared by individuals and entities performing certification or licensure reviews, or by professional accreditation organizations, as well as related assessments prepared for the facility by its staff, contractors or related entities, except 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). Thus, this regulation arguably implemented the language contained in the Committee Reports, excluding from access under PAMII peer review or medical care evaluation materials which are privileged under state law. CLA argues this regulation is invalid because it directly conflicts with the clear intent of Congress as expressed in the text of the PAMII Act. Defendants argue it is a valid regulation and reflects Congressional intent expressed in 1991 when the PAMII Act was reauthorized.

CLA argues that the district court erred in denying it access to peer review and quality assurance records, contending: (1) it impermissibly relied upon 42 C.F.R. § 51.41(c)(4), which conflicts with Congressional intent as expressed in the text of the Act itself; (2) it erred in failing to conclude that PAMII preempts the...

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