Florida health officials said Monday they will assign care coordinators to about 1,600 children with disabilities amid allegations from federal health officials that the state was cutting in-home services and essentially forcing kids into adult nursing homes.
An individual care coordinator will work with no more than 40 disabled children at a time who are receiving in-home nursing services and ensure they have continued access to those services. The Agency for Health Care Administration said it will begin the transition within 90 days. Many of the children require ventilators, feeding tubes and other machinery that is too complicated for parents to monitor.
The changes come several months after federal health officials threatened to sue the state and accused it of violating federal law by allowing more than 200 children with disabilities and even babies to be kept in nursing homes, often for years.
Federal regulators say children languish in facilities, sharing common areas with elderly patients and having few interactions with others, rarely leaving the nursing homes or going outside. After visiting children in six nursing homes, investigators noted the children are not exposed to social, educational and recreational activities that are critical to child development. Educational opportunities are limited to as little as 45 minutes a day, according to a detailed letter from U.S. Department of Justice officials last year.
A lawsuit filed in South Florida federal court on behalf of more than a dozen children last year echoes similar complaints, alleging more than 3,300 children with disabilities are at risk of being pushed into adult nursing homes because the state is slashing nursing and other services that would otherwise keep them at home with their families.
State officials said they have travelled the state meeting with children in the homes and have repeatedly stressed that all the medically necessary services are being provided, but parents and doctors often disagree with the agency over what services are considered medically necessary.
Critics said the state has already been using the care coordination model and that it's primarily designed to control costs. The state still hasn't decided how much they will defer to children's doctors when deciding what services to pay for, said Matthew Dietz, an attorney for the plaintiffs.
However, he said the policy change is a step in the right direction.
"The state of Florida has admitted that there is a problem, and that this problem needs to be fixed. Unfortunately, rather than welcoming all of the stakeholders, including the many children we represent, and the putative class of all kids with disabilities, and the federal government, AHCA has ignored them and again decided that it knows what is best for these families with children with disabilities," he said.
Officials said in a statement that the "changes clarify misunderstanding of its current policies and exemplify the agency's existing commitment to ensuring that children in Florida promptly receive Medicaid services in the most integrated setting appropriate to meet their needs."