Tuesday, December 12, 2017

Feds: Fla. dumping disabled kids in nursing homes

FORT LAUDERDALE — More than 3,300 children with disabilities are at risk of being pushed into adult nursing homes because the state is slashing nursing and other services that would otherwise keep them at home with their families, according to a lawsuit filed against state health officials.

The lawsuit mirrors a letter sent this week by federal officials to Attorney General Pam Bondi alleging that Florida is violating federal law by allowing more than 200 children with disabilities and even babies to be kept in nursing homes, often for years.

The suit and federal regulators say children languish in the facilities, sharing common areas with elderly patients, and have few interactions with others, rarely leaving the nursing homes or going outside. After visiting children in six nursing homes, investigators noted the children were not exposed to social, educational and recreational activities that are critical to child development. Educational opportunities were limited to as little as 45 minutes a day, according to a detailed letter sent Tuesday by U.S. Department of Justice officials.

"These kids who are institutionalized in geriatric nursing homes are receiving less services than kids in prison," said Paolo Annino, a law professor at Florida State University and one of the attorneys working on the lawsuit filed against the state earlier this year in Miami federal court.

The average length of stay is three years, according to the letter. Some children grow up in a nursing home, the letter says. One nursing home staffer told investigators, "Once we get the children, very few of them go home."

The letter gives the state 10 days to respond. If the state does not comply voluntarily, then the U.S. attorney general may initiate a lawsuit under the federal disability act.

Bondi's office deferred comment Friday to state health officials named in the letter.

Florida's Agency for Health Care Administration said in a statement late Friday that the letter resulted in "unfounded and inaccurate allegations," stressing it does not limit medically necessary home health services.

"The decision of where a child receives care is up to the parents, in conjunction with the child's doctor. The agency will never interfere with a family's choice for the location of their child's care. The agency uses a professional, rigorous, federally-approved, quality control system to ensure every family receives the appropriate level of care for their child," according to the statement.

While the suit and federal regulators claim that more than 20 percent of the children in nursing homes are wards of the state, officials with the Department of Children and Families disputed that.

"All the kids we found were desperately ill or severely disabled children in special pediatric facilities only and not in adult facilities," according to a statement.

Meanwhile, parents say they are desperately fighting to get services to keep their children at home.

The waiting list for services at home or in the community has jumped from 14,629 in 2005 to more than 21,000 in 2012, with more than half waiting longer than five years. Currently, state policy does not give priority on the waiting list to children in nursing homes, federal officials said.

Despite the lengthy wait, the number of children actually enrolled in these programs has decreased by several thousand over the past several years. That is "resulting in a growing list of children waiting years for services and having access to a waiver slot only once they have literally deteriorated to the point of crisis," according to the letter.

At the same time, the state turned down nearly $40 million in federal dollars for a program that transitions people from nursing homes back into the community. The state has also been paying community-based providers less, reducing payments by 15 percent last year because of legislative budget cuts, the letter stated.

Yet the state implemented policies that expanded nursing home care, by offering facilities a $500 enhanced daily rate for caring for children, which is more than double what the state pays for adults, according to the letter.

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