Under the federal Americans with Disabilities Act, people with disabilities or medical conditions must be housed and treated in community settings whenever possible, not in large isolated institutions as most states did in previous decades. Since the law was passed in 1990, advocates for disabled people and children have used it to shut down often squalid institutions and to move disabled and mentally ill people into their own homes or into group homes that are part of larger communities.
In recent years, however, Florida health administrators have relied upon nursing homes to house hundreds of children who could safely live at home with their parents – often at less expense to the state, advocates claim. In his letter, Perez said the state has cut millions from programs that support the parents of disabled youngsters, refused $40 million in federal dollars that would have enabled some children to stay or return home, encouraged nursing homes to house children by increasing their per diem rate – and even repealed state rules that limited the number of kids who could be housed in nursing homes with adults.
Such policies, the Justice Department says, are not only contrary to federal law, they hurt children: Housed in nursing homes that are ill-equipped to care for them, youngsters often are deprived of an education, are unable to see their own parents and siblings – many of whom live hundreds of miles away – have no ability to socialize with typically developing peers, and sometimes are forced to sit for hours in front of a television for lack of recreation or other activities.
In court pleadings, and in a statement Thursday to The Miami Herald, state health regulators say they are complying with all provisions of the landmark law. The state provides all services that are “medically necessary” to sick and disabled children – including skilled nursing care and home health aides – “up to 24 hours a day, seven days a week,” said Shelisha Coleman, a spokeswoman for the state Agency for Health Care Administration, or AHCA, which is a defendant in a 2012 lawsuit that makes the same claims as the Justice Department.
What are the ethics here? The law set up a system to keep children with disabilities at home whenever possible. The state is doing something else. It’s warehousing disabled kids.
I have some experience in state politics. The nursing home industry is often a major campaign contributor to both parties. These kinds of clients bring in millions of dollars of profit. Further, if the children could have been taken care of at home then they form a lesser burden to the institutions than more severe cases – all the more reason to prefer them.
There’s big money here, not to mention the bureaucratic ease of simply processing the children into a system where monthly visits and supervision by state officials is unnecessary or routine.
I’m unimpressed and unhappy with how this is working out.
It’s cold blooded to take children who have a disability and put them in a nursing home without other children, without education and without hope. Not quite murder, but definitely not what the law provided for.