King v. Cook Cnty. Health & Hosps. Sys., 1-19-0925

CourtUnited States Appellate Court of Illinois
Writing for the CourtJUSTICE REYES delivered the judgment of the court, with opinion.
Citation177 N.E.3d 381,2020 IL App (1st) 190925,448 Ill.Dec. 623
Parties Dr. Judy KING, Plaintiff-Appellee, v. The COOK COUNTY HEALTH AND HOSPITALS SYSTEM, Defendant-Appellant.
Docket NumberNo. 1-19-0925,1-19-0925
Decision Date18 June 2020

2020 IL App (1st) 190925
177 N.E.3d 381
448 Ill.Dec.

Dr. Judy KING, Plaintiff-Appellee,

No. 1-19-0925

Appellate Court of Illinois, First District, Fourth Division.

June 18, 2020

Kimberly M. Foxx, State's Attorney, of Chicago (Cathy McNeil Stein, Martha Victoria Jimenez, and James Beligratis, Assistant State's Attorneys, of counsel), for appellant.

Joshua Burday, Matthew Topic, and Merrick Wayne, of Loevy & Loevy, of Chicago, for appellee.

JUSTICE REYES delivered the judgment of the court, with opinion.

177 N.E.3d 383
448 Ill.Dec. 625

¶ 1 This appeal involves the circuit court of Cook County's order granting a Freedom of Information Act (FOIA) ( 5 ILCS 140/1 et seq. (West 2016)) request by plaintiff Dr. Judy King to the defendant Cook County Health and Hospitals System (CCHHS). Dr. King's FOIA request provided, in pertinent part, that CCHHS disclose the zip codes used to create a map of the locations of individuals who had previously received mental health services while detained in the Cook County jail. On appeal, CCHHS maintains that the zip code information of mental health recipients is exempt from disclosure pursuant to sections 7(1)(a) and 7(1)(b) of FOIA (id . § 7(1)(a), (b)) because the information is specifically prohibited from disclosure by federal and state law or, in the alternative, constitutes private information. Because we conclude that the unredacted zip code information for these individuals is protected information under the Mental Health and Developmental Disabilities Confidentiality Act (Confidentiality Act) ( 740 ILCS 110/1 et seq. (West 2016)), we reverse the judgment of the circuit court and remand the matter to the circuit court for proceedings consistent with this opinion.


¶ 3 On January 26, 2017, Dr. King submitted a FOIA request to CCHHS for "the data (including records that show the data source) CCHHS used to determine that the Roseland area had the highest concentration ‘of people that leave the detainee situation and go to live in the community’ when compared to other community areas and records that identify the other five (5) community or geographic areas under consideration for future [community triage centers]." Dr. King's FOIA request stemmed from information presented at a CCHHS finance committee meeting that was used to support the argument that Chicago's Roseland community would be an appropriate site for a new community triage center. The information presented to the finance committee consisted of various internally generated maps demonstrating that the Roseland area contained the greatest concentration of patients who had previously received mental health services at CCHHS facilities while they were detainees at the Cook County jail.

¶ 4 CCHHS responded to Dr. King's FOIA request by producing the maps upon which the committee based its decision. The maps were color-coded and indicated ranges of individuals residing in certain demarcated areas. The demarcated areas, while representative of zip codes, did not have the zip code identified on the maps.

¶ 5 Dr. King subsequently sought review of CCHHS's decision from the Illinois Attorney General's public access counselor, arguing that CCHHS did not properly respond to her FOIA request where it had not provided her with the data used to create the maps—namely, the zip code information of the former patients. The public access counselor issued a nonbinding letter recommending that CCHHS disclose the responsive data to Dr. King. However,

177 N.E.3d 384
448 Ill.Dec. 626

the public access counselor acknowledged that if the records contained any information identifying the individuals, "that information may be properly redacted as non-responsive because Dr. King has clarified that she is not seeking such information."

¶ 6 CCHHS did not provide any zip code information to Dr. King (redacted or otherwise), and, consequently, Dr. King filed suit in the circuit court of Cook County seeking this information in response to her FOIA request. The parties filed cross-motions for summary judgment. CCHHS maintained (1) that it had already adequately responded to Dr. King's FOIA request by supplying her with the maps upon which the finance committee had based its decision and (2) that, in any event, the zip code information was exempt under section 7(1)(a) of FOIA pursuant to federal regulations implementing the Health Insurance Portability and Accountability Act of 1996 (HIPAA) ( Pub. L. No. 104-191, 110 Stat. 1936 (1996) (codified as amended in scattered sections of Titles 18, 26, 29, and 42 of the United States Code)) and the Confidentiality Act. CCHHS further argued that the zip codes represented private information under section 7(1)(b) of FOIA and were thus exempt from disclosure. Dr. King asserted that the zip code information was not exempt from disclosure under FOIA, since it could not be used to identify the individuals who received mental health treatment.

¶ 7 After a hearing on the cross-motions for summary judgment, the circuit court entered and continued the matter for CCHHS to confirm that the residential zip codes were the only data used to create the maps. Thereafter, CCHHS was granted leave to file additional authority in support of its summary judgment motion. In this motion, CCHHS confirmed that the data used to create the maps were the residential zip codes of the former patients and maintained that, nonetheless, this zip code information was protected under HIPAA regulations and the Confidentiality Act.

¶ 8 Upon consideration of CCHHS's additional argument, the circuit court denied CCHHS's motion for summary judgment, granted Dr. King's motion for summary judgment, and ordered CCHHS to produce to Dr. King the complete zip codes used to create the maps. Subsequently, CCHHS filed a motion to clarify the circuit court's order maintaining that the circuit court did not render an opinion as to whether the zip code information was exempt under section 7(1)(a) of FOIA. The circuit court construed the motion as a motion to reconsider and denied the motion, stating it considered both section 7(1)(a) and section 7(1)(b) of FOIA. After Illinois Supreme Court Rule 304(a) (eff. Mar. 8, 2016) language was added to the order granting summary judgment in Dr. King's favor, this appeal followed.


¶ 10 On appeal, CCHHS asserts that the circuit court erred when it ordered the zip code information of individuals who received mental health treatment while detained in the Cook County jail to be disclosed under FOIA. CCHHS maintains that this information is exempt under sections 7(1)(a) and 7(1)(b) of FOIA where disclosing it would be in violation of federal and state law, thereby constituting a disclosure of private information. Specifically, CCHHS maintains that the zip codes are exempt under the Confidentiality Act ( 740 ILCS 110/1 et seq. (West 2016)) and the federal regulations implementing HIPAA (45 C.F.R. §§ 160, 164 (2016)). CCHHS contends that the proper disclosure of this information is through "de-identified" zip codes, i.e. , zip codes where only the first three digits are identified. See id.

177 N.E.3d 385
448 Ill.Dec. 627

§ 164.514 (2016); 740 ILCS 110/2 (West 2016).

¶ 11 In response, Dr. King stresses that the purpose of FOIA is to facilitate governmental transparency and that such transparency requires the courts to apply a liberal construction of the FOIA exemptions in favor of disclosure in this instance. While Dr. King generally asserts (without any citation or argument) that HIPAA does not prohibit the disclosure of zip codes standing alone, she maintains that FOIA requires disclosure where HIPAA defers to FOIA to determine which information is exempt.

¶ 12 A. Standard of Review

¶ 13 Whether the zip codes derived from the mental health records are exempt from disclosure under FOIA ( 5 ILCS 140/7 (West 2016) ) is a matter of statutory construction and our review proceeds de novo . City of Chicago v. Janssen Pharmaceuticals, Inc. , 2017 IL App (1st) 150870, ¶ 13, 413 Ill.Dec. 454, 78 N.E.3d 446 ; Stern v. Wheaton-Warrenville Community Unit School District 200 , 233 Ill. 2d 396, 404, 331 Ill.Dec. 12, 910 N.E.2d 85 (2009) ("De novo review is also appropriate because this appeal arises from an order granting summary judgment."). Our review is guided by several well-established principles of statutory construction. It is well settled that the primary objective of this court when construing the meaning of a statute is to ascertain and give effect to the intent of the General Assembly. Southern Illinoisan v. Illinois Department of Public Health , 218 Ill. 2d 390, 415, 300 Ill.Dec. 329, 844 N.E.2d 1 (2006). In determining legislative intent, our inquiry begins with the plain language of the statute, which is the most reliable indication of the legislature's objective in enacting a law. In re Madison H. , 215 Ill. 2d 364, 372, 294 Ill.Dec. 86, 830 N.E.2d 498 (2005). A fundamental principle of statutory construction is to view all provisions of a statutory enactment. Southern...

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