FORT LAUDERDALE, Fla. (AP) — Florida officials are violating federal law by unnecessarily warehousing hundreds of children with disabilities and even babies in sterile nursing homes, away from their families and with little social interactions often for years, according to a letter sent Thursday by federal investigators.
After visiting 200 children in six nursing homes across the state, U.S. Department of Justice Officials warned the state is violating the federal Americans with Disabilities Act by unnecessarily institutionalizing children, often for long periods of time, and violating their civil rights by segregating and isolating them in hospitals where children and young adults sit in hallways, waiting for staff to come by and have some contact with them. The average length of stay is three years, according to a letter sent to Attorney General Pam Bondi.
Federal officials began investigating last year after being contacted by child advocates in South Florida who became frustrated when state officials failed to make changes after a nearly two-year fight. Advocates said the state is relying on cheaper nursing home care instead of providing services to care for them at home.
The Justice Department sent Bondi’s office a letter in January asking for data and documents, but despite numerous requests Bondi’s office refused to give any information voluntarily, according to the letter. Bondi’s office did not immediately respond to email and phone call requests for comment Thursday.
Federal investigators identified numerous children who didn’t need to be in nursing homes and “would benefit from moving home with their families or other community settings,” according to the letter.
Many of the children have few interactions with others, rarely leaving the facilities and are not exposed to social, educational and recreational activities “that are critical to child development,” according to the letter. Educational opportunities are limited to as little as 45 minutes a day.
The state fails to look for other placement for children in nursing homes and once they are there offer no realistic discharge or transition planning, often leaving children in these facilities for years, according to the letter.
“The kids are all Medicaid recipients so they could go in at any age and come out at death because they’re covered by Medicaid dollars,” said Marjorie Evans, who runs Broward Children’s Center, a nonprofit that cares for disabled children and adults.
Federal officials concluded the state has made it difficult for children to access medical services that would allow them to move home by making drastic cuts to programs that help disabled children and adults. That has led to a yearlong waiting list to access servings. At the same time, 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 than what the state pays for adults, according to the letter.
Many family members who are still able to care for their disabled children at home, said the state has denied or reduced the number of hours they will cover for an in-home nurse, making it nearly impossible for parents to continue caring for their children at home.
One advocate said state health officials are desperate to find beds for these children, regardless of whether the facility is the best option for the child’s needs.
“We would get calls saying they have to get out of the hospital, we have to put them somewhere so whatever bed is available that’s the one they go into,” said Evans, who was among the advocates that contacted federal officials.
With more empty beds popping up at nursing homes, the facilities began looking for ways to bring in other patients, including infants and toddlers. Experts say the facilities don’t offer the services that children require.
One mother said her three-year-old daughter who has Down Syndrome has been in the facility since she was a baby. The girl, who requires intensive help so she can eat and breathe. The mother told federal investigators she wants to care for her daughter at home full time, but the state will only pay for enough home care on certain weekends, according to the letter.
Another mother said she had to drive two hours every day for more than three years to visit her son at a nursing home. The boy nearly drowned and requires a ventilator, but his doctor prescribed home health services so he could be cared for at home. The state ultimately provided those services after the family filed a lawsuit.
Many of the children have been injured in car accidents or near-drowning’s and have physical disabilities, but are mentally cognizant of what life was life before they accident.
“They get very depressed” and need psychological services, said Evans.
Federal officials visited 200 children in six nursing homes around the state, including ones in Miami, Tampa and Orlando, where children live in cold, hospital like settings, rarely leaving the facility, wearing identification bands as they watch TV in a common area or just sit in bed. At one facility, a common room contained children’s toys along with a sitting area for elderly residents.
Brian Lee, executive director of Families for Better Care, an advocacy group for nursing home residents, said the DOJ report brought him to tears, and pointed to the failures of Gov. Rick Scott and the Legislature to appropriately fund non-institutionalized care programs.
“Can you imagine the quality of life as a child living in a nursing home?” asked Lee, who was previously the state nursing home ombudsman. “Literally no one to play with? It’s heartbreaking.”
He said he hoped the report spurred major change in the system.
“Is this just going to be a report that’s just going to be a slap on the wrist for Florida?” he asked. “I’m hoping Gov. Scott and the Legislature have compassion for children, have compassion for nursing home residents and that they’ll actually step up and do something right.”
Florida’s Agency for Health Care Administration said the letter mirrors a class action lawsuit filed against the state in a South Florida federal court.
The agency said in a statement that it has previously tried to dismiss the lawsuit, saying the plaintiff’s don’t actually contest a barrier to services but rather disagree with what constitutes medical necessity. If the agency does decide to take legal action on the letter from the Justice Department, state health officials said they will deny the allegations on the same basis.
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