The ruling said about 140 children in the Medicaid program are in three nursing homes in Broward and Pinellas counties. It also said more than 1,800 children are considered at risk of being institutionalized.
Middlebrooks wrote that the Americans with Disabilities Act requires the state to provide services in the most “integrated setting appropriate” to meet the needs of people with disabilities. He also cited a major 1999 U.S. Supreme Court ruling that said “undue institutionalization” of people with disabilities is a form of discrimination.
But the statement Monday from the Agency for Health Care Administration disputed Middlebrooks’ conclusions.“During the trial, witnesses testified that their medically complex children were in nursing homes for various reasons unrelated to the state or its policies,” the statement said. “Not one parent testified that they are ready and willing to take a child home but cannot do so because of the state’s actions or omissions.
The Justice Department filed the lawsuit in 2013, after conducting an investigation that concluded the state Medicaid program was unnecessarily placing children in nursing homes. The state has vehemently fought the allegations and the lawsuit, with the U.S. Supreme Court last year declining to take up a state appeal aimed at preventing the case from moving forward.
A key part of Middlebrooks’ ruling was that the Medicaid program and contracted managed-care organizations were not providing adequate private-duty nursing that could enable children to receive care in their family homes or communities. Middlebrooks ordered that the Medicaid program provide 90 percent of the private-duty nursing hours that are authorized for the children. He also ordered the state to improve what are known as “care coordination” services and to take steps to improve the transition of children from nursing homes.
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