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Press Release

Justice Department Settles with Missouri Eating Disorder Clinic Over HIV Discrimination

For Immediate Release
Office of Public Affairs

The Justice Department announced today that, as part of its Barrier-Free Health Care Initiative, it has reached a settlement with Castlewood Treatment Center LLC, of St. Louis, Mo., under the Americans with Disabilities Act (ADA).  The settlement resolves allegations that Castlewood Treatment Center violated the ADA by refusing to treat a woman for a serious eating disorder because she has HIV.  This is the second settlement addressing HIV discrimination by a medical provider reached by the Justice Department in two weeks. 

The Justice Department found that Castlewood refused to treat Susan Gibson because of her HIV, despite Castlewood’s determination that she was qualified to receive counseling treatment for her eating disorder, and despite advice from its own medical staff that they were able to treat someone with HIV at Castlewood.  The department also determined that for months Castlewood staff told Gibson that she was on a waiting list for the program, even though they had no intention to admit her into the program.  In the meantime, Gibson’s condition worsened and her health declined.  Castlewood’s actions delayed Gibson from receiving appropriate medical treatment for up to seven months.  Gibson’s complaint was brought to the Justice Department’s attention by the American Civil Liberties Union, LGBT & AIDS Project.

“Excluding a person from necessary medical treatment solely because of HIV is unconscionable,” said Thomas E. Perez, Assistant Attorney General for the Civil Rights Division.  “The Civil Rights Division takes HIV discrimination in any form seriously, and will not allow for the marginalization of those living with HIV.” 

Under the settlement, the Castlewood Treatment Center must pay $115,000 to Gibson and $25,000 in civil penalties.  In addition, Castlewood must train its staff on the ADA and develop and implement an anti-discrimination policy.  The department will monitor Castlewood’s compliance for four years.

Last week the department announced a similar agreement with the Fayetteville Pain Center to address HIV discrimination.  Both settlements are part of the Department of Justice’s Barrier-Free Health Care Initiative, a partnership of the Civil Rights Division and U.S. Attorney’s offices across the nation, to target enforcement efforts on a critical area for individuals with disabilities.  The initiative, launched on the 22nd anniversary of the ADA in July 2012, includes the participation of 40 U.S. Attorney’s offices.  The division expects the initiative to address access to health care for people with HIV and those with hearing disabilities, as well as physical access to medical facilities.  In 2012, the division and U.S. Attorneys offices reached two settlement agreements regarding access to medical care for people with HIV and four settlements regarding access to medical care for people with hearing disabilities.  For more information on the Barrier Free Health Care Initiative visit

For more information on the ADA and HIV visit   Those interested in finding out more about these settlements or the obligations of public accommodations under the ADA may call the Justice Department’s toll-free ADA information line at 800-514-0301 or 800-514-0383 (TDD), or access its ADA website at  ADA complaints may be filed by email to

Related Materials:

Castlewood Settlement Agreement

Updated August 7, 2015

Press Release Number: 13-165