Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-almd-2_11-cv-00224/USCOURTS-almd-2_11-cv-00224-3/pdf.json

Nature of Suit Code: 446
Nature of Suit: Americans with Disabilities Act - Other
Cause of Action: 42:12101 Americans with Disabilities Act

---

IN THE DISTRICT COURT OF THE UNITED STATES FOR THE

MIDDLE DISTRICT OF ALABAMA, NORTHERN DIVISION

LOUIS HENDERSON, et al., )

 )

Plaintiffs, )

 ) CIVIL ACTION NO.

v. ) 2:11cv224-MHT

 ) (WO)

KIM THOMAS, Commissioner, )

Alabama Department of )

Corrections, et al., )

 )

Defendants. )

 OPINION AND ORDER

The eight named plaintiffs (Louis Henderson, Dana

Harley, Darrell Robinson, Dwight Smith, Albert Knox,

James Douglas, Alqadeer Hamlet, and Jeffery Beyer) bring

this lawsuit on behalf of themselves and a class of all

current and future HIV+ prisoners incarcerated in Alabama

Department of Corrections (ADOC) facilities. They

challenge ADOC’s policy of segregating HIV+ inmates from

the general prison population. They have named as

defendants ADOC Commissioner Kim Thomas and the wardens

of the four ADOC facilities that house HIV+ inmates.

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The plaintiffs claim that the HIV-segregation policy

discriminates against them on the basis of a disability

(HIV+ status) in violation of Title II of the Americans

with Disabilities Act (ADA), 42 U.S.C. § 12101 et seq.,

and § 504 of the Rehabilitation Act, 29 U.S.C. § 794.

Jurisdiction is proper under 28 U.S.C. § 1331 (federal

question). 

The case is currently before the court on the

defendants’ motion to dismiss. The defendants argue that

dismissal is warranted (1) because the action is barred

by res judicata; (2) because the plaintiffs have failed

to state a claim for which relief can be granted; (3)

under the Prison Litigation Reform Act of 1995 (PLRA),

110 Stat. 1321; and 4) on sovereign-immunity grounds.

For the reasons that follow, the court denies the motion

to dismiss, but sets aside the res judicata issue until

a ruling on the merits.

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I. MOTION-TO-DISMISS STANDARD

In considering the defendants’ motion to dismiss, the

court accepts the plaintiffs’ allegations as true, Hishon

v. King & Spaulding, 467 U.S. 69, 73 (1984), and

construes the complaint in the plaintiffs’ favor. Duke

v. Cleland, 5 F.3d 1399, 1402 (11th Cir. 1993). To

survive a motion to dismiss, a complaint must present

“enough facts to state a claim to relief that is

plausible on its face.” Bell Atl. Corp. v. Twombly, 550

U.S. 544, 570 (2007). “Threadbare recitals of the

elements of a cause of action, supported by mere

conclusory statements, do not suffice.” Ashcroft v.

Iqbal, 556 U.S. 662, 678 (2009). A complaint satisfies

the plausibility standard when “the plaintiff pleads

factual content that allows the court to draw the

reasonable inference that the defendant is liable for the

misconduct alleged.” Id.

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II. BACKGROUND

A. ADOC’s HIV-Segregation Policy

Alabama law requires HIV testing for all prisoners.

1975 Ala. Code §§ 22-11A-17 & 22-11A-38. Alabama

statutory and administrative law, however, is silent on

the segregation of HIV+ prisoners. In the absence of an

explicit policy, the plaintiffs point to several specific

ways in which ADOC’s HIV-segregation policy functions in

practice. At its core, the defendants’ HIV-segregation

policy dictates that HIV+ inmates are housed in separated

accommodations, both inter- and intra-facility, and

regardless of security classification.

Alabama has five levels of prisoner classification:

close-custody, medium, minimum-in, minimum-out, and

minimum-community. Security classification is a multifactor analysis that includes an individual’s criminal

history, past convictions, past violence, length of

sentence, and pendency of unresolved charges. Atchison

Affidavit (Doc. No. 47-1) ¶ 3. 

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Close-custody is “reserved for prisoners who have

demonstrated severe behavioral problems, some prisoners

sentenced to life without parole, and some detainees

awaiting trial or sentencing for capital offenses.”

Second Amended Complaint (Doc. No. 61) ¶ 37. Mediumcustody prisoners are held at medium- or close-security

institutions and are housed in double-occupancy cells or

dormitories. Medium-custody prisoners may receive work

assignments inside a secure facility. 

The “minimum” classification includes three subparts, all of which permit some type of work outside a

secure facility. Most important for present purposes,

only minimum-out and minimum-community inmates may

transfer to a work-release center. Atchison Affidavit

(Doc. No. 47-1) ¶ 5. 

The plaintiffs allege that, despite this

classification system, all HIV+ inmates are housed in

four facilities. Male HIV+ inmates are housed at either

Limestone Correctional Facility or Decatur Work

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Release/Community Work Center. Female HIV+ inmates are

housed at either Julia Tutwiler Prison for Women or the

Montgomery Women’s Facility. 

The centerpiece of Alabama’s segregation policy is

that HIV+ prisoners are housed at certain facilities and

completely barred from others. For instance, male

inmates who have a six-month clear record may apply to

transfer to a facility closer to their families. Id.

¶ 13. While no inmate has a right to transfer, HIV+ male

inmates are prohibited entirely from transferring. Thus,

the male plaintiffs are barred from approximately two

dozen facilities around the State.

The HIV-segregation policy is replicated within

facilities. At Limestone, all HIV+ prisoners are housed

on the A-Side. HIV+ prisoners, therefore, are excluded

from the general population area in B-Side and the FaithBased Honor Dorm in C-Side. They are also barred from

the senior dormitory in A-Side. Limestone separates HIV+

prisoners by forcing them to wear white armbands, thereby

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disclosing their health status to fellow prisoners,

staff, and visitors.

Because Alabama has far fewer female inmates, it

maintains only one secure institution (Julia Tutwiler

Prison for Women) and two work-release facilities for

women. Within Tutwiler, HIV+ prisoners are housed in two

of 15 housing units: an HIV dormitory and the healthcare

unit. Despite these differences in institutional

setting, the HIV-segregation policy as applied to females

mirrors the male counterpart.

The plaintiffs further allege that ADOC utilizes a

discriminatory medical-clearance policy when deciding

which inmates to send to work-release facilities.

According to the plaintiffs, the policy forces inmates to

start antiretroviral medications before their viral loads

require it. Second Amended Complaint (Doc. No. 61) ¶ 86.

The plaintiffs, therefore, allege discriminatory

treatment in transferring male prisoners to Decatur Work

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Release and female prisoners to Montgomery Women’s

Facility. Id. ¶¶ 89-90. 

Additionally, the plaintiffs allege that ADOC’s

segregation policy excludes them from certain programs.

HIV+ inmates, for example, are barred from the

residential component of any program, such as Limestone’s

substance-abuse program. And by implication, the

plaintiffs are barred from programs at the majority of

ADOC’s prisons. This includes several programs that are

not available at Limestone, such as agricultural programs

at J.O. Davis Correctional facility, trade schools at

Staton Correctional Center, and a secular substance abuse

program at Easterling Correctional facility. Id. ¶¶ 101-

103. The HIV-segregation policy extends beyond

residential areas and prohibits HIV+ inmates from

obtaining food-service employment. Finally, the

plaintiffs assert that the HIV-segregation policy results

in disparate punishment and the unlawful disclosure of

their medical status.

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B. Prior Litigation

Alabama first instituted its HIV-segregation policy

in the 1980s, when widespread public concern over

HIV/AIDS prompted the overwhelming majority of States to

isolate HIV+ prisoners. But once the sources of HIV

transmission were firmly established, many States

rescinded these policies. By 1994, only six States had

HIV+ segregation policies. Today, only Alabama and South

Carolina maintain a policy of isolating all HIV+

prisoners in separate housing units. 

This is not the first lawsuit challenging the

segregation of HIV+ prisoners in Alabama. In 1987,

prisoners challenged the segregation of recreational,

religious, and educational programs under the

Rehabilitation Act. After a decade of litigation, the en

banc Eleventh Circuit Court of Appeals held that HIV+

prisoners were not “otherwise qualified” under the

Rehabilitation Act and that no “reasonable

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1. The Onishea plaintiffs also brought an Eighth

Amendment claim, which was rejected.

10

accommodations” were required. Onishea v. Hopper, 171

F.3d 1289 (11th Cir. 1999) (en banc).1

The Eleventh Circuit premised its ruling on an

exception to § 504 of the Rehabilitation Act. The

statute excludes from its definition of an “otherwise

qualified individual with a disability” those persons

that have a “‘currently contagious disease or infection

and who, by reason of such disease or infection, would

constitute a direct threat to the health or safety of

other individuals.’” Id. at 1296-97 (quoting 29 U.S.C.

§ 705(20)(D)). 

This statutory exception codified the Supreme Court’s

ruling in School Board of Nassau County v. Arline, 480

U.S. 273 (1987). Under Arline, four factors determine

whether the contagious-disease exception applies:

“[F]indings of fact, based on reasonable

medical judgments given the state of

medical knowledge, about (a) the nature

of the risk (how the disease is

transmitted), (b) the duration of the

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risk (how long is the carrier

infectious), (c) the severity of the

risk (what is the potential harm to

third parties) and (d) the probabilities

the disease will be transmitted and will

cause varying degrees of harm.”

Id. at 288 (alteration in original). In weighing these

factors, Arline instructs courts to “defer to the

reasonable medical judgments of public health officials”

when making these findings of fact. Id. The Arline

Court concluded that a person “who poses a significant

risk of communicating an infectious disease to others ...

will not be otherwise qualified ... if reasonable

accommodation will not eliminate that risk.” Id. at 287

n.16 (emphasis added). Thus, the contagious-disease

exception requires courts not only to examine the risk

associated with the disease but also to make findings

about whether a reasonable accommodation can ameliorate

that risk.

In Onishea, the Eleventh Circuit, building on the

Arline test, emphasized: “In the state of medical

knowledge and art at the time of trial, HIV infection

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inevitably progressed to AIDS. AIDS always led to death,

often after lengthy suffering.” Onishea, 171 F.3d at

1293. Given this premise, the court of appeals held

that, when “transmitting a disease inevitably entails

death, the evidence supports a finding of ‘significant

risk’ if it shows both (1) that a certain event can occur

and (2) that according to reliable medical opinion the

event can transmit the disease.” Id. at 1299. The

Eleventh Circuit concluded that the evidence adduced at

trial established that HIV posed a “significant risk” in

the prison context. 

In 1997, while Onishea was pending, another group of

HIV+ prisoners filed suit in this court, claiming that

Alabama’s segregation policy violated the ADA and the

Eighth Amendment. Edwards v. Alabama Dep’t of Corr., 81

F. Supp. 2d 1242 (M.D. Ala. 2000) (Thompson, J.). With

regards to the ADA claim, this court held that it was

identical to the Onishea plaintiffs’ Rehabilitation Act

claim and was precluded under res judicata. Id. at 1249.

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This court noted that “nothing in [its] opinion should be

taken to hold that the court has rejected the application

of a changed-circumstances argument to the plaintiffs’

ADA claim.” Id. at 1250 n.2. 

Regarding the Eighth Amendment claim, this court

found res judicata inapplicable because of changed

factual conditions. Id. at 1250. The Eighth Amendment

claim, however, was dismissed because the plaintiffs

failed to exhaust their administrative remedies under the

PLRA. Id. at 1256-57.

Shortly after Edwards, a class action was brought

challenging the constitutional adequacy of medical care

for HIV+ inmates at Limestone Correctional Facility. A

consent decree was entered in 2004 and terminated in

2006. See Settlement Agreement, Leatherwood v. Campbell,

No. CV-02-BE-2812 (N.D. Ala. Apr. 29, 2004) (Bowdre, J.).

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C. This Suit

Eight plaintiffs brought this suit under the

Rehabilitation Act and the ADA. According to the

allegations in the complaint, plaintiffs Louis Henderson,

Darrell Robinson, Albert Knox, James Douglas, and Jeffery

Beyer are housed at Limestone; plaintiffs Dwight Smith

and Alqadeer Hamlet are housed at Decatur Work Release;

and plaintiff Dana Harley is housed at Tutwiler.

The named plaintiffs are just a fraction of the

approximately 260 HIV+ inmates in the Alabama prison

system. They represent a class of all prisoners

diagnosed with HIV in the custody of ADOC, now and in the

future. Henderson v. Thomas, 2012 WL 3777146 (M.D. Ala.

2012) (Thompson, J.)

Five state officials are sued in their official

capacities: Kim Thomas, Commissioner of the Alabama

Department of Corrections; Billy Mitchem, warden at

Limestone; Frank Albright, warden at Tutwiler; Bettina

Carter, warden at Decatur Work Release/Community Work

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Center; and Edward Ellington, warden at Montgomery

Women’s Facility. 

The plaintiffs seek prospective relief: a declaratory

judgment that the segregation policy violates the ADA and

the Rehabilitation Act and an injunction against its

further enforcement. The plaintiffs seek no money

damages.

III. DISCUSSION

A. Res Judicata

The defendants raise the affirmative defense of res

judicata as a bar to the “re-litigation” of its HIVsegregation policy. Res judicata prohibits a subsequent

action if four elements are present: “(1) a final

judgment on the merits, (2) rendered by a court of

competent jurisdiction, (3) the parties, or those in

privity with them, must be identical in both suits, and

(4) the same cause of action must be involved in both

cases.” Hart v. Yamaha-Parts Distributors, Inc., 787 F.2d

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2. The defendants do not rely on the Leatherwood

class action for their res judicata argument. See

Defendants’ Brief (Doc. No. 35) at 12 n.5 (“While there

are reasonable grounds to conclude that the Named

Plaintiffs are collaterally estopped from bringing their

claims by virtue of Leatherwood, the preclusive effect of

the other actions is such that the Court need not even

consider any collateral estoppel resulting from the

Leatherwood matter.”). In any event, the Leatherwood

plaintiffs raised an Eighth Amendment claim, not a

disability claim.

The defendants also cite a recent 42 U.S.C. § 1983

suit brought by an HIV+ prisoner at Limestone who

challenged the prison’s armband policy as a violation of

his constitutional right to privacy under the Fourteenth

Amendment. Id. at 16 n.8. The Eleventh Circuit

concluded that the defendants were entitled to qualified

immunity. Reed v. Allen, 379 Fed. App’x 879 (11th Cir.

2010). Reed is inapposite because, among other reasons,

it is premised on a constitutional claim.

16

1468, 1470 (11th Cir. 1986). The defendants contend that

the plaintiffs’ claims under the Rehabilitation Act and

the ADA are identical to those raised in Onishea and

Edwards.

As described above, the same class of plaintiffs

failed in their challenges to this policy in Onishea and

Edwards.2

 In Onishea, the plaintiffs brought suit under

the Rehabilitation Act and the Eighth Amendment.

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Edwards, 81 F. Supp. 2d at 1246-47 (summarizing the

decade-long history of the Onishea litigation). In

Edwards, the plaintiffs’ claims were brought under the

ADA and the Eighth Amendment. Id. at 1245.

The plaintiffs concede that the first three elements

of res judicata are satisfied. Plaintiffs’ Brief (Doc.

No. 37) at 2. The plaintiffs, however, argue that the

defendants cannot meet the fourth element because of

changed-factual circumstances. Relying on Edwards, the

plaintiffs argue that the “‘determinative factor in

ascertaining whether two causes of action are identical

for res judicata purposes is not only whether the same

legal claim is asserted, but also whether the factual

underpinnings of the causes of action are constant.’” Id.

(quoting Edwards, 81 F. Supp. 2d at 1249); see also

Edwards, 81 F. Supp. 2d at 1248 (“It is now said, in

general, that if a case arises out of the same nucleus of

operative fact, or is based upon the same factual

predicate, as a former action, that the two cases are

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really the same ‘claim’ or ‘cause of action’ for purposes

of res judicata.”) (internal quotation marks omitted).

The plaintiffs contend that the “central factual

premise of the Onishea decision--that HIV infection

inevitably progresses to AIDS and then to death-–is no

longer true.” Plaintiffs’ Brief (Doc. No. 37) at 3.

Since the introduction of highly active antiretroviral

therapy in 1997, HIV has gradually become a “manageable

chronic condition.” Id. at 4-5. These changed

circumstances, in turn, impact the “significant risk”

standard for contagious diseases under the ADA and

Rehabilitation Act. 

Because this issue requires an examination of the

past and present state of HIV treatments, this court need

not address the res judicata issue now. As a general

rule, an affirmative defense, such as res judicata, “will

not support a [Fed. R. Civ. P.] 12(b)(6) motion to

dismiss for failure to state a claim.” Fortner v.

Thomas, 983 F.2d 1024, 1028 (11th Cir. 1993). Only when

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3. Although not mentioned by either side, the court

notes that Congress’s recent amendments to the ADA may

supply a basis for changed legal conditions.

Specifically, the ADA now lists “functions of the immune

system” as a major bodily function. 42 U.S.C.

§ 12102(2)(B). This amendment may reflect congressional

concern that diseases that affect the immune system–-such

(continued...)

19

the “defense’s existence can be judged on the face of the

complaint” may a court grant a motion to dismiss on a res

judicata ground. Concordia v. Bendekovic, 693 F.2d 1073,

1075 (11th Cir. 1982). If more information is necessary

to adjudicate the res judicata defense, then the court

must treat the motion “as if it were a motion for summary

judgment under [Fed. R. Civ. P.] 56.” Id. 

At oral argument on September 16, 2011, counsel for

the defendants indicated that discovery related to the

changed-circumstances argument was appropriate in order

for the court to make an informed decision about the

recent improvements in HIV treatments. Oral Argument

Transcript (Doc. No. 56) at 30-32. The court, therefore,

sets aside the res judicata issue for the moment and will

make a ruling after the bench trial.3

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(...continued)

as HIV and AIDS-–merit protection under federal antidiscrimination statutes. See also infra Section III.B.1.

4. The defendants also argued that Governor Robert

Bentley was improperly named as a defendant in this

action. After an agreement between the parties at oral

argument on September 16, 2011, the court dismissed

Governor Bentley as a defendant. See Doc. No. 53.

20

B. Failure to State a Claim

The defendants raise three Fed. R. Civ. P. 12(b)(6)

arguments that the plaintiffs’ complaint fails to state

a claim. First, they argue that the “Plaintiffs’ cursory

non-descript allegations of ‘discrimination’” runs afoul

of the plausibility standard. (Doc. No. 35) at 22.

Second, they contend that the plaintiffs have no right to

be incarcerated at any particular facility. Third, the

defendants submit that prisoners have no right to

confidentiality relating to their HIV status.4

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1. The Plausibility Standard

A complaint must present “enough facts to state a

claim to relief that is plausible on its face.” Twombly,

550 U.S. at 570. Thus, “[t]hreadbare recitals of the

elements of a cause of action, supported by mere

conclusory statements, do not suffice.” Iqbal, 556 U.S.

at 678. The defendants submit that the plaintiffs have

failed to state sufficient facts to establish a claim

under Title II of the ADA and § 504 of the Rehabilitation

Act.

In the Eleventh Circuit, the “causes of action under

Title II of the ADA and the Rehabilitation Act are

essentially identical.” Everett v. Cobb County Sch.

Dist., 138 F.3d 1407, 1409 (11th Cir. 1999). The only

salient difference is that a claim under the

Rehabilitation Act can be brought only against a

recipient of federal funding, a fact that the defendants

concede. Defendants’ Brief (Doc. No. 35) at 25 n.10.

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Thus, for purposes of this opinion, the court uses the

two statutes interchangeably.

To state a claim under Title II of the ADA, a

plaintiff must demonstrate that he “(1) is disabled, (2)

is a qualified individual, and (3) was subjected to

unlawful discrimination because of [his] disability.”

Waddell v. Valley Forge Dental Assoc., Inc., 276 F.3d

1275, 1279 (11th Cir. 2001) (internal quotation marks

omitted) (alteration in original). 

Under these statutes, a “disability” is defined as

“(A) a physical or mental impairment that substantially

limits one or more major life activities of such

individual; (B) a record of such an impairment; or (C)

being regarded as having such an impairment.” 42

U.S.C. § 12102(1). In this suit, the plaintiffs have

alleged that they have an existing physical impairment

that substantially limits a major-life activity. Second

Amended Complaint (Doc. No. 61) ¶ 105.

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A disability under the statutory scheme, therefore,

is (1) a physical or mental impairment that (2)

substantially limits (3) a major-life activity. An

impairment is not necessarily a disability under the

statutory definition; the impairment must substantially

limit a major-life activity. See Adams v. Rice, 531 F.3d

936, 943-44 (D.C. Cir. 2008) (distinguishing an

impairment and a disability).

Under the ADA Amendments Act of 2008, a major-life

activity includes, but is not limited to, “caring for

oneself, performing manual tasks, seeing, hearing,

eating, sleeping, walking, standing, lifting, bending,

speaking, breathing, learning, reading, concentrating,

thinking, communicating, and working.” 42 U.S.C.

§ 12102(2)(A). The statutory definition of major-life

activities also encompasses “major bodily functions”

which “includes the operation of a major bodily function,

including but not limited to, functions of the immune

system, normal cell growth, digestive, bowel, bladder,

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neurological, brain, respiratory, circulatory, endocrine,

and reproductive functions.” Id. § 12102(2)(B) (emphasis

added).

The defendants contend that the plaintiffs have not

pled sufficient facts to establish that their HIV status

substantially limits a major-life activity. The

defendants believe that the complaint is deficient in

multiple ways.

First, according to the defendants, the “Named

Plaintiffs must present an individual assessment of

whether HIV substantially limits a ‘major life activity’

of a particular plaintiff.” Defendants’ Brief (Doc. No.

39) at 13 (citing Toyota Motor Mfg., Ky., Inc. v.

Williams, 534 U.S. 184, 194 (2002)). 

 The complaint specifies that each named plaintiff is

diagnosed with HIV. See, e.g., Second Amended Complaint,

(Doc. No. 61) ¶ 16 (Henderson); Id. ¶ 32 (Harley). The

complaint also provides information on the contemporary

medical consensus regarding HIV treatment. Id. ¶¶ 1, 4-

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5. The defendants concede that HIV is a physical

impairment under the ADA. See Defendants’ Brief (Doc.

No. 39) at 13. At oral argument, the defendants also

agreed that the complaint alleges that the “major life

activity” at issue in this litigation is the immune

system. Oral Argument Transcript (Doc. No. 56) at 35.

25

5, 41-42. The plaintiffs further allege that “HIV is an

impairment of the immune system that substantially limits

a person with HIV in one or more major-life activities.

It is therefore a disability within the meaning of 42

U.S.C. § 12102(1)(A) [Title II of the ADA] and 29 U.S.C.

§ 705(9)(B) [Rehabilitation Act].” Id. ¶ 105.5

 Given

these allegations, it is “plausible on its face” that

every one of the HIV+ plaintiffs suffers from an

impairment (HIV) that substantially limits a major-life

activity (the immune system). Twombly, 550 U.S. at 570.

Second, the defendants contend that the plaintiffs

have failed to plead sufficient facts that there is no

“significant risk” of HIV infection if prisons are

integrated. Defendants’ Brief (Doc. No. 35) at 28.

Under Onishea, when “transmitting a disease inevitably

entails death, the evidence supports a finding of

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‘significant risk’ if it shows both (1) that a certain

event can occur and (2) that according to reliable

medical opinion the event can transmit the disease.”

Onishea, 171 F.3d at 1299. If the plaintiffs’ HIV status

poses a “significant risk,” they are not considered

“otherwise qualified” under the statute and fall outside

its protections.

At this stage of the litigation, taking the

allegations in the complaint as true, the plaintiffs have

demonstrated that HIV does not pose the same “significant

risk” as it did in the 1990s. The court finds it

significant that the Eleventh Circuit anchored its ruling

on “the state of medical knowledge and art at the time of

trial.” Id. at 1293. In the early 1990s, “HIV infection

inevitably progressed to AIDS. AIDS always led to death,

often after lengthy suffering.” Id. at 1293. Given this

premise, the Eleventh Circuit held that when

“transmitting a disease inevitably entails death, the

evidence supports a finding of ‘significant risk’ if it

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shows both (1) that a certain event can occur and (2)

that according to reliable medical opinion the event can

transmit the disease.” Id. at 1299. 

The complaint provides detailed allegations regarding

the recent improvement in HIV treatments. See, e.g.,

Second Amended Complaint (Doc. No. 61) ¶ 4 (“By the mid1990s, however, new classes of antiretroviral medications

proved extremely effective at suppressing the virus.

These medications changed HIV from a fatal disease to a

chronic condition that can be successfully treated.”)

(emphasis added). Assuming it is true that HIV no longer

“inevitably entails death,” Onishea’s heightened

“significant risk” test may be undermined to the point

that it no longer controls.

If Onishea is inapplicable, the Supreme Court’s more

general “significant risk” test for communicable diseases

would apply. In Arline, the Court concluded that a

person “who poses a significant risk of communicating an

infectious disease to others ... will not be otherwise

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qualified ... if reasonable accommodation will not

eliminate that risk.” Arline, 480 U.S. 287 n.16 (emphasis

added). 

The complaint pleads sufficient facts to show that

reasonable accommodations can be made to integrate HIV+

inmates. For instance, the complaint notes that all but

two state penal systems have integrated HIV prisoners

into the general population and that the National

Commission on Correctional Health Care counsels against

segregation. Second Amended Complaint (Doc. No. 61)

¶¶ 5-6 & 43. The plaintiffs, therefore, have pled

sufficient facts to show that they do not pose a

“significant risk” under either Onishea or Arline.

Finally, the defendants find fault with the

plaintiffs’ “cursory, non-descript allegations such as

their repeated general references to ‘services, programs,

or activities.’” Defendants’ Brief (Doc. No. 35) at 28.

Similarly, the defendants argue that the plaintiffs have

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not pled that they are “otherwise qualified” for these

programs. 

The plaintiffs provide detailed lists of the types of

programs and accommodations that they are ineligible for

solely because of their HIV status. See, e.g., Second

Amended Complaint, Doc. No. 61, ¶ 50 (Limestone senior

dorm); id. ¶ 56 (Limestone honor dorm); id. ¶ 67

(Tutwiler internal segregation); id. ¶¶ 91-103

(accommodations and programs at other ADOC facilities).

Regarding work-release, the plaintiffs claim

discriminatory placement–-not, as the defendants

construe, total exclusion–-and have pled sufficient facts

to survive a motion to dismiss. See id. ¶¶ 81-90. And,

as to the named plaintiffs, they have pled that they are

“otherwise qualified” for transfer and other programs.

See, e.g., id. ¶ 18 (Henderson); id. ¶ 31 (Beyer). 

This complaint is not the series of “conclusory

allegation[s]” that the plausibility standard bars.

Twombly, 550 U.S. at 557. The plaintiffs have more than

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30

“nudged their claims across the line from conceivable to

plausible.” Id. at 570. 

2. Requesting a Transfer

The defendants contend that the plaintiffs have no

right to transfer to new accommodations. Within ADOC, no

inmate, “regardless of HIV status, enjoys the right to

demand that they be placed in the prison of their

choosing.” Defendants’ Brief (Doc. No. 35) at 30.

Defendants also note that “a prisoner does not have a

[constitutional] right to confinement in a particular

penal facility.” Id. at 30 (citing Sandin v. Conner, 515

U.S. 472, 478 (1995) and Meachum v. Fano, 427 U.S. 215,

225 (1976)).

The defendants misconstrue the plaintiffs’ claim.

The plaintiffs do not assert a constitutional right to

placement in any particular facility. Rather, the

plaintiffs seek the statutory right to apply for a

transfer to another facility–-or within Limestone and

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Tutwiler–-without being discriminated against on the

basis of a disability. 

That is the plaintiffs’ claim for relief in this

suit. ADOC policy permits inmates to request transfers

to other facilities in order to be closer to home or to

enroll in vocational programs. Atchison Affidavit (Doc.

No. 47-1) ¶ 13. Given that the ADA and Rehabilitation Act

apply to prisons, these statutory protections against

disability discrimination extend to programs and

accommodations at ADOC facilities. See Pa. Dept. of

Corr. v. Yeskey, 524 U.S. 206, 212 (1998) (ADA Title II);

Onishea, 171 F.3d at 1296 n.11 (Rehabilitation Act).

Indeed, the “text of the ADA provides no basis for

distinguishing these [correctional and rehabilitative]

programs, services, and activities from those provided by

public entities that are not prisons.” Yeskey, 524 U.S.

at 210. Accordingly, the plaintiffs have stated a claim

upon which relief can be granted.

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3. Medical Privacy

The defendants submit that prisoners have no

constitutional right to privacy in their HIV+ status,

relying on a precedent from the Onishea litigation. In

Harris v. Thigpen, 941 F.2d 1495 (11th Cir. 1991), the

Eleventh Circuit assumed arguendo that prisoners maintain

a right to medical privacy in their HIV status and held

that Alabama’s legitimate penological interest in safety

outweighed any privacy right. Id. at 1512 & 1521.

The plaintiffs concede that the there is no

independent basis for the medical-privacy claims

“[i]nsofar as these disclosures only affect the

prisoners’ family relationships and personal well-being.”

Plaintiffs’ Brief (Doc. No. 37) at 26. However, when the

disclosure of private medical information permits

disability discrimination by a private contractor, the

plaintiffs have a claim under federal law. See 28 C.F.R.

§§ 35.130(b)(1)(v) & 35.130(b)(3)(I). The complaint’s

allegations regarding work placement and HIV status

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trigger these protections. See Second Amended Complaint,

(Doc. No. 61) ¶¶ 84-85. 

C. The PLRA

The defendants raise two arguments for dismissal

pursuant to the PLRA. First, they contend that the

plaintiffs failed to exhaust their administrative

remedies. Second, the defendants assert that the PLRA

bars the type of relief sought.

1. Failure to Exhaust

The PLRA mandates that, “No action shall be brought

with respect to prison conditions under section 1983 of

this title, or any other Federal law, by a prisoner

confined in any jail, prison, or other correctional

facility until such administrative remedies as are

available are exhausted.” 42 U.S.C. § 1997e(a). As this

is an affirmative defense, “[t]he defendants bear the

burden of proving that the plaintiff has failed to

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34

exhaust his available administrative remedies.” Turner

v. Burnside, 541 F.3d 1077, 1082 (11th Cir. 2008).

Although this issue is raised at the motion-to-dismiss

stage, the court may look behind the pleadings and

conduct fact-finding to resolve this question. See

Bryant v. Rich, 530 F.3d 1368, 1374 (11th Cir. 2008)

(noting that a judge may conduct fact-finding when

deciding “a motion to dismiss for failure to exhaust

nonjudicial remedies”). 

The parties dispute whether Alabama’s medical

grievance system is “available” for a complaint about the

HIV-segregation policy. At Alabama’s four facilities

that house HIV+ inmates, a prisoner must file an informal

“Medical Grievance” form to the healthcare unit through

the institutional mail system. A written response on the

bottom of the same document is provided within five days.

See Reese Affidavit (Doc. No. 35-1) ¶ 6; Hunt Affidavit

(Doc. No. 35-2) ¶ 6. Below the response, the form

states, in all caps:

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“IF YOU WISH TO APPEAL THIS REVIEW YOU

MAY REQUEST A GRIEVANCE APPEAL FORM FROM

THE HEALTH SERVICES ADMINISTRATOR.

RETURN THE COMPLETED FORM TO THE

ATTENTION OF THE HEALTH SERVICE

ADMINISTRATOR. YOU MAY PLACE THE FORM

IN THE SICK CALL REQUEST BOX OR GIVE IT

TO THE SEGREGATION SICK CALL NURSE ON

ROUNDS.”

Reese Affidavit (Doc. No. 35-1) ¶ 6. A written response

to a medical grievance appeal is provided within five

days. In the interim, an inmate may be brought in for a

one-on-one conversation with the medical staff. Id. ¶ 6.

The defendants contend that this medical grievance

system was not exhausted by the plaintiffs.

Specifically, ADOC points to the plaintiffs’ claims of

disparate-healthcare treatment and the restrictivemedical-clearance criteria for work release as issues

that should have been addressed through the prison’s

medical grievance process. The defendants provide

evidence-–exhibits attached to affidavits–-showing that

one plaintiff (Harley) used the medical grievance system

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in the past, thus establishing that the plaintiffs were

aware that it existed. See id. Ex. B.

The plaintiffs respond that the medical grievance

process is not “available” to them to challenge Alabama’s

HIV-segregation policy. The plaintiffs contend that the

Reese and Hunt affidavits focus exclusively on healthcare

claims, not on the segregation policy more generally.

According to the plaintiffs, the defendants have not made

any showing that the medical officers have any authority

over the HIV-segregation policy. 

The plaintiffs submit that ADOC “does not maintain

any administrative remedy program system-wide, at

Limestone, or at Tutwiler” for non-medical complaints.

Plaintiffs’ Brief (Doc. No. 37) at 28. The plaintiffs

support this contention by inference from the medical

grievance forms and through prisoner declarations that

aver that no facility-specific, non-medical grievance

system exists at Limestone and Tutwiler. See Hatcher

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Declaration (Doc. No. 37-5) ¶¶ 7-9 (Limestone); Harley

Declaration (Doc. No. 37-6) ¶¶ 5-9 (Tutwiler).

The plaintiffs also submitted a declaration by

Allison Neal, an ACLU attorney. The Neal Declaration

states that ADOC’s special counsel informed her during a

telephone conversation that “there is no formal systemwide administrative remedy or grievance procedures.”

Neal Declaration (Doc. No. 37-4) ¶ 2. The Neal

Declaration also states that Limestone’s warden told her

that there was no non-medical grievance system at that

institution. Id. ¶ 3. 

Under the PLRA, a grievance system needs to be

“available” in order to trigger the exhaustion

requirement. See Turner, 541 F.3d at 1084 (“A remedy has

to be available before it must be exhausted.”). “Without

the possibility of some relief, the administrative

officers would presumably have no authority to act on the

subject of the complaint, leaving the inmate with nothing

to exhaust.” Booth v. Churner, 532 U.S. 731, 736 n.4

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(2001). The court finds that the medical grievance forms

are “available” only to address medical issues and that

no general, non-medical, system-wide grievance system

exists in ADOC prisons.

At the top of the medical grievance forms, prisoners

may check one of only two boxes: “Medical Grievance” or

“Medical Grievance Appeal.” The medical grievance form,

therefore, is no misnomer: the form deals solely with

medical claims, not broader disputes about ADOC housing

and transfer policy. 

Moreover, the medical grievance forms include checkboxes for administrators to complete. These boxes

includes labels for healthcare issues (e.g., “access to

onsite care” and “medication issues”) and a catch-all box

labeled “other.” See, e.g., Reese Affidavit (Doc. No.

35-1) at 11. There is no indication on the form that it

could be used to complain to prison officials-–as opposed

to the Correctional Medical Services personnel–-about

accommodations policy. 

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This reading of the medical grievance form comports

with how prisoners interpreted it. See, e.g., Harley

Declaration (Doc. No. 37-6) ¶ 4-5. These declarations

state that prisoners are told to submit only medicallyrelated grievances to these systems. In fact, plaintiff

Harley’s medical grievance forms submitted by the

defendants cut against their argument. Harley complains

about medical issues, not ADOC’s HIV segregation policy

as it applies to accommodations. See, e.g., Harley

Grievance (Doc. No. 35-1) at 13.

And at oral argument, defense counsel listed

examples of medical grievances: “[a]ny decision made by

a member of the medical staff: when labs are drawn; what

time of day they’re drawn; whether a doctor

evaluates...one of the named plaintiffs.” Oral Argument

Transcript (Doc. No. 56) at 34. These claims are not in

the same class as a grievance against the HIV segregation

policy. 

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Perhaps most revealing, the defendants have submitted

no evidence that the medical professionals reviewing the

medical grievance forms had any authority over nonmedical issues or ADOC policy more generally. Allowing

ADOC to characterize the medical grievance process as a

generalized system would bait-and-switch the plaintiffs.

See Goebert v. Lee County, 510 F.3d 1312, 1323 (11th Cir.

2007) (criticizing prison officials for playing “hideand-seek” with administrative remedies); see also Hutto

v. Barnes, No. 04-0522-WS-M, 2006 WL 2052596, at *1 n.1

(S.D. Ala. July 2006) (noting that ADOC failed to offer

evidence of any state grievance procedure available to

Alabama prisoners in support of its exhaustion defense).

In light of the evidence before the court, the medical

grievance system is not “available” to the plaintiffs to

address their grievances concerning the HIV-segregation

policy. 

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41

The question, then, is whether ADOC maintains a

general, non-medical grievance procedure. The court

concludes that it does not. 

The defendants have provided no evidence that an

alternative, generalized system exists. The Neal

Declaration confirms that, in this case, absence of

evidence is evidence of absence. See Neal Declaration

(Doc. No. 37-4) ¶ 2. The defendants have failed to meet

their burden of establishing that a general grievance

procedure exists. Because there is no non-medical

grievance process, there is no exhaustion requirement

before filing suit to challenge the HIV segregation

policy. As the Eleventh Circuit has explained:

“We find that the term ‘available’ in

section 1997e(a) is used to acknowledge

that not all prison actually have

administrative remedy programs. Some

state penal institutions may not have an

administrative remedy program to address

prison conditions, and thus there are no

‘available’ administrative remedies to

exhaust. Section 1997e(a) permits these

prisoners to pursue their claims

directly in federal court.”

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42

Alexander v. Hawk, 159 F.3d 1321, 1326-27 (11th Cir.

1998).

The court notes that, with no generalized grievance

system, ADOC inmates have lost “a way of attempting to

improve prison conditions without having to file a

lawsuit.” Turner, 541 F.3d at 1084. In turn,

corrections officials “lose the substantial benefits that

administrative remedies were intended to provide them.”

Id. at 1085. ADOC officials have decided against

maintaining a general grievance process to address inmate

complaints about potentially unlawful activity in the

prison system. Accordingly, the plaintiffs may file suit

directly in federal court to address these non-medical

grievances.

2. The “Need-Narrowness-Intrusiveness” Test

In prison litigation suits, a court granting

prospective relief must determine “that such relief is

narrowly drawn, extends no further than necessary to

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43

correct the violation of the Federal right, and is the

least intrusive means necessary to correct the violation

of the Federal right.” 18 U.S.C. § 3626(a)(1)(A). 

The defendants contend that the “relief requested

does not meet the requisite standards for prospective

relief under the PLRA.” Defendants’ Brief (Doc. No. 35)

at 37. According to the defendants, the plaintiffs have

failed to satisfy this “need-narrowness-intrusiveness”

test because a “prohibition on all discriminatory

policies and practices for HIV inmates is entirely too

broad and will ultimately hinder ADOC administrators.”

Id. at 38 (emphasis in original). 

 The “need-narrowness-intrusiveness” test, however,

is a limitation on judicial authority over prisons at the

remedial stage, not a heightened-pleading requirement

imposed on the plaintiffs. The PLRA’s plain language

makes this clear. See 18 U.S.C. § 3626(a)(1)(A) (“The

court shall not grant or approve any prospective relief

unless the court finds” that it satisfies the needCase 2:11-cv-00224-MHT-WC Document 199 Filed 09/05/12 Page 43 of 48
44

narrowness-intrusiveness test.) (emphasis added). Other

provisions in § 3626(a) reinforce this reading, see id.

§ 3626(a)(3) (requirements for prisoner release orders);

id. § 3626(b) (placing conditions on the time period for

prospective relief); see also Babbitt v. Sweet Home

Chapter of Comm. for a Great Oregon, 515 U.S. 687, 702-03

(1995) (applying the Whole Act Rule), as does the

relevant precedent. See Williams v. Edwards, 87 F.3d

126 (5th Cir. 1996); Anderson v. Garner, 22 F. Supp. 2d

1379 (N.D. Ga. 1997) (Murphy, J.). 

The PLRA did not abrogate the longstanding rule that,

at the motion-to-dismiss stage, a complaint is judged by

whether it presents “enough facts to state a claim to

relief that is plausible on its face,” Twombly, 550 U.S.

at 570, not whether the relief requested will be granted

in full. 

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D. Sovereign Immunity

The defendants assert that sovereign immunity

precludes this suit. They note that the plaintiffs may

not seek damages under Title II of the ADA because

Congress failed to validly abrogate the States’ sovereign

immunity. Seeking to avoid the Young fiction, Ex parte

Young, 209 U.S. 123 (1908), the defendants argue that

Onishea and Edwards demonstrate that “not only is there

... no violation of federal law, but there is certainly

not any ongoing and continuous violation.” Defendants’

Brief (Doc. No. 35) at 41. They contend that the

plaintiffs failed to “allege an ‘ongoing and continuous

violation.’” Id. 

But, as the plaintiffs point out, this is a suit for

prospective relief, not for damages. Indeed, the relief

sought is quintessentially prospective: a declaratory

judgment and an injunction. See Second Amended Complaint

(Doc. No. 61) at 37. The five defendants have been sued

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46

in their official capacities, id. ¶¶ 11-15, thus

triggering the Ex parte Young analysis.

In determining whether Young’s exception to sovereign

immunity applies, “a court need only conduct a

‘straightforward inquiry into whether [the] complaint

alleges an ongoing violation of federal law and seeks

relief properly characterized as prospective.’” Verizon

Maryland, Inc. v. Public Service Comm. of Maryland, 535

U.S. 635, 645 (2002) (quoting Idaho v. Coeur d’Alene

Tribe of Idaho, 521 U.S. 261, 296 (1997)) (alteration in

original). The court need not look to the merits of the

suit to determine whether Young applies; an allegation in

the complaint will suffice. Here, the plaintiffs allege

that the “Defendants are violating Plaintiffs’ rights

under Title II of the ADA and Section 504 of the

Rehabilitation Act.” Second Amended Complaint (Doc. No.

61) ¶ 113 (emphasis added). Because the plaintiffs have

alleged an ongoing violation of federal law and are

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47

seeking only prospective relief, sovereign immunity

presents no bar to this action.

The court notes that this case falls within a long

history of suits brought by inmates seeking to vindicate

their constitutional and statutory rights. See, e.g.,

Brown v. Plata, 131 S. Ct. 1910 (2011) (affirming threejudge district court’s order to reduce prison

overcrowding); Hutto v. Finney, 437 U.S. 678 (1978)

(affirming district court’s 30-day time limit for placing

prisoners in isolation cells); Laube v. Campbell, 333 F.

Supp. 2d 1234 (M.D. Ala. 2004) (Thompson, J.) (approving

settlement agreement to remedy Eighth Amendment

violations at Julia Tutwiler Prison for Women). The

Eleventh Amendment did not prevent courts from ordering

prospective relief in these cases. Indeed, ADOC

officials have recognized this fact in past litigation

over this policy. See Onishea, 171 F.3d at 1296 n.11

(noting that defendants conceded sovereign immunity point

during en banc oral argument).

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* * *

Accordingly, it is ORDERED that the defendants’

motion to dismiss (Doc. No. 34) is denied with the

understanding that the court will address the res

judicata issue after the bench trial.

DONE, this the 5th day of September, 2012.

 /s/ Myron H. Thompson 

UNITED STATES DISTRICT JUDGE

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