Feds: Fla. warehouses disabled kids in nursing homes

Florida mother Zurale Cali has fought for three years to allow her special needs five-year-old son, Andi, to stay with her family rather than be institutionalized in a nursing home. / WFOR

(CBS/AP) FORT LAUDERDALE, Fla. - Federal investigators say Florida officials are violating federal law by unnecessarily warehousing hundreds of children with disabilities in geriatric nursing homes.

The Department of Justice sent a letter to state Attorney General Pam Bondi this week, saying that in visits to six nursing homes around the state, investigators identified numerous children who didn't need to be there and who "would benefit from moving home with their families or other community settings."

The Miami Herald reports that, according to the letter written by Assistant U.S. Attorney General Thomas E. Perez, hundreds of Florida children spend their formative years with virtually no education or socialization.

Justice Dept. letter to Fla. AG Bondi (pdf)

Some children, the letter stated, "are unnecessarily separated from their families and communities for years," including some who entered facilities as infants or toddlers, and have spent a decade or longer institutionalized. Florida, the letter states, administers a system providing "unnecessary segregation and isolation of children, often for many years, in nursing home facilities."

Federal officials concluded the state has made it difficult for children to get medical services that would allow them to move back home.

Bondi's office is defending the state against a previously filed lawsuit that claims the institutionalization of children violates federal law, including Title II of the Americans With Disabilities Act.

Critics have said that Florida has in recent years repealed state rules limiting the number of children that can be housed with adults in nursing homes, and have relied more and more upon nursing home facilities to house children who could receive care safely - and more cheaply - with their families.

Perez states that if the state does not take steps outlined in the letter to "correct" the practice, the Justice Department may take action of its own.

Bondi's office did not immediately respond to a request for comment.

During its investigation, Justice officials visited nursing homes in Miami, Fort Lauderdale, Orlando, Tampa and St. Petersburg that collectively house more than 200 children. Family members and caregivers were also interviewed.

The DOJ investigation found that Florida had implemented policies "that impair access to medically necessary services and supports that would enable children to transition home or to other community-based settings." Among the practices cited are the state's reducing or limiting the availability of medically prescribed in-home services "without reasonably considering the child's actual needs"; and making substantial cuts to programs designed to support children and adults with developmental disabilities in the community while simultaneously expanding facility-based care, including enhanced perdiem rates.

For a majority of the children referred to these facilities, Florida pays more than $500 per day per child - more than double what the facilities receive from the state for their elderly residents.

CBS Station WFOR reported earlier this year that the families of more than 250 children were suing Florida for unnecessarily institutionalizing their children, claiming the state told them needed medical care would be withheld unless the children were placed into a nursing care facility.

DOJ said the state's policies put children with medically complex or medically fragile conditions who currently live at home at risk of placement in nursing facilities and other segregated institutional environments if they are to receive necessary care.

"Nursing homes are not made for children," attorney Matt Dietz told WFOR correspondent Michele Gillen. "A parent should not have a gun placed to their head - 'Take less care, or your child's going to go into a nursing home.'"

Report from Florida Association for Medically Fragile Children (pdf)

[bigfishpr]

As a woman who became disabled 31 years ago, and whose family fought to keep me from being institutionalized, I cannot believe this type of forced action is still taking place in America today.

Had I been institutionalized 31 years ago, I most likely would have passed away due to secondary issues such as bed sores, infections, etc.

Instead today I hold two degrees, I am a successful business woman, married, with a beautiful five year old daughter, and I would like to believe, I have made a difference in the communities I have lived.

For any of you who are questioning the "cost" of reversing this forced action - ask yourselves, what would you do if tomorrow you awoke in an institution (nursing home, etc.), and were stripped of your rights of freedom. You could not leave of your own accord. You could not choose your meals, or activities for the day. You would be forced to sit and wait out your existence.

Think of this...then decide...what can you do to SAVE these innocent people, and give them life?

[maraline]

Every state can opt into the Title 19 Medicaid Waiver program which is designed to keep disabled children in their homes or communities. Each state that opts into the program submits its own 5 year plan to the feds for approval, and if it is approved the federal government supplies funds for 'slots' for disabled kids and the state must also contribute funds. These funds pay for persons to work with the disabled person in their communities in our state. Apparently FLORIDA hasn't opted into the program. Our state opted in around 1988 and the program has been successful in keeping my two sons out of nursing homes. Both my sons are adopted, and are now adults, and a new type of set-up was started in our state this year called 'self determination' in which many of the intermediate agencies previously dipping into the pot are no longer needed, making the program even MORE efficient and MORE user friendly to the clients. Our program is largely handled by an agency called PPL [an international agency I believe]. PPL is mainly a billing service and is very non-intrusive, unlike in the past when state level Medicaid services were nearly impossible to implement, and a large percentage of each recipient's budget went to useless paper pushing groups, rather than to the person needing the service. So far the new set-up has been phenomenal..In our state President Reagan [responding to the plea of a local mom] was instrumental in getting the state to accept the Title 19 Waiver plan for the first time. It is economical and person centered...it is definitely a better option than any institutional setting, both from a financial standpoint, and from the best interest of the clients. In parts of the state of VA wonderful programs for the disabled are being implemented as well. For more information look at this site:
http://wallresidences.com/
As for FLORIDA...what can you expect after the horrendous travesty they perpetrated on Terri Schaivo? NO excuse for what they did to that poor woman...just horrible.

[ladyang]

See what happens when states are in charge of "anything"! Fed gov't are the only ones who can protect everyone and anyone. However, the repugs will protect those who look like them!

Folks, don't vote against your own best interests!

FORWARD!!!!!

[lannyjackson]

For the states rights advocates, this is why the federal government steps in and makes federal laws,states over reaches.

[mamawarrior]

WHY is this discussion turning into Romney/Obama rhetoric being thrown back and forth? WHY does it become conservative/liberal? We are talking about children and their families doing the best they can to survive and EPIDEMIC that has been ignored as it continues to rise 25% every two years since they started counting! 1 in 88 Children born in 2000 have Autism. The CDC hasn't even counted any of the other kids born after that that also are diagnosed, including my second son (idiot alert-don't attack me for having another, I was pregnant with him when we found out about his brother). We have barely scratched the surface of helping these kids and their families and the system is crumbling. What is going to happen five years from now, when my son is 18? Or ten years from now, when he is 22? Keep denying help for these kids and their families. The rates will continue to rise and you may care more because if you don't know anyone with autism yet, the way the numbers are going- YOU WILL, and SOON! I hope you care enough to help by then.

[carolhill814]

This has happened for so many years I can't count way before Bush and other resent presidents.

So please don't act as though Romney will make it worse because that is a lie.

I was working in a rest home in the early 60's and I saw children living in the one I was working in.

The parents dumped him there and the people who worked there treated him like he was a meat until I got there and told the owner I will call the police if this continues. He was strapped to the bed by his feet and arms and barely was cleaned up.

I made sure he was well cared while I was there but there were so many others in other places I worked so please this has gone on for so many years I can't count.

The laws have to change in all states for this not to go on so please don't throw stones unless you know what you are speaking about.

[thara22]

That was barbaric and what happened to the poor boy after you left by the way?

[bmamo]

I wonder if Rick Scott (or his wife) own those facilities??

[Dmiller265]

Typical Republicans...no one but Republicans who are wealthy deserve to be treated with respect.

[Jhihmoac]

This is almost like being back in the 19th Century when they shut the unfortunate away from the masses...Sad...

[beachgirl2365]

If Romney /Ryan are elected you will see more of this.........Hell you may even see disabled kids kenneled like animals at the shelter if it means they will make a bigger profit,.......

[dianle777]

What an extremely sad situation and it should make each person question their own heart as we all tolerate such situations. Florida is not the only state to do this. Care for children and adults with disabilities is usually at the bottom of the list of states priorities.