DOJ settlement will bring new protections for people with opioid use disorder in Pa. courts

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HARRISBURG — A recent settlement between the U.S. Department of Justice and the Pennsylvania court system offers new protections to people who county courts allegedly barred from taking medications for opioid use disorder.

The agreement follows the DOJ alleging the system forced some people under court supervision into a lose-lose scenario: Give up medication prescribed by a doctor or risk going to jail.

Advocates celebrated the settlement, which requires that three county court systems adopt an anti-discrimination policy for substance use disorder medications and that statewide court administrators encourage all other county court systems to do the same.

While still denying the claims, officials overseeing Pennsylvania’s court system agreed to pay $100,000 total to individuals allegedly harmed by the restrictions. Statewide court administrators must also provide training to all judges handling criminal matters and report on which counties agree to adopt the anti-discrimination policy.

“This case makes it clear that those practices are illegal, they’re dangerous, and they need to stop,” Sally Friedman, an attorney with the advocacy group the Legal Action Center, told Spotlight PA. “And I think other courts around the country are going to pay attention.”

Sonya Mosey is one of the people whose complaint prompted the Justice Department lawsuit. In a previous Spotlight PA story, she described how an opioid use disorder medication ban in Jefferson County in 2018 led her to fear she would relapse and die.

After she learned of the settlement, she cried on the way to work.

“It was a relief,” she said. “But it was also … a sense of like all this time and we finally got somewhere.”

The Department of Justice lawsuit named as defendants the entire state court system, the Pennsylvania Supreme Court, and four individual county courts.

The agreement requires three of those county court systems — Blair, Jefferson, and Northumberland — to adopt an agreed upon nondiscrimination policy for medications for opioid use disorder.

The two sides agreed for the state Supreme Court to be dismissed from the case. The Pennsylvania Supreme Court’s administrative arm agreed to take a number of actions to implement the settlement.

What did the two sides say about the settlement?

Throughout the case, the two sides have offered differing interpretations of the scope of the alleged violations.

Stacey Witalec, a spokesperson for the administrative arm of the Pennsylvania Supreme Court, said in a statement that the DOJ claimed violations of the Americans with Disabilities Act were committed by “a few local treatment courts” and that the federal agency “found no systemic” violations.

That description contrasted with how the Department of Justice described the case in earlier legal filings. The agency identified six unnamed individuals who it says were harmed in four counties, and it listed seven other counties that it alleged have or recently had administrative policies restricting the use of opioid use disorder medication.

Those 11 county courts have tens of thousands of people under supervision, many for drug law violations, and there is “thus a high likelihood” that Pennsylvania courts harmed others with opioid use disorder, the Justice Department alleged in a legal filing last September.

The agreement will “alleviate the burden of the ongoing litigation on the courts, who continue to deny the DOJ’s claims,” said Witalec. Under the state constitution, the Pennsylvania Supreme Court has “general supervisory and administrative authority” over the lower courts in the state system.

Witalec called Pennsylvania’s court system a national leader for offering effective treatment and rehabilitation opportunities. She said courts here “reiterate their continuing and steadfast commitment to our treatment courts and to providing full access to the justice system and fair and evenhanded treatment to all citizens, including those with disabilities.”

In a news release, the DOJ emphasized the $100,000 compensation the court system agreed to pay, policy changes and recommendations, and training required under the settlement.

“People with opioid use disorder caught up in the criminal justice system should be supported in seeking treatments that can help them attain recovery,” said Kristen Clarke, assistant attorney general of the Justice Department’s Civil Rights Division.

What do other advocates say?

Jordan Scott of the Pennsylvania Harm Reduction Network said the settlement’s emphasis on how these changes will be implemented gives her peace of mind that “this is actually going to help make things better” and it won’t be just “another piece of paper.”

Sara Rose, deputy legal director of the ACLU of Pennsylvania, also pointed to the details of the settlement, saying she hopes the training requirements will reduce bias against people who use opioid use disorder medications.

An Allegheny County physician and president-elect of the Pennsylvania Society of Addiction Medicine, James Latronica welcomed the settlement. But he also said $100,000 seemed low, given the harm that can occur to people forced off their prescribed medications for opioid use disorder.

“It’s extremely disruptive to someone’s life,” Latronica said. “… The way that we treat substance use in general with a punishment-first mentality is completely foreign to every other area of medicine.”

Why did the DOJ bring the case?

Nationwide, people wanting to access federally approved medications for opioid use disorder face a number of obstacles, including when they are under court supervision or incarcerated.

The Department of Justice says it has taken other actions to prevent discrimination, including for people under court supervision in Massachusetts and people incarcerated at Allegheny County Jail.

But people can face other restrictions on these medications. Pennsylvania Attorney General Michelle Henry announced last September that her office secured commitments from companies operating dozens of nursing homes in the state to not discriminate against people with opioid use disorder.

That initiative began with a complaint from a man who was prescribed medication for the disorder and was turned away from multiple nursing home facilities, according to Henry’s office.

What happens next for Pa. courts?

The settlement gives 60 days for statewide court administrators to recommend and encourage all judicial districts to adopt the anti-discrimination policy that’s included as part of the agreement. Within six months, those administrators must report back on the steps they took and which counties agreed to adopt the policy.

The Blair, Jefferson, and Northumberland County court systems have 90 days to adopt the policy and distribute it to treatment court team members and individuals under court supervision.

Settlement documents didn’t clarify why the fourth county court system named as a defendant, Lackawanna, is not required to implement the policy.

A spokesperson for the Justice Department declined to clarify when asked why by Spotlight PA. Witalec told Spotlight PA that Lackawanna County maintained throughout the litigation that its policies complied with the Americans with Disabilities Act, and said the county will consider “whether to voluntarily adopt the suggested policy terms to the extent they differ from what is already in place.”

Among other provisions, the policy for substance use disorder medications says, “No judge, unit, or member of this judicial district will interfere with a licensed prescriber’s decisions about an individual’s appropriate medication and treatment regimen.”

The policy says it’s not intended to interfere with “appropriate exercises of judicial discretion in individual cases,” and suggests that if judges are concerned about an individual’s use or misuse of medication, in many cases, the appropriate action will be for a probation officer or representative of the court system to communicate with the prescriber.

Statewide court administrators must also provide reports to the DOJ describing their training efforts and complaints related to opioid use disorder medication.

The agreement remains in effect for two years.

How is Mosey doing now?

“My life is great,” she told Spotlight PA.

She is studying to receive a bachelor’s degree in behavioral sciences, and she’s working with at-risk youth.

“I’ve taken my experiences and my mistakes in life, and I’m trying to help young people not do the same thing,” Mosey said. “I work a lot, but it’s very rewarding.”

The settlement includes $100,000 in total compensation for the people allegedly harmed, and Mosey told Spotlight PA she expects to receive $10,000. But that money isn’t why she stuck with the case and continued advocating for the issue.

“I just wanted there to be some change,” she said. “I wanted there to be something to make it so that other people in my situation and other people dealing with addiction didn’t have to go through what I had to go through.”

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