Health administrators chided the Justice Department for essentially ambushing the state Thursday by releasing the strongly worded report on a DOJ website without first providing the state with copies of documents, transcripts of interviews and nursing home inspection reports upon which the Justice Department based its findings.

The state, Coleman said, does not have any policies or rules designed to force children into nursing homes. Advocates for sick and disabled children, she added, are complaining about individual decisions made solely on the basis of what is most appropriate for each child, she added.

In a court pleading last June, AHCA said federal law allows the agency to “place appropriate limits on a service based on such criteria as medical necessity” and cost-cutting.

In its report, though, the Justice Department said such individual decisions — some of which are “applied irrationally or without appropriate consideration of the child’s needs” — reflect a systemic policy that forces families to institutionalize their loved ones. During its investigation, the DOJ visited large nursing homes that collectively house more than 200 children in Miami, Fort Lauderdale, Orlando, Tampa and St. Petersburg, interviewing families and caregivers along the way.

The parents of one 8-year-old girl who is “medically fragile” and lives at home, though both parents must work, have seen medical services for their daughter denied or reduced 13 times since 2006, the report said, even though the girl’s condition has not improved or changed. “It’s a fight and a battle all the time,” to avoid institutionalization, the girl’s mother told investigators.

Matthew Dietz, a Miami civil rights attorney who already is challenging the state’s practices in federal court, called the report a “stinging indictment” of the state’s policies governing disabled children. “It’s a story of a systemic attempt by the state of Florida to deprive families and children with disabilities of the care needed to merely survive in a community-based setting,” Dietz said.

“The state’s reliance on nursing facilities to serve these children violates their civil rights and denies them the full opportunity to develop bonds with family and friends and partake in educational, social and recreational activities in the community,” Dietz added.

Deborah Linton, who heads The Arc of Florida, an advocacy group for people with developmental disabilities, said members of her group were “alarmed, as well as saddened” that warehousing children in nursing homes had “become an acceptable practice” among state social service administrators.

Other states, Linton said, have developed and funded programs that allow families to care for sick or disabled children at home — often at less expense than nursing homes and institutions.

“Florida can do better by these most vulnerable little ones,” Linton said.