U.S. Department
of Justice
Disability Rights Cases
Tennessee Board of Law Examiners
On December 17, 2024, the U.S. Attorney's Office (USAO) for the Middle District of Tennessee issued a Letter of Findings under Title II of the Americans With Disabilities Act (ADA) against the Tennessee Board of Law Examiners (TBLE) and the Tennessee Lawyers Assistance Program (TLAP). The Letter of Findings concludes that the public entities violated the ADA by discriminating against bar applicants based on their diagnosis of or treatment for a substance use or mental health disorder. The letter of findings requests the TBLE and TLAP to address the violations identified during the USAO's investigation.
Cox v. City of Boston
On December 3, 2024, the United States filed a Statement of Interest in Cox v. City of Boston, No. 1:22-cv-11009 (D. Mass.) addressing the correct interpretation of the health services exception in the ADA as applied to a police department. The health services exception is an exception to the ADA’s exclusion of individuals who currently illegally use drugs, and states that “an individual shall not be denied health services, or services provided in connection with drug rehabilitation, on the basis of the current illegal use of drugs if the individual is otherwise entitled to such services.” 42 U.S.C. § 12210(c). Under Title II of the ADA, the Exception applies to the denial of health services provided by any public entity covered by Title II, including state and local police departments. The case was brought by the estate of an individual with opioid use disorder, who died of an opioid overdose while in overnight detention after being arrested by the Boston Police Department.
United States v. Unified Judicial System of Pennsylvania
On January 31, 2024, the Unified Judicial System of Pennsylvania (UJS) agreed to pay $100,000 and to encourage all its component courts to adopt new policies to ensure that individuals under Pennsylvania state court supervision can take lawfully prescribed medications to treat opioid use disorder (OUD). The settlement agreement resolved the Justice Department's lawsuit against the UJS, the Supreme Court of Pennsylvania, and the Blair, Jefferson, Lackawanna and Northumberland County Courts of Common Pleas.
The United States filed its original complaint on February 24, 2022, asserting that UJS courts violated Title II of the ADA by implementing administrative policies categorically limiting or prohibiting the use of lawfully prescribed medication for the treatment of OUD by individuals in court supervision programs. The United States had previously notified the UJS that its courts had engaged in discrimination in a letter of findings issued on February 2, 2022. The District Court dismissed the United States' original complaint on April 21, 2023, without prejudice and the United States filed an amended complaint on May 22, 2023. A second motion to dismiss by the Defendants and an opposition filed by the United States were pending before the court at the time of resolution.
Press Release Letter of Findings
Press Release Settlement Agreement
Alabama Medicaid
On December 5, 2022, the United States executed a settlement agreement with the state of Alabama's Medicaid Agency (Alabama Medicaid), under Title II of the ADA regarding access to health services. The agreement will ensure that Alabama Medicaid recipients with Hepatitis C (HCV) who also use alcohol or illicit drugs, including those with a substance abuse disorder (SUD), will be provided equal access to medications to treat their hepatitis. Alabama Medicaid previously maintained a sobriety restriction policy that prevented any person with HCV who had used any alcohol or illicit drugs within the six months prior to treatment initiation from receiving potentially life-saving medication to cure their HCV. Alabama Medicaid has withdrawn the policy and the agreement requires notification to Medicaid recipients and Medicaid providers of these changes and prompt remediation of any instances where the prior policy is applied.
On January 24, 2024, the Departments of Justice and Health and Human Services issued a Dear Colleague Letter to state Medicaid administrators urging them to ensure that their Medicaid programs allow access to life-saving medications for people with Hepatitis C (HCV), regardless of whether or not they also have substance use disorder (SUD), in accordance with the Americans with Disabilities Act.
Strickland v. Delaware County
On December 11, 2023, the Department of Justice filed a statement of interest in Strickland v. Delaware County, a lawsuit in the U.S. District Court for the Eastern District of Pennsylvania in which the plaintiff alleged that the George W. Hill Correctional Facility in Delaware County unlawfully denied him access to methadone that he was taking to treat OUD under the supervision of a qualified medical provider before his incarceration. The plaintiff further alleged that the jail had a blanket policy of only providing access to methadone for pregnant individuals and that all other individuals on methadone when entering the jail were put through medically supervised withdrawal. The department's statement of interest explains that Title II of the ADA prohibits jails from categorically restricting access to Food and Drug Administration-approved OUD medications, like methadone, without individually assessing whether the person being denied access needs that medication to effectively treat their disability.
Allegheny County Jail
On November 30, 2023, Allegheny County agreed to offer treatment with any FDA-approved medication for opioid use disorder (OUD) to all individuals booked into the Allegheny County Jail (ACJ) for whom such treatment is medically appropriate. The County also agreed to pay $10,000 to an individual the United States alleged was unlawfully denied access to methadone in violation of Title II of the Americans with Disabilities Act. Under the three-year agreement, Allegheny County will implement new policies and personnel training programs to ensure that people with OUD incarcerated at ACJ receive medically appropriate treatment for their disability. This includes ensuring that all individuals who were receiving OUD medication from a licensed treatment provider before their incarceration are continued on that medication. The County will also offer the option to all individuals with OUD booked into ACJ to receive treatment with any FDA-approved OUD medication that is medically appropriate even if they were not being treated with that medication before their incarceration.
United States v. City of Blaine, Minnesota
On November 20, 2023, the United States filed a Complaint and proposed Consent Decree to resolve allegations that the City of Blaine, Minnesota violated Title I of the Americans with Disabilities Act by discriminating against an employee with alcohol use disorder. The lawsuit alleges that the city discriminated against the employee, who voluntarily disclosed that he was to undergo treatment, by requiring him to pay for alcohol and controlled substances testing and evaluation based on his disability. Under the Consent Decree, the City will implement non-discrimination policies and procedures, train its staff on the ADA, and pay out-of-pocket losses and compensatory damages to the complainant.
United States v. Cumberland County, Tennessee
On January 18, 2023, the United States filed its Complaint and proposed Consent Decree to resolve allegations that Cumberland County, Tennessee violated Title I of the Americans with Disabilities Act by denying a corrections officer a reasonable accommodation and constructively discharging/terminating him based on his disability of opioid use disorder. In addition, the County implemented a policy that prevents people who are taking legally prescribed controlled substances or certain medications from having those substances or medications present in their system while at work for the County, thus prohibiting working for the County while taking such medications. Under the Consent Decree, Cumberland County will implement non-discrimination policies and procedures, train its staff on the ADA, and pay a total of $160,000 to the complainant.
Indiana State Board of Nursing
On March 25, 2022, the United States found that the Indiana State Board of Nursing violated Title II of the ADA by prohibiting the use of disability-related medication to treat opioid use disorder (OUD) by nurses enrolled in the Indiana State Nursing Assistance Program. Participation in the program, which assists in the rehabilitation of and monitors nurses recovering from drug or alcohol addiction, is in many cases required for nurses recovering from addiction to maintain, or have reinstated, an active nursing license necessary for employment.
On September 1, 2022, the United States reached an agreement to resolve its findings that the Nursing Board violated Title II of the ADA. The Nursing Board has agreed to permit nurses to participate, on equal terms, in the states’ rehabilitation program while taking medication, including medication to treat OUD, when the medication is prescribed by a licensed practitioner as part of a medically necessary treatment plan and incorporated into a recovery monitoring agreement. The Nursing Board has also agreed to pay damages to the complainant, and to report periodically on its compliance to the United States.
Next Step Healthcare LLC
On April 28, 2022 the U.S. Attorney’s Office for the District of Massachusetts reached a settlement agreement with Next Step Healthcare LLC., under Title III of the ADA, to resolve the allegation that the complainant was discriminated against in their application for admission to the facility based on the use of medications for Opioid Use Disorder. The agreement includes adoption of a non-discrimination policy, training of staff, written notification to the Department of future complaints, and $92,383.00 as a civil penalty.
Massachusetts Trial Court
On March 24, 2022, the U.S. Attorney's Office for the District of Massachusetts entered into a settlement agreement with the Massachusetts Trial Court under Title II of the ADA to resolve its investigation of the public entity for discrimination against individuals with disabilities on the basis of Opioid Use Disorder (OUD). The agreement resolves a complaint filed with the U.S. Attorney’s Office that the Trial Court discriminated against drug court participants taking Medication for Opioid Use Disorder (MOUD). Under the terms of the agreement, all 25 of the Massachusetts drug courts will implement the Trial Court’s new policy in which only licensed prescribers or opioid treatment programs (OTP) will make decisions regarding a participant’s treatment plan, including the type of medication and dosage. Treatment plans will be developed by the licensed prescriber or OTP after conducting an individualized assessment for each participant.
Ready to Work
On March 17, 2022, the United States executed a settlement agreement with Ready to Work, a not-for-profit residential, work, and social services program for individuals who are homeless. The agreement resolves a complaint under Title III of the Americans with Disabilities Act (ADA) that Ready to Work discriminated against an individual with opioid use disorder (OUD) by denying her admission to its residential, work, and social services program because she uses a prescribed medication to treat her OUD. The agreement requires Ready to Work to adopt non-discrimination policies, train staff on its non-discrimination obligations, and report on compliance. Ready to Work will also pay $7,500 in damages to the complainant.