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.
“Unnecessary institutionalization denies children the full opportunity to develop and maintain a bond with family and friends; impairs their ability to interact with peers without disabilities; and prevents them from experiencing many of the social and recreational activities to contribute to child development,” the lawsuit says.
It adds: “Many of the institutionalized children remain in facilities for very long periods of time, even when it is apparent that their medical conditions would permit return to the community with appropriate supports.”
The lawsuit, aimed primarily at the state’s Agency for Health Care Administration, the Department of Health and the Department of Children & Families, follows several months of in-depth reporting on the children’s plight by the Miami Herald.
A spokesman for the Agency for Health Care Administration said the federal government is meddling in state business.
The suit appears to be one of the final official acts of Thomas E. Perez, who headed the DOJ’s civil rights division until gaining Senate approval last week to be President Barack Obama’s labor secretary, an appointment that was held up for months.
To a large degree, the controversy is over money: Even as Florida health administrators have increased the payment for pediatric nursing-home beds by close to 30 percent — the state will now pay about $550 per day for a child in a nursing home — the state has relentlessly cut services for families struggling to care for a severely disabled child at home.
Reimbursement rates for service providers in the community have remained stagnant since 1987, the suit says, resulting “in shortages of nursing services in certain parts of the state.”
And three years ago, state lawmakers simply cut $6 million from a program that pays for private-duty nursing care for Floridians who wish to remain outside institutions.