Background
Bilal Adom, an incarcerated wheelchair user at Salinas Valley State Prison, has a painful spinal condition and urinary and occasional fecal incontinence. CDCR provided him with adult diapers and other incontinence supplies for nearly a year, including through a permanent supply order. After he transferred to another prison housing unit, however, staff terminated the order without first examining him or asking about his incontinence.
For nearly five months, Adom repeatedly told prison medical and custodial personnel that he could not control his bodily functions and, without supplies, soiled himself, his bedding, and his wheelchair. He reported using towels, trash bags, tissues, and plastic as makeshift diapers and described resulting pain, humiliation, and psychological distress. CDCR offered measures such as shower access, laundering, and a small number of extra towels and boxer shorts before restoring his supplies in January 2022. Adom sued under Title II of the Americans with Disabilities Act and the Eighth Amendment. The district court granted summary judgment to the defendants on all claims.
The Court’s Holding
In a divided published opinion, the Ninth Circuit reversed summary judgment on Adom’s ADA claim and remanded. Viewing the evidence in Adom’s favor, the majority held that a reasonable jury could find him disabled because of his spinal condition, incontinence, or both. It also could find that he was denied meaningful access to CDCR’s toileting and hygiene services because, without adult diapers, he could not manage his bodily functions with hygiene and dignity comparable to other prisoners. The majority concluded that the alleged denial was “by reason of” his disabilities because those disabilities made it harder for him to obtain the services’ benefits.
The court further held that Adom produced enough evidence for a jury to find deliberate indifference, which is required for compensatory damages under Title II. CDCR could not avoid its accommodation obligations solely by asserting that its institutional actors had deemed the requested supplies medically unnecessary or not medically indicated. The panel remanded for the district court to determine in the first instance whether Adom has standing to seek an injunction requiring a permanent accommodation order. Judge Bea dissented, reasoning that Adom was not qualified for the supplies without proof of medical necessity, that any denial was not by reason of disability, and that the evidence could not establish deliberate indifference.
Key Takeaways
- A prison’s ADA duties may require more than physical access to toilets, showers, and laundry; a jury may consider whether a disabled prisoner has meaningful, hygienic, and dignified access to those services.
- A public entity is not excused from providing a reasonable accommodation solely because it has determined that the accommodation is not medically necessary or indicated.
- Repeated notice of an accommodation need, an abrupt termination without gathering new information, and allegedly inadequate responses can create a triable issue of deliberate indifference supporting compensatory damages.
Why It Matters
The decision recognizes that facially equal access to prison facilities may be insufficient under Title II when a disability prevents an incarcerated person from using those facilities in a meaningfully comparable way. Correctional institutions may need to modify ordinary practices or provide supplies even when a prisoner technically can reach toilets and showers.
The ruling also separates ADA accommodation analysis from medical-necessity determinations. Although medical evidence may remain relevant, an institution cannot treat the absence of a medical indication as automatically resolving whether disability law requires an accommodation.