Bone v. Univ. of N.C. Health Care Sys.
| Decision Date | 14 January 2022 |
| Docket Number | 1:18cv994 |
| Court | U.S. District Court — Middle District of North Carolina |
| Parties | JOHN BONE, et al., Plaintiffs, v. UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM, Defendant. |
JOHN BONE, et al., Plaintiffs,
v.
UNIVERSITY OF NORTH CAROLINA HEALTH CARE SYSTEM, Defendant.
No. 1:18cv994
United States District Court, M.D. North Carolina
January 14, 2022
MEMORANDUM OPINION, ORDER, AND RECOMMENDATION OF UNITED STATES MAGISTRATE JUDGE
L. Patrick Auld, United States Magistrate Judge.
This case comes before the Court on (i) the “Motion for Partial Summary Judgment” (Docket Entry 103) (“Plaintiffs' Motion”) filed by John Bone, Timothy Miles, the National Federation of the Blind, Inc. (the “NFB”), and Disability Rights North Carolina (individually, the “DRNC, ” and collectively, the “Plaintiffs”); (ii) “Defendant UNC Health Care System's Motion for Summary Judgment Against Plaintiff Timothy Miles” (Docket Entry 107) (“Defendant's Miles Motion”); (iii) “Defendant UNC Health Care System's Motion for Summary Judgment Against Plaintiff John Bone” (Docket Entry 109) (“Defendant's Bone Motion”); (iv) “Defendant UNC Health Care System's Motion for Summary Judgment Against Plaintiff The National Federation of the Blind” (Docket Entry 111) (“Defendant's NFB Motion”); (v) “Defendant UNC Health Care System's Motion for Summary Judgment Against Plaintiff Disability Rights of North Carolina” (Docket Entry 112) (“Defendant's DRNC Motion”); and (vi) “Plaintiffs' Motion to Seal” (Docket Entry 104) (the “Sealing
Motion”). For the reasons that follow, the Court (i) should grant in part and deny in part Plaintiffs' Motion, Defendant's Bone Motion, and Defendant's NFB Motion; (ii) should deny Defendant's Miles Motion and Defendant's DRNC Motion; and (iii) will deny the Sealing Motion without prejudice.
BACKGROUND
I. Procedural History
In December 2018, Plaintiffs initiated “this action against the University of North Carolina Health Care System (d/b/a UNC Health Care) (‘[at times, UNCHCS]') and Nash [Hospitals, Inc.] (‘[at times, ] Nash'), for denying blind individuals an equal opportunity to access their health care information, in violation of Titles II and III of the Americans with Disabilities Act of 1990 ([the] ‘ADA'), 42 U.S.C. §§ 12131-12134, 12181-12189, Section 504 of the Rehabilitation Act (‘Section 504'), 29 U.S.C. § 794(a), and Section 1557 of the Patient Protection and Affordable Care Act (‘Section 1557'), 42 U.S.C. § 18116” (collectively, the “Acts”) (Docket Entry 1, ¶ 1; accord Docket Entry 18 (the “Amended Complaint”), ¶ 1).[1] As this Court (per the undersigned United States Magistrate Judge) previously explained:
According to the Amended Complaint, [Bone] is “blind and uses Braille to make and receive written communications.” (Docket Entry 18, ¶ 7.) Similarly, the
Amended Complaint alleges that [Miles] is “blind and cannot read standard print. He relies on large print or electronic documents that he can enlarge to make and receive written communications.” (Id., ¶ 8.) The Amended Complaint identifies [NFB] as a non-profit corporation that “promotes the general welfare of the blind by assisting the blind in their efforts to integrate themselves into society on terms of equality and by removing barriers that result in the denial of opportunity to blind persons in virtually every sphere of life, including education, health care, employment, family and community life, transportation, and recreation.” (Id. ¶ 9; see also id. (“The vast majority of [NFB's] approximately 50, 000 members [including Bone and Miles] are blind persons who are recognized as a protected class under federal laws.”).) Finally, the Amended Complaint describes [DRNC] as a non-profit corporation “authorized to pursue administrative, legal, and other appropriate remedies to protect and advocate for the legal rights of individuals with disabilities and to redress incidents of discrimination in the state.” (Id., ¶ 11; see also id., ¶ 12 (“[DRNC] represents the interests of its blind constituents in North Carolina who require medical documents in alternative formats.”).)
In turn, the Amended Complaint alleges that Defendant UNCHCS “is an integrated health care system owned by the state of North Carolina[, ] established by state law, N.C. G.S § 116-37. [UNCHCS] currently consists of UNC Hospitals and its provider network . . . and eleven affiliate hospitals and hospital systems across the state, including [Nash], ” with its “principal place of business [] in Chapel Hill, North Carolina.” (Id., ¶ 13.) The Amended Complaint further identifies [Nash] as a “non-profit hospital affiliate” of [] UNCHCS, which “employs and contracts with numerous providers for the delivery of medical services in its facilities, ” with a “principal place of business [] in Rocky Mount, North Carolina.” (Id., ¶ 14.) According to the Amended Complaint, both [] UNCHCS and [Nash] receive “federal financial assistance from the Department of Health and Human Services.” (Id., ¶ 60.)
The Amended Complaint asserts that “Titles II and III of the ADA, Section 504, and Section 1557 require [UNCHCS and Nash] to communicate in an equally effective manner with all blind individuals, and to ensure that their contractors . . . do the same.” (Id., ¶ 2.)
Moreover, the Amended Complaint maintains that [UNCHCS and Nash] and their contractors violate these laws by “depriv[ing] blind individuals of full and equal access to their medical services, programs, and activities. They provide critical communications, such as health care notices, visit summaries, follow-up instructions, forms, questionnaires, invoices, and other types of documents, only in standard print, a format inaccessible to blind individuals.” (Id., ¶ 3.) In particular, the Amended Complaint states that:
ineffective communication with blind . . . patients . . . compromises their ability to review, and, if necessary, respond to communications on a timely basis, and forces them to rely on and divulge private medical and financial information to sighted third parties for assistance. This disrupts blind patients' access to their health care, prevents them from understanding and following medical instructions, and results in unfair financial penalties for not being able to access and pay medical bills on time, all leading to significant financial and personal hardship.
(Id.)
To support its claims, the Amended Complaint sets forth the following facts . . . .:
A. Plaintiff Bone
[] Bone [is] a resident of Rocky Mount, North Carolina, [and] relies on [Nash] for his emergency medical needs.
[He] visited Nash General Hospital to receive emergency medical services in December 2016, and again in or about June and July 2017. During [] Bone's 2016 visit [and 2017 hospitalization], he received services from [Nash] directly and from its contractors . . . . Upon information and belief, all of these entities are either components of [UNCHCS] and/or [Nash].
During these two hospital visits, [] Bone informed hospital and provider staff that he was blind and needed to receive medical bills in
Braille. The staff did not ask [] Bone to take any additional steps to obtain medical bills in Braille.
Neither the hospital nor its contractors initially sent bills to [] Bone in Braille. Instead, [] Bone received all of the bills related to his hospital visits in print.
[] Bone could not read the print bills and did not know how much money he owed or who[m] to pay for his two emergency medical visits.
The hospital and its contractors continued sending [] Bone second and final bill notices in print; he accrued late fees; and [Nash] and at least three of its contractors referred him to collection agencies. The creditors pursued payment from [] Bone and threatened him.
Only after [Bone's counsel] wrote to [Nash] did it agree to provide Braille invoices for previously sent bills. None of [Nash]'s contractors, however, have provided Braille invoices. Thus, [] Bone still does not know how much money he owes for his two emergency medical visits. Furthermore, [UNCHCS, Nash], and their contractors have all failed to address whether [] Bone could expect to receive Braille documents going forward without attorney involvement. They have not provided any assurances that the hospital system would ensure timely provision of alternative formats on a systemic basis.
(Id., ¶¶ 15-21 (internal paragraph numbers omitted).)
B. Plaintiff Miles
[] Miles resides in Chapel Hill, North Carolina and is a regular patient of several different medical practices operating out of [UNCHCS, which h]e visits . . . at least once every six months and often more frequently. For example, between June and August 2018, [] Miles visited three different UNC practices. . . .
During visits to [UNCHCS] providers, [] Miles receives standard[-]print versions of documents and
often asks the staff for large[-]print versions of the documents instead. These include notices he is asked to sign, forms, visit summaries, and follow-up instructions. [UNCHCS] providers consistently refuse to provide [] Miles with these documents in large print. Some providers have offered to read documents aloud to [] Miles, but this is not effective for [] Miles, who, particularly in the case of visit summaries and follow-up instructions, wants to have a document to take home with him to review after his visits. He does not want to be forced to memorize all of the information contained in these documents. With respect to notices, these documents are often long[, ] and provider staff typically paraphrase and attempt to summarize the contents, rather than read the entire notice verbatim. Such summarizing does not provide [] Miles with all of the same information contained in the standard[-]print notices.
[] Miles also receives all of his invoices from [UNCHCS] providers in standard print. These invoices typically come from [UNCHCS]'s billing department...
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