Case: DOJ Investigation of the Indiana State Board of Nursing

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Case Summary

In this out-of-court matter, brought under Title II of the Americans with Disabilities Act (ADA), the U.S. Justice Department (DOJ) found on March 25, 2022, that the Indiana State Board of Nursing violated the ADA by prohibiting nurses who take medication to treat Opioid Use Disorder (OUD)--such as methadone and buprenorphine (Suboxone)--from participating in the Indiana State Nursing Assistance Program. The program assists in rehabilitating and monitoring nurses with substance use disorders, a…

In this out-of-court matter, brought under Title II of the Americans with Disabilities Act (ADA), the U.S. Justice Department (DOJ) found on March 25, 2022, that the Indiana State Board of Nursing violated the ADA by prohibiting nurses who take medication to treat Opioid Use Disorder (OUD)--such as methadone and buprenorphine (Suboxone)--from participating in the Indiana State Nursing Assistance Program. The program assists in rehabilitating and monitoring nurses with substance use disorders, and is often required for these nurses to maintain an active license or have one reinstated. 

DOJ opened its investigation after receiving a complaint from a nurse that in 2017, she was denied participation in the State Nursing Assistance Program because she takes buprenorphine for OUD; she was told she would have to taper off the medication within three months. The investigation corroborated her complaint, and noted that tapering off medication poses a significant risk of relapse and harm.

DOJ found that by requiring the complainant to taper off her prescribed medication as a condition to ISNAP participation, the Nursing Board discriminated against her on the basis of disability. It explained that under the ADA, the Nursing Board is required to make reasonable modifications to its policies, practices, or procedures when necessary to avoid discrimination on the basis of disability, unless the public entity can demonstrate that doing so would fundamentally alter the nature of the service, program, or activity. DOJ determined that the Board's no-medication criteria were not necessary for the provision of its program. 

It sought prompt corrective measures, including: 1. A change in policy, including an explicit policy that that the Nursing Board, and its contracted vendors, may not discriminate against, exclude from participation, or deny the benefits of its services, programs, or activities—including ISNAP—to qualified individuals with disabilities because they have OUD. 2. Training of Nursing Board staff and the staff of ISNAP vendors about OUD and the nondiscrimination requirements of Title II of the ADA. 3. Compensatory damages to the complainant and other aggrieved individuals . 4. Written status reports. 

On September 1, 2022, the DOJ announced that it reached an agreement with the Nursing Board. Under the terms of the agreement, the Nursing Board agreed to allow nurses to participate in the states’ rehabilitation program while taking medication, including medication to treat OUD, when the medication was prescribed as part of a medically necessary treatment plan covered by a recovery monitoring agreement. In addition, the Nursing Board agreed to revise its written polices to ensure that nurses taking prescribed medications for OUD were not subjected to discriminatory conditions or terms. The Nursing Board also agreed to pay $70,000 in damages to the complainant. The agreement was to last two years, and the parties agreed to reports every six months.

As of November 2023, reporting is ongoing.

Summary Authors

Jonah Hudson-Erdman (4/19/2022)

Simran Takhar (11/9/2023)

Documents in the Clearinghouse

Docket

Last updated Aug. 30, 2023, 1:43 p.m.

Docket sheet not available via the Clearinghouse.

Case Details

State / Territory: Indiana

Case Type(s):

Disability Rights

Key Dates

Case Ongoing: Yes

Plaintiffs

Plaintiff Description:

U.S. Department of Justice, Civil Rights Division, Disability Rights Section

Attorney Organizations:

U.S. Dept. of Justice Civil Rights Division

Public Interest Lawyer: Yes

Filed Pro Se: No

Class Action Sought: No

Class Action Outcome: Not sought

Defendants

Indiana State Board of Nursing (Indianapolis, Marion), State

Indiana, State

Defendant Type(s):

Jurisdiction-wide

Hospital/Health Department

Case Details

Causes of Action:

Americans with Disabilities Act (ADA), 42 U.S.C. §§ 12111 et seq.

Special Case Type(s):

Out-of-court

Available Documents:

Findings Letter/Report

Outcome

Prevailing Party: Plaintiff

Nature of Relief:

Injunction / Injunctive-like Settlement

Damages

Source of Relief:

Settlement

Form of Settlement:

Private Settlement Agreement

Amount Defendant Pays: $70,000

Order Duration: 2022 - None

Issues

General/Misc.:

Public benefits (includes, e.g., in-state tuition, govt. jobs)

Rehabilitation

Disability and Disability Rights:

Opioid disorder/medication

Reasonable Accommodations

Discrimination Area:

Accommodation / Leave

Discrimination Basis:

Disability (inc. reasonable accommodations)

Medical/Mental Health Care:

Medical care, general

Medication, administration of