Alix Mayer

President & Board Chair

Free Now Foundation

50 Woodside Plaza #417

Redwood City, CA 94061

November 6, 2026

VIA EMAIL

Paula M. Stannard

Director of the Office for Civil Rights

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Washington, DC 20201

Re: Request for Statement of Interest and Civil Rights Division Action: Free Now Foundation, et al. v. Poway Unified School District, No. 3:26-cv-02937-AJB-BJW (S.D. Cal.)

Dear Director Stannard:

Robert F. Kennedy Jr. suggested I contact you about this matter.

I write to bring your attention a pending federal case that presents a question of first impression under Title II of the Americans with Disabilities Act: whether a public school may refuse even to consider a disabled child’s request for a reasonable modification of state immunization requirements solely because the physician who documented the child’s disability is not licensed in that State and did not submit the request through a state-controlled electronic portal. The ADA does not permit that result. Federal law guarantees a disabled child an individualized assessment and reasonable modification, and state procedure cannot displace those protections. Yet California’s school vaccination system, as local districts apply it, places state procedure above the ADA. We respectfully ask the Division to file a Statement of Interest under 28 U.S.C. § 517 affirming that Title II’s protections apply and are not overridden by these state-law requirements.

The California ADA lawsuit

Free Now Foundation, a California non-profit, together with a sixth-grade student, A.T., and his mother, are the plaintiffs in Free Now Foundation, et al. v. Poway Unified School District, No. 3:26-cv-02937-AJB-BJW, pending in the United States District Court for the Southern District of California before Judge Anthony J. Battaglia. The case challenges the Poway Unified School District’s (“PUSD” or the “district”) violations of Title II of the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act in implementing and enforcing California’s school vaccination law. Those violations include the following:

1) The district treats state law governing childhood vaccine exemptions as overriding its obligations under the federal ADA, which the Supremacy Clause forbids;

2) The state law, as the district implements it, erects unlawful barriers that exclude students with disabilities whose physicians have determined they cannot safely receive vaccines;

3) The district discriminates among classes of disabilities, in violation of 28 C.F.R. § 35.130(b)(1)(iv), by allowing students who have an Individualized Education Program (IEP) to continue attending school regardless of immunization status while forcing students whose disabilities do not require an IEP through a process controlled entirely by the State;

4) The State’s “in-state” physician requirement violates the ADA by unduly and arbitrarily restricting (controlling) where a student who needs a vaccine exemption as an accommodation may obtain care and medical documentation; and

5) Once a valid, ADA-compliant request for accommodation is made (the accommodation being exemption from vaccines), the district must engage in an individualized inquiry with the parent and may deny the request only on an ADA-compliant fundamental-alteration or “direct threat” analysis (28 C.F.R. §§ 35.130(b)(7), 35.139). The district did neither.

Our student plaintiff is an eleven-year-old with a permanent kidney disability: stage 4 hydronephrosis has destroyed the function of one of his kidneys. He has attended school without some required vaccinations because he had an IEP for a separate speech impairment. Under California law, a student with an IEP may not be denied the special education and related services the IEP requires because of immunization status (Cal. Health & Safety Code § 120335(h)), and until now, the district allowed him to remain in school on that basis without any medical documentation. The district therefore applies a double standard to different classes of disabilities. It also recognizes this child’s kidney disability with physical accommodations at school, such as additional restroom breaks and water, but will not accommodate the same disability when the requested accommodation is exemption from vaccination.

The student’s medical exemption from his longtime California pediatrician was invalidated in October 2024 after the Medical Board of California placed the pediatrician on probation. Nothing about the child’s health had changed. His parents could not find any California physician willing even to evaluate him for an exemption; several told them they feared professional consequences. The parents then submitted an ADA request for accommodation prepared by a Texas-licensed physician working with Frontline Health Advocates, who determined that immunization is not medically safe for the child. The district rejected the request in writing because the physician is not licensed in California and the request was not submitted through the State’s CAIR-ME electronic system, which only California-licensed physicians can use. The district told the family that “there is no federal law pertaining to submitting medical exemptions for immunizations required for school enrollment” and that any concerns should be directed to the State of California. In other words, the district told a disabled child that federal civil rights law does not apply to him. The only alternative it offered was virtual or independent study without on-campus attendance.

The district identified no ADA coordinator, grievance procedure, or interactive process for the request (see 28 C.F.R. § 35.107), and it made no individualized assessment of the child’s condition or of any risk to others. On October 28, 2026, the student’s IEP team met to exit him from special education because he has met his speech goals, and his IEP has now ended. The IEP was the only thing that has kept the district from excluding him. Opposing counsel has been noticed that this student’s IEP has ended, and the student certainly faces imminent exclusion from school, which will result in irreparable harm. We are filing a motion for a preliminary injunction to prevent the district from excluding him from school while the case is pending.

California students face one of the most restrictive school vaccination mandates in the nation, with no personal-belief or religious exemption and a medical exemption available only through a state-controlled portal. Yet a substantial part of the school community is subject to neither a mandate nor an exemption process. California’s school immunization mandate applies only to pupils.^[1] School staff, teachers, and other adults in the school community, roughly 10% of the school population,^[2] are subject to no state vaccination mandate or exemption process.^[3] In addition, approximately 15% of California students, more than 880,000, have disabilities and receive special education,^[4] and, as was the case with our student plaintiff, students with IEPs may continue attending school regardless of immunization status.

A medical exemption in California must meet extraordinarily narrow criteria. Since January 1, 2021, it must be issued by a California-licensed medical doctor or doctor of osteopathy and entered into the State’s CAIR-ME electronic system. Cal. Health & Safety Code § 120372. A physician who has been disciplined by the Medical Board is stripped of the ability to issue exemptions, even if the discipline has been resolved and even if it had nothing to do with vaccines or patient care, and every exemption that physician previously wrote is voided, regardless of the child’s medical needs, resulting in arbitrary and capricious mass termination of valid medical exemptions.

The State evaluates medical exemptions against narrow criteria drawn from guidance of the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices and the American Academy of Pediatrics, which recognize only a small set of contraindications, such as a severe allergic reaction to a prior dose or vaccine component and certain forms of immunosuppression. Many exemptions are treated as “temporary” and must be renewed and resubmitted through CAIR-ME.

The California Department of Public Health (CDPH) is the final decision-maker on whether an exemption is “valid.” In case after case we have seen, CDPH has revoked or denied the medical exemptions it reviewed, without examining the child, and the only avenue for review is a state appeal process that does not apply the ADA’s individualized-assessment standards. The decision is then relayed to the child’s school, which acts as the enforcement arm. California’s medical-exemption process is a direct and deliberate barrier to the rights and protections the ADA affords disabled students. It creates a de facto mandate for students to receive every required dose of each vaccine required for school attendance. If even one dose is missing and unaccompanied by a de factoinaccessible medical exemption, the child is barred from school.

As a result, the only realistic options for many affected families are to homeschool or leave the State, effectively imposing medical segregation that excludes these children from both public and private schools. Families with fewer resources often cannot afford either option. A third option, which many parents have chosen, is to seek an out-of-state physician, such as those working with Frontline Health Advocates, and request an accommodation under the ADA. As in our student plaintiff’s case, school districts refuse to honor those requests, insisting that state law overrides the ADA.

Students who cannot safely be vaccinated, whose parents cannot homeschool, or whose families cannot leave California are forced to choose between vaccination against their physicians’ advice or losing their education. Among families who have no school choice in California because they cannot homeschool or leave the state, we have heard from some whose children suffered further injury from vaccines their physicians had advised against.

These students and families suffer irreparable harm, including:

1) Serious medical harm, and the risk of it, to students compelled to receive vaccines against medical advice;

2) Learning losses and social costs to students who are no longer in any type of school;

3) Economic and social losses to entire families who relocate to a different state; and

4) Economic losses for families who homeschool, usually forcing one parent in a dual-income household to give up one income.

Worse, the State uses the in-state physician requirement to control the process, and it has made it nearly impossible for parents to find an in-state physician willing to evaluate a child for a medical exemption.

Physicians must certify exemptions under penalty of perjury. CDPH automatically reviews the exemptions of any physician who submits five or more medical exemptions in a calendar year, and exemptions from any school whose vaccination rate falls below 95%. Cal. Health & Safety Code § 120372. These triggers place any physician who honors a patient’s medical needs under state scrutiny.

The process is designed to punish physicians who write exemptions. As a result, almost all California physicians now refuse to write vaccine medical exemptions, or even to evaluate a child for one; that was our student plaintiff’s experience. California law does not permit parents to obtain a medical exemption from an out-of-state physician. Parents who want their children evaluated for a medical exemption therefore have effectively no options in-state, and state law forbids them from going out of state. If CDPH revokes an exemption, the physician may be referred to the Medical Board of California for investigation. Physicians have reported losing their licenses or facing discipline from the Medical Board after providing informed-consent information about vaccines or writing exemptions the State considered excessive.

The State’s approach has produced a list of disciplined physicians, and schools are required to check that list to see whether an exemption was issued by a physician on it. As in our student plaintiff’s case, the State has also invalidated previously approved exemptions because the issuing physician was later disciplined, even though nothing about the child’s medical condition had changed. Disabled children lose their protection not because of anything about their health, but because the State has sanctioned their doctor.

The State’s treatment of in-state physicians also violates the ADA, as our complaint alleges. In-state physicians are being penalized for advocating for patients who have disabilities and need accommodation. The ADA makes it unlawful to coerce, intimidate, threaten, or interfere with any individual for aiding or encouraging another person in the exercise of rights protected by the ADA. 42 U.S.C. § 12203(b). California’s system does exactly that.

Our request, and how we can help

Free Now Foundation is pursuing this case through litigation and legal advocacy, with counsel from the Law Office of Jessica R. Barsotti and Disabled Rights Advocates, PLLC. Frontline Health Advocates (FHA) supplies the nationwide patient network, clinical-documentation coordination, accommodation-development process, and case information that allow these matters to be identified, supported, and brought forward for legal review.

We respectfully request that your Office file (1) file a Statement of Interest under 28 U.S.C. § 517 explaining that Title II does not permit a public school to refuse to consider a disabled student’s accommodation request solely because the documenting physician is not licensed in the State or did not use a state electronic portal, and that state law cannot override the ADA’s requirements of individualized assessment and reasonable modification, and direct the DOJ Office of Civil Rights to do the same; (2) direct the DOJ Office of Civils Rights to open an investigation into California’s in-state physician requirement and CAIR-ME process as barriers to the rights of students with disabilities under Title II of the ADA and Section 504; and (3) meet with us– and encourage the DOJ Office of Civil Rights to do the same– to discuss the case and the broader pattern described below. Due to our student plaintiff suffering irreparable harm because he will soon be excluded from school, we are forced to file a preliminary injunction. Your and DOJ’s prompt action is now critical.

FHA is the principal patient-facing and case-development infrastructure supporting this broader effort. Through its nationwide patient network, Frontline conducts structured patient intake, coordinates with qualified healthcare providers, organizes relevant medical histories and supporting documentation, develops individualized disability-accommodation materials, and documents recurring barriers encountered by patients seeking consideration under applicable federal disability law, including the Americans with Disabilities Act and the ADA Amendments Act of 2008. Although California presents a particularly urgent example, FHA works with patients across the country, including in states such as New York, West Virginia, and Connecticut, where state agencies, schools, employers, public entities, private entities, and other institutions deny, disregard, or improperly redirect medically supported accommodation requests into state exemption systems that are broken, unworkable, and incapable of providing meaningful review.

FNF and FHA are prepared to assist HHS and the Department of Justice through appropriate channels by providing de-identified case patterns, patient-impact information, institutional correspondence, documentation of recurring denials, and referrals involving state or institutional actors whose conduct warrants investigation under federal disability law, with appropriate patient consent. Frontline’s patient-service and documentation process provides the practical foundation for identifying these matters and developing the evidence necessary for a more in-depth review.

Children with disabilities in California are being shut out of their classrooms because a state process has been placed above federal civil rights law.

Finally, this case directly meets HHS, Department of Education, and Department of Justice’s obligations set forth in Section 4 of the August 10, 2026 Executive Order 14420 “Delivering Gold Standard Childhood Vaccine Recommendations for Americans.” Section 4(a) directs that “The Attorney General shall take appropriate measures to further meritorious legal actions challenging State laws that conflict with States’ constitutional and Federal statutory obligations related to parental authority, religious freedom, disability accommodations, and equal protection under the law, including, to the extent applicable under Federal law, States’ obligations to provide religious and medical exemptions from childhood and adolescent immunization requirements.” Section 4(b) further requires the Departments of Justice, Education, and HHS to ensure that their contractors and grantees, including States and localities, comply with those same obligations.

Since California also outlawed religious exemptions, California effectively has no functioning exemptions at all, creating this de facto vaccine mandate.

The HHS and DOJ Offices for Civil Rights are uniquely positioned to make clear that the ADA means what it says. We urge you to act, and we would welcome the opportunity to discuss this matter with you or your staff.

Respectfully,

Alix Mayer

President, Free Now Foundation

cc: Secretary of Health & Human Services, Robert F. Kennedy, Jr.; Stefanie Spear, Principal Deputy Chief of Staff / Senior Counselor to the Secretary; Luis Perez, Director of Disability Rights Section; Linda McMahon, Secretary of Education; Senator Ron Johnson; Jessica R. Barsotti, Esq., Law Office of Jessica R. Barsotti; Dawn M. Uballe, Esq., Disabled Rights Advocates, PLLC; Christine Pazzula, JD, Disabled Rights Advocates, PLLC; Dr. Bill Lionberger, President, Frontline Health Advocates

[1] Cal. Health & Safety Code § 120335(b) (governing authority “shall not unconditionally admit any person as a pupil” unless the pupil has been fully immunized).

[2] Ed100, Administration Is a Small Part of California’s Education System

Fingertip Facts on Education in California (5,731,260 K-12 students and 287,358 teachers in 2025–26), https://www.cde.ca.gov/Ds/ad/ceffingertipfacts.asp. Approximately 675,000 staff out of a combined school population of about 6.4 million is roughly 10.5%.

[3] California law requires K-12 school employees to undergo tuberculosis screening; it does not require them to be vaccinated. See Cal. Educ. Code § 49406. The State’s COVID-19 order requiring school workers to verify vaccination or submit to testing was rescinded effective September 17, 2022. Cal. Dep’t of Pub. Health, Order of the State Public Health Officer: Vaccine Verification for Workers in Schools (Sept. 13, 2022), https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Order-of-the-State-Public-Health-Officer-Vaccine-Verification-for-Workers-in-Schools.aspx.

[4] Pub. Pol’y Inst. of Cal., Students with Disabilities in California (Oct. 2026) (“California schools serve over 880,000 students with disabilities—about 15% of total enrollment.”), https://www.ppic.org/wp-content/uploads/students-with-disabilities-in-california.pdf; see alsoCal. Dep’t of Educ., Special Education (850,995 individuals, birth through age 22, received special education services in 2023–24), https://www.cde.ca.gov/sp/Se/cefspeced.asp.