The Department of Justice filed a class-action lawsuit against the state of Florida on July 22, accusing the state of violating federal law by segregating as many as 200 children with disabilities in institutions who could otherwise live in more integrated settings.
The decision comes as no surprise in light of an extensive DOJ investigation, released in September 2012, which found a rash of Americans with Disabilities Act violations.
“Unnecessary institutionalization denies children the full opportunity to develop and maintain bonds with family and friends; impairs their ability to interact with peers without disabilities; and prevents them from experiencing many of the social and recreational activities that contribute to child development…,” the DOJ states in the lawsuit, filed in the U.S. District Court for the Southern District of Florida. “Such unjustified isolation and segregation of persons with disabilities violates the ADA’s mandate that public entities ‘administer services, programs, and activities in the most integrated setting appropriate to the needs of qualified individuals with disabilities.’”
The lawsuit takes aim at the state’s Medicaid funding priorities, specifically its perverse incentives that favor institutionalized care.
While reimbursement rates for services provided to individuals living in nursing homes and other more segregated settings have increased by 28 percent since January 2004, reimbursement rates for in-home services have remained flat since 1987. As a result, the number of children in the state living in these more segregated settings grew from 136 to nearly 200.
Many of these segregated settings resemble hospitals and lack meaningful activities and services to allow the children to develop, according to the lawsuit. The state also allegedly fails to properly and timely evaluate many of these children when they enter these settings, to see if alternative placements are more appropriate. Likewise, the state allegedly fails to regularly evaluate the children to determine if its appropriate for them to leave.
At the same time, the waiting list for families waiting for in-home services has ballooned from about 15,000 in July 2005 to more than 22,000 by September 2012, leaving many families with no option but to send their children away.
“Florida must ensure that children with significant medical needs are not isolated in nursing facilities, away from their families and communities,” said Eve Hill, deputy assistant attorney general for the DOJ’s Civil Rights Division, in a news release. “Children have a right to grow up with their families, among their friends and in their own communities.”
The lawsuit is signed by Thomas Perez, whom the Senate just confirmed as the new Secretary of Labor. Including Florida, the DOJ sued 11 states, as well as intervened in multiple other cases, in regard to violations of the ADA’s integration mandate during Perez’s tenure as head of the DOJ’s Civil Rights Division, according to Mother Jones.