Document: 480 U.S. 273 107 S.Ct. 1123 94 L.Ed.2d 307 SCHOOL BOARD OF NASSAU COUNTY, FLORIDA and Craig Marsh, Individually as Superintendent of Schools Nassau County, Floridav.Gene H. ARLINE. No. 85-1277. Argued Dec. 3, 1986. Decided March 1987. Rehearing Denied April 20, See 481 1024, 1913. Syllabus Section 504 the Rehabilitation Act 1973, 29 U.S.C. § 794 (Act), provides, inter alia, that no "otherwise qualified handicapped individual," defined in 706(7), shall, solely by reason his handicap, be excluded from participation any program receiving federal financial assistance. 706(7)(B) defines "handicapped individual" to mean person who "(i) has a physical . impairment which substantially limits one or more [his] major life activities, (ii) record such an impairment, (iii) is regarded having impairment." Department Health Human Services (HHS) regulations define "physical impairment" mean, physiological disorder affecting respiratory system, "major activities" include working. Respondent was hospitalized for tuberculosis 1957. The disease went into remission next 20 years, during time respondent began teaching elementary school Florida. In 1977, 1978, November had relapses, after latter two she suspended with pay rest year. At end 1978-1979 year, petitioners discharged her hearing because continued recurrence tuberculosis. After denied relief state administrative proceedings, brought suit Federal District Court, alleging violation 504. Court held not person" under Act, but that, even assuming were, "qualified" teach school. Appeals reversed, holding persons contagious diseases are within 504's coverage, remanded further findings whether qualified" job. Held: 1. A afflicted may meaning Pp. 280-286. (a) HHS regulations. Her hospitalization 1957, affected limited "one [her] activities," establishes "record 280-281. (b) fact also does remove coverage. To allow employer justify discrimination distinguishing between disease's effects on others its patient would unfair, contrary 706(7)(B)(iii) legislative history, demonstrate Congress' concern about impairment's effect others, inconsistent basic purpose ensure individuals jobs prejudice ignorance others. replaces fearful, reflexive reactions actions based reasoned medically sound judgments do 281-286. 2. most cases, order determine 504, district court must conduct individualized inquiry make appropriate fact, reasonable medical given knowledge, nature risk (e.g., how transmitted), duration (how long carrier infectious), (c) severity (what potential harm third parties), (d) probabilities will transmitted cause varying degrees harm. making these findings, courts normally should defer public health officials. Courts then determine, light "reasonable accommodation" can made established standards inquiry. 287-288. 3. Because did it impossible this job teacher, case additional fact. 288-289. 772 F.2d 759 (CA 11 1985), affirmed. BRENNAN, J., delivered opinion WHITE, MARSHALL, BLACKMUN, POWELL, STEVENS, O'CONNOR, JJ., joined. REHNQUIST, C.J., filed dissenting opinion, SCALIA, joined, post, p. ----. Brian T. Hayes, Monticello, Fla., petitioners. Sol. Gen. Charles Fried amicus curiae, support petitioners, special leave Court. George K. Rahdert, St. Petersburg, respondent. Justice BRENNAN 1 87 Stat. 394, amended, prohibits federally funded discriminating against individual handicap. This presents questions tuberculosis, disease, considered and, if so, 2 * From 1966 until 1979, Gene Arline taught She 1979 suffering relapse years. court, board's decision dismiss violated Act.1 3 trial at principal evidence provided Marianne McEuen, M.D., assistant director Community Tuberculosis Control Service Florida Rehabilitative Services. According records reviewed Dr. App. 11-12. For Arline's remission. Id., 32. Then, culture revealed again active system; cultures taken 1978 were positive. 12. 4 superintendent schools testified response reports. both second relapse, spring board remainder 49-51. hearing, Arline, "not done anything wrong," "continued reoccurence [sic] tuberculosis." 49-52. 5 memorandum, argued disputed [school dismissed her] basis illness. Since illness qualifies Plaintiff 'handicapped person' clear result handicap 504." Record 119. held, however, although there "[n]o question suffers handicap," nevertheless "a terms statute." Pet. Cert. C-2. found "difficult conceive Congress intended included definition person." "even assuming" could deemed person, C-2—C-3. 6 "persons coverage section 504," condition "falls neatly statutory regulatory framework" Act. 759, 764 (CA11 1985). "for risks infection precluded Mrs. being 'otherwise qualified' possible some accommodation position" other position. 765 (footnote omitted). We granted certiorari, 475 1118, 106 1633, 90 179 (1986), now affirm. II 7 enacting amending enlisted all programs funds effort "to share Americans opportunities education, transportation, housing, care, take granted." 123 Cong.Rec. 13515 (1977) (statement Sen. Humphrey). end, only increased vocational rehabilitation, addressed broader problem including antidiscrimination provision patterned Title VI Civil Rights 1964.2 reads pertinent part: 8 "No otherwise United States, 706(7) title, in, benefits of, subjected activity ." 794. 9 1974 expanded use read follows:3 10 "[A]ny (i) mental person's 706(7)(B). amended reflected protecting stemming simple prejudice, "archaic attitudes laws" "the American people simply unfamiliar insensitive difficulties confront[ing] handicaps." S.Rep. 93-1297, 50 (1974), U.S.Code Cong. & Admin.News 1974, 6400. combat erroneous prevalent perceptions handicapped, so preclude "[a] having, [but who] present have actual incapacity all." Southeastern College v. Davis, 442 397, 405-406, n. 6, 99 2361, 2366-2367, 60 980 (1979).4 12 determining particular promulgated significant As we previously recognized, drafted oversight approval Congress, see Consolidated Rail Corporation Darrone, 465 624, 634-635, nn. 14-16, 104 1248, 1254-1255, 79 568 (1984); they provide "an important source guidance Alexander Choate, 469 287, 304, 24, 105 712, 722, 83 661 (1985). particularly here critical used individual.5 "Physical follows: 13 condition, cosmetic disfigurement, anatomical loss following body systems: neurological; musculoskeletal; sense organs; respiratory, speech cardiovascular; reproductive, digestive, genito-urinary; hemic lymphatic; skin; endocrine." 45 CFR 84.3(j)(2)(i) 14 addition, 15 "functions caring one's self, performing manual tasks, walking, seeing, speaking, breathing, learning, working." 84.3(j)(2)(ii). III 16 Within framework, then, consider individual. testimony suffered "in acute form degree system," condition. 11. thus term regulations, since "physiological [system]." serious enough require hospitalization, than sufficient establish activities impairment. Thus, 1957 suffices 706(7)(B)(ii), therefore 17 Petitioners concede constitute handicapping extent leaves "diminished capabilities," Brief 15, demonstrates Tr. Oral Arg. 52-53. maintain, irrelevant case, diminished capabilities, threat relapses posed others.6 18 agree defining meaningfully distinguished claimant this. contagiousness each resulted same underlying It unfair seize upon distinction discriminatory treatment.7 19 Nothing history suggests result. That concerned extended 706(7)(B)(iii), those "regarded having" impairment.8 Senate Report provides example covered subsection kind visible limit functioning." 64.9 Such might diminish ability work negative impairment.10 Allowing prejudiced By actually physically impaired, impaired who, result, activity, acknowledged society's accumulated myths fears disability limitations flow impairment.11 Few aspects give rise level fear misapprehension contagiousness.12 Even suffer recovered noninfectious epilepsy cancer faced irrational contagious.13 carefully structured replace perceived handicaps judgments: broad, eligible relief. pose certain circumstances excluding diseases. exclusion accused never opportunity their evaluated determination qualified." Rather, vulnerable mythology—precisely type injury sought prevent.14 conclude suffice 504.15 IV 21 remaining schoolteacher. answer need essential achieve goal deprivations stereotypes, unfounded fear, while giving weight legitimate concerns grantees avoiding exposing safety risks.16 factors conducting well established.17 context employment Medical Association 22 "[findings of] facts, parties) harm." Amicus Curiae 19. 23 officials.18 step "otherwise-qualified" evaluate, reasonably accommodate employee 17, supra. 24 paucity factual we, like Appeals, unable stage proceedings resolve nor probability transmit disease. Nor discharged, School Board accommodated her.19 Accordingly, resolution requires V 25 hold person. remand judgment 26 Affirmed. 27 Chief whom SCALIA joins, dissenting. 28 Pennhurst State Hospital Halderman, 451 1, 101 1531, 67 694 (1981), where intends impose grant funds, "it unambiguously." S.Ct., 1540. principle applies full force scope "those 'receive' assistance." States Transportation Paralyzed Veterans America, 477 597, 605, 2705, 2711, 91 494 (1986). Yet, today ignores principle, resting own fairness implied Ante, 282-286. approach, I believe, foreclosed Pennhurst, our prior decisions interpreting Our premised view legislation imposing obligations recipients "much contract." U.S., 1539. Education Hendrick Hudson Central Rowley, 458 176, 204, 26, 102 3034, 3049, 73 690 (1982). stated " 'Congress apparently determined bear costs providing quid pro quo receipt funds.' supra, quoting 633, 13, 1254, (1984). legitimacy rests voluntarily knowingly accept exchange. There knowing acceptance unless speaks "with voice" identifying conditions attached funds. 30 requirement unambiguously express imposed moneys compelling cases exists long-standing regulation subject matter. early 1796, legislated directly area diseases.1 also, left leeway enacted myriad statutes designed protect introduction spread diseases.2 When extensive regulation, declined expansively. Bowen Assn., 476 610, 642-647, 2101, 2120-2123, 584 (1986); 303, 307, 721, 723, Absent expression intent contrary, "Congress 'will significantly changed federal-state balance.' 644, 2121, Bass, 404 336, 349, 92 515, 523, 488 (1971). 31 Applying principles, cannot reached doubt capabilities resulting condition.3 language central constitutes "by handicap." silent issue,4 principles outlined above compel conclusion protections extend Arline. 32 reaching conclusion, Instead, posits "meaningfully" 282. position, observes Act's impair adverse congressional recognition told, reveals regulate contagiousness. 284. 33 analysis misses mark several respects. begin with, way purposes separately claimant. extending generalized Although citing examples described points nothing materials suggesting contemplated posing Act.5 ordinary construction, meager proof determinative. Court's evidence, therefore, possibly "knowing acceptance" entities County conditioned issues. 34 299, 720, "[a]ny interpretation responsive powerful countervailing considerations—the objectives desire keep manageable bounds." wholly disregarded admonition here. 42 1983, due process law. Both rejected argument, issue pattern evident statute, compare 2000d, see, e.g., pp. 39-40 6373; 95-890, (1978). Cf. TenBroek Matson, Disabled Law Welfare, 54 Cal.L.Rev. 809, 814-815, 21-22 (1966) (discussing theory "negative practices toward disabled resemble commonly "underprivileged ethnic religious minority groups' "). range prohibition broader, VI, covers receive aid primary objective promotion employment. Note, Accommodating Handicapped: Rehabilitating Southeastern, 80 Colum.L.Rev. 171, 174-175, (1980). focus 1973 increase rehabilitation; original whose employability, expected benefit rehabilitation. reviewing Health, Education, Welfare's subsequent attempt devise implement concluded rehabilitation provisions Titles too narrow deal care stemmed stereotypical handicapped. 16, 37-38, 50. id., 39 ("This includes protection sections 503 technically clause (A) new definition. Members groups handicapped"); 37-39, 63-64; 120 30531 (1974) Cranston). appendix explained chose "set forth list specific impairments difficulty ensuring comprehensiveness list." pt. 84, Appendix A, 310 Nevertheless, "such orthopedic, visual, speech, impairments, cerebral palsy, epilepsy, muscular dystrophy, multiple sclerosis, cancer, heart diabetes, retardation, [and] emotional illness" covered. Ibid. reinforced what careful reading statute makes plain, "that results substantial limitation activities." many comments when first proposed suggested unreasonably broad definition, so-called "traditional handicaps," inherent 15-16 (Act "impair others"); 13-14 ("[T]he concept 'handicap' [should limited] either real diminution individual's capabilities. [A]n necessarily perform question. words, employer's reluctance hire inability part, rather expose employees clientele infection"). argues is, capable spreading without symptoms associated contends true carriers Acquired Immune Deficiency Syndrome (AIDS) virus. premise concludes argument misplaced here, gave present, reach, AIDS considered, contagiousness, 4, prohibit inception example, Representative Vanik, remarks signpost road 295-296, 717-718 (1985), cited improper ruled palsied child, academically competitive, school, teacher claimed appearance 'produced nauseating effect' classmates." 117 45974 118 36761 (1972) (remarks Mondale) (a woman "crippled arthritis" "college trustees [thought] 'normal students shouldn't her' "); 525 Humphrey); cf. Macgregor, Some Psycho-Social Problems Associated Facial Deformities, Am. Sociological Rev. 629 (1961). among illustrative "cosmetic disfigurement," lend position relevant oneself. 84.3(j)(2)(i)(A) oral took disfigurement affect work. recognized "working" listed said argue totally circular lifts itself bootstraps." 15-16. circular, direct. plainly cover (whether actual, past, perceived) "[T]he handicapped." 13; 632, 1253 ("Indeed, enhancing much year felt necessary amend clarify types well"). 50; generally, Cal.L.Rev., 814; Strauss, Chronic Illness, Sociology Illness 138, 146-147 (P. Conrad R. Kern eds. 1981). isolation chronically ill appears across centuries, development complex often pernicious mythologies nature, cause, transmission exception. Dubos J. Dubos, White Plague (1952); S. Sontag, Metaphor Senator Humphrey noted "irrational part employers fellow workers" difficult former patients secure (1977). Feldman, Wellness Work, Psychosocial Stress Cancer 173-200 (C. Cooper ed. 1984) (documenting patients); ("Any treated mystery acutely feared morally, literally, contagious. surprisingly large number find themselves shunned relatives friends TB, infectious disease"); Dell, Social Dimensions Epilepsy: Stigma Response, Psychopathology 185-210 (S. Whitman B. Hermann 1986) (reviewing epileptics); Epilepsy Foundation America 5-14 ("A review salient itself, impetus handicaps"). reaffirmed approach amendments There, reasons drug addicts alcoholics, understood danger categorically House proposal exclude alcoholics individual, instead adopted abusers "whose current alcohol drugs prevents duties direct property others." 124 30322 (1978); Cranston et al. Amici 35-36; 43 Op.Atty.Gen. consistent render them See, Strathie Transportation, 716 227, 232-234 (CA3 1983); Doe New York University, 666 761, 775 (CA2 dissent implies "own Act," 289, (1981). evident, plain detailed it, neither discusses "handicapped" view. dissent's construction arbitrary (and unfair) unfaithful canons construction. infidelity. "simply general statement 'findings' "no preference kinds treatment." 19, 1541. Wright Roanoke Redevelopment Housing Auth., 479 418, 422, 766, 770, 93 781 (1987). ("In thought statements indicating preference—at 'nudge preferred directio[n]' contrast mandate stark. think today's beyond bounds. Construing complement complicate efforts enforce laws. state, infra, 288, officials unsupportable. Conforming hardly threaten States' communicable Indeed, respond rationally assist local helping obstacle preventing diseases: report surprising, brief amici curiae respondent, California, Maryland, Michigan, Minnesota, Jersey, York, Wisconsin "inclusion ambit reorder priorities agencies alter balance authority." California 30. poses communicating workplace eliminate risk. place active, classroom schoolchildren. conceded argument. 45. "An able meet program's requirements spite 406, 2367, (1979). context, functions" 84.3(k) functions job, enable functions. Accommodation imposes "undue burdens" grantee, 412, 2370, fundamental alteration [the] program," 410. 84.12(c) (1985) (listing undue hardship); 315 ("[W]here overcome causes hardship employer, failure promote discrimination"); 410-413, 2369-2370; 299-301, 19; 718 F.2d, 231. address, private physicians relied. Employers affirmative obligation employee. required another he doing, deny alternative available existing policies. supra; 84.12 315-316 §§ 243, 264; May 27, ch. 31, 474; generally Morgenstern, Role Government Protecting Citizens Communicable Diseases, 47 U.Cin.L.Rev. 537 regulating addressing, reporting requirements, quarantines, denial marriage licenses presence diseases, compulsory immunization, certification testing employees. Ariz.Rev.Stat.Ann. 36.621 seq. (1986) (reporting requirements); Conn.Gen.Stat. 19a-207, 19a-221 (quarantines); Fla.Stat. 741.051-741.055 (marriage licenses); Mass.Gen.Laws c. 71 55B (1984) (certification employees); Miss.Code Ann. 37-7-301(i) (Supp.1986) (compulsory immunization students); W.Va.Code 16-3-4a (medical testing). testifying concerning recommending termination, petitioner Florida, "I total student population personnel benefit, best if—not continue offer employment." 62. Marsh added: am charged board, responsibility protecting, safety, welfare students, every County. And clearly states you know, all—after knowledge recurring reoccurrence, [was] interest system classroom." 81. Before consulted recommended termination small children constant contact. 12-17. 701 seq.; 84 (1985); H.R.Rep. 95-1149 95-890 93-1297 (1974); 93-244 (1973); 93-318 (1973). conclusion. majority, ante, 285, 14, specifically "constitute (emphasis added). If anything, evinces avoid interference concerns. Oversight Hearings before Subcommittee Select Committee Labor, 95th Cong., 2d Sess., (1978) Rep. Hyde) ("Congress needs thoughtful wide-ranging consideration persons, balanced realities economics, commonsense"). Vanik relied 283, 9. expressed apparent disapproval ruling 'a "produced effect" classmates.' 9, (1971)

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