Make us your home page

Today’s top headlines delivered to you daily.

(View our Privacy Policy)

Trial pitting nursing home residents against Medicaid begins

TALLAHASSEE — Marguerite Pace, 48, has a business degree, a law degree and passes her time in a Sarasota nursing home bed. Renal failure and collapsed vertebrae have kept her from moving around on her own since 2006.

But she harbors a vision about what life could be. She would like an apartment of her own, a motorized wheelchair, an aide to help her bathe and dress and, most of all, a job.

"I want to work," Pace says. "I don't need legs for that."

Her story and those of dozens of other nursing home residents are playing out this month in a federal lawsuit over how Florida treats some of its frailest citizens.

Southern Legal Counsel and AARP have sued the state under the Americans with Disabilities Act, alleging that Florida's Medicaid program too often relies on nursing homes instead of bringing services to people's homes. The disabilities act requires states to integrate people into their communities.

Similar lawsuits have sprung mentally ill people from institutions. This case extends the debate to nursing homes.

Battle lines were drawn Monday in opening statements.

Lawyers for the state noted that Florida serves about 50,000 frail Medicaid clients at home or in assisted living homes, compared to 40,000 to 45,000 in nursing homes. Since 2009, state agencies have transferred 1,700 nursing home residents back into the community.

"We have had a flat nursing home population for a decade while home and community based programs are expanding," said Justin Senior, general counsel for the Agency for Health Care Administration. "It's a pretty dramatic success."

Plaintiffs' lawyers say the state has not done enough. They want U.S. District Court Judge Robert Hinkle to order Florida to expand its at-home programs.

"We think thousands of people could come out" of nursing homes, plaintiffs' attorney Stephen Gold said. "If they can reside in the community with appropriate services, the failure to do that is discrimination."

Pace, who appeared in a video deposition, was the first witness as plaintiffs began to put on their case. She can use a cell phone and a computer and has researched programs that teach disabled people how to drive.

But Medicaid workers had rejected her request for at-home care. They were not worried about money. Both sides agree that supporting people at home or in assisted living is usually less expensive than a nursing home.

But Pace wouldn't be safe outside the nursing home, Medicaid said. She lacks support in the community, the Medicaid report said. She needs "24-hour observation and care" and can't leave "because of safety issues."

Jacksonville resident Clayton Griffin was also denied at-home care while living in a nursing home. He also needed 24-hour care and observation, Medicaid evaluators said.

Griffin, 58, simply moved out two years ago, trying to pay his own way from a Social Security check. But it was nowhere near enough. In September, Judge Hinkle ordered the state to start providing him at-home services, so now he gets frozen meals he can microwave and aides about four hours a day to get him out of bed, clean his house and do laundry.

Testifying by telephone, Griffin said he attends church, does his own shopping in a motorized wheelchair, goes to the movies and socializes with neighbors in his apartment.

"I have a sense of independence," he said. "I have the fellowship with people my own age. Well people. They aren't sick."

Gold asked him if he was still seeing a "lady friend."

"Yes," said Griffin.

"No further questions."

The nonjury trial is expected to last two weeks. Later this week or early next, the state gets to put on its defense, to explain in detail why people like Pace and Griffin might, in fact, be unsafe in the community.

Hinkle could take months to rule.

Trial pitting nursing home residents against Medicaid begins 02/07/11 [Last modified: Tuesday, February 8, 2011 7:10am]
Photo reprints | Article reprints

© 2017 Tampa Bay Times


Join the discussion: Click to view comments, add yours

  1. Florida education news: Computer coding, guidance counseling, career planning and more


    SESSION STARTERS: State Sen. Jeff Brandes refiles legislation to allow Florida high school students to swap computer coding for foreign language credits.

  2. Rays morning after: Offense showing some life



  3. Protectors of Confederate statue readied for a battle that never materialized

    Local Government

    BROOKSVILLE — Big Dixie flags were waving. County employees had erected a barrier around the Confederate soldier statue at Main and Broad streets. Roads and parking areas were blocked off. Uniformed local officers and federal law enforcement patrolled.

    Police tape and barricades surround the Confederate statue in Brooksville.
  4. Manhattan Casino choice causes political headache for Kriseman


    ST. PETERSBURG — Days before the mayoral primary, Mayor Rick Kriseman's decision to let a Floribbean restaurant open in Midtown's historic Manhattan Casino has caused political angst within the voting bloc he can least afford to lose: the black community.

    Last week Mayor Rick Kriseman chose a Floribbean restaurant concept to fill Midtown's historic Manhattan Casino. But that decision, made days before next week's mayoral primary, has turned into a political headache for the mayor. Many residents want to see the building's next tenant better reflect its cultural significance in the black community. [JAMES BORCHUCK   |   Times]
  5. FSU-Bama 'almost feels like a national championship game Week 1'


    The buzz is continuing to build for next Saturday's blockbuster showdown between No. 1 Alabama and No. 3 Florida State.