MIAMI (AP) - Florida health officials are sending staff to visit more than 200 disabled children living in nursing homes, days after federal investigators accused the state of unnecessarily sending medically needy kids to adult facilities.
Florida Agency for Health Care Administration Secretary Liz Dudek said she dispatched staff Tuesday to visit the nursing homes and will also meet with parents to make sure they feel the child is in the best place.
"Everyone including this fragile population of children deserved to be cared for in the least restrictive environment," Dudek said Wednesday. She stressed that if the children can be cared for safely at home, "then that's where we want them to be."
U.S. Department of Justice officials sent a scathing letter last week, accusing the state of routinely cutting in-home medical services, leaving parents with no other option than nursing homes.
Investigators visited children in six nursing homes around the state, noting that children, even babies, languish in facilities, sharing common areas with elderly patients and having few interactions with others, rarely leaving the nursing homes or going outside. According to the letter, 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.
Dudek said her agency works with the schools system and that she wasn't aware of any circumstances where the appropriate services weren't being provided.
Federal officials said Florida is violating the federal Americans with Disabilities Act and is infringing on the children's civil rights by segregating and isolating them. The average length of stay is three years, according to the letter.
The state has until Friday to respond. If the state doesn't comply voluntarily, then the U.S. Attorney General may initiate a lawsuit under the federal disability act.
But Dudek said her agency is already in compliance and offered no other details about what else the state's response might say.
Parents say they are desperately fighting to get services to keep their children at home because they have to reapply for services every six months and are routinely denied even though their child's medical condition has not changed. That usually kicks off a stressful appeals process, they said.
Dudek denied the agency has a blanket policy of denying such requests, but said prior authorization for certain services must be approved by a team of medical professionals.
State health officials said they did not have figures on how many parents had placed their children in the facilities after significant cuts to home services or what percent of the appeals end up winning.
Meanwhile, the waiting list for services at home or in the community has jumped from 14,629 in 2005 to more than 21,000 in 2012, with more than half waiting longer than five years. State policy does not give priority on the waiting list to children in nursing homes, federal officials said.
Despite the alleged wait, the number of children actually enrolled in these programs has decreased by several thousand over the last several years. That is "resulting in a growing list of children waiting years for services and having access to a waiver slot only once they have literally deteriorated to the point of crisis," according to the letter.
"We do not have a waiting list...they get the services that they need," Dudek said.
At the same time, the state turned down nearly $40 million in federal dollars for a program that transitions people from nursing homes back into the community.
Yet the state implemented policies that expanded nursing home care, by offering facilities a $500 enhanced daily rate for caring for children, which is more than double than what the state pays for adults, according to the letter.
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