CONF0Rn'ffir COFY

OFORIOINAL
krArggles Court
1 John Doe $tP 0 2 010
8771 Santa Monica Blvd #5A3
7 Los Angeles CA 9006945AT JolnA. Clarke, Ex 0tficorCtrrt

3
Telephone, {474) 7.+95363 Ey*#
CASE MANAGEMEhIT CONFERENCH
4 Plaintiff, in pro per
JAtl 0 fr 2011
5 Date

7 JohnH.Reld
\){dr tr tJchh.
I SUPERIOR COURT OF THE STATE OF CALIFORNTA

9 COUNTY OF LOS ANGELES _ SANTA MONICA COURTHOUSE

10 John Doe, an indidivual Case no.

sc1"09,1S6
t1 Plaintiff, COMPTAINT FOR DAh4AGES AbID
PRELIMIT\T ANTD PERMANENT
17
VS. TNJUNCTTON
L3
Carolyn Costin, no individual; (UNRUH CIVIL RIGHTS ACT)
T4 Monte Nido Residential Center, Inc.n a
California corp oration ; JURY TRIAL REQUESTED
15
Monte Nido Lake Vista, LLC, a California
L6 limited liability company; and
I)oes 1-10, inclusive
L7
Defendants.
18

T9

2A COMES NO\U PIAINTIFF, John Doe ("Plaintiff'), who alleges and complains against

7T Defendants Carolyn Costin, Monte Nido Residential Center, Inc., Monte Nido l^ake Vista, LLC,

27 and Does L-10, as follows:

7.3 Irvrnouucnor.I
74 1. Eating disorders are severe mental illnesses, affecting millions of individuals in the

75 United States alone. ]ililhile traditionally thought of as an issue overwhelmingly affectrng women,

26 more and more research is determining that men, too, suffer from these disorders in great

27

28

COMPLAINT
 1 numbers. One recent study uncovered “evidence that eating disorders are as common in men as in
2 women, and are perhaps more severe.”1
3 2. In spite of this, treatment options for men remain unconscionably limited; see, e.g.,
4 Elizabeth Bernstein, Men, Boys Lack Options to Treat Eating Disorders, Wall Street Journal, April 17,
5 2007, at D1.
6 3. Defendant Carolyn Costin herself acknowledged this deplorable disparity, noting
7 that “[w]orse still, eating disordered males seeking treatment are turned down when requesting
8 admission to most of the programs in the country because these programs treat females only.”2

9 4. Defendant Carolyn Costin has established and operates three residential facilities
10 for the treatment of eating disorders, two of which are located in California. Hypocritically, and in
11 violation of the Unruh Civil Rights Act, Defendant Costin discriminates against men at every one
12 of these residential facilities.
13 PARTIES
14 5. Plaintiff is a thirty-three (33) year old man, residing in Los Angeles County,
15 California. Plaintiff is an attorney, licensed to practice before the California State Bar. Plaintiff has
16 been repeatedly diagnosed with an eating disorder, and is currently so diagnosed. As a result of
17 Plaintiff’s eating disorder and comorbid conditions, and the difficulties Plaintiff has encountered
18 in seeking treatment for them, Plaintiff has been unemployed and/or receiving state disability
19 insurance for the majority of the past two years. Plaintiff sought treatment from Defendants, and
20 was refused because Plaintiff is male.
21 6. As these proceedings involve, at their very core, extremely private and sensitive
22 issues of gender and mental health, Plaintiff has a significant interest in withholding his identity
23 from public view and proceeding anonymously, to protect himself against possible social stigma,
24 harassment, injury, ridicule, and/or personal embarrassment. See, e.g.: Matrixx Initiatives, Inc. v.
25 Doe, 138 Cal. App. 4th 872, 879 (Cal. App. 6th Dist. 2006) (discussing the typical procedures
26
1
Arnold E Andersen et al, Osteoporosis and osteopenia in men with eating disorders, 355 THE LANCET 1967 (2000)
27 2
CAROLYN COSTIN, THE EATING DISORDER SOURCEBOOK 25 (Lowell House, 2d ed. 1999); this language is
suspiciously missing from later editions of the same text, see, e.g., CAROLYN COSTIN, THE EATING DISORDER
28 SOURCEBOOK 39 (McGraw-Hill, 3d ed. 2006)
2
COMPLAINT
 1 employed by anonymous plaintiffs and defendants); Doe v. Rostker, 89 F.R.D. 158, 161 n6 (N.D.
2 Cal. 1981) (noting that plaintiffs in cases involving mental illness have a strong interest in
3 proceeding anonymously, due to the presence of social stigma); Doe v. Gallinot, 486 F. Supp. 983
4 (C.D. Cal. 1979); and United States v. Doe, 655 F.2d 920, 922 n1 (9th Cir. Wash. 1980).
5 7. Plaintiff is informed and believes, and based thereon alleges, that at all relevant
6 times hereto, defendant Monte Nido Residential Center, Inc. was and is a California corporation,
7 entity number C1772021, with a principal place of business at 514 Live Oak Circle Drive,
8 Calabasas, California, 91302.

9 8. Plaintiff is informed and believes, and based thereon alleges that, at all relevant
10 times hereto, defendant Monte Nido Lake Vista, LLC was and is a California limited liability
11 company, entity number 200709210005, with a principal place of business at 28855 Lake Vista
12 Drive, Agoura Hills, California 91301.
13 9. Plaintiff is informed and believes, and based thereon alleges that, at all relevant
14 times hereto, the administrative offices for both Monte Nido Residential Center, Inc. and Monte
15 Nido Lake Vista, LLC are and have been located at 27162 Sea Vista Drive, Malibu, California
16 90265.
17 10. Plaintiff is informed and believes, and based thereon alleges that, at all relevant
18 times hereto, defendant Carolyn Costin (“Costin”) was and is a licensed Marriage and Family
19 Therapist (“MFT”), license no. 13192, with a principal place of business at 27162 Sea Vista Drive,
20 Malibu, California 90265. Defendants describe Costin as “the founder and executive director of
21 The Monte Nido Treatment Center and its affiliates,” who serves “as the clinical director for
22 Monte Nido in Malibu [and] as the executive director for all Monte Nido affiliates.”3 Costin has
23 written four books, some in multiple editions, on the subject of eating disorders, and “serves on
24 the Board of Trustees of the National Eating Disorder Association (NEDA) and on the editorial
25 board for "Eating Disorders: The Journal of Treatment and Prevention.”4 Plaintiff is informed and
26

27 3
Monte Nido® Treatment Center / About the Founder, at http://www.montenido.com/montenido/?fa=founder
(retrieved August 30, 2010) (“Founder”)
28 4
Id.
3
COMPLAINT
 1 believes, and based thereon alleges, that Costin was, in addition to founding and serving as
2 executive director for her own residential programs, similarly involved in the founding and/or
3 operation of the Castlewood Treatment Center. Plaintiff is further informed and believes, and
4 based thereon alleges, that Costin herself made the decision to deny men access to her residential
5 treatment programs.
6 11. Plaintiff is ignorant of the true names and capacities of Defendants sued herein as
7 Does 1 through 10, inclusive, and therefore sues said Defendants by such fictitious names, and
8 prays that their true names and capacities when ascertained may be incorporated by appropriate

9 amendment hereto.
10 12. Plaintiff is informed and believes, and based thereon alleges, that at all times herein
11 mentioned, each Defendant was the agent, servant and employee of its Co-Defendants, and in
12 doing the things hereinafter mentioned, was acting in the course and scope of its authority as such
13 agent, servant and employee, and with the ratification and consent of each of the other Co-
14 Defendants, respectively.
15 JURISDICTION AND VENUE
16 13. Defendants’ residential facilities in the state of California are located in the cities of
17 Calabasas (south of Mulholland Highway) and Agoura Hills, and their administrative offices, or
18 headquarters, are in Malibu, California. Defendant Costin’s principal place of business is in
19 Malibu, California. This matter is an unlimited civil case. Cal. Civ. Proc. Code § 86. Plaintiff is
20 informed and believes, and based thereon alleges, that any and all decisions, planning, and any
21 other act giving rise to the violation of the Unruh Civil Rights Act, occurred at Defendants’
22 administrative offices in Malibu, California. Additionally, Plaintiff is informed and believes, and
23 based thereon alleges, that the representative who denied Plaintiff consideration for admission (see
24 ¶ 53, infra) was located at Defendants’ administrative offices in Malibu, California. Assignment to
25 the Los Angeles County Superior Court, Western District, Santa Monica Courthouse, is therefore
26 proper.

27
28
4
COMPLAINT
 1 FACTS COMMON TO ALL CAUSES OF ACTION
2 Severity of Eating Disorders
3 14. Anorexia and bulimia are unquestionably serious medical conditions. “The
4 disorder is fatal in 10% of cases.” Denise Gellene, Men found to be anorexic, bulimic also, Los Angeles
5 Times, February 01, 2007. California state law recognizes this, requiring that, e.g., “every health
6 care service plan contract … that provides hospital medical, or surgical coverage shall provide
7 coverage for the diagnosis and medically necessary treatment of severe mental illnesses … under the
8 same terms and conditions applied to other medical conditions.” California Health and Safety Code §

9 1374.72 (emphasis added). Specifically enumerated as “severe mental illnesses” are “anorexia
10 nervosa” and “bulimia nervosa.” Id. at §§ (d)(8)-(9). Further, the California Government Code
11 § 12945.2(c)(8) defines a serious health condition as “an illness, injury, impairment, or physical or
12 mental condition that involves … [i]npatient care in a hospital, hospice, or residential health care
13 facility.”
14 Defendants’ Treatment Facilities
15 15. Defendants own and/or operate, and at all times relevant hereto have operated, at
16 least three facilities for the residential treatment of eating disorders: Monte Nido Residential
17 Treatment Center (“Monte Nido”) in Calabasas, California; Monte Nido Vista Residential
18 Treatment Center (“Monte Nido Vista”) in Agoura Hills, California (together, the “California
19 Residential Facilities”), and the RainRock Residential Treatment Center for Women - A Monte
20 Nido Affiliate (“RainRock”), near Eugene, Oregon (collectively, the “Residential Facilities”).5
21 16. Plaintiff is informed and believes, and based thereon alleges, that Monte Nido is a
22 six bed facility, and Monte Nido Vista is now a ten bed facility. Monte Nido opened in March
23 19966, and Monte Nido Vista opened February 16, 2008 as a six-bed facility.78 Plaintiff is informed
24 and believes, and based thereon alleges, that Monte Nido Vista recently underwent construction
25
5
Services and Facilities, at http://www.carolyncostin.com/services.php (retrieved August 30, 2010)
26 6
Founder, supra.
7
About Carolyn, at http://www.carolyncostin.com/about.php (retrieved August 30, 2010)
27 8
Academy News: AED News Briefs, Academy for Eating Disorders Newsletter, at
http://www.aedweb.org/source/newsletter/index.cfm?fuseaction=Newsletter.showIssuetoPrint&Issue_ID=6 (April 1,
28 2008)
5
COMPLAINT
 1 and expansion, increasing its capacity to ten beds in or around the first part of 2010. In spite of
2 widely disseminated reports of the increasing need for male eating disorder treatment and the
3 existence of long-standing examples of successful integration of which Costin was aware, Plaintiff is
4 informed and believes, and based thereon alleges, that no attempt was made to facilitate the
5 treatment of men in this expansion by, e.g., providing for a single occupancy room.
6 17. Monte Nido and Monte Nido Vista are accredited by the Joint Commission,
7 organization ID 477495, as Behavioral Health Care9 facilities, and Defendants proudly display the
8 Joint Commission seal on each facility’s web page. “The Joint Commission accredits and certifies

9 more than 18,000 health care organizations and programs in the United States.”10
10 18. Defendants have made each of the Residential Facilities available to women only.
11 The California Residential Facilities are identically identified by Defendants as “[a] Residential
12 treatment center designed and created by recovered professionals to heal women suffering from
13 Anorexia, Bulimia and Exercise Addiction,” while RainRock is identified by Defendants as a
14 “Residential Treatment Center for Women.”11
15 19. Defendants also operate the Eating Disorder Center of California (“EDCC”) in the
16 Brentwood neighborhood of the City of Los Angeles, which provides and did provide a partial
17 hospitalization (“PHP”), or “day treatment,” program. In or about early 2009, the EDCC also
18 began offering an intensive outpatient program (“IOP”).
19 20. Defendants’ PHP and IOP programs are, and at all times relevant hereto were,
20 mixed-sex. The PHP program consists of five to seven hours a day, six days a week, of group
21 therapy, supervised meals and snacks, supervised group exercise, some unstructured free time, and
22 individual therapy and nutrition counseling sessions. Men and women, including adolescents, are
23 fully integrated and attend all groups, etc., together.
24
25 9
Defined as organizations “that provide mental health, chemical dependency, child welfare, foster care, and mental
retardation/developmental disabilities services for clients of various ages in various organized service settings,” Quality
26 Check/Quality Report Glossary of Terms, at
http://www.jointcommission.org/QualityCheck/06_glossary#Behavioral_Health_Care (retrieved August 30, 2010).
27 10
About The Joint Commission, at http://www.jointcommission.org/AboutUs/ (retrieved August 30, 2010) (“Joint
Commission”)
28 11
Services and Facilities, supra
6
COMPLAINT
 1 21. Many of the patients at EDCC have been, or will be, patients at one of Defendants’
2 California Residential Facilities. Defendants describe this interplay with: “Day treatment is often
3 tried prior to admission to one of our residential programs, but also serves as an important step
4 down aftercare program.”12 “The EDCC may serve as a stand-alone facility for clients that may
5 need this level of care for recovery. It may serve as a transition option related to the Monte Nido
6 Residential Treatment Program or other inpatient facilities. In addition, it may serve as a holding
7 environment for those clients waiting to get into Monte Nido.”13
8 22. Defendants have described the California Residential Facilities as featuring a

9 “private bath … in each bedroom [and a] home-like atmosphere.”14

10 23. Plaintiff is informed and believes, and based thereon alleges, that the California
11 Residential Facilities are continuously staffed twenty-four (24) hours a day, seven (7) days a week.
12 24. Plaintiff is informed and believes, and based thereon alleges, that each bedroom at
13 both of the California Residential Facilities is equipped with an alarm system, that the alarm
14 systems are activated during any period of reduced supervision (e.g., at night), and that the
15 operation of the alarm systems would aggressively dissuade any unauthorized egress, commingling,
16 or other potential threats to privacy, and would ensure such encroachment or violation would be
17 immediately detected.
18 Prevalence of Eating Disorders Among Men
19 25. Knowledge of the increasing prevalence of males suffering from an eating disorder
20 has been readily available to the general public, let alone a professional practitioner as widely
21 connected and published as Costin, for many years.
22 26. In 1993, three years before Costin opened Monte Nido, the L.A. Times reported
23 that an estimated “10% of the 4 million anorexics and bulimics in the United States are male. An
24 even greater percentage of the 10 million people who have binge eating disorders are male,
25
26 12
Local After Care Options, at http://www.montenido.com/montenido/?fa=about_transitioning (retrieved August
30, 2010)
27 13
Monte Nido® Treatment Center: About the Program - Program Options, at
http://www.montenido.com/montenido/?fa=about_options (retrieved August 30, 2010)
28 14
Services and Facilities, supra.
7
COMPLAINT
 1 according to the National Institute of Mental Health … Many experts feel that the number of
2 males with eating disorders is actually underreported and that the disease's incidence is increasing
3 for men. Dr. Barton Blinder, clinical professor and director of eating disorder research in the
4 department of psychiatry at UC Irvine College of Medicine, says that in the last 10 years, an
5 increasing number of serious male cases have been reported.” Julie Bawden Davis, Consumed by
6 Food, Los Angeles Times, August 31, 1993.
7 27. In a 1994 article, the L.A. Times reported that “up to 1 million men may be
8 suffering from eating disorders” in the United States. Marlene Cimons, Experts Say More Men

9 Seeking Treatment for Eating Disorders, Los Angeles Times, November 30, 1994.
10 28. A Harvard University Medical School study, released in 2006 and officially
11 published more than a year before Monte Nido Vista opened (two full months before Monte Nido
12 Lake Vista LLC was formed), reports that the “[l]ifetime prevalence estimates of DSM-IV anorexia
13 nervosa, bulimia nervosa, and binge eating disorder are .9%, 1.5%, and 3.5% among women, and
14 .3% .5%, and 2.0% among men.” James I. Hudson et al., The Prevalence and Correlates of Eating
15 Disorders in the National Comorbidity Survey Replication, BIOLOGICAL PSYCHIATRY, February 2007, at
16 348 (“Harvard Study”).
17 29. The results of the Harvard Study were widely reported, e.g.: “Contrary to the long-
18 held belief that anorexia and bulimia are female afflictions, the first national survey on eating
19 disorders has found that one-quarter of adults with the conditions are men.” Denise Gellene, Men
20 found to be anorexic, bulimic also, Los Angeles Times, February 01, 2007; “Harvard researchers
21 reported the results of the first national study of eating disorders in a population of nearly 3,000
22 adults and found that 25 percent of those with anorexia or bulimia and 40 percent of binge eaters
23 were men … [and] they may have trouble finding treatment: Some eating disorder programs admit
24 only women.” Sandra G. Boodman, Eating Disorders: Not Just for Women, Washington Post, March
25 13, 2007; The Early Show: ‘Man-orexia’ On The Rise (CBS News television broadcast, October 1,
26 2008 5:40 AM).

27
28
8
COMPLAINT
 1 Eating Disorder Treatment Settings That Do Not Discriminate Against Men
2 30. Plaintiff is informed and believes, and based thereon alleges, that other eating
3 disorder treatment settings, some very similar to those of Monte Nido and Monte Nido Vista, have
4 successfully included treatment of men (hereinafter, the “Inclusive Treatment Settings”). For
5 example:
6 a. Castlewood Treatment Center in Ballwin, Missouri, is a ten bed residential facility
7 in a converted house with single and double bedrooms with private bathrooms
8 (very analogous to Monte Nido and Monte Nido Vista), which accepts men for all

9 levels of care provided, including residential. Castlewood answers the question

10 “How do Men/Women, Anorexic, Bulimic, and Compulsive Overeating Clients
11 Interact,” with: “We believe that diversity actually is optimal since it forces clients
12 to confront the real world issues that confront them daily. Still it takes some skill
13 on our part to optimally facilitate the community issues for all clients to learn and
14 none to be revictimized. We work with these community issues to establish a
15 ‘therapeutic community’ and allow for clients to help one another.”15 Castlewood’s
16 residential program includes intensive co-educational group work in, e.g., sexual
17 healing, and gender sexuality intimacy and relationships.16 Plaintiff personally
18 experienced the successful integration, without incidents of compromised privacy,
19 of male and female clients in the Castlewood residential setting; this integration
20 included daily morning ‘weights and vitals,’ where all Castlewood clients
21 encountered one another for several minutes at a time, while clad only in hospital
22 gowns.
23 b. The Eating Disorders Programs at UCLA’s Resnick Neuropsychiatric Hospital are
24 8-bed mixed-sex inpatient facilities, each room having a private bathroom,
25 providing “inpatient and partial hospitalization programs [that] treat male and
26
15
Eating Disorder FAQs, Eating Disorder Treatment, at http://www.castlewoodtc.com/eating-disorders-faqs.php#17
27 (retrieved August 30, 2010).
16
Residential Program, at http://www.castlewoodtc.com/pdf/Residential-Treatment-Schedule.pdf (retrieved August
28 30, 2010)
9
COMPLAINT
 1 female children, adolescents and adults who have anorexia nervosa, bulimia
2 nervosa or other non-specific eating disorders.”17
3 c. The CRC Health residential facility Austin Sendero, near Austin, Texas, provides
4 “treatment facilities for anorexia, bulimia, and binge eating disorders in males and
5 females.”18 The operators of Austin Sendero point out that the “programs that are
6 part of the CRC Health network aren’t hospitals. Instead, [they] offer warm, home-
7 like environments.”19
8 d. Rogers Memorial Hospital’s Eating Disorder Center in Oconomowoc, Wisconsin,

9 provides “long-term intensive residential treatment [in] a home-like environment”

10 for men and women, and Rogers Memorial Hospital also provides inpatient
11 “treatment for both male and female adults who require intensive stabilization for
12 eating disorders” and partial hospitalization “[f]or males and females 18 years or
13 older who are affected by eating disorders.”20
14 e. Casa Palmera, in Del Mar, California, offers a “state-of-the-art, yet tranquil
15 treatment facility [that] provides a safe and patient-centered healing environment
16 for women and men alike.”21
17 f. River Oaks Hospital in New Orleans, Louisiana, maintains a 16-bed inpatient
18 eating disorders treatment program that, while separating men and women for a
19 weekly body image group, houses and treats men alongside women.22 “’I believe
20 the mix of males and females is helpful,’ says Susan Willard, clinical director of the
21 hospital's eating-disorders treatment center.”23 River Oaks also operates the New
22
23 17
Frequently Asked Questions | UCLA Eating Disorders Program, at http://eatingdisorders.ucla.edu/body.cfm?id=24
(retrieved August 30, 2010).
24 18
Austin Sendero Recovery, at http://www.austinsendero.com/austinsendero (retrieved August 30, 2010).
19
Top Eating Disorder Treatment Programs, at http://www.austinsendero.com/ (retrieved August 30, 2010).
25 20
About Eating Disorder Treatment - Rogers Memorial Hospital, at http://www.rogerseatingdisorders.org/about/
(retrieved August 30, 2010).
26 21
Eating Disorder Treatment Center, ED Treatment Options, at http://www.casapalmera.com/treatments/eating-
disorders.php (retrieved August 30, 2010).
27 22
River Oaks Hospital - Eating Disorders, at https://www.riveroakshospital.com/eatingdisorder/treatment.htm
(retrieved August 30, 2010).
28 23
Bernstein, supra
10
COMPLAINT
 1 Orleans Institute, a mixed-sex trauma recovery and stabilization program with an
2 available eating disorder treatment track.24
3 g. Del Amo Hospital, an inpatient facility in Torrance, California, provides an
4 “intensive, comprehensive program for adult men and women struggling with
5 Anorexia Nervosa, Bulimia Nervosa, Compulsive Overeating and Eating Disorders,
6 Not Otherwise Specified, including Binge Eating.25
7 h. Rosewood Ranch in Wickenburg, Arizona, notes: “While the stereo-typical eating
8 disorder sufferer is a female, a recent Harvard University study revealed that more

9 men suffer from eating disorders than had previously been thought. Out of 3,000
10 people diagnosed with anorexia and bulimia, 25 percent were male. The research
11 also indicated that binge eating is the most prevalent eating disorder and that up to
12 40% of binge eaters are male. Rosewood provides treatment for men and women at
13 all their locations.”26 Rosewood offers levels of care encompassing “Inpatient
14 Residential, Partial Hospitalization with housing, IOP, Outpatient Services and
15 Transitional living.”27 Rosewood was originally open to women only, but expanded
16 their services to treat men in or around September, 2008.28
17 31. Plaintiff is informed and believes, and based thereon alleges, that there exist only
18 inpatient and outpatient eating disorder treatment options for men in Los Angeles County,
19 California, and that no residential options for men exist in Los Angeles County.
20 32. Treatment centers that accept men are finding the services in increasing demand.
21 At Rogers Memorial, “the number of male eating-disorder patients has grown 50% [from 2004 -+
22 2007]; males now represent [as of 2007] 25% of the 200 or so eating-disorder patients a year in the
23
24
24
New Orleans Institute, at http://www.riveroakshospital.com/specialty_no_spsc.html (retrieved August 30, 2010)
25 25
Del Amo Behavioral Health System - Eating Disorders Recovery Program, at
http://www.delamohospital.com/AdultEatingDisorders.html (retrieved August 30, 2010).
26 26
Rosewood Centers for Eating Disorders statistics and information, at
http://www.rosewoodranch.com/index.asp?pageId=36 (retrieved August 30, 2010).
27 27
Rosewood Centers for Eating Disorders Hope at a Challenging Time, at
http://www.rosewoodranch.com/index.asp?pageId=61 (retrieved August 30, 2010).
28 28
EDReferral.com, supra
11
COMPLAINT
 1 residential program.”29 At the “University of Iowa's eating-disorders program … 14% of the
2 patients are male.”30 The “Center for Eating Disorders at Sheppard Pratt … has four to six male
3 patients in residence at a time, double the number from five years ago.”31
4 33. The National Eating Disorders Association, of which Costin is a member of the
5 Board of Trustees, states: “There is a broad consensus … that eating disorders in males are
6 clinically similar to, if not indistinguishable from, eating disorders in females.”32
7 Residential vs. Inpatient Treatment
8 34. As Costin herself acknowledges, there is a substantial difference between hospital

9 inpatient programs and residential programs, particularly the California Residential Facilities:
10 “Having run hospital eating disorder programs I knew I wanted to offer something very different. I
11 wanted to provide a healing environment and a top notch treatment program for disorders such as
12 Anorexia, Bulimia and Exercise Addiction. Monte Nido became that place … I created Monte
13 Nido because I wanted a home-like environment rather than a hospital for my clients who needed
14 24-hour care. Since Monte Nido opened, over a decade ago, the field of eating disorders has
15 changed dramatically. Other small residential facilities opened up across the country and I was
16 pleased that an increasing number of individuals were able to get this kind of care.”33
17 35. Costin further describes the benefits of a residential setting to patient therapy,
18 health, and prognosis, stating: “All of the Monte Nido residential programs are homes located in
19 beautiful serene settings, which promote tranquility and connection to nature. Our locations
20 significantly contribute to providing a healing environment. Each program accepts only a small
21 number of clients, allowing for highly individualized treatment, which I believe is crucial for
22 optimal growth and long-term recovery.”34
23
24
29
Bernstein, supra
25 30
Id.
31
Id.
26 32
Males and Eating Disorders: Research, at
http://www.nationaleatingdisorders.org/nedaDir/files/documents/handouts/MalesRes.pdf
27 33
Monte Nido® Treatment Centers - for Anorexia, Bulimia & Other Eating Disorders, at
http://www.montenido.com (retrieved August 30, 2010)
28 34
Id.
12
COMPLAINT
 1 36. Public policy favors residential treatment over more restrictive inpatient settings.
2 Cal Wel & Inst Code § 5325.1 states that “[i]t is the intent of the legislature that persons with
3 mental illness shall have rights including … [a] right to treatment services which promote the
4 potential of the person to function independently. Treatment should be provided in ways that are
5 least restrictive of the personal liberty of the individual.” Compared to inpatient settings,
6 residential programs are less restrictive of the personal liberty of the individual.
7 37. Insurance companies, too, may dictate the choice of a residential program over an
8 inpatient setting. Typically, inpatient treatment is covered only for individuals in the most acute

9 phases of their disorders, while residential treatment – often less expensive than inpatient
10 treatment – may be the only covered and viable option for those not so acute that inpatient
11 treatment is deemed medically necessary, but not healthy enough to successfully participate in an
12 outpatient program without 24-hour supervision, such as a PHP or IOP level of care. See, e.g.,
13 Anthem Blue Cross Behavioral Health Medical Necessity Criteria, Effective January 1, 2010,
14 available at http://www.anthem.com/ca/provider/f1/s0/t0/pw_a115176.pdf (setting out the
15 varying criteria for eating disorder coverage for the Acute Inpatient, Residential Treatment Center,
16 Residential Treatment Center Without 24-Hour Nursing, Partial Hospitalization Program,
17 Intensive Outpatient Program, and Outpatient Treatment levels of care). Insurance companies
18 generally conduct frequent utilization reviews (see, e.g., Cal. Health & Safety Code § 1367.01),
19 and are quite aggressive at moving covered individuals to lower, less expensive, levels of care as
20 soon as possible, while keeping nominally within the bounds of what is medically necessary. See,
21 e.g., Smith v. Vista Behavior Health Plans, No. B191271, slip op. at 1-2 (Cal. App. 2d Dist. Aug. 22,
22 2007); Bellaire Gen. Hosp. v. Blue Cross Blue Shield, 97 F.3d 822, 829 (5th Cir. Tex. 1996).
23 38. Moreover, with the high cost of treatment for an eating disorder (Defendants’
24 California Residential Facilities command a daily rate of $1,325, and patients are expected to
25 remain for at least thirty days – a minimum financial commitment of almost $40,00035), and the
26 relatively low ‘reasonable and customary’ reimbursement rates for out-of-network providers,

27
35
Monte Nido® Treatment Center: FAQs, at http://www.montenido.com/montenido/?fa=faqs (retrieved August 30,
28 2010)
13
COMPLAINT
 1 finding a treatment facility can require finding a fit both with the program, and with a prospective
2 patient’s insurance and/or financial situation. See, e.g., Renfrew Ctr. v. Blue Cross & Blue Shield, No.
3 94-CV-1527, slip op. at 10 (N.D.N.Y Apr. 10, 1997).
4 Plaintiff’s Eating Disorder Treatment
5 39. For several months in 2008, Plaintiff was an outpatient client of Defendants,
6 working with Keesha Broome (“Broome”), a Marriage and Family Therapist Intern, license number
7 55934. Plaintiff is informed and believes, and based thereon alleges, that at all times relevant
8 hereto, Broome has worked and “works as a therapist under the clinical direction of Carolyn

9 Costin for the Monte Nido Treatment Center and its Affiliates and also sees clients in an
10 outpatient setting.”36
11 40. On or before September 19, 2008, Broome directed Plaintiff to seek a higher level
12 of care. Because no residential programs locally admit men, Broome referred Plaintiff to local
13 hospitals, while acknowledging that a residential treatment program would be the best placement
14 for Plaintiff: “Although I have referred you to hospitals (primarily because they are readily available
15 ways to keep you safe from imminent danger), I think you would most benefit from a residential
16 setting … your state of mind, the hopelessness, the inability to feed yourself warrants a higher level
17 of care,” specifically, “you would most benefit from a residential setting.” E-mail from Keesha
18 Broome to Plaintiff (September 19, 2008 8:57:31 PDT).
19 41. Additionally, Broome acknowledged that one of Defendants’ California Residential
20 Facilities would be an excellent treatment setting for Plaintiff, were he female: “If we took men I
21 would 100% recommend our program.” Id. Broome went on to note: “Carolyn does offer
22 treatment for males at her day treatment facility in Brentwood. The thing about offering treatment
23 to both males and females at a facility is that it requires more space for privacy in living quarters,
24 etc. This is difficult to achieve and so Carolyn had to choose. She chose to serve the female
25 demographic because it is more affected by eating disorders. Unfair, but true.” E-mail from Keesha
26 Broome to Plaintiff (September 19, 2008 20:15:09 PDT).

27
36
Spirituality and Recovery: About Carolyn and Keesha, at http://www.eatingdisordersblogs.com/spirituality/about-
28 carolyn-and-keesha.html (retrieved August 29, 2010)
14
COMPLAINT
 1 42. Plaintiff was unsuccessful in locating a residential treatment facility that would take
2 men within a reasonable distance of his home in Los Angeles County, California.
3 43. On or around October 1, 2008, Plaintiff was assessed via telephone by the
4 Castlewood Treatment Center in Ballwin, Missouri (“Castlewood”), and as a result of that
5 assessment, was placed on its waiting list.
6 44. While waiting for a bed to open at Castlewood, Plaintiff began participating in a
7 mixed-sex intensive outpatient eating disorder program (“IOP”) offered by A New Journey in Santa
8 Monica, California. On October 23, 2008, The A New Journey staff, including then clinical

9 director Dawn Delgato (Marriage and Family Therapist, California license no. 44242) insisted
10 Plaintiff seek a higher level of care, as Plaintiff’s condition continued to deteriorate.
11 45. On December 9, 2008, a bed at Castlewood finally became available, and Plaintiff
12 began residential treatment there.
13 46. On or about March 24, 2009, Plaintiff returned to California and admitted as a
14 patient to Defendants’ EDCC PHP.
15 47. On or about June 5, 2009, EDCC staff and Plaintiff’s insurance provider agreed
16 that Plaintiff required a higher level of care. Defendants’ California Residential Programs
17 remained closed to men, and so were not considered as an option. Plaintiff was given referrals to
18 Del Amo Hospital and UCLA’s Resnick Neuropsychiatric Hospital and discharged from the
19 EDCC, without meaningful followup or continuity of care.
20 48. Plaintiff immediately contacted UCLA and was placed on a waiting list. On or
21 about July 17, 2009, Plaintiff admitted to UCLA’s highly restrictive inpatient eating disorder
22 program. Encountering treatment philosophies and methodologies that differed dramatically from
23 that which he had encountered in previous treatment settings, including EDCC and Castlewood,
24 Plaintiff did poorly at UCLA, and was rapidly administratively discharged.
25 49. Plaintiff attempted to manage his eating disorder and comorbid conditions through
26 outpatient treatment, for several months, without much success. Plaintiff’s condition continued

27
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15
COMPLAINT
 1 to deteriorate. In February of 2010, Plaintiff was briefly hospitalized for evaluation pursuant to
2 Cal. Welf. & Inst. Code § 5150.
3 50. Shortly thereafter, Plaintiff contacted the River Oaks Hospital and was placed on
4 the waiting list for its New Orleans Institute trauma program. Plaintiff was treated inpatient at
5 River Oaks for several weeks from April through May, 2010. While at River Oaks, Plaintiff was, at
6 staff’s direction, simultaneously enrolled in the trauma and eating disorders tracks offered at the
7 New Orleans Institute. Plaintiff was forced to leave inpatient treatment before completing the New
8 Orleans Institute’s typically thirty day program, as his insurance company declined to cover further

9 inpatient days, finding his condition no longer suitably acute for an inpatient level of care to be
10 medically necessary. Plaintiff was discharged from River Oaks with his conditions, including his
11 eating disorder, unresolved.
12 51. Plaintiff returned to Los Angeles in mid-May, 2010, and resumed working with his
13 outpatient treatment team. Plaintiff attempted to work full time, but was ultimately unsuccessful.
14 52. On or about July 14, 2010, Plaintiff applied for and received California State
15 Disability Insurance coverage. Plaintiff’s physician, a psychiatrist, listed both ICD-9 code 296.33,
16 Major Depressive Disorder, Recurrent, Severe, and ICD-9 code 307.1, Anorexia Nervosa, on the
17 doctor’s certification of disability.
18 53. On August 30, 2010, at 12:31 pm, Plaintiff contacted Monte Nido by calling
19 (310) 457-9958 and speaking with a representative who identified herself as Vicky. Plaintiff
20 explained that his insurance company had insisted an inpatient level of care was insufficient, but
21 that his outpatient treatment team had recommended a residential treatment setting. Plaintiff
22 specifically inquired about participating in residential treatment at one of Defendants’ California
23 Residential Facilities.
24 54. In response to Plaintiff’s inquiry regarding residential treatment, Vicky stated “we
25 just take females into our program.” Plaintiff was referred to the Center for Discovery37 in
26
37
The Center for Discovery facilities, including its Lakewood location, are operated by Discovery Practice
27 Management, Inc., (Joint Commission OrgID 150964) all but one of which are categorized as “Child/Youth” facilities.
Discovery Practice Management, Inc. operates a single adult facility, Oceanaire, “a spacious and intimate residential
28 program in a serene and confidential location on the Palos Verdes Peninsula … for adult women.” Oceanaire Eating
16
COMPLAINT
 1 Lakewood, California (a residential program that only accepts “male and female adolescents (ages
2 10 - 19 years old)”38), Del Amo Hospital (an inpatient program without a residential option39), or
3 Rader at North Shores Hospital in Ventura County, California (likewise an acute care inpatient
4 program without a residential option40).
5 FIRST CAUSE OF ACTION
6 FOR VIOLATION OF THE UNRUH CIVIL RIGHTS ACT AGAINST ALL DEFENDANTS
7 55. The Unruh Civil Rights Act is codified at Cal. Civ. Code § 51 et seq, and declares
8 that: “All persons within the jurisdiction of this state are free and equal, and no matter what their

9 sex41, race, color, religion, ancestry, national origin, disability, medical condition, marital status, or
10 sexual orientation are entitled to the full and equal accommodations, advantages, facilities,
11 privileges, or services in all business establishments of every kind whatsoever.” Id. § 51(b).
12 56. The Unruh Civil Rights Act goes on to specify that “[n]o business establishment of
13 any kind whatsoever shall discriminate against, boycott or blacklist, or refuse to buy from, contract
14 with, sell to, or trade with any person in this state on account of any characteristic listed or defined
15 in subdivision (b) or (e) of Section 51 …” Cal. Civ. Code § 51.5(a).
16 57. Plaintiff is a man.
17 58. Plaintiff alleges that Defendants’ California Residential Facilities are business
18 establishments within the meaning of the Unruh Civil Rights Act, engaged in the business of
19 providing residential eating disorder treatment services and associated physical and mental health
20 care.
21 59. On August 30, 2010, and on at least two prior occasions, Plaintiff communicated
22 with Defendants with the intention and purpose of obtaining eating disorder treatment at one of
23
Disorder Residential Program | Treating Adult Women, at http://www.oceanaire-ed.com/ (retrieved August 30,
24 2010)
38
Eating Disorder Program for Adolescents, at http://www.centerfordiscovery.com/eatingdisorderprogram/ (retrieved
25 August 30, 2010)
39
Summary of Accreditation Quality Information for Pacific Shores Hospital, OrgID 2953, at
26 http://www.qualitycheck.org/qualityreport.aspx?hcoid=2953 (retrieved August 30, 2010)
40
Summary of Accreditation Quality Information for Pacific Shores Hospital, OrgID 3252, at
27 http://www.qualitycheck.org/qualityreport.aspx?hcoid=3252 (retrieved August 30, 2010)
41
The Unruh Civil Rights Act, §51(e)(4), incorporates the definition of “sex” found at Cal. Gov’t Code § 12926(p),
28 which in turn incorporates Cal. Penal Code § 422.56. The distilled definition is, essentially, “a person's gender.”
17
COMPLAINT
 1 Defendants’ California Residential Facilities. Defendants unequivocally refused to consider this,
2 as Defendants’ California Residential Facilities “just take females” and discriminate against and
3 refuse to sell their services to persons of the male sex, completely denying men the
4 accommodations, advantages, facilities, privileges, or services offered by Defendants in their
5 California Residential Facilities. Plaintiff sought clarification of this position, even citing to the
6 Unruh Civil Rights Act. Defendants repeated their discriminatory practices.
7 60. Defendants denied Plaintiff full and equal accommodations, facilities, and services
8 because of his sex, in violation of the Unruh Civil Rights Act, on at least two occasions. The first

9 occasion was on or about September 19, 2008 when, though one of Defendants’ employees would
10 otherwise have recommended, without reservation or qualification, the program for Plaintiff,
11 Plaintiff was forced to seek treatment elsewhere because he is male. The second occasion occurred
12 on or about June 5, 2009, when Plaintiff, at the time a patient at Defendants’ EDCC, was found
13 by Defendants and by his insurance company to require a higher level of care, and could not
14 consider stepping up to the residential level of care offered at Defendants’ California Residential
15 Facilities.
16 61. Plaintiff is informed and believes and thereon alleges that Defendants, and each of
17 them, denied to Plaintiff the services, advantages, accommodations, facilities, and privileges
18 provided to other persons, as alleged above, on account of Plaintiff's sex. Defendants expressly
19 stated that Plaintiff’s sex was the only reason for Defendants’ conduct.
20 62. Plaintiff was and continues to be harmed by Defendants’ conduct, including,
21 without limitation: actual or required displacement from his friends and established therapeutic
22 community by being forced to seek residential treatment hundreds, if not thousands, of miles from
23 his home; by being denied the continuity of treatment enjoyed by female patients of Defendants,
24 who can and do transition between the residential and non-residential levels of care offered by
25 Defendants; and/or, by being forced to seek treatment in substantially more restrictive, less
26 comfortable, and less therapeutic settings of inpatient programs at hospitals, rather than the less

27
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18
COMPLAINT
 1 restrictive, more comfortable, and more therapeutic residential setting with the attendant benefits
2 to long-term prognosis.
3 63. Defendants’ refusal to admit men was more than a substantial factor in causing
4 Plaintiff’s harm, it was the direct and proximate cause.
5 64. Defendants’ wrongful conduct is continuing in that Defendants continue to deny
6 Plaintiff and all persons of Plaintiff's sex the full and equal accommodations, advantages, facilities,
7 privileges, and services of the above-mentioned business establishments.
8 65. Unless Defendants are restrained by a preliminary and permanent injunction of

9 this court, Plaintiff's injury will be great and irreparable. Plaintiff has no plain, speedy, and
10 adequate remedy at law because it will be impossible for Plaintiff to determine the precise amount
11 of damage that he will suffer if Defendants’ conduct is not restrained.
12 66. As a proximate result of the wrongful act of Defendants, Plaintiff is additionally
13 entitled to recover statutory damages of four thousand dollars ($4,000), as provided in Cal. Civ.
14 Code § 52(a).
15
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17
18
19
20
21
22
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24
25
26

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19
COMPLAINT
 1

WHEREFORE, plaintiffp*p judgment against defendants, and each of them, as follows,

7
1. For a preliminary injunction and a permanent injunction enjoining defendant and
3
defendant's agents, servants, and employees, and all persons acting under, in concert with, or for
4
defendant from denying, and aiding and inciting such denial, and from making any
5
discrimination, distinction, or restriction in providing full and equal accommodations, advantages,
6
facilities, and services in defendant's business establishment;
7
2. For statutory damages in the sum of $4,000;
I
3. For costs of suit herein incurred, including without limitation expert fees; and
9
4. For such other and further relief as the court may deem proper.
10

11
JURYTRIAL REQUESTED
T7 Plaintffherebyrequests a trial by juryon all issues so triable.
l3 Dated this September 7,7010
L+

15
John l)oe, Plaintiff, In Pro Per
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17

18

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73

74

75

26

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7A
COMPTAINT