Iowa Protection & Advocacy Ser v. Gerard Treatment
| Decision Date | 25 June 2001 |
| Docket Number | No. C 01-3013-MWB.,C 01-3013-MWB. |
| Parties | IOWA PROTECTION AND ADVOCACY SERVICES, INC., Plaintiff, v. GERARD TREATMENT PROGRAMS, L.L.C., Defendant. |
| Court | U.S. District Court — Northern District of Iowa |
Sharon K. Malheiro, Davis, Brown, Koehn, Shors & Roberts, P.C., Des Moines, IA, for plaintiff.
C. Bradley Price, Rustin Davenport, DeVries, Price & Davenport, Mason City, IA, for defendant.
TABLE OF CONTENTS
I. INTRODUCTION .........................................................1153
A. Factual Background ................................................1153
B. Procedural Background .............................................1154
II. LEGAL ANALYSIS .......................................................1156
A. Standards For A Preliminary Injunction ............................1156
B. Consideration Of The Relevant Factors .............................1157
1. Likelihood of success on the merits ............................1157
a. Rights of access under the DDA and the PAMII Act ............1157
i. Genesis of the P & A system .............................1157
ii. Authority of P & As .....................................1158
iii. Rights of access ........................................1159
b. Likelihood of success here ..................................1161
i. The Riel decision .......................................1161
ii. Effect of a guardian's denial of consent under the PAMII
Act .....................................................1163
iii. Other limitations .......................................1167
2. Irreparable harm ...............................................1172
3. Balance of harms and public interest ...........................1174
C. Bond ..............................................................1175
III. CONCLUSION ...........................................................1176
How much access to records, facilities, and patients of a psychiatric medical institution for children is a non-profit advocacy agency entitled to have in the course of its investigation of the death of one resident of the institution and its determination that there is probable cause to believe that other residents are in jeopardy of abuse or neglect? That is the question animating the advocacy agency's present request for a preliminary injunction. The advocacy agency contends that the psychiatric institution has denied or interfered with its access to information essential to its investigation, in violation of the Protection and Advocacy for Mentally Ill Individuals Act of 1986, as amended in 1991 (PAMII Act), 42 U.S.C. § 10801 et seq., and the "Protection and Advocacy of Individual Rights" provision of the Developmental Disabilities Act of 1984, as amended (DDA), 42 U.S.C. § 6042. The psychiatric institution, however, contends that it has cooperated with the advocacy agency's investigators, once their authority to conduct the investigation was ascertained, and that the advocacy agency is not entitled to unlimited access to its records, facilities, and patients, but only to "reasonable" access that will not interfere with operations of the facility, and that "reasonable access" to individuals and their records is limited to cases in which the advocacy agency has probable cause to believe that those specific individuals are in jeopardy. The court must determine whether a preliminary injunction is required to guarantee the advocacy agency the level of access to which it is entitled under the PAMII Act and the DDA. At oral arguments on the advocacy agency's request of a preliminary injunction, the critical issue before the court crystalized into the question of whether or not the advocacy agency has a right of access to records and patients even in cases in which the patients' guardians have told either the advocacy agency or the institution that they do not want the advocacy agency to have such access.
Plaintiff Iowa Protection and Advocacy Services, Inc. (IPAS) alleges that it is an independent, non-profit agency created by federal law to serve individuals with disabilities. More specifically, IPAS alleges that it has a federal mandate to conduct investigations of abuse and neglect and potential abuse and neglect of disabled persons pursuant to 42 U.S.C. § 6042, 42 U.S.C. § 10801 et seq., and state law. Defendant Gerard of Iowa, which contends that its proper name is Gerard Treatment Programs, L.L.C. (Gerard), is a psychiatric medical institution for children located in Mason City, Iowa.
On or about February 9, 2001, a juvenile resident of Gerard, Tanner J. Wilson, died of "cardiopulmonary arrest while being restrained." See Amended and Substituted Complaint And Request For Injunctive And Declaratory Relief, Exhibit B (medical examiner's report on "immediate and basic" cause of death). IPAS alleges that Mr. Wilson died while being restrained by employees of Gerard. IPAS alleges that it became aware of Mr. Wilson's death on February 12, 2001. Consequently, on February 14, 2001, investigators from IPAS arrived at Gerard to conduct an investigation into Mr. Wilson's death. However, the investigators were denied access at that time and again on February 15, 2001, for reasons that are disputed. IPAS filed its initial Complaint in this matter on February 16, 2001, after which the parties were able to negotiate some access to Gerard's facility and records concerning Mr. Wilson. IPAS alleges, however, that Gerard continued to interfere with its investigators' full access to all of Mr. Wilson's records.
During the course of its investigation of the death of Mr. Wilson, IPAS alleges that it received information that provided IPAS with probable cause to believe that "other residents" of Gerard's facility in Mason City may also be in jeopardy of being abused. See Amended And Substituted Complaint, ¶ 20. IPAS alleges that it notified Gerard's counsel in early March that its investigation had expanded beyond the death investigation into a "probable cause" investigation concerning potential abuse of other residents at the facility. In an Amended and Substituted Complaint, filed April 2, 2001, IPAS alleges that Gerard has interfered with that expanded investigation as well. Specifically, IPAS alleges, first, that access to records and residents has not been allowed. Second, IPAS alleges that, prior to being allowed to begin its investigation and before Gerard provided IPAS with a list of names, addresses, and telephone numbers of parents, guardians, and/or guardians ad litem of residents of the facility, Gerard contacted those persons and informed them of IPAS's investigation and the possibility that IPAS would seek interviews with those persons or the residents for whom they were responsible. Although IPAS contends that Gerard provided no such notice of the investigations by the Iowa Department of Investigations and Appeals, the Iowa Department of Human Services, and law enforcement departments, Gerard contends that it was specifically prohibited by those entities from providing any notice of investigations and possible interviews. Although IPAS's Amended Complaint does not make clear in what way Gerard's notice to parents, guardians, and/or guardians ad litem interfered with IPAS's investigation, IPAS alleges that its investigation has been irreparably harmed by Gerard's interference.
As noted above, IPAS filed its initial Complaint And Request For Expedited Relief on February 16, 2001, and an Amended and Substituted Complaint And Request For Injunctive And Declaratory Relief on April 2, 2001. In its Amended Complaint, IPAS alleges two causes of action. First, IPAS alleges that "[t]he policy and actions of the Defendant violates [sic] the right of Plaintiff to meaningful and timely access to the records of Mr. Wilson as well as to the other residents and records of the facility in violation of the Protection and Advocacy for Mentally Ill Individuals Act of 1991, 42 U.S.C. § 10801, et seq., and the policy and actions, unless enjoined will violate [IPAS's] right to that information in the event of future deaths and probable cause determinations." Amended And Substituted Complaint, ¶ 31. Second, IPAS alleges that "[t]he policy and actions of the Defendants [sic] in contacting the parents/guardians/guardians ad litem prior to providing the [IPAS] with the name, address and telephone numbers of the parents/guardians/guardians ad litem violates 42 U.S.C. § 10801, et seq., and unless enjoined will violate [IPAS's] rights in the event of future deaths and probable cause determinations." Id. at ¶ 32.
In its Amended Complaint, IPAS seeks declaratory and injunctive relief. Specifically, IPAS "requests that after notice and hearing, this Court enter a declaratory judgment that the Defendant's policies, regulations, practices and conduct of interfering with and denying the Plaintiff proper and immediate access violates [sic] 42 U.S.C. Section 6042 and 42 U.S.C. Section 10801, et seq." Id. at 35 (Declaratory Relief). Also, IPAS prays that the court do the following:
A. Enter a preliminary injunction enjoining Defendant, its agents or employees from denying [IPAS] full and immediate access to the records of all individuals receiving services at Gerard.
B. Enter a permanent injunction enjoining the Defendant, its agents or employees from denying [IPAS] full and immediate access to the records of all individuals receiving services at Gerard if a complaint is received and/or probable cause exists to believe that abuse or neglect has occurred.
C. Enter a permanent injunction enjoining Defendant, its agents or employees from denying [IPAS] full and immediate access to...
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