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Ross v. Jefferson County Dept of Health

11th Circuit Court
2012 WL 5519095
November 15, 2012

Keywords:  ADA – general, employment, enforcement, legal concepts, sovereign immunity, state & local government


Whether a county health board is entitled to sovereign immunity from Title II of the ADA?

Facts of the Case

Plaintiff Sherry Ross is a former dental assistant with the Jefferson County Department of Health (“Health Department”). She was fired after failing to return to work after taking an approved medical absence under the Family and Medical Leave Act (“FMLA”). Ross submitted a doctor’s note stating that she was able to return to work on February 19, 2009. The Health Department informed her in a termination letter that her approved leave of absence ended on February 16, 2009. The letter stated that the Health Department could not approve additional leave because of the “critical nature” of her position and that she was terminated for failing to return to work.

Ross filed a complaint of discrimination based on her disability, fibromyalgia, under the Americans with Disabilities Act (“ADA”) and based on race under Title VII. She alleged that the Health Department refused her request for reasonable accommodation by denying her request for light duty and firing her for using leave under the FMLA. The Health Department argued that it is a state entity and as such is immune to Ross’s disability suit under the Eleventh Amendment. The Health Department also argued that Ross failed to request reasonable accommodations. In response to the allegation of racial discrimination, the Health Department argued that Ross could no longer assert this claim after admitting during a deposition that race was not related to her termination. Finally, the Health Department asserted that it had a legitimate, non-discriminatory reason to terminate Ross.

Ross responded that the Health Department was not entitled to immunity and that she had submitted enough evidence to support a case of disability or racial discrimination. The United States District Court for the Northern District of Alabama held that the Health Department was immune from Ross’s suit under the ADA and that Ross failed to request reasonable accommodations. It also held that Ross waived her claim to racial discrimination under Title VII. Ross appealed to the Eleventh Circuit Court of Appeals.

Issues of the Case

  1. Is the Jefferson County Department of Health a state agency entitled to sovereign immunity?
  2. Did Ross waive her Title VII race discrimination claim?

Arguments & Analysis

1. The Jefferson County Department of Health is a state agency entitled to sovereign immunity.

Under the Eleventh Amendment, states cannot be sued by private individuals without their consent. This protection exists to limit the power of federal courts to intrude on states’ rights to sovereignty. Sovereign immunity exists to “accord[] the States the respect owed them as members of the federation and not to affront the dignity or integrity of a state by requiring a state to respond to lawsuits in federal courts.” Congress may pass legislation that allows states to be sued despite the Eleventh Amendment, but the Supreme Court has held that it did not do so by passing the ADA. State sovereign immunity extends to state agencies that are considered “arms of the state.” Courts decide whether an agency is an arm of the state by considering how state courts treat the agency.

Alabama courts treat county boards of health as state agencies and have held that boards of health are state agencies immune to suits by private citizens. In this case, the Eleventh Circuit stated that it must adhere to those decisions unless there is “persuasive indication” that the state’s highest court would come to a different conclusion. Courts consider four factors when determining if an entity is a state agency immune to suits: 1) The Court examines how state law defines the entity; 2) The Court considers the degree of control the State maintains over the entity; 3) The Court looks at where the entity derives its funding; 4) The Court considers who is responsible for judgments against the entity.

Ross argued that the Health Department is not immune from a suit for money damages under the ADA because the Health Department is an agent of the county and not of the state. The Eleventh Circuit held that state law defines the Jefferson County Health Department as an “arm of the state.” Here, under state law, county boards of health control the termination of employment, the function at issue in this case. However, the individual within the Jefferson County Health Department with the authority to terminate employment, the Health Officer, is defined by state law to be a state officer. While county boards of health have the sole authority to perform public health work, they are subject to control by the State Board of Health.

Turning to the second factor, the Court noted that the state controls personnel decisions within the Health Department, and that the state board of health control county boards of health. The state health officer must approve any leave by a county health officer that exceeds 30 days. Therefore, the state controls the hiring and firing of employees even though the Health Department uses the county personnel system.

Regarding the third factor, the Court held that although the county supplies the Health Department’s funding, this is not enough to establish county control because state law requires the county to supply the funding. In addition, the Court found no evidence that the county exerts control over the Health Department.

Looking at the fourth factor, the Court noted that it has previously held that liability of the state treasury is not enough to determine whether an entity of the government should have immunity under the Eleventh Amendment. Here, the Health Department was responsible for paying any monetary judgment out of its own budget. However, the Court emphasized that it does not “limit Eleventh Amendment immunity ‘to who foots the bill….’” Therefore, despite the fact that the Health Department was responsible for paying judgments out of its budget, this was not sufficient to outweigh the other three factors. The Eleventh Circuit held that the district court correctly decided that the Health Department was a state agency, and immune from Ross’s claim under the ADA.

2. Did Ross waive her Title VII race discrimination claim?

Under Title VII, an employer may not refuse to hire, or to fire, or to discriminate against any individual because of her race, color, religion, sex, or national origin. A plaintiff claiming discrimination in violation of Title VII must establish that the defendant intentionally discriminated against her. Because Ross stated in a deposition that she did not feel that her termination had anything to do with race, the Court held that she conceded that the Health Department did not discriminate against her based on her race in violation of Title VII.


The Eleventh circuit ruled that (1) The Health Department is a state agency entitled to immunity against the ADA claim under the Eleventh Amendment and (2) Ross waived her Title VII race discrimination claim.

Policy & Practice

Under this ruling, Eleventh Amendment sovereign immunity for state agencies is determined according to how the state treats the entity in question. In the Eleventh District, a county board of health will be considered an agent of the state if it is defined as an arm of the state by statute, if a state officer must approve personnel decisions, and if state law requires the county to provide funding. If the county is liable for judgments against the entity, the Court will still consider the entity a state agency if the state provides the budget from which the damages will be paid.

Note that the Sixth Circuit has held differently, ruling that reimbursement from the state does not weigh in favor of a determination that state sovereignty applies (See Lowe v. Hamilton County Dept. of Job & Family Services, 610 F.3d 321 (6th Cir. 2010).



These materials do not constitute legal advice and should not be relied upon in any individual case. Please consult an attorney licensed in your state for legal advice and/or representation. These materials were prepared by the legal research staff of the Burton Blatt Institute (BBI) at Syracuse University in partnership with the Southeast ADA Center to highlight legal and policy developments relevant to civil rights protections and the impact of court decisions in the Southeast Region under the Americans with Disabilities Act (ADA). These materials are based on federal disability rights laws and court decisions in effect at the time of publication. Federal and state disability rights law can change at any time. In addition, state and local laws and regulations may provide different or additional protections. Materials are intended solely as informal guidance, and are neither a determination of your legal rights nor responsibilities under the ADA or other federal, state, and local laws, nor binding on any agency with enforcement responsibility under the ADA. The accuracy of any information contained herein is not warranted. Any links to external websites are provided as a courtesy and are not intended to nor do they constitute an endorsement of the linked materials.