AHCA Secretary Dudek Battles Allegations of Children in Nursing Homes

The secretary of the Agency for Health Care Administration is trying to quell questions about the placement of disabled children in nursing homes, saying a meeting between state and federal officials reinforced her view that Florida has not violated any laws, reports Jim Saunders of the News Service of Florida.

“I feel even stronger about the fact that we are in compliance,” AHCA Secretary Liz Dudek said in an interview.

Officials from the U.S. Department of Justice, which issued a scathing report and threatened legal action in September, met Thursday with representatives of AHCA and other state agencies about allegations that children with costly, complex medical conditions have unnecessarily been placed in nursing homes.

AHCA has tried for more than two months to fight the allegations and said it has taken steps such as contacting parents of disabled children to make sure they know the children can live and receive services outside of nursing homes. But the agency continues to face the possibility of a lawsuit by the Department of Justice alleging violations of the Americans with Disabilities Act.

Also, a lawsuit is pending in federal court in South Florida on behalf of children who have been placed in nursing homes or who are “at risk” or being placed in the homes. The plaintiffs’ attorneys will file a motion by Nov. 27 to try to get the case certified as a class-action lawsuit — an effort that the state is battling.

Matthew Dietz, an attorney for the plaintiffs, said children should not be placed in nursing homes and should receive services in their communities, which could involve living with their families or in places such as group homes. He compared the state’s handling of the children to something out of Charles Dickens.

“A medical facility is not an appropriate place to raise a child,” Dietz said.

But Dudek said she has been frustrated by “misinformation” about the issue and also said the Department of Justice has refused to disclose information it gathered during an investigation that prompted the September report. She said such information would include the names of parents contacted by federal investigators.

The Department of Justice, which informed the state in December 2011 that it had opened the investigation, has focused on part of the American with Disabilities Act that requires public agencies to ensure that disabled people “receive services in the most integrated setting appropriate to their needs.”

As of September, 221 children with severe medical conditions had been placed in nursing homes. As examples, many children had what are known as tracheostomy tubes to help them breathe, while many other were on ventilators.

After the meeting with the Department of Justice, AHCA issued a news release that said it has contacted the parents or guardians of children in nursing homes. It said 14 percent expressed interest in the children receiving medical services at home instead of in a nursing facility. But after parents learned more, AHCA said only 1 percent were interested in taking steps to make the move.

Dudek said AHCA plans to meet with advocates for disabled people to find out how it can better communicate with parents about their choices.

But the Department of Justice report in September said investigators “found few examples of concrete efforts by the state to identify services that would enable children entering these facilities to return home to their families.” Dietz also questioned AHCA’s statements about its more-recent contacts with parents whose children are in nursing homes.

“I would love to know the questions they asked these parents,” he said.

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