Date Issued: November 3, 2014
RECIPIENTS
- All Providers of OASAS Certified Services
- Local Governmental Units (LGUs)
BACKGROUND
The purpose of this bulletin is to inform OASAS certified treatment providers that the United States Court of Appeals for the Second Circuit in DeStefano v Emergency Housing Group et al. has determined that Alcoholics Anonymous ("A.A.") is a religious activity and accordingly OASAS funding of providers who mandate patient participation in A.A. and, by extension, other government funding of providers who mandate participation in A.A., is a violation of the principle of separation of church and state.
The DeStefano decision concluded that the promotion of religious beliefs by staff members of government funded providers through coerced, required or mandated participation in A.A. constitutes impermissible governmental indoctrination of religion in violation of the First Amendment to the United States Constitution. Consequently, an OASAS certified provider that requires or coerces a patient to participate in A.A. would not be eligible to receive government funding. While the DeStefano decision was specifically concerned only with A.A., the same constitutional concerns would apply to any approach, 12 step or otherwise, that has a sufficiently religious character. Government funded providers should be cautious not to risk violation of the constitutional principle of separation of church and state.
However, the DeStefano decision also concluded that it is permissible for a government funded provider to make A.A. programs available to patients, as long as the provider and its program staff make it clear that participation is on a voluntary basis without any coercion.
While this decision will likely require some government funded providers to alter their policies, nothing in the DeStefano decision alters the central role that A.A. plays in providing peer support, spiritual exploration and personal growth in support of recovery.
PROVIDER ACTIVITIES WHICH ARE IMPACTED BY THE DECISION
Government funded providers should give careful consideration to activities provided as a planned component of a treatment plan which could be construed as coercion or otherwise mandated participation in a religious activity. For example, government funded providers:
- must not require that a patient attend A.A.
- must not provide staff supervision of any meetings of A.A.
- must not compel the reading, listening or viewing of written, audio or visual material developed by A.A.
- may suggest that individuals receiving services participate in A.A.
- may require that a patient attend recovery support groups in the community, as long as the patient has the option of choosing attendance of activities that are of a non-religious nature.
- may request a patient read, listen or view materials developed by A.A., as part of an introduction to available resources, as long as the materials are not limited to A.A.
- may make space available to A.A. for holding meetings, as long as the space is available to other groups as well.
Employees who are members of A.A. may participate in such meetings, as long as they are not acting as an employee of the provider.
THE ROLE OF A.A. IN RECOVERY
OASAS recognizes that not all alcohol and drug involved persons require treatment and that many individuals find recovery outside of the system of certified treatment providers. The use of A.A. for individuals during and after treatment has been regularly suggested and encouraged by clinicians. A.A. offers the individual a readily accessible alternative that is supportive of and complementary to chemical dependence treatment. While A.A. is a valuable resource to many individuals, it is not the same as treatment. While treatment professionals can inform and encourage individual involvement with A.A., it should be recognized that A.A. cannot replace OASAS certified chemical dependence treatment for all persons.
CONCLUSION
As a result of the DeStefano decision, an OASAS certified treatment program that requires, or coerces, participation in A.A. would not be eligible to receive government funding. As each government funded provider must make its own planning decisions, OASAS recommends that each provider carefully review the DeStefano decision with its own attorney to ensure that they do not violate the constitutionally mandated separation of church and state.
SOURCE(S) OF FURTHER INFORMATION
The decision of the U.S. Court of Appeals may be downloaded from the Internet at http://caselaw.lp.findlaw.com/scripts/getcase.pl?court=2nd&navby=case&no=999146. If you have any questions concerning the issues detailed in this Bulletin, please contact Susan Brandau, Director for the Bureau of Recovery Services at (518) 485-2107.