In a groundbreaking case that could help to define the rights of recovering drug addicts, a federal judge in Scranton has ruled that the Pennsylvania Board of Nursing must answer a lawsuit that says the agency has a secret, unwritten policy that forbids any nurse from holding a license while receiving methadone treatment for a chronic opioid addiction.
Requiring nurses who are recovering from heroin addiction to prove that they are "weaned" from methadone may be found to violate the Americans with Disabilities Act, U.S. District Judge James M. Munley held in Reynolds v. Commonwealth of Pennsylvania.
"Plaintiff has been forced to choose between abandoning a successful treatment for her addiction and ending her career as a nurse," Munley wrote.
The ruling is a victory for attorneys Lawrence D. Berger of Shepherd Finkelman Miller & Shah in Media, Pa., and Michael Churchill of the Public Interest Law Center of Philadelphia.
The plaintiff, Melinda Lamberson Reynolds, claims in the suit that she has been a nurse for more than 25 years, and has been taking methadone treatments ever since her recovery from a heroin addiction in the 1970s and 1980s.
Methadone, the suit says, does not impair cognitive function or limit mental capability, intelligence or the ability to maintain employment. And "methadone maintenance" treatment is a "reasonable accommodation" that allows opioid-dependent people to perform the essential functions of a job like nursing safely and skillfully.
Pennsylvania's alleged policy of refusing to issue a nursing license to anyone who is on methadone is a "secret" one, the suit says, because state officials will not admit to its existence. Instead, the suit says, the nursing board enforces it by requiring any nurse with opioid addiction to take treatment at a state-approved facility and none of the methadone clinics are ever approved to be on that list.
Senior Deputy Attorney General Michael L. Harvey moved to have the suit dismissed, arguing that state agencies and officials are immune under the 11th Amendment from being sued under the ADA, and that the members of the state Board of Nursing are entitled to quasi-judicial immunity for their decisions.
In response, the plaintiffs lawyers argued that neither immunity applied and that Reynolds is not seeking court review of how her case was handled, but is instead challenging the alleged secret policy that forbids ever granting a nursing license to someone on methadone.
Munley found that the U.S. Supreme Court has held states are immune to suits under Title I of the ADA, which governs employment discrimination, because Congress never properly abrogated the immunity.
But Munley found that for claims under Title II of the ADA -- which governs access to state programs and facilities -- the justices held in Tennessee v. Lane that state courts must be open to the disabled.
Although the Lane ruling was explicitly narrow and applied only to access to state courts, Munley found that the alleged Pennsylvania nurse-licensing policy is also subject to an ADA suit.
The plaintiff, Munley noted, contends that officials denied her the right to practice nursing because she is a drug addict who uses methadone -- a policy that the suit alleges is not rational since methadone makes it possible for her safely to perform her job.
But Harvey argued that Congress never developed a legislative record of discrimination in issuing and suspending professional licenses.
Munley sided with the plaintiffs, finding that Congress properly abrogated the 11th Amendment immunity for such a claim by citing "a history and pattern of discrimination by the states in the provision of services to persons with disabilities."
As applied to state licensing and regulation of medical professionals, Munley said, "the remedies provided in Title II of the ADA are congruent and proportional to the problem of disability discrimination identified by Congress."
Munley also rejected Harvey's argument that the doctrine of quasi-judicial immunity bars the plaintiff's claims against the individual members of the nursing board.
The suit, Munley said, was not lodged as a challenge to the nursing board's decision, but as a challenge to the underlying policy that drove the decision.
"Taking all the plaintiff's allegations in the light most favorable to her, she alleges that defendants formulated a policy designed to deny anyone on methadone maintenance a nursing license. The lawsuit is about the formulation of this policy, not the decision to suspend plaintiff because of it," Munley wrote.
Neither Harvey nor Berger could be reached immediately for comment.