Disability Rights Tex. v. Hollis

103 F.4th 1058

DISABILITY RIGHTS TEXAS, Plaintiff—Appellee, v. Roy HOLLIS, in his official capacity as the Chief Executive Officer of Houston Behavioral Healthcare Hospital, LLC, Defendant—Appellant.

No. 23-20171

United States Court of Appeals, Fifth Circuit

Filed: June 5, 2024

Appeal from the United States District Court for the Southern District of Texas, USDC No. 4:22-CV-121, Keith P. Ellison, U.S. District Judge

Beth L. Mitchell, Courtney Luther (argued), Disability Rights Texas, Central Texas Regional Office, Austin, TX, for Plaintiff—Appellee.

Sophia Mariam George, Jeffery T. Nobles (argued), Husch Blackwell, L.L.P., Houston, TX, Clay B. Wortham, Wortham, L.L.P., Chicago, IL, for Defendant—Appellant.

Brant Levine (argued), Elizabeth Parr Hecker, U.S. Department of Justice, Civil Rights Division, Appellate Section, Washington, DC, for Amicus Curiae United States of America.

Mark S. Whitburn, Whitburn & Pevsner, P.L.L.C., Arlington, TX, for Amici Curiae Mental Health America of Greater Dallas, National Alliance on Mental Illness of Texas, National Association for Rights Protection and Advocacy, Texas Jail Project, Texas Council for Developmental Disabilities.

Melanie Ann Bray, Disability Rights Louisiana, New Orleans, LA, for Amici Curiae National Disability Rights Network, Disability Rights Louisiana.

Before Stewart, Duncan, and Engelhardt, Circuit Judges.

Carl E. Stewart, Circuit Judge:

Disability Rights Texas ("DRTx"), an advocacy organization designated to protect the rights of persons with mental illness pursuant to the Protection and Advocacy for Individuals with Mental Illness Act brought this action against Houston Behavioral Healthcare Hospital ("Houston Behavioral") to compel the disclosure of video footage pertaining to the involuntary confinement of its client G.S., an individual with mental illness. Holding that the videotape footage must be disclosed, the district court granted summary judgment for DRTx and issued an injunction. Houston Behavioral appealed. We AFFIRM.

I. FACTUAL AND PROCEDURAL HISTORY

In August 2021, G.S. was detained in a psychiatric inpatient program at the Houston Behavioral Psychiatric Intensive Care Unit ("PICU").¹ Following his release, G.S. filed a complaint with DRTx, alleging that he was abused at Houston Behavioral, and signed a waiver allowing DRTx to access his records. Relevant here, the Developmental Disabilities Assistance and Bill of Rights Act, 42 U.S.C. § 15001, et seq. (the "DD Act"); the Protection and Advocacy for Individuals with Mental Illness Act, 42 U.S.C. § 10801, et seq. (the "PAIMI Act");² and the Protection and Advocacy for Individual Rights Act, 29 U.S.C. § 794e, (the "PAIR Act") (collectively, the "P&A Acts") mandate states to designate nonprofits ("P&A organizations")³ to protect and advocate for the civil rights of individuals with disabilities. DRTx serves as the P&A organization for Texas pursuant to the PAIMI Act, 42 U.S.C. § 10801(b)(2).

On August 19, 2021, DRTx requested G.S.'s records from his confinement at Houston Behavioral, including records from the PICU. Houston Behavioral cooperated with DRTx's first set of requests for information, and on August 26, 2021, it produced all records requested. On September 8, 2021, DRTx requested that Houston Behavioral preserve surveillance video footage, which it claimed was necessary to investigate the alleged abuse of its client, G.S., and other Houston Behavioral patients. The video footage depicts G.S. and other patients receiving care in the PICU. With its record request, DRTx included G.S.'s signed authorization to permit release of his relevant health information. Thereafter, Houston Behavioral refused to provide DRTx with the requested video record.

On or about September 17, 2021, DRTx received a letter explaining that Houston Behavioral was prohibited from releasing the video because the footage depicts substance use disorder ("SUD") treatment information protected under 42 C.F.R. Part 2 regulations.⁴ On November 18, 2021, DRTx replied to Houston Behavioral explaining that the Part 2 SUD confidentiality requirements did not apply to G.S.'s treatment because (1) he was receiving mental health services in a psychiatric services unit and (2) Houston Behavioral records did not identify G.S. as someone with an SUD. Additionally, DRTx maintained that it would not be possible to identify any individual on the silent video as someone with an SUD.

When Houston Behavioral continued to deny it access to the requested video footage, DRTx filed this suit to compel Roy Hollis, in his official capacity as the Chief Executive Officer of Houston Behavioral, to produce the video record. DRTx sought declaratory and permanent injunctive relief. Both parties filed cross-motions for summary judgment. After conducting a motion hearing on February 24, 2023, the district court granted DRTx's motion with modifications and denied Hollis's motion. The district court granted an injunction limited to the footage pertaining to G.S.'s complaint. Hollis appealed the district court's final judgment. Houston Behavioral has preserved the video record evidence pending this court's adjudication of the issue. We issued a temporary administrative stay and ordered that Hollis's opposed motion for injunction pending appeal be carried with the case on July 11, 2023.

II. STANDARD OF REVIEW

"This court reviews de novo a district court's grant of summary judgment, applying the same standard as the district court." Austin v. Kroger Tex., L.P., 864 F.3d 326, 328 (5th Cir. 2017) (citation omitted). Summary judgment is proper "if the movant shows that there is no genuine dispute as to any material fact and the movant is entitled to judgment as a matter of law." FED. R. CIV. P. 56(a); Alkhawaldeh v. Dow Chem. Co., 851 F.3d 422, 426 (5th Cir. 2017).

III. DISCUSSION

Enacted in 1975, the DD Act authorizes P&A organizations "to pursue legal, administrative, and other appropriate remedies or approaches" to ensure that individuals with disabilities are protected. 42 U.S.C. § 15043(a)(2)(A)(i). However, the DD Act is limited in scope to P&A organizations designed to protect and advocate for individuals with developmental disabilities. Id. at § 15043(a)(1). Relevant here, the PAIMI Act protects the rights of individuals with mental illness. Enacted in 1986, the PAIMI Act conditions states' federal funding on their establishment of P&A organizations with the authority to investigate and remedy suspected abuse or neglect of individuals with mental illness. Id. at § 10805(a)(1). The PAIMI Act, like the DD Act, directs that P&A organizations shall have broad investigatory authority to carry out their responsibility to protect individuals with mental illness and to advocate on their behalf. Id. (authorizing P&A organizations to "investigate incidents of abuse and neglect . . . ; pursue administrative, legal, and other appropriate remedies . . . ; and . . . pursue administrative, legal, and other remedies on behalf of an individual"). Enacted in 1994, the PAIR Act serves people with disabilities who are not covered under either the DD Act or the PAIMI Act. 29 U.S.C. § 794e.

In addition to their general investigative authority, P&A organizations have the authority, consistent with the requirements of the P&A Acts, to "have access to all records of any individual" with disabilities or mental illness "who is a client of the [P&A] system if such individual or legal guardian, conservator, or other legal representative of such individual, has authorized the system to have such access." 42 U.S.C. § 15043(a)(2)(I)(i); 42 U.S.C. § 10805(a)(4)(A); 29 U.S.C. § 794e(f)(2).

The district court correctly determined that this suit is governed by the PAIMI Act because it involves DRTx's efforts to obtain video records of an individual with a mental illness. Specifically, § 10805(a) provides that a P&A organization such as DRTx:

shall . . . (4) in accordance with section 10806 of this title, have access to all records of—

(A) 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;

(B) any individual (including an individual who has died or whose whereabouts are unknown)-(i) who by reason of the mental or physical condition of such individual is unable to authorize the system to have such access; (ii) who does not have a legal guardian, conservator, or other legal representative, or for whom the legal guardian is the State; and (iii) with respect to whom a complaint has been received by the system or . . . there is probable cause to believe that such individual has been subject to abuse or neglect; and

(C) any individual with a mental illness, who has a legal guardian, conservator, or other legal representative, with respect to whom a complaint has been received by the system or with respect to whom there is probable cause to believe the health or safety of the individual is in serious and immediate jeopardy . . . .

42 U.S.C. § 10805(a). Section 10806 then provides:

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.

Id. § 10806(b)(3)(A).

Where an individual has no parent or guardian, the P&A organizations may access records so long as they have probable cause to believe that abuse has occurred. 42 U.S.C. § 15043(a)(2)(I)(ii); 42 U.S.C. § 10805(a)(4)(B); 29 U.S.C. § 794e(f)(2). Where an individual's guardian has failed or refused to act, the P&A organizations may access records under the DD Act and the PAIR Act so long as they have probable cause to believe that the individual...