First Set of Interrogatories to the US Department of Health, Education, and Welfare

     [||1daff2cb-d293-4c1a-863e-f7a3b3b4e84b||] 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, ) 

Plaintiffs, ) 

  

VS. ) Civil Action No. 

METHODIST HOSPITAL OF GARY, ) H 77-154 

INC., An Indiana Not-for- 

Profit Corporation and DENIS ) 

E. RIBORDY, as President of 

the Board of Directors, et al., ) 

Defendants. ) 

  

FIRST SET OF INTERROGATORIES TO THE UNITED 

STATES DEPARTMENT OF HEALTH, EDUCATION AND WELFARE 

Plaintiffs request that defendant Joseph Califano, United 

States Secretary of Health, Education and Welfare, and his agents 

and employees (hereinafter "HEW"), answer under oath, pursuant to 

Rule 33 of the Federal Rules of Civil Procedure, the following 

interrogatories, and request separate, complete written responses 

to each within thirty (30) days after their service. With 

respect to each interrogatory please state the source of the 

answer given or, if appropriate, the name and title of the 

officer, agent or employee having knowledge of the facts. 

These interrogatories are to be deemed continuing in nature 

and supplemental answers shall be required of you if prior to 

  
  

 



  

Pa
 

    

trial you directly or indirectly obtain further or different in- 

formation from that contained in the answer. 

In answering each interrogatory defendants are requested to 

identify in a manner suitable for use as a description in a sub- 

poena or notice for production of documents, or to produce: all 

of the information (whether documentary, human or otherwise) and 

all records maintained by, and/or in the possession or control of 

defendants or any other person or organization which pertain or 

relate to the information called for by each interrogatory, 

whether or not such identification or production is specifically 

requested in that interrogatory. 

As used herein: 

(2) the term "Title VI" means Title VI of the Civil Rights 

Act of 1964, 42 U.S.C. § 20004; 

b) "Section 504" means § 504 of the Rehabilitation Act as 

amended in 1973, 29 U.S.C. & 794; 

(c) the term "Section 1122" means Section 1122 of the 

Social Security Act, as amended in 1972, 42 U.S.C. 1320a-1l. 

(d) the term "Hill-Burton" refers to Title VI of the 

Public Health Services Act, 42 U.S.C. § 29. 

1. Describe the complete assignment and delegation of, 

and structure for civil rights responsibilities within HEW: 

(a) between the central Office for Civil Rights and 
= 

central office or divisions administering the substantive HEW 

programs; 

(b) between the central Office for Civil Rights an of 

the regional offices; 

  

  
  

  

 



      

(c) between the central offices administering the 

Ie
 

Hh
 

i 

13]
 

[9
 

i (T A" 

-
é
 substantive HEW programs and the regional 

(d) between the divisions in th (()
] 

[ r i | 

0 th
 

H
h
 

b
=
 ( 0) n H {y | 

sponsible for or with authority over substantive HEW programs and 

the divisions responsible for securing civil rights compliance. 

Specifically include responsibility concerning the Hill-Burton 

program, and programs established under the Public Health Act and 

under. Title V, XVil1i, and XIX of the Social Security Act. 

2. Describe any guidelines, directives, policies or agree- 

ments which relate to the structures and functions set forth in 

the answer to Interrogatory l. State whether, when and why these 

guidelines, directives and policies were instituted, and whether, 

when and why they have changed since 1970. 

3. State the name, position, level or title of the person 

responsibile for and/or head of each of the assignments and re- 

sponsibilities set forth in Interrogatory 1, specifically includ- 

ing the persons in the central office and Region V responsible 

for assuring civil rights compliance by Indiana health facilities 

receiving federal funds. 

4. Describe the complete assignment relationship between 

HEW and state agencies which administer state plans with respect 

to programs established under the Public Health Act and under 

Titles V and XIX of the Social Security Act. Specifically in- 

clude the delegation and assignment of civil rights responsibili- 

ties; the specific functions and responsibilities of the central 

office, the regional offices and the state agencies; whether, 

why and to what extent these arrangements differ as between g 

different regional offices and different state agencies; and the 

  

  

 



      

extent to which the central office of HEW exerts control 

authority over the civil rights responsibilities of the state 

agencies. 

5. State whether HEW has issued any guidelines, letters 

directives, policy statements, manuals, agreements or other com- 

munications describing or pertaining to the functions, 

and responsibilities set forth in the answer to Interrogatory 4. 

If the answer is yes, specifically identify and describe all such 

documents. 

6. Identify each continuing program, requiring methods of 

administration under 45 C.F.R. 80.4 (b), in which any of the other 

defendants in this action are participating. Attach copies of 

the appropriate methods of administration for each of these pro- 

grams. 

7. Identify each agency,division, corporation or other 

body, including the defendants, which is receiving or has re- 

ceived since 1970 federal funds for the provision of health ser 

vices, for the construction of health facilities or for the 

administration of programs under the Public Health Act, the Hill- 

Burton Program and Titles V and XIX of the Social Security Act in 

Lake County, Indiana. Include the name of the body, the amount 

of money received, the program administered, and the name of any 

other body that performed the same functions since 1970. 

8. Identify all guidelines and policy statements for 

facility and agency compliance with Title VI and/or Section 504 

which were given to any of the defendants in this 

recipients of federal funds for health facilities or under con- 

tinuing programs in Region V and attach copies of each to this 

  

  

  

 



      

discovery instrument. 

9. Describe all actions and communications taken by the 

other defendants in this action which assure or purport to give 

assurances of compliance with civil rights obligations, incl 

but not limited to assurances given pursuant to 45 C.F.R. 80 

Specifically identify all documents containing such assurances 

including the date received, and attach copies of each to this 

discovery instrument. 

10. Separately state each and every procedure employed by 

the central office and Region V to assure compliance with Title 

VI and Section 504 in connection with and as a condition of ap- 

proving proposals or applications under Section 1122, the Hil 

Burton program, and other health facility construction programs 

administered by HEW: 

(a) prior to approving such applications and proposals 

(b) periodically; and 

(c) upon receiving complaints of civil rights violations. 

Include the person(s), job title, operating branch or division 

guidelines, instructions, agreements and communications to per- 

sons 1invalved in such procedures. 

ll. Describe every action which you, your agents, employe 

or persons acting on behalf of HEW took to assure compliance wit 

the requirements of Title VI and Section 504 by Methodist 

Hospital of Gary, Inc.: 

(a) prior to giving Section 1122 approval to the initial 

construction of Broadway Methodist Hospital; 

5 

Q ee
 

o jo
r 

[=
H 

3 (0
) 

  
  

  

 



  

(b) prior to approving applications for Hill-Burton funds 

for the initial construction of Broadway Methodist Hospital 

(c) prior to giving Section 1122 approval to the 1974 ap- 

plication for the expansion of Broadway Methodist Hospital; 

(d) prior to giving Section 1122 approval to the 1976 o ie | 

plication for the expansion of Broadway Methodist Hospital; 

- 

(e) prior to approving the 1976 application for Hill-Burton 

funds for the expansion of Broadway Methodist Hospital. 

Identify each person by name, job title, operating branch or divi-   sion, and location of office (central or regional) who participa- 

| 
ted in or performed any of the actions described in the answers to 

| 
. { 

this Interrogatory. | 

12. If any delegation of any aspect of the responsibility 

for assuring civil rights compliance by Methodist Hospital of 

Gary, Inc., in connection with Section 1122 proposals and Hill- 

Burton applications and funds was given to a state agency: 

(a) state the name of all such agencies, the persons in 

such agencies authorized to perform such responsibilities and 

describe all actions taken:   
(b) describe all authority guidelines, and communications 

authorizing such delegation; and 

(¢) describe the role of HEW in such delegation, including | 

the method and nature of review of such state agency action. 

13. Describe all procedures required by HEW prior to ap- 

proval of a health facility for participation in the Medicare 

Medicaid and Title V programs which relate to or are designed to | 

secure assurance of compliance with Title VI and Section 504. 

Specifically describe and/or attach copies of guidelines        



      

  instructions, regulations, directives or agreements pertaining to 

such procedures. 

3 

14. Describe completely all procedures, standards and 

guidelines required of state agencies which administer the 

Medicaid, and Title VI programs to assure compliance with 

state agencies'cbligations under Title VI and Section 504, prior 

to their approval of applications by health facilities for 

ticipation in these programs. Identify and/or attach copies of 

guidelines, instructions, regulations, directives or agreements 

pertaining to such procedures.   
15. Describe completely all procedures, standards and ie   

guidelines promulgated by HEW to assure that health facilities 

—
 

Is i OT
) 

td
 ~ 

La | 
od
 approved by state agencies for participation in Me 

Title V are in compliance with Title VI and Section 504. Identify 

and describe, and/or attach copies of guidelines, instructions, 
| 
{ 

| 
| 

regulations, directives or agreements pertaining to such proced- | 
| 

ures. | 

l6. Describe all procedures, and standards required by HEW | 

for Title VI and Section 504 clearance by a health facility prior 

to its participation in the Medicare program. Set forth and/or 

attach copies of guidelines, instructions, regulations, di- 

rectives or agreements pertaining to such procedures. | 

17. Describe all procedures promulgated by HEW pursuant to 

Title VI and Section 504 regarding civil rights clearance prior   
to the commencement of a project to relocate or create a sat- 

ellite of a health facility that is participating in the Medicare, J 

Medicaid, or Title V programs, Include: 

(2a) whether, how and why the procedures differ for each of 

 



      

the programs; and 

(b) the date such procedures were promulgated and by whom. 

Identify and describe, and/or attach copies of guidelines, in- 

structions, regulations, directives or agreements pertaining to 

such procedures. 

18. Describe fully all relocations and/or construction of 

second hospital facilities by hospitals and other recipients of 

federal funds, including Medicare, Medicaid, Title Vv, and Hill- 

Burton funds during the past five years. For each include the 

following information: 

(a) the name of the recipient; 

(b) the programs pursuant to which the recipient receives 

and/or received federal funding; 

(c) the name and location of the original facility, its 

capacity, services, and patient population by age, race and na- 

tional origin; 

(d) the name and location of the relocation or newer facil- 

ity, its capacity, services, and patient population by age, race ~
 

} 

(M
h : J )] 4 

and national origin; 

(e) all studies undertaken regarding these facilities; 

(£) all procedures undertaken to assure compliance with 

Title VI and Section 504; 

19. (a) Set forth the areas and items which any official 

or employee of HEW reviews before granting approval to a health 

facility, construction proposal, recommended by a state agency, 

pursuant to Section 1122 and the Hill-Burton program; 

(b) set forth the areas and items which any 

Ge 

  
  

  

  

 



      

or employee of HEW reviewed before granting approval to the ini- 

tial construction of Broadway Methodist Hospital and 

approval for the expansion of Broadway Methodist Hospital. Attach 

a copy of all letters and/or forms which were issued by HEW in   
this regard; 

(c) identify each and every HEW official or employee of HEW 

who participated in this Section 1122 and Hill-Burton approval of 

the initial construction of Broadway Methodist Hospital and the 

1976 approval for the expansion of Broadndy Methodist Hospital and 

describe his/her role and function in the approval process.   20. For any investigation, report, or document issued or 

signed by HEW or anyone acting on its behalf which 

applications of Methodist Hospital by Gary, Inc,, for the con- 

struction of Broadway Methodist Hospital, the 1976 application 

for the expansion of Broadway Methodist Hospital and civil rights 

responsibilities, obligations and compliance:   
specifically state the date that each such investiga- i 

tion, and report was commenced or document was issued; 

(c) state the person or persons, and their titles, respon- 

sible for issuing the document, or investigation or report; 

(d) specifically state all tnformation, and sources, doc- | 

umentary or testimonial, upon which the document was based 

(e) state the reason for compiling each investigation,   
report or document. 

21. Describe in detail the factors considered and basis 

upon which proposals for the connection and/or expansion of Broad: 

way Methodist Hospital were reviewed, evaluated, recommended andAx 

 



      

approved by HEW. Specifically include: 

(a) the role of and weight given to any information 

mitted by Methodist Hospital of Gary, Inc., and/or any member of ' 

its medical and/or nonmedical staff to HEW: 

sub- 

(b) the projections concerning population growth, comm 

development, and need for health facilities in the immediate vi- 

cinity of (i) the Merrillville, Indiana site of Broadway Methodist 

Hospital and (ii) the Gary, Indiana site of Gary Methodist 

Hospital. 

22. Describe in detail the factors considered and basis 

upon which proposals for the construction and/or expansion 

Broadway Methodist Hospital were reviewed, evaluated, recommen 

and/or approved by HEW, as to the following items: 

(a) location of the laundry at Broadway; 

(b) joint and shared planning among hospitals in Lake 

County, and particularly any efforts by Methodist Hospital 

Gary, Inc., to avoid duplication of services; 

(c) plans by Methodist Hospital of Gary, Inc., for 

Practice Residence programs; 

(d) plans by Methodist Hospital of Gary, Inc., for 

tracting and retaining physicians and nurses to and in Gary 

(e) the construction and renovation timetable as pro 

by Methodist Hospital of Gary, Inc., regarding Gary Methodis 

Hospital and Broadway Methodist Hospital; 

(f) hospital-based physician offices; 

(g) plans for construction of condominium for privat 

practice by physicians; 

    
1 

| 

mended | 

i 

+= 
No de 

| 

| 
{ 

% : 
Family _ 

BC. 

(h) relationship of Methodist Hospital of Gary, Inc. 

“lO~   

 



  

medical schools and plans for medical education training programs, 

internships and residencies at Gary Methodist Hospital and 

Broadway Methodist Hospital;   
(1) health needs and patterns of utilization of medical | 

care facilities, and particularly emergency room facilities, by 

the following population categories: 

{1) black 

  (2) Hispanic 
| 

(3) elderly | 

(4) handicapped 
| 

(5) women of child-bearing age 

(6) children (under age 18) 

(7) lower income residents: 

(j) projections as to number of patients by race at each 

Health Services Building, Gary and Broadway:   
(k) catchment areas of projected patient population groups; | 

| 
(1) response by community groups; 

(m) impact of the construction and/or expansion of 

Broadway Methodist Hospital on residents of Calument Township; 

(n) problems of convenience and accessibility by lower 

income, racial minority, and/or handicapped residents of Gary to 

Broadway Methodist Hospital, by public transportation or other- 

wise, particularly in relation to use of linear accelerator, out- 

patient services and services unavailable at Gary Methodist   
Hospital; 

(0) impact of the construction and/or expansion of   
Broadway Methodist Hospital on Calumet Township in relation to 

jobs, housin atterns, roperty values, small businesses, ’ rl 

-ll=     
 



      

pharmacies; 

(p) impact of the construction and/or expansion of 

Broadway Methodist Hospital on non-medical employees at 

Methodist Hospital; 

(qd) impact of the construction and/or expansion of 

Broadway Methodist Hospital on further potential medical patients 

residing in Calument Township; 

(r) impact of the construction and/or expansion of 

Broadway Methodist Hospital on the location of practice 

physician specialists; 

de 

™X7r 
LV 

(s) impact of the construction and/or expansion of 

Broadway Methodist one (i) the ratio of doctors to patients 

on (11) the ratio of nurses to patients at Gary Methodis 

Hospital. 

Respectfully submitted 14 

  

JACK GREENBERG 

MELVYN R. LEVENTHAL 
BETH J. LIEF 

10 Columbus Circle e 

New York, New York 10019 

JULIAN B. ALLEN 

CHARLES B. MILLER 
2009 Broadway 

Gary, Indiana 46407 

MARILYN G. ROSE 

CHRISTINE B. HICKMAN 

1751 BN. Street, N.W. 

washington, D. C. 20036 

Attorneys for Plaintiffs 

we) Fie [||1daff2cb-d293-4c1a-863e-f7a3b3b4e84b||]