Discrimination | HIVAIDS | Massachusetts

Yes. Massachusetts has enacted anti-discrimination laws protecting people with HIV from discrimination in employment, housing, and public accommodations. In addition, there are a number of federal laws that protect people from discrimination based on their HIV status.

• Moun ki gen SIDA oubyen ki VIH pozitif, menm si yo pa gen okenn sentòm epi yo pa gen okenn siy maladi oubyen siy aparan.
• People who have a record of or who are regarded or perceived as having HIV.
• Under federal law, but not Massachusetts law, a person who does not have HIV, but who “associates” with a person with HIV – such as a friend, lover, spouse, roommate, business associate, advocate or caregiver.

People with HIV are protected under Massachusetts General Law Chapter 151B and the federal Americans with Disabilities Act (ADA).  Both of these statutes prohibit discrimination in employment on the basis of a person’s disability. Massachusetts law covers workplaces with six or more employees. The ADA covers workplaces with 15 or more employees.

An employer may not take adverse action against an applicant or employee simply on the basis that the person has a disability such as HIV or AIDS.  This means that an employer may not terminate, refuse to hire, rehire, or promote, or otherwise discriminate in the terms or conditions of employment, based on an individual’s HIV/AIDS status.

Fòk nou konsantre isit la se si yon moun ki gen SIDA oswa VIH te trete yon fason diferan pase lòt kandida oswa anplwaye ki nan menm sitiyasyon.

Men kèk egzanp diskriminasyon ilegal:

• Yon patwon pa ka refize anboche yon moun ki gen VIH paske li pè ke VIH la ka transmèt bay lòt anplwaye oswa bay kliyan.
• Yon patwon pa ka refize anboche oswa pran yon desizyon sou anplwa ki baze sou posibilite, oswa menm pwobabilite, pou yon moun vin malad epi li pa pral kapab fè travay la nan lavni.
• Yon anplwayè pa ka refize anboche yon moun paske sa ap ogmante prim asirans sante oswa konpansasyon travayè.

No. Massachusetts law (M.G.L. c. 111, § 70F) prohibits an employer from requiring that an employee take an HIV test under any circumstances at any stage of the application or employment process.

Under the ADA and Massachusetts law, prior to employment, an employer cannot ask questions that are aimed at determining whether an employee has a disability.  Examples of prohibited pre-employment questions are:

• Èske ou janm te entène lopital oubyen anba swen yon doktè?
• Èske ou janm te resevwa benefis pou aksidan travay oswa andikap?
• Have you ever had any medical problems that would make it difficult for you to do your job?
• Ki medikaman ou pran?

Sepandan, yon anplwayè ka mande yon kandida si li gen konesans, konpetans ak kapasite pou fè fonksyon travay la.

Under the ADA, after a conditional offer of employment, an employer may request a medical examination or any medical information, without limitation.  However, the ADA does require the employer to follow certain practices:

• The employer must require the medical exam or inquiry of all applicants in the job category.
• The information must be kept strictly confidential. It must be on separate forms and kept in a segregated file apart from a general personnel file.
• The information may not be shared with others, with a limited exception for supervisors or managers who need to be informed of necessary job restrictions or accommodations, or safety personnel who may be told if the person with a disability requires emergency treatment.
• The results of the medical examination cannot be used to withdraw the job offer unless the results indicate that the individual is not able to perform the essential functions of the job with reasonable accommodation.

After employment has begun, an employer may only require a medical exam of a current employee if it is “job-related and consistent with business necessity.” The employer must demonstrate that the medical examination is necessary to measure the employee’s actual performance of job functions.

Of course, as noted above, employers in Massachusetts are prohibited from requesting an HIV test at any time.

In general, Massachusetts law limits employer health inquiries more strictly than federal law. Under Massachusetts law, after a conditional offer of employment, an employer may only require a medical examination for the purpose of determining whether the employee is capable of performing the essential functions of the job with reasonable accommodation.

The risk of HIV transmission from a health care worker to a patient is considered so small that it approaches zero.  Nevertheless, in cases where hospitals have sought to restrict or terminate the privileges of HIV-positive health care workers who perform invasive procedures, courts have reacted with tremendous fear and have insisted on an impossible “zero risk” standard. As a result, the small number of courts that have addressed this issue under the ADA have upheld such terminations.

Dispozisyon anplwa ki nan ADA a prevwa ke yon anplwaye pa kalifye pou fè travay la si li poze yon "menas dirèk pou sante oswa sekirite lòt moun". Pou detèmine si yon anplwaye poze yon "menas dirèk", yon tribinal analize:

• Nati, dire ak gravite risk la;
• Pwobabilite risk la; epi
• Si wi ou non risk la ka elimine pa akomodasyon rezonab.

In the case of HIV-positive health care workers, courts have ignored the extremely remote probability of the risk and instead have focused on the nature, duration and severity of the risk. The following excerpt from a recent case is typical of courts’ approach:

“We hold that Dr. Doe does pose a significant risk to the health and safety of his patients that cannot be eliminated by reasonable accommodation. Although there may presently be no documented case of surgeon-to-patient transmission, such transmission clearly is possible. And, the risk of percutaneous injury can never be eliminated through reasonable accommodation … Thus, even if Dr. Doe takes extra precautions … some measure of risk will always exist …”(Doe v. University of Maryland Medical System Corporation, 50 F. 3d 1261 (4^yèm Cir. Md) (1995)).

It is important to note that only a small number of courts have addressed the rights of HIV-­positive health care workers.  The AIDS Law Project believes that these cases have been incorrectly decided and are inconsistent with the intent of Congress in passing the ADA. Because of the unsettled nature of the law in this area, a health care worker who is confronted with potential employment discrimination should consult a lawyer or public health advocate.

Malgre ke li ka itil pou konsilte ak yon avoka, etap sa yo ka itil pou kòmanse konsidere ak evalye yon pwoblèm diskriminasyon nan travay potansyèl.

1. Consider the difference between unfairness and illegal discrimination. The bottom line of employment law is that an employee can be fired for a good reason, a bad reason, or no reason at all. A person can be legally fired for a lot of reasons, including a bad “personality match.” What they cannot be fired for is a discriminatory reason specifically outlawed by a statute.

2. Pou w ka pwouve yon plent pou diskriminasyon (sa vle di, ke yo te revoke w, degrade w, elatriye akoz diskriminasyon epi non pa akoz yon rezon lejitim), ou dwe kapab montre bagay sa yo:

• Patwon-an te konnen oswa te dekouvri ke ou VIH pozitif oswa ou gen SIDA;
• Ou te kalifye pou fè fonksyon esansyèl travay la avèk oswa san aranjman rezonab; epi
• Yo te pran aksyon negatif kont ou akòz estati VIH oswa SIDA ou epi rezon pretèks anplwayè a bay pou aksyon negatif la se fo.

3. Si patwon ou konnen ou gen VIH oswa SIDA, idantifye egzakteman ki moun ki konnen, kijan yo konnen, ak ki lè yo te dekouvri sa. Si ou pa di patwon ou, èske gen nenpòt lòt fason patwon an ta ka konnen oswa sispèk estati VIH ou a?

4. Konsidere rezon ki fè ou kwè ke yo ap trete w yon fason diferan akòz estati VIH ou a, tankou domèn sa yo:

• Èske lòt anplwaye ki nan menm sitiyasyon yo te trete menm jan an oswa yon lòt jan?
• Èske patwon ou an te swiv règleman pèsonèl li yo?
• Èske tretman negatif la te kòmanse yon ti tan apre anplwayè a te aprann estati VIH ou a?
• Èske ou te pèdi travay ou akòz maladi pandan nenpòt peryòd tan epi èske tretman negatif la te kòmanse lè ou te retounen nan travay?
• Ki vèsyon patwon ou a pral bay sou evènman yo? Kijan ou pral pwouve ke vèsyon patwon an se fo?

5. Èske w gen difikilte pou w ranpli devwa travay ou akòz nenpòt pwoblèm sante oswa medikal ki gen rapò ak VIH? Èske kondisyon w lan anpeche w travay aplentan, oswa èske w bezwen pran konje pou randevou medikal, travay ki pi lejè oswa yon pozisyon ki mwens estrèsan? Ou ta ka vle eseye fè brainstorming pou kreye yon aranjman rezonab ke ou ka pwopoze bay anplwayè w la. Men kèk pwen pou w konsidere:

• Ki jan konpayi an fonksyone e kijan akomodasyon an ta mache an pratik?
• Mete tèt ou nan plas sipèvizè w la. Ki objeksyon yo ta ka soulve kont aranjman rezonab yo mande a? Pa egzanp, si ou bezwen kite nan yon sèten lè pou randevou medikal, ki moun ki ta ranplase devwa w yo?

It is illegal under both Massachusetts law (M.G.L. c. 151B) and the federal National Fair Housing Amendments of 1989 to discriminate in the sale or rental of housing on the basis of HIV status.  A person cannot be evicted from an apartment because of his or her HIV status, or because he or she is regarded as having HIV or AIDS.

In addition, a person cannot be discriminated against in housing because of their “association” with a person with HIV.  This means a person cannot be discriminated against because their roommate, lover, friend, relative, or business partner has HIV.

Yes. Massachusetts law exempts owner-occupied two-unit housing. In addition, the Fair Housing Act exempts, in some circumstances, ownership-occupied buildings with no more than four units, single-family housing sold or rented without the use of a broker and housing operated by organizations and private clubs that limit occupancy to members.

Yes. Under both Massachusetts law (M.G.L. c. 272, § 98) and the ADA, it is unlawful to exclude a person with HIV from a public place (what the law refers to as a “public accommodation”) or to provide unequal or restricted services to a person with HIV in a public place. Under both statutes, the term “public accommodation” includes any establishment or business that offers services to the public. In addition, the Federal Rehabilitation Act of 1973 (29 U.S.C.A. § 794) prohibits discrimination on the basis of disability in any agency or program that receives federal funding, including hospitals, medical or dental offices, and educational institutions.

Therefore, people with HIV are protected from discrimination in virtually every public place or business, including bars, restaurants, hotels, stores, schools, vocational or other educational programs, taxi cabs, buses, airplanes and other modes of transportation, health clubs, hospitals and medical and dental offices, as long as these facilities are generally open to the public.

Believe it or not, persons with HIV are still faced with discrimination by hospitals, doctors, dentists, and other health care providers.  This discrimination can take the form of an outright refusal to provide medical services or an illegal referral because of a patient’s HIV status.

Doktè yo tipikman eseye jistifye diskriminasyon kont moun ki gen VIH ak youn nan de agiman sa yo:

• “Trete Moun ki gen VIH se Danjere” (Gen kèk doktè ki refize trete moun ki gen VIH paske yo pè pou yo pa transmèt VIH); epi
• "Tretman Moun ki gen VIH Mande Ekspètiz Espesyal" (Gen kèk doktè ki refere pasyan yo bay lòt founisè swen medikal ki baze sou yon kwayans ki pa kòrèk ke doktè jeneralis yo pa kalifye pou bay swen pasyan ki gen VIH).

Both an outright refusal to provide medical treatment and unnecessary referrals on the basis of a person’s disability are unlawful under the ADA and Massachusetts law.

Tribinal yo ak ekspè medikal yo te reponn a agiman sa yo nan fason sa yo:

1. “Treating People with HIV is Dangerous”

Doktè ak dantis ka deklare ke yon refi pou trete yon pasyan ki gen VIH se lejitim paske yo pè yo ka pran VIH tèt yo atravè pike zegwi oswa lòt ekspozisyon nan san. Sepandan, etid sou travayè swen sante yo konkli ke risk pou pran VIH akòz ekspozisyon pwofesyonèl la minim, sitou lè yo itilize prekosyon inivèsèl.

For this reason, in 1998, the United States Supreme Court ruled in the case, Bragdon kont Abbott, that health care providers cannot refuse to treat people with HIV based on concerns or fears about HIV transmission (524 U.S. 624 (1998)).

Anplis pèspektiv legal la, ni Asosyasyon Medikal Ameriken an ni Asosyasyon Dantè Ameriken an, ansanm ak anpil lòt òganizasyon pwofesyonèl swen sante, te pibliye règleman ki di li pa etik pou refize tretman bay yon moun ki gen VIH.

2. "Tretman Moun ki gen VIH mande yon ekspètiz espesyal"

Nan ka sa yo, merit yon plent pou diskriminasyon depann de si, ki baze sou prèv medikal objektif, sèvis oswa tretman pasyan an bezwen an mande yon rekòmandasyon bay yon espesyalis oswa si li nan kad sèvis ak konpetans founisè a.

Nan Etazini kont Morvant, yon tribinal federal te rejte reklamasyon yon dantis ki te di pasyan ki gen VIH bezwen yon espesyalis pou swen dantè routin (898 F. Supp. 1157 (ED La 1995)). Tribinal la te dakò ak temwayaj ekspè yo ki te di ke pa gen okenn fòmasyon espesyal oswa ekspètiz, apa de sa yon dantis jeneral genyen, ki nesesè pou bay tretman dantè bay moun ki gen VIH. Tribinal la te rejte espesyalman agiman dantis la ki te di ke li pa t kalifye paske li pa t rete okouran de literati ak fòmasyon ki nesesè pou trete pasyan ki gen VIH. Pandan ke ka sa a te leve nan kontèks swen dantè, li aplikab nan lòt anviwònman medikal tou.

Under Title III of the ADA (42 U.S.C. §§ 12181-12188), and similar provisions of Massachusetts law, it is illegal for a health care provider to:

• Refize yon pasyan ki VIH pozitif pou "jwi sèvis medikal yo nèt ale epi egalman" oubyen refize yon pasyan ki VIH pozitif pou "benefisye" sèvis medikal yo menm jan ak lòt pasyan yo.
• Etabli "kritè kalifikasyon" pou privilèj pou resevwa sèvis medikal yo, ki gen tandans pou elimine pasyan ki teste pozitif pou VIH.
• Bay pasyan ki VIH pozitif oswa ki pa bay pasyan sèvis "diferan oswa separe" nan "anviwònman ki pi entegre a".
• Refize sèvis medikal egal a yon moun ke yo konnen ki gen yon "relasyon" oswa "asosyasyon" ak yon moun ki gen VIH, tankou yon mari oswa yon madanm, yon patnè, yon pitit, oswa yon zanmi.

Lè nou aplike dispozisyon espesifik ADA ki anwo yo nan pratik swen sante, pratik sa yo ilegal:

• Yon founisè swen sante pa ka refize trete yon moun ki gen VIH paske li santi li gen risk transmisyon VIH la oubyen paske doktè a tou senpleman pa santi l alèz pou trete yon moun ki gen VIH.
• Yon founisè swen sante pa ka dakò pou trete yon pasyan sèlman nan yon anviwònman tretman deyò biwo abityèl doktè a, tankou yon klinik espesyal nan yon lopital, tou senpleman paske moun nan VIH pozitif.
• A health care provider cannot refer an HIV-positive patient to another clinic or specialist, unless the required treatment is outside the scope of the physician’s usual practice or specialty. The ADA requires that referrals of HIV-positive patients be made on the same basis as referrals of other patients.  It is, however, permissible to refer a patient to specialized care if the patient has HIV-related medical conditions which are outside the realm of competence or scope of services of the provider.
• A health care provider cannot increase the cost of services to an HIV-positive patient in order to use additional precautions beyond the mandated OSHA and CDC infection control procedures. Under certain circumstances, it may be an ADA violation to even use unnecessary additional precautions which tend to stigmatize a patient simply on the basis of HIV status.

Yon founisè swen sante pa ka limite lè yo pwograme pou trete pasyan ki gen VIH, tankou ensiste pou yon pasyan ki gen VIH vini nan fen jounen an.

Pou pouswiv yon plent anba Lwa Ameriken sou Andikap pou diskriminasyon nan travay, patwon-an dwe gen omwen 15 anplwaye. Yon moun dwe depoze yon plent bay Komisyon Egalite Opòtinite nan Travay (EEOC) nan lespas 180 jou apati dat zak diskriminasyon an. Yon moun ka retire yon plent ADA nan men EEOC epi depoze yon pwosè nan tribinal eta a oswa federal.

Pou pouswiv yon plent anba Lwa Ameriken sou Andikap pou diskriminasyon nan yon kote piblik, yon moun ka, san l pa ale nan yon ajans administratif anvan, depoze yon plent nan tribinal leta oswa federal pou yon soulajman sèlman (sa vle di, chèche yon lòd tribinal pou konduit diskriminatwa a sispann). Pa gen domaj lajan ki disponib pou vyolasyon Tit III ADA a sof si Depatman Lajistis Etazini mande yo. Sepandan, yon moun ka jwenn domaj lajan anba Lwa Federal sou Reyabilitasyon an nan ka kont antite ki resevwa finansman federal.

Pou pouswiv yon reklamasyon anba Lwa Reyabilitasyon an, yon moun ka depoze yon plent administratif nan biwo rejyonal Depatman Sante ak Sèvis Sosyal federal la epi/oswa depoze yon pwosè dirèkteman nan tribinal la.

Pou pouswiv yon plent anba Lwa Nasyonal sou Jistis nan Lojman pou diskriminasyon nan lojman, yon moun ka depoze yon plent nan Biwo Lojman ak Devlopman Iben Etazini nan yon ane apre vyolasyon an. Yon moun ka depoze yon pwosè tou nan dezan apre vyolasyon an. Yo ka depoze yon pwosè kit yon moun te depoze yon plent nan HUD kit li pa te depoze yon plent.