The federal government is suing Florida over its treatment of children with disabilities. (Photo by Makena Zayle Gadient.)
By Ashley Lopez
Florida Center for Investigative Reporting
The U.S. Department of Justice filed a lawsuit Monday against the state of Florida in Fort Lauderdale for allegedly violating the Americans With Disabilities Act by “warehousing” hundreds of disabled children in nursing homes.
Florida healthcare agencies have acted with “deliberate indifference to the suffering” of frail and disabled children by offering parents no “meaningful” choice but to warehouse their children in nursing homes along with elders, the U.S. Department of Justice said in a lawsuit against the state filed Monday.
The Justice Department’s civil-rights division accused the state of violating the landmark 1990 Americans with Disabilities Act — which forbids discrimination against people with special needs — by funding and managing its community programs so poorly that hundreds of children have been forced to live, and sometimes grow up, in institutions for the elderly.
Last September, the Justice Department told state health administrators that Florida’s system of care for frail and disabled children was discriminatory, because it failed to offer parents meaningful opportunities to care for their medically fragile children outside large, segregated institutions. While the state made half-hearted reforms, the DOJ said, the discrimination persisted.
The Justice Department, the lawsuit says, “has determined that compliance with the ADA cannot be secured by voluntary means” by the state. The DOJ is asking a federal judge to declare the state’s program for disabled children in violation of federal law and to force the state to cease warehousing children in institutions.
According to the Sun-Sentinel, “nearly 200 Florida children with medical disabilities are being warehoused unnecessarily in nursing facilities when they could be cared for in their family homes or other community-based settings,” the U.S. Department of Justice alleges.
The federal government has been warned state officials since 2011 to improve this situation. However, little has changed, and the feds are now seeking legal action.
There is also evidence that budget cuts to state agencies in the past few years have led to underfunding programs for many of these disabled children. Furthermore, when the state has granted money to help remedy the situation, officials turned down the money for political reasons:
Tea party-dominated Florida has been extremely reluctant to spend any money to provide care for this vulnerable population of children. The state even went so far as to turn down $37.5 million in federal money that would help move children out of nursing homes, all because the money was seen as part of Obamacare. Not even the threat of a civil rights lawsuit, apparently, was enough to get the state to do more …
The DOJ lawsuit is harshly critical of Florida’s budget moves to cut services to disabled children. The complaint points out that Medicaid home health care reimbursement rates in Florida haven’t changed since 1987, a factor that has resulted in nursing shortages. Making matters worse, in 2010, the complaint says, the state cut funding for private duty nursing services by $6 million. Meanwhile, the state has raised the rates paid to nursing homes taking in medically fragile kids by more than 28 percent since 2004.
The Herald reports that the state’s funding decisions also affected the availability of home care for many of these kids.
According to the Herald:
One program that is designed to allow parents to care for disabled children at home or in community settings now has a wait list with about 22,000 names. As of last fall, the lawsuit says, more than half of the Floridians have been waiting for care for five years or longer. Additional dollars for the program set aside by lawmakers earlier this year will only help “fewer than five percent” of those waiting.
As money for community care dwindled — and payments to nursing homes dramatically increased — the number of children living in institutions also grew, the lawsuit says. In 2011, the AHCA, acting at the behest of a large Broward nursing home, withdrew its own provision limiting the number of children in each nursing home to 60. Close to 200 children remain in nursing home beds in the state.
“As a result of the state’s actions and inaction, the state has forced some families to face the cruel choice of fearing for their child’s life at home or placing their child in a nursing facility,” the DOJ said in a news release.
The DOJ wrote that Florida policies have “contributed to the unnecessary institutionalization of children” and the state’s violations of the Americans with Disabilities Act “are serious, systemic and ongoing and require comprehensive relief for these children and their families.”