Northeastern Law Team Helps Win Landmark ADA Settlement Protecting Public Health Services

05.21.26 — A legal theory developed at Northeastern Law’s Action Lab at the Center for Health Policy and Law has produced its first landmark result: a federal settlement in Gather Church v. Lewis County that establishes new protections for syringe service programs and other harm reduction services under the Americans with Disabilities Act.

“Harm reduction programs have long been targets of misguided legal attacks. But the toolkit for protecting these vital programs and services has been limited. Until now. The Gather Church decision is a gamechanger for those working to shield harm reduction programs and clients from all forms of government interference amidst mounting attacks,” said Professor Leo Beletsky, faculty director of the Action Lab, which houses the Advancing Harm Reduction Through the Law initiative.

The settlement, reached in February, resolves Gather Church v. Lewis County — the first federal case to use the ADA to challenge discriminatory zoning targeting a syringe service program. Lewis County, Washington, repealed a 2024 ordinance that had effectively shut down Gather Church’s mobile harm reduction program and agreed to pay $500,000 in attorney’s fees. The case was litigated by the ACLU, ACLU of Washington and Chicago civil rights firm Kaplan & Grady — including two Action Lab-trained attorneys, Amelia Caramadre ’22 and David Sinkman.

The legal foundation for the argument dates to 2018, when Beletsky began conversations with Greg Dorchak ’14, who envisioned using the ADA to secure medication access for people with opioid use disorder in jails and other institutional settings. Those conversations led Beletsky to a broader question: Could the ADA also protect harm reduction programs — like syringe services — from discrimination?

The Drug Law and Policy course Beletsky teaches at Northeastern Law has long functioned as an incubator for innovative ideas for the use of the law to address addiction and other public health challenges. Then-students Kat Delos Reyes ’20 and Abigail Fletes ’20 used the course to further develop the ADA theory. Working as a team with an interdisciplinary group of colleagues from Harvard and WVU, this collaboration culminated in a 2022 article in the Yale Journal of Health Policy, Law, and Ethics which set out the case that harm reduction services constitute protected health services under the ADA.

In the meantime, the Action Lab secured private funding to provide post-graduate fellowships to strengthen the legal workforce with expertise in using the law to advance public health approaches to addiction and overdose. Its inaugural cohort included Amelia Caramadre ’22 and David Sinkman, a former U.S. Department of Justice prosecutor whose work on opioid-related prosecutions had sparked an interest in proactive legal strategies to promote public health. After completing their fellowships, Caramadre and Sinkman transitioned to Kaplan and Grady to further their work.

Fast forward to 2025, when Kaplan & Grady working the ACLU of Washington decided to pursue litigation to protect Gather Church—a harm reduction provider—against discriminatory zoning.

“Gather Church’s religious mission is serving people struggling with drug addiction,” said Sinkman. “Lewis County directly targeted the church — the county’s sole syringe service program — in direct violation of civil rights and religious liberty protections. Local governments cannot be allowed to discriminate against members of their communities."

The settlement is considered a potential turning point. Harm reduction programs face growing opposition from local governments across the country. The ruling by U.S. District Court Chief Judge David G. Estudillo — finding that Lewis County’s ordinance likely violated federal disability law — and the county’s subsequent retreat gives those programs a legal roadmap to fight back.

Building on this success, AHRLA is planning to work with Andi Goodman ‘25, Hala Baradi ’25, Arianna Murray ’25, Johnathon Card ’18 and others in its network of the Action Lab-trained alumni to leverage this important new tool to protect some of the most vulnerable programs and clients.