Responding to charges of warehousing medically fragile children in geriatric nursing homes, the heads of three Florida state agencies Thursday announced new measures to help keep the youngsters in the least restrictive settings.
The “enhanced” care plan adopted by the Agency for Health Care Administration, the Department of Health and the Department of Children and Families will use 28 nurse care coordinators from the Medicaid program and more frequent case reviews to “empower parents,” said state Health Care Administration Secretary Liz Dudek, and “have somebody that they can go to to find what’s available for their child.”
Dudek said the enhanced care process would give parents personalized monthly contact, possibly helping them remove their children from the nursing homes.
Last fall, civil rights lawyers at the U.S. Department of Justice accused the state of placing children in institutions far from home, where they may have little contact with the outside world, even when their parents want to care for them.
“Many children entering nursing facilities in the state are unnecessarily separated from their families and communities for years,” wrote Assistant Attorney General Thomas E. Perez of the Justice Department to Florida Attorney General Pam Bondi in September. “With adequate services and supports, these children could live at home with their families or in other more integrated community settings.”
The federal Americans With Disabilities Act requires states to care for disabled people in the “least-restrictive” settings – if not their family homes, then in their communities.
Perez noted that DOJ had visited the six largest nursing homes where Florida children are placed and found the state had failed to connect families with the needed supports.
“We…spoke with many parents who want to have their children living at home but report their frustration with state policies that inhibit their ability to do so,” he wrote.
Dudek has maintained that the state did not violate the ADA, and she did so again Thursday, saying she had visited the six facilities cited by Perez.
“I can tell you that what I found was way better than what I thought I would find,” she said. “The children had multidisciplinary programs ongoing, the school was very involved, it was clear the [Children’s Multidisciplinary Assessment Team] process was working.
“I have to wonder what the Department of Justice was looking at when they went through there – and I would invite any of you to go to any of those facilities – because I certainly did not see what they were seeing,” she said.
Dudek said the state is in constant dialogue with the Justice Department.
DCF secretary David Wilkins said high-level approval from his agency will be required before placing a child in state custody into a nursing home. The agency will review the children’s cases monthly to find ways to place them in medical foster homes.
“If we do have children that are in skilled nursing facilities that no longer have to be there, we have to find a foster parent who has the medical expertise to, in essence, take care of that child in their home,” he said.
Wilkins said DCF is recruiting medical foster parents in Pensacola, Naples, Tampa, Broward and Palm Beach.
“We understand this issue,” Wilkins said. “We are on top of this issue.”
by Margie Menzel
