NASHVILLE, Tenn. — One of Tennessee’s largest HIV service providers has taken the state Department of Health to court over new rules that would require immigration status checks for people who rely on Ryan White, the federal HIV/AIDS care program.
Nashville CARES filed the lawsuit Monday in Davidson County Chancery Court. Lawyers from the Tennessee Justice Center represent the nonprofit, which wants the court to declare the new contract changes invalid and to block them while the case moves forward.
The dispute began in August. On Aug. 18, case managers were told in an email from the department’s HIV program director that patients without proof of citizenship or legal residency could no longer be newly enrolled in many Ryan White services and in Housing Opportunities for People with AIDS, a companion housing program. The department pulled that rule back days later, after Nashville CARES challenged it.
A memo dated Oct. 1 then replaced it with broader language. Every agency serving Ryan White patients must now amend its contract so that it requires eligibility verification for each potential beneficiary, a step the memo ties to state law. That law requires that anyone seeking public benefits be verified as lawfully present in the United States.
Nashville CARES argues that the rules break federal law. Neither program requires immigration checks at the federal level, and federal law specifically exempts programs that treat communicable diseases from those checks. For low-income Tennesseans living with HIV, Ryan White money covers doctor visits, medications, in-home care, case managers, insurance premium aid and end-of-life hospice services.
The nonprofit says hundreds of its clients could be affected. The lawsuit counts at least 129 patients who get help paying for health insurance, 150 to 160 people whose mental health care and medication management it pays for, and 80 to 100 who are treated at its clinics. U.S. citizens who cannot produce documents could also lose services.
Both programs serve as payers of last resort, covering people who cannot afford or reach care any other way. Nashville CARES first asked the department for a declaratory order on Sept. 29, then filed a revised version on Oct. 14, and the state has 60 days to respond to that petition, a delay the nonprofit says made going straight to court necessary.
The department did not comment on the lawsuit Monday. It is the second legal challenge this year to state efforts to add immigration status checks to health programs that serve as a safety net for people with little income.
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