Children warehoused in Florida nursing homes! Another Governor Ron DeSantis human rights failure.

Where are the disability rights groups in Florida? 

Echo opinion published in the Orlando Sentinel:

Florida’s all about the children. Just not those children.

For the last three years, Florida’s governor and Republican legislators have insisted that their radical policies were contrived to protect children from leftie scourges.

Never mind that before the state’s Republican leadership instigated all-out social warfare, few parents were much concerned about the evils of Black history, transgender therapy, leftie professors, rainbow flags, children’s literature, the Disney Company, drag queens and all those suspected commie school marms.

Oh yeah. All about the kids, but not all the kids. Profoundly impaired children warehoused in nursing homes? Not so much.

U.S. District Judge Donald Middlebrooks recognized the disparity last week, when he ruled that Florida has been systematically violating federal laws prohibiting the “unjustified institutionalization” of disabled people, particularly children.

Child advocates (led by the Health Care Access Project at the Florida State University College of Law) and the U.S. Justice Department argued in a federal lawsuit filed more than a decade ago, that the Florida Agency for Health Care Administration (AHCA) was stashing frail, medically needy children in unsuitable nursing homes, often hundreds of miles from their families, when the same Medicaid dollars could pay for effective care at home or in a community setting.

But the AHCA’s funding policy — the judge called it a “maze” — afforded parents no real alternative.

“Any family who wants to care for their child at home should be able to do so,” the judge wrote. “Those who are institutionalized are spending months, and sometimes years of their youth isolated from family and the outside world. They don’t need to be there. I am convinced of this after listening to the evidence, hearing from the experts, and touring one of these facilities myself.”

The judge added, “If provided adequate services, most of these children could thrive in their own homes, nurtured by their own families.”

His order stated that the evidence was “overwhelming.” Yet, AHCA strung out the litigation for a decade.

Apparently, Medicaid managed-care providers found it more convenient to institutionalize the kids. 

Nursing home operators had beds to fill. Besides, Florida’s chintzy reimbursement rates rendered reliable in-home nursing services tough to find.

None of this is shocking. Not in Florida. State care of vulnerable children has generated scandal after scandal over the years. Newspaper exposés have regularly described gut-wrenching stories of neglect, mistreatment and deaths suffered by Florida kids in foster care and juvenile lock-ups.

Sorry kids, but with underfunded social services and overwhelmed, underpaid social workers, nurses and caregivers, Florida gets what it pays for.

Warped priorities similarly dogged the state’s Neurological Injury Compensation Association (NICA), which was created in 1988, to guarantee lifetime care for children with serious neurological birth injuries (in return for not filing malpractice suits).

A joint investigation by ProPublica and the Miami Herald in 2021, found that while NICA was regularly denying afflicted children medication, medical equipment, wheelchairs, therapy and in-home nursing care, program managers were hoarding $1.5 billion (amassed from annual fees paid by the state’s physicians) in a fat investment fund. The agency was paying lawyers hundreds of thousands of dollars to fend off demands for medical services which would have cost only a fraction of what was frittered away on legal fees.

That was too much, even for Tallahassee. “A heartless bureaucracy,” Jimmy Patronis, the state’s chief financial officer, called NICA. 

A sweeping reform package was passed that spring by the Florida Legislature. The Miami Herald has reported that the reorganized agency now spends less, on average, for round-the-clock in-home nursing services than the Agency for Health Care Administration pays to house its young charges in nursing homes.

AHCA, however, has indicated no interest in reform. For 10 years, the agency fought the case in federal court — for so long that three of the child plaintiffs died before Judge Middlebrooks ruled in their favor.

Meanwhile, about 140 medically fragile children have been stashed in nursing homes. The judge noted that another 1,800 were “at risk” of institutionalization.

The federal court ruling will surely force Florida to do better for these children. Except AHCA intends to appeal the order, citing the “judge’s failure to understand the law.” (Middlebrooks has served on the federal bench since 1997.)

Sure, children are a priority. But if they’re frail, medically impaired and helpless, Florida has other priorities.

By Fred Grimm, a longtime resident of Fort Lauderdale, has worked as a journalist in South Florida since 1976. Reach him by email at leogrimm@gmail.com or on Twitter: @grimm_fred.