Answers to First Set of Interrogatories to Northern Indiana Health Systems Agency, Inc.

     [||d3024da2-5c43-4b08-a666-f33f2c131125||] : a 

IN THE UNITED STATES DISTRICT COURT. ., “4p SN /) 
FOR THE NORTHERN DISTRICT OF INDIANA 7. 7, | 

HAMMOND DIVISION aI 95 
£1 (. 

£ Mo TAD 
AVS SRA 

  

RICHARD GORDON HATCHER, WILLIE LEE 
PAGE, METRO CORPS OF GARY, INC., a 
Not-For-Profit Corporation, and 
others similarly situated, 

Plaintiffs 

-—yg- CIVIL NO. H 77-154 

METHODIST HOSPITAL OF GARY, INC., 

an Indiana Not-For-Profit 
Corporation, and DENIS E. RIBORDY, 
as President of the Board of 
Directors, et al, 

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Defendants 

ANSWERS TO FIRST SET OF INTERROGATORIES 
10 NORTHERN INDIANA HEALTH SYSTEMS AGENCY, INC. 
  

Comes Now the Defendant, NORTHERN INDIANA HEALTH SYSTEMS 

AGENCY, INC., and for Answer to Plaintiffs' Interrogatories, says: 

A. 

1. Describe briefly but completely all agreements and 
amendments to agreements between the HSA and any state or federal 
agency, bureau, division or department concerning responsibilities, 
functions, and operations under Section 1122 of the Social Security 
Act, as amended in 1972, 42 U.S.C. §1320a-1 (hereinafter Section 1122), 
the Hill-Burton program, Section. 314 of the Public Health Services 
Act, Titles XV and XVI of the National Health Planning and Resource 
Development Act of 1974, and any other state or federal law or authority. 

ANSWER: A. Designation Agreement Between the Secretary 
of Health, Education and Welfare and Northern 
Indiana Health Systems Agency, Inc. (Attach- 

ment #1). 

B. Contractural Agreement Between Northern 
Indiana Health Systems Agency, Inc., and the 
Indiana Department of Mental Health (Attach- 
ment #2). 

C. Agreement Between the Indiana Emergency Medical 
Services Commission and the Northern Indiana 
Health Systems Agency, Inc., for Financial 
Assistance in Providing Personal Professional 
Services and Travel (Attachment #3). 

 



  

NOTE: There is currently no agreement between NIHSA 
| and the State Board of Health relative to 

Section 1122 review; however, such an agreement 
is under development by the State Board of Health. 
Contact David J. Edwards, M.D., at the Indiana 
State Board of Health for additional information. 

  

2. Describe briefly but completely all functions, 
responsibilities, and obligations of the HSA pursuant to any 
agreements and contracts with state and federal agencies, bureaus, 
divisions, or departments; including but not limited to Section 
1122, the Hill-Burton program, Section 314 of the Public Health 
Services Act, and Titles XV and XVI of the National Health Planning 
and Resource Development Act of 1974. 

ANSWER: See Attachments #1, #2, and #3. 

. 3. Describe all written or oral guidelines or instructions 
for the operation of the functions and programs set forth in the 
answers to Interrogatories 1 and 2, and state what person or 
agency issued or authorized such guidelines. Identify all written 
guidelines or instructions, and attach copies of each to this 
discovery instrument. 

ANSWER: All relevant information is contained within the 

agreements themselves (Attachments #1, #2, and #3). 

4. Specify the authority (e.qg., statute, contract, executive 
order, etc.) pursuant to which the HSA is operating to fulfill its 
health facilities construction responsibilities under Section 1122 
and, if applicable, the Hill-Burton program. 

ANSWER: Section 1513 (f) of the Public Health Service Act. 
142 U.S.C. 3001-2(£f)] and 42 U.S.C. 300m-2(a). 

5. Describe briefly but completely the geographical area 
over which the HSA has authority and responsibility with respect to 
the functions and programs set forth in the answers to Interrogatories 
l and 2. Include descriptions of any sub-areas, how, when, and why 
these areas and sub-areas were determined, and whether, how, and why 
areas have been modified or redlined. 

ANSWER: Northwest Subarea Counties 

Jasper, Lake, Newton, Porter 
  

" Northcentral Subarea Counties 

Cass, Elkhart, Fulton, LaPorte, Marshall, Miami, 
Pulaski, St. Joseph, Starke . 

  

Northeast Subarea Counties 
Adams, Allen, DeKalb, Huntington, Kosciusko, 

LaGrange, Noble, Steuben, Wabash, Wells, 
Whitley 

  

Development of subareas —- See Attachment #4 

ee 

 



® * 

  

Effective date of subareas - May 1, 1976 

Modification of subareas ~ None. 

6. Describe briefly but completely when the HSA was 
organized and when and how it began operation. 

ANSWER: See Attachment #5. 

7. List all offices of the HSA and their addresses, 
indicating which, if any, is the main office, when each began 
operation, and whether each has specific functions, obligations, 
responsibilities, or particular geographical or project concerns. 

ANSWER: Main Office/Subarea Office Central 
900 East Colfax 
South Bend, Indiana 46617 

  

- Subarea Office - West 
8149 Kennedy Avenue 
Suite B 
Highland, Indiana 46322 

  

- Subarea Office = East 
Roberts Building 
4646 U. S. Highway 24 West 
Fort Wayne, Indiana 46804 

  

Date of initial operation of all three 
offices: May 1, 1976 

Subarea responsibilities: See By-Laws, 
Attachment #6, Section 7.03. 

8. State the name of the most recent predecessor to the 
HSA; when and why it ceased operation; and whether, how, and why 
the functions, obligations, and responsibilities of the HSA 
differ from its predecessor. 

ANSWER: Northwest Indiana Comprehensive Health 
Planning Council, Inc. 

Comprehensive Health Planning Council, 
Region V, Inc, 

Region 3 Health Planning Council, Inc. 
Comprehensive Health Planning Council, 

Region 2, Inc. 

These agencies ceased operations as their 
State and federal funding mechanisms expired 
with the passage of P. L. 93-641, which created 
Health Systems Agencies. The responsibilities, 
functions, and obligations of NIHSA are more 
broad than the predecessor agencies. For 
example, permanently designated HSA's have 
review and approval authority over federal 
health grants under programs enumerated in P. L. 
93-641. CHP's had only the power to comment. 

~3- 

 



  

é 

9. Describe briefly but completely the organizational 
structure of the HSA, including any committees, divisions, or 
units. : 

ANSWER: See Attachment #7. 

10. Describe briefly but completely the functions of each 
of the components of the organizational structure identified in 
the answer to Interrogatory 9. 

ANSWER: See Attachment #6, By-Laws. 

11. For each of the functions set forth in the answer to 
Interrogatory 10, specify the title or position of the person in 
charge of such function. 

ANSWER: President (Chairman of Board of Directors and 
Executive Committee) 

Finance Committee Chairman (Treasurer of ~ 
Corporation) 

Nominating Committee Chairman 

Northwest Subarea Advisory Council Chairman 

Northcentral Subarea Advisory Council Chairman 

Northeast Subarea Advisory Council Chairman. 

12. For each title or position listed in the answer to 
Interrogatory 11, state the name, race, national origin, sex, 
occupation, date, and method of appointment, and term of office 
of each person whe has served in such position since the HSA 
began operation. 

ANSWER: See Exhibit "A" attached to these Answers. 

13. Identify all other present members of the HSA not listed 
in the answer to Interrogatory 12, and state the following for each: 
his or her name, race, national origina, sex, occupation, date and 
method of appointment, job title, job function, and term of office 
or position. 

ANSWER: See Attachment #8 

"NOTE: "Minority", unless otherwise indicated, 
indicates black. 

Terms of appointment: See Attachment #9 

Method of appointment: See Attachment #6, By-Laws. 

 



  

® * 

14. Identify all present employees of the HSA, and state for 
each: race, national origin, sex, and duties. 

ANSWER: See Attachment #10, Staff List. 

15. State whether any of the present or former members or 
employees of the HSA, members of their families or business 
associates now serve or ever served in any capacity on a Board or 
other division of Methodist Hospital of Gary, Inc., has or had staff 
privileges at Gary Methodist Hospital or Broadway Methodist. If 
the answer is affirmative, list the names and occupation of each 
such person. 

ANSWER: No, to the best of our knowledge. 

16. Describe specifically the standards, guidelines, and 
procedure for choosing members of the HSA, and the authority 
pursuant to which such standards, guidelines, and procedures were 
promulgated and adopted. Identify all written guidelines, 
memoranda, and instructions concerning these standards and procedures 
and attach copies of each to this discovery instrument. 

ANSWER: See Attachment #6, By-Laws and Attachment #11, 
Nominating Committee Policy 

Authority: Public Law 93-641. 

17. Separately and completely describe the procedures, 
standards, and guidelines through which applications concerning health 
facilities proposals are received and proposed and recommendations 
made for Section 1122, Hill-Burton or any other programs described 
in the answers to Interrogatories 1 and 2. 

ANSWER: See Attachment #12, Project Review Manual. 

18. Identify any written guidelines, or instructions concerning 
the procedures described in the answer to Interrogatory 17 and attach 
copies of each to this discovery instrument. 

ANSWER: See Attachment #12, Project Review Manual. 

19. For each year since the HSA began operation, identify 
each hospital facility construction project which was submitted 
to the HSA under any of its functions (including but not limited to 
Section 1122 and the Hill-Burton Program); identify which function 
pertained to each; the location of the project; and the disposition 
of each application. 

ANSWER: See Attachment #13. 

20. Specifically identify any of the projects listed in the 
answer to Interrogatory 19 which involved a relocation of an 
existing health facility, the construction or expansion of a new 
health facility not within the City of Gary, Indiana, by a corporation 
or applicant which operates a health facility within the City of Gary, 
or the construction or expansion of a new health facility not within 
the City of Gary by a corporation or applicant which does not operate 
a health facility within the City of Gary. 

Ne 

 



  

ANSWER: Projects #76-W-02, 77-W-07, and 77-W-18 as cited 
in Attachment #13. 

21. State whether any of the projects identified in the 
answers to Interrogatory 19 were reviewed by the HSA for compliance 
with Title VI of the Civil Rights Act of 1964 and/or §504 of the 
Rehabilitation Act of 1973, as amended, (a) prior to approval or 
disapproval of the project by the HSA of (b) after approval of the 
project by the HSA, any state agency or the Department of Health, 
Education and Welfare. If the answer is affirmative, identify all 
such projects and identify and attach copies of all letters, 
surveys, and reports issued by the HSA or anyone working on its 
behalf concerning such reviews. 

ANSWER: Civil rights issues were addressed in the course 
of review of those projects cited in the response 
to Interrogatory 20. Documentation is provided as 
follows: 

“Project 76-W-02 
  

(1) Staff analysis 
(2) Northwest Subarea Advisory Council Minutes - 

August 12, 1976 
(3) Executive Committee Minutes - August 25, 1976 

(including statement from Barbara Wesson) 

Note: These documents were submitted to Mr. Simmons, 
Counsel for the Plaintiff, on September 27, 1977, 
in regard to our response to Interrogatory A (25). 

  

Project 77-W-07 
  

(1) Staff analysis (Attachment #14) 
(2) Northwest Subarea Advisory Council Minutes - 

May 12, 1977 (Attachment #15) 

Project 76-W-18 
  

(1) Staff analysis (Attachment #16) 
(2) Northwest Subarea Advisory Council Minutes - 

July 14, 1977 (Attachment #17) 
(3) Executive Committee Minutes ~- July 27, 1977 

(Attachment #18). 

22. Describe the method by which the HSA determines the 
needs of various population groups in the area for which it is 
responsible for new and/or expanded health facility construction. 

ANSWER: See Attachment #12, Project Review Manual, 
Section 4.5. 

23. Identify and describe any and every plan, study, report, 
or proposal which the HSA has undertaken, written, or used to 
determine the needs of various population groups for new and/or 
expanded health facility construction. 

- = 

 



  

ANSWER: This information is contained in the current 
health system plan and annual implementation 
plan of NIHSA, Inc. 

24. Describe what efforts the HSA has made or is making to 
determine the needs of and/or services delivered to black and 
Hispanic and handicapped citizens. Identify which of the plans, 
studies, reports, or proposals described in the answers to 
Interrogatory 23 pertain to the needs of and services to (a) blacks 
and Hispanics and (b) handicapped persons, and describe the findings, 

summaries, conclusions, and recommendations of each. 

ANSWER: Refer to Health Systems Plan (HSP) dated August, 
1977, previously submitted. Table 2-2, page II-6, 
relates HSP goals to the national health priority 
of primary care for the underserved. Specific 
reference is included relative to goal #1 - infant 
mortality, goal #3 - mental illness, alcoholism 
and drug abuse, goal #10A - primary care 
practitioner distribution, and goal #11A - 
habilitation and rehabilitation for mental illness, 
mental retardation, and developmental disabilities. 
See Chapter III for a more detailed description of 
these goals and their associated objectives and 
recommended actions. 

B. 

Answers to Interrogatories B(25) through and including B(36) 
have been previously filed. 

37. State whether the HSA applied for designation, and/or 
has been designated, as the health service agency under Title XV 
of the National Health Planning and Resource Development Act of 
1974. If the answer is affirmative, describe all efforts made to 
become so designated and identify all documents, applications, and 
communications concerning such efforts. 

ANSWER: Initial Grant Application - January, 1976 
Conditional Designation as a Health 
Systems Agency by Department of 
Health, Fducation and Welfare - May, 1976 

Application for Full Designation as a 

Health Systems Agency - March, 1977 
Denial of Application for Full 
Designation =- Continuation of . 
Conditional Designation by DHEW =~ May, 1977 

Re-Application for Full Designation - September, 

38. Describe whether, when, how, and why the HSA and/or any 
state or federal agency, department, or division has developed 
plans, standards, or guidelines for comprehensive health planning, 
including health facilities and services for the area in which the 
HSA operates. Include the following information: 

=] = 

1977 

 



  

(a) a specific definition of the area served by the 
HSA; 

(b) how the boundaries of the area described in 
38 (a) were determined; 

(c) a specific description of any sub-areas or 
service areas within the area described in 

. 38(a), and how the boundaries of those sub-areas 
or service areas were determined; 

(d) whether, how, and why the areas and sub-areas 

have changed; 
(e) a list of the persons, agencies, departments 

or divisions responsible for making the determinations 
listed in 38 (a) through (4); 

(f£) a list of any plans, studies, reports, or 
documents used to make the determinations. 

ANSWER: (a) See response to Interrogatory A(5) . 
(b) The boundaries for the 24 county HSA area were 

designated by the Governor of Indiana in 
accordance with requirements of Section 1511 
of the Public Health Service Act. 2 

(c) See response to Interrogatory A(5). The 
boundaries were determined on a population bagis 

(d) The area and subareas have not changed since 
their inception. 

(e) Governor of Indiana: Otis R. Bowen, M.D. 
Department of Health, Education and Welfare, 

Public Health Service 
Northern Indiana Health Planning Consortium 
Steering Committee (predecessor to NIHSA). 

(£) Public Law 93-641, Section 1511 
Attachment #4. 

PURSUANT TO THE INFORMAL REQUEST OF THE PLAINTIFFS, DEFENDANT, 
KIPTON KAPLAN, EXECUTIVE DIRECTOR OF THE NORTHERN INDIANA HEALTH 
SYSTEMS AGENCY, INC., HEREWITH PROVIDES THE FOLLOWING ADDITIONAL 
INFORMATION: 

i Minutes from meetings at which 1969 application for 
Broadway Methodist Hospital was reviewed. 

See Attachments #19 - #26. 

2. 1969 application from Broadway Methodist Hospital. 

See Attachments #27 - #29. 

Si. EA 1973 Comprehensive Health Plan. 

See Attachment #30. 

4. Hamilton Associates Study - 1960. 

See Attachment #31. 

 



  

Be Respond to Interrogatory 30 in regard to the 1969 
review of Broadway Methodist Hospital. 

(a) Not applicable; Section 1122 of the Social 
Security Act had not been enacted at the 
time of the 1969 review. 

(b) Not applicable; see response above. 

(c) The information submitted by Methodist Hospital 
(the application) was the major source of 
information on which the review was based. 

(d) The result of the vote is included in the minutes. 
A vote by member was not recorded. 

(e) Projections relative to population growth included 
in the application were considered in the course. 
of review. 

(f) The action taken was advisory to the State Board 
of Health relative to the use of Hill-Burton 
funds. 

8. Respond to Interrogatory #31 by weighing each 
consideration in terms of its importance. 

(a) Arthur D. Little Study 2 

(b) Gary Model Cities Health needs 
Study 73 

(c) A. T. Kearney Study ; 33 

1 = important 
5 = very important. 

KIPTON KAPLAN, being first duly sworn upon his cath, deposes 
and says that the facts stated in the foregoing Answers to First 
Set of Interrogatories to Northern Indiana Health Systems Agency, Inc., 
are true in substance and in fact to the best of his knowledge and 
belief. 

  

KIPTON KAPLAN 

___ SUBSCRIBED AND SWORN to before me, a Notary Public, on this 
IS™ day of NOJ¢M AB LR , 1977, 

ROTARK PPRLIC 7 

  

    
  

My commission expires: 

Pen Oy 198% 
  

\ yy 

 



DATE OF TERM OF $ 

  
  

  

  

  

OFFICE NAME RACE SEX OCCUPATION APPOINTMENT OFFICE bs 

President Clyde Bond White Male Teacher /Farmer 5/1/76 8 mos. ‘ 

Nick Angel White Male County Commissioner 
Lake County 1/1/77 l vr. 

Finance Committee Vincent 
Chairman Santare, M.D, White Male Physician 5/1/76 8 mos. 

1/1/77 l yr. 

Nominating Committee : 
Chairman Paula : 

Auburn White Female Personnel Director » 
City of South Bend 5/1/76 8 mos. 

Clyde Bond White Male Teacher /Farmer 5/1/76 l vr. 

NW Subarea Advisory Nick Angel White Male County Commissioner 
Council Chairman Lake County 5/1/76 8 mos. 

1/1/77 1 yr. 

NC Subarea Advisory Walton Collins White Male Asst. to Chancellor : 
Council IU/South Bend 5/1/76 8 mos. 

Charles Harmon White Male Electronics Tech. 1/1/71 1 yr. 

NE Subarea Advisory Clyde Bond White Male Teacher /Farmer 5/1/76 8 mos. 
Council Chairman : ® 

Lester Gerig White Male Insurance Executive 1/1/77 } yr. 

Method of Appointment: See Attachment #6, By-Laws, 

EXHIBIT "A" 
  

 



IN THE UNITED STATES DISTRICT COURT 

FOR THE NORTHERN DISTRICT OF INDIANA 
HAMMOND DIVISION 

  

  

RICHARD GORDON HATCHER, WILLIE LEE 

PAGE, METRO CORPS OF GARY, INC., a 
Not-For-Profit Corporation, and 
others similarly situated, 

Plaintiff 

-VS=- CIVIL NO. H77-154 

METHODIST HOSPITAL OF GARY, INC., 

an Indiana Not-For-Profit 
Corporation, and DENIS E. RIBORDY, 
as President of the Board of 
Directors, et al., 

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Defendants 

CERTIFICATE OF SERVICE 
  

I, ANTHONY DeBONIS, JR., hereby certifies that on the 

l6th day of November, 1977, I caused to be served upon counsel 

of record: 

BETH J. LIEFF 
10 Columbus Circle 
New York, New York 10019 

JULIAN ALLEN 

2009 Broadway 
Gary, Indiana 46407 

MARILYN G. ROSE 

CHRISTINE B. HICKMAN 

1751 N Street, NW 

Washington, D. C. 20036 

ERIC SERVASS 
Assistant Attorney General 
State House 
Indianapolis, Indiana 46320 

BRUCE SAYERS 

Hodges, Davis, Gruenber, Compton & Sayers 

5525 Broadway 
Gary, Indiana 46410 

REBECCA L. ROSS 
Attorney, Department of Justice 
10th & Constitution Avenue, NW 
Washington, D. C. 20530 

 



  

by depositing the same in the United States Mail, First-Class 

postage properly affixed and properly addressed, the following 

Answers to First Set of Interrogatories to Northern Indiana Health 

CALL) 

Systems Agency, Inc. 

  

Ap HORYN JooRiS, TE.// 

SUBSCRIBED AND SWORN to before me this 16th day of 

November, 1977. 

  

My Commission Expires: il 

; Who Wi, IM yo] Sores 

: Ta 0/21/79 nA ay SA A, 
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