NAACP v. Wilmington Medical Center, Inc.

• Decision Date: 13 May 1980
• Docket Number: Civ. A. No. 76-298.
• Citation: 491 F. Supp. 290
• Parties: NATIONAL ASSOCIATION FOR THE ADVANCEMENT OF COLORED PEOPLE, Puerto Rican Civil Rights League, Inc., Older Americans Coalition, Wilmington United Neighborhoods, Brandywine Trinity United Methodist Church, Raymond W. Brown, Maria Galindez, for herself and as parent and guardian for her minor children Reynaldo Galindez and Pedro Galindez, Milagro Quinones, Denise Smokes, Maria Miran, on behalf of themselves and others similarly situated, and City of Wilmington, a Municipal Corporation, Plaintiffs, v. The WILMINGTON MEDICAL CENTER, INC., Defendant.
• Court: U.S. District Court — District of Delaware

491 F. Supp. 290

NATIONAL ASSOCIATION FOR THE ADVANCEMENT OF COLORED PEOPLE, Puerto Rican Civil Rights League, Inc., Older Americans Coalition, Wilmington United Neighborhoods, Brandywine Trinity United Methodist Church, Raymond W. Brown, Maria Galindez, for herself and as parent and guardian for her minor children Reynaldo Galindez and Pedro Galindez, Milagro Quinones, Denise Smokes, Maria Miran, on behalf of themselves and others similarly situated, and City of Wilmington, a Municipal Corporation, Plaintiffs, v. The WILMINGTON MEDICAL CENTER, INC., Defendant.

Civ. A. No. 76-298.

United States District Court, D. Delaware.

May 13, 1980.

Douglas A. Shachtman of Community Legal Aid Society, Inc., Wilmington, Del., Marilyn G. Rose and Sanford Newman, Center for Law and Social Policy, Washington, D. C., for all plaintiffs, except the City of Wilmington.

Jeffrey S. Goddess and Jerome M. Capone of City of Wilmington Law Dept., Wilmington, Del., for plaintiff City of Wilmington.

Rodney M. Layton and William J. Wade of Richards, Layton & Finger, Wilmington, Del., for defendant Wilmington Medical Center, Inc.

OPINION

LATCHUM, Chief Judge.

Once again this Court is called upon to consider the legality of "Plan Omega," the controversial proposal of the defendant Wilmington Medical Center, Inc. ("WMC") to relocate a major portion of its urban hospital facilities and services to a suburban location. The case has been in active litigation before this Court and the Court of Appeals for more than three and a half years and thus far has spawned eight reported opinions.¹

In order to understand the issues presently before the Court it is necessary first to review the procedural history of this bitterly contested action.

I. PROCEDURAL HISTORY

Certain black, Puerto Rican and handicapped individuals, and groups representing similar persons (the "plaintiffs") commenced this action on September 10, 1976, naming as defendants WMC, the Secretary of the Department of Health, Education and Welfare ("HEW"), the Director of the Delaware Bureau of Comprehensive Health Planning ("BCHP"), and the Chairman of Health Planning Council, Inc. ("HPC"). The gravamen of the original complaint against WMC claimed that it, as a recipient of federal funds under the medicare and medicaid programs, had violated its obligations to the plaintiffs, beneficiaries of Title VI of the Civil Rights Act of 1964, 42 U.S.C. § 2000d and Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794, by commencing to implement Plan Omega.² In addition, plaintiffs alleged that HEW had violated its duty to enforce Title VI and Section 504: (1) by approving Plan Omega under Section 1122 of the Social Security Act, 42 U.S.C. § 1320a-1 ("Section 1122"); (2) by approving regulations thereunder which failed to require that a proposal under Section 1122 comply with Title VI and Section 504; (3) by entering into an agreement with BCHP which failed to ensure that proposals under Section 1122 comply with Title VI and Section 504; (4) by adopting a procedure which prohibited HEW review of Section 1122 proposals for substantive compliance with Title VI and Section 504; (5) by following such an allegedly improper procedure in approving Plan Omega; and (6) by failing to file an environmental impact statement concerning Plan Omega under the National Environmental Protection Act of 1969, 42 U.S.C. § 4321 et seq. (the "NEPA claim"³).⁴ Finally, the complaint charged that BCHP and HPC had violated Title VI and Section 504 by not adopting procedures to ensure that proposals under Section 1122 comply with Title VI and Section 504 and by making findings and recommending approval of Plan Omega.⁵

This Court subsequently stayed its actions on the complaint and ordered HEW to conduct a civil rights investigation of plaintiffs' allegations. 426 F.Supp. 919 (D.Del. 1977). That investigation led to a finding that Plan Omega, as then proposed, constituted a prima facie violation of Title VI and Section 504.⁶ HEW also found, however, that, by giving written assurances in certain areas, WMC could bring Plan Omega into compliance with Title VI and Section 504. Consequently, after negotiations between HEW and WMC, the parties entered into a contract drafted in open-ended, normative language which obligated WMC to modify and supplement those particular features which HEW had determined would otherwise have a prima facie discriminatory effect (the "Supplemental Agreement"⁷).

In an opinion filed on April 7, 1978, this Court reviewed HEW's findings and held that HEW's conclusion, that Plan Omega as modified by the Supplemental Agreement would not violate Title VI or Section 504, was not arbitrary and capricious. NAACP v. WMC, Inc., 453 F.Supp. 280 (D.Del.1978). This Court further held that the plaintiffs had no right to bring a private action under those statutes and granted summary judgment in favor of the defendants, HEW and WMC.⁸ Plaintiffs appealed that decision and the Court of Appeals reversed in part, holding that the plaintiffs did have a private right to a trial de novo in this Court on their Title VI and Section 504 claims. NAACP v. WMC, Inc., 599 F.2d 1247 (C.A.3, 1979). The Court of Appeals therefore remanded the case to this Court for a trial on the merits.

Following remand, this Court, in accordance with the mandate of the Third Circuit, dismissed HEW from this action for the purposes of the trial on plaintiffs' private right of action.⁹ BCHP, HPC and their respective directors were dismissed from this action by agreement of all parties by court order dated July 17, 1979.¹⁰

On September 4, 1979, this Court granted plaintiffs leave to file a Third Amended and Supplemental Complaint.¹¹ This amendment added the City of Wilmington as a party plaintiff and struck those paragraphs relating to HEW in the complaint. Also added were allegations of violations of the Age Discrimination Act of 1975, 42 U.S.C. § 6102 ("Section 6102" claim)¹² and an allegation charging WMC with "intending" the discriminatory consequences alleged under all three civil rights acts.

The trial to the Court sitting without a jury commenced on October 9, 1979, and concluded on November 15, 1979. Some 28 witnesses testified for plaintiffs in their case in chief, 18 witnesses testified for WMC in its case in chief, 3 witnesses testified for plaintiffs in rebuttal, and 4 witnesses testified for WMC on surrebuttal. The trial transcript consists of 3,349 pages of testimony. Over 400 exhibits were introduced into evidence. Post-trial briefing¹³ was completed on January 24, 1980, and the case is now ready for final disposition.

This opinion shall constitute the Court's findings of fact and conclusions of law as required by Rule 52(a), F.R.Civ.P.

II. FACTS

The Court finds itself unwillingly cast by this litigation into the role of a modern day Nostradamus. The Court is not being asked to perform those traditional tasks for which courts have a special competence — the determination of facts relating to actual events which have occurred in the past. Rather, the Court is required to prophesy the consequences of events which may or may not occur in the future. Lacking a crystal ball or any other reliable talismanic symbol, the Court must look to the facts as they exist today, the modified plans of WMC, and the conflicting judgments of the medical and social experts who testified at trial in an attempt to pierce the mists that obscure future events.

The Court will begin its prognostications with a description of the present demographic characteristics of New Castle County and the role played by WMC in providing health care today. One must look at this actual world in order to determine first how Plan Omega would differ from the present and, second, what impacts those possible differences might have on the various minorities who are protected by the statutes invoked by the plaintiffs in this case.

A. WMC And Its Role In Providing Health Care

WMC is the major provider of hospital care services to the people of New Castle County. This privately owned, non-profit corporation has a capacity of 1104 of the 1471 non-profit, acute general hospital beds in New Castle County. That number represents 55% of similar beds in the entire State. In addition, it includes a 60 bed rehabilitation center in New Castle County ("Pelleport") which will not be affected by Plan Omega.¹⁴ Acute hospital care is provided at three "divisions" of WMC — the General, Memorial and Delaware Divisions. All three divisions are located in different areas of the City of Wilmington¹⁵ and are well served by bus routes which run throughout the heavily populated portions of the County.¹⁶ WMC provides both general medical and surgical services and secondary and tertiary hospital care.¹⁷ Many of the latter types of services are provided exclusively by WMC.¹⁸ Indeed, WMC is the sole provider of tertiary hospital care in the State of Delaware.¹⁹

WMC was organized in 1965 through the merger of three non-profit hospitals — Wilmington General, Memorial and Delaware Hospitals. These three hospitals currently constitute the three divisions of WMC. Two primary reasons prompted the merger: (1) to reduce the duplication of facilities and concentrate hospital care available to the community, and (2) to provide the scope of clinical experience to attract the support of a major teaching university toward a resident program. By 1965, the intern and resident programs at the three independent hospitals had reached a crises point. The programs needed strengthening in order to attract residents who would become physicians and serve in the state and community.²⁰ These objectives were perceived, and are still perceived, by the doctors on WMC's staff as being best served by placing all the medical and surgical services under one roof. The goal of physical consolidation of all health care services was viewed by the staff in 1965, and at present, as the best method for providing...