Doe v. County of Centre PA

Citation242 F.3d 437
Decision Date05 March 2001
Docket NumberNo. 00-3195,00-3195
Parties(3rd Cir. 2001) JOHN DOE; MARY DOE, APPELLANTS v. COUNTY OF CENTRE, PA; CHILDREN & YOUTH SERVICES OF CENTRE COUNTY; BOARD OF COMMISSIONERS OF THE COUNTY OF CENTRE; TERRY WATSON, INDIVIDUALLY AND IN HIS OFFICIAL CAPACITY AS THE DIRECTOR OF CENTRE COUNTY OFFICE OF CHILDREN AND YOUTH SERVICES; CAROL SMITH, INDIVIDUALLY AND IN HER OFFICIAL CAPACITY AS THE ASSISTANT DIRECTOR ADMINISTRATOR OF THE CENTRE COUNTY OFFICE OF CHILDREN AND YOUTH SERVICES; LISA RICE, INDIVIDUALLY AND IN HER OFFICIAL CAPACITY AS A FOSTER HOME SPECIALIST OF THE CENTRE COUNTY OFFICE OF CHILDREN AND YOUTH SERVICES
CourtUnited States Courts of Appeals. United States Court of Appeals (3rd Circuit)

ON APPEAL FROM THE ORDER OF THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF PENNSYLVANIA (D.C. Civ. No: 99-cv-00683) District Court Judge: The Honorable James F. McClure, Jr. [Copyrighted Material Omitted]

[Copyrighted Material Omitted]

Mathew M. Gutt (argued) Carl G. Roberts Ballard Spahr Andrews & Ingersoll, Llp 1735 Market Street, 51st Floor Philadelphia, Pennsylvania 19103-7599; Stefan Presser Scott Burris American Civil Liberties Union of Pennsylvania 125 South 9th Street, Suit 701 Philadelphia, Pennsylvania 19107, Attorneys for Appellants

Catherine Hanssens Colleen Sullivan Lambda Legal Defense and Education Fund, Inc. 120 Wall Street, Suite 1500 New York, New York 10005-3904, Attorneys for American Public Health Association, Aids Alliance for Children, Youth, and Families, Aids Law Project of Pennsylvania, Alliance for Children's Rights, Lambda Legal Defense and Education Fund, Inc., The Juvenile Law Center, Lawyers for Children, Inc., Legal Aid for Children/Pittsburgh, The Legal Aid Society of New York/Juvenile Rights Division, The National Alliance of State and Territorial Aids Directors, National Center for Youth Law, The Support Center for Child Advocates, The Youth Law Center, and The Association of Maternal and Child Health Programs, as Amici Curiae on behalf of Appellants

Gerard J. Geiger (argued) Newman, Williams, Mishkin, Corveleyn, Wolfe & Fareri, P.c. 721 Monroe Street Stroudsburg, Pennsylvania 18360, Attorney for Appellees

Anthony T. McBeth (argued) Law Offices of Anthony T. McBeth 407 North Front Street, First Floor Harrisburg, Pennsylvania 17101, Robert L. Knupp Knupp, Kodak & Imblum, P.C. P.O. Box 11848 Harrisburg, Pennsylvania 17101-1848, Attorney for The County Commissioners Association of Pennsylvania, as Amicus Curiae on behalf of Appellees

Before: Mansmann, Alito, and Fuentes, Circuit Judges

OPINION OF THE COURT

Fuentes, Circuit Judge

The primary issue raised by this appeal is whether Centre County violated the appellants' civil rights by excluding them from participation in the County's foster care program because their son has HIV and AIDS, and because of their race. This case began when appellants John and Mary Doe, an interracial couple with an HIV - positive son named Adam,1 approached Centre County's Foster Child Program, seeking to become foster parents. County officials responded by adopting a policy providing that foster families whose members have "serious infectious diseases" may care only for children with the same disease. The policy would permit the Does to care for uninfected children only if the Does agreed to release information regarding their son and the biological parents executed a written consent releasing the County from potential liability. The Does refused to agree to the policy and filed suit, alleging disability discrimination in violation of, among other statutes, Title II of the Americans with Disabilities Act and Section 504 of the Rehabilitation Act, and racial discrimination in violation of Title VI of the Civil Rights Act of 1964. The Does sought invalidation of the policy, approval as foster parents, and compensatory and punitive damages. The District Court granted summary judgment to the County on the disability discrimination claims, reasoning that the policy was justified under the ADA's direct threat exception since foster children placed with the Does could sexually assault Adam and contract HIV.

Because we believe that a reasonable fact finder could find that placement of at least some foster children in the Does' home would not entail a significant risk of harm, we will reverse. Furthermore, we will reverse the District Court's judgment that none of the Does' racial discrimination claims are ripe for adjudication. However, we will affirm the District Court's decision that the individual County officials are entitled to qualified immunity. We will also affirm the District Court's holding that county government entities are immune from punitive damages.

I.

The appellants, John Doe, a 51 year old African-American man, and Mary Doe, a 52 year old Caucasian woman, are married, and live in State College, Centre County, Pennsylvania, with their two adopted sons, Adam, 11 years old, and Steven, 12.

Over the years, Mary has dedicated herself to the care of foster children with special needs. From 1972 to 1989, she cared for 8 foster children and eventually adopted 7 of them. Adam and Steven, who came to Mary as infants, were the last two children she adopted. Adam came to Mary with HIV and AIDS, which he contracted from his birth mother. Another of Mary's adopted sons was blind, retarded and had cerebral palsy. Others had been physically and sexually abused. Her efforts have earned her several awards, including Foster Parent of the Year by the New York State Foster Parents' Association.

Overcoming a troubled youth and time in prison, John earned a college degree and became active in church and community affairs. He has served as a program worker in residential group homes for persons with mental retardation and is currently a cab driver. He had no children of his own, but upon marrying Mary, he accepted her children, including Adam, into his home.

AIDS (Acquired Immunodeficiency Syndrome) is the last stage of progression of the HIV virus (Human Immunodeficiency Virus). HIV infects and destroys specific white blood cells, known as T lymphocytes, that support the body's immune system. As the virus progresses, infected persons become more and more susceptible to opportunistic infections and diseases, and, although persons with HIV can live for years, the virus has no cure. See generally Bragdon v. Abbott, 524 U.S. 624, 633-37 (1998) (describing the course of HIV and AIDS in detail, with references to medical texts and authorities).

Due to the virus, Adam suffers eating and digestion problems. He receives nourishment through a feeding tube. He has symptoms of autism and permanent learning deficits, including difficulties speaking and expressing himself. Unable to care for himself, Adam relies on his parents and others to assist him with eating, cleaning, and personal hygiene.

Prior to 1996, HIV and AIDS severely threatened Adam's health. His eating and digestive problems were far more severe, and he weighed only 37 pounds at the age of six in March 1996. At that time, doctors began aggressive drug therapy that has suppressed Adam's HIV viral load to undetectable levels.2 Today, despite his physical limitations, Adam has good overall health, and suffers no greater risk of opportunistic infection than a child without HIV.

Adam attends school classes for children with special needs. School officials keep his HIV-positive status confidential and do not require disclosure of that status to parents of HIV-negative students. Adam has not transmitted HIV to his brother, Steven, nor to any children with whom he attends school.

The probability of HIV transmission from Adam to others is a crucial issue in this case. During proceedings, the District Court entertained testimony about HIV and AIDS from two medical experts, Joel H. Hersh, an expert in Public Health Administration, and Robert M. Swenson, M.D., a physician and expert in the treatment of infectious diseases. The following discussion proceeds from their testimony and related affidavits. See generally Doe v. County of Centre, 60 F. Supp. 2d 417, 419-26 (M.D. Pa. 1999) (summarizing portions of the medical evidence) [hereinafter Doe I]; Doe v. County of Centre, 80 F. Supp. 2d 437, 441-44 (M.D. Pa. 2000) (same) [hereinafter Doe II].

HIV is transmitted only through absorption of infected blood or sexual secretions into the bloodstream or mucous membranes of an uninfected person. Bodily fluids such as sweat, tears, or saliva, while containing minute amounts of HIV, pose little to no risk of infection, nor does skin contact with HIV-positive blood, unless the skin is broken or has open wounds. Thus, the chance of HIV transmission from casual contact is virtually nonexistent. Normal sibling fighting and roughhousing present negligible risk of transmission. In fact, Dr. Hersh testified that out of the 21,000 AIDS cases in Pennsylvania, there are no reported cases of virus transmission due to familial contact or fighting. Even intense physical activities create little risk of infection. For example, Dr. Swenson noted that a study involving football players found that the risk of HIV transmission was one in every 85 million violent contacts.

The two primary modes of infection are through the use of infected hypodermic needles and through unprotected sex. According to Dr. Swenson, the probability of HIV transmission through sexual activity varies depending on the activity involved, the specific roles of the infected and uninfected persons in the sexual activity, and the viral load of the infected person. Certain generalities apply. For example, the lower an HIV-positive person's viral load, the lower the transmission risk. In addition, during sexual intercourse, HIV is more easily transmitted from an insertive to a receptive partner than from a receptive to an insertive partner.

Relying on his professional experience and the prevailing medical research, Dr. Swenson...

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