Florida’s Nursing Home Transition Class Action Suit Goes to Trial

History is in the making as Judge Robert Hinkle of the US District Court in Tallahassee is in the process of ruling on whether or not the state of Florida discriminated against 1000’s of Floridians with disabilities who are living in nursing homes. The outcome could change the lives of 1000’s of young people with disabilities who are living in nursing homes against their will who as a result of the ruling could potentially have a community based living option.

Currently, most Medicaid eligible people who are sick enough or disabled enough to quality for substantial care must receive that care in a nursing home. Then in 1999 the Supreme Court’s decision in Olmstead v. L.C. changed that. Known as the Olmstead Decision, the court ruled that requiring an individual who has a disability to take their Medicaid benefits in an institution is a form of segregation, which amounts to discrimination under the Americans with Disabilities Act. The ruling required that states provide community based services if individuals want them, if they are appropriate, and if they can be accommodated.

In 2008, on behalf of approximately 8500 persons with disabilities in Florida, Philadelphia civil rights attorney Steven Gold, Florida AARP attorneys and others filed a class action suit claiming Florida was not abiding by the Olmstead Decision.  Florida was offering some Medicaid waivers to people to receive their care in the community, however, the majority of the state’s Medicaid funds were still being allocated to nursing homes for institutional care.

In 2009, the state and the plaintiffs agreed on a settlement requiring Florida to make a certain amount of progress in transitioning people out of institutions.  The class action suit was placed into “abeyance” for up to a year to allow the state to implement a transition program. Recognizing an opportunity to move people into the community the Florida Association of Centers for Independent Living began collaborating with three state agencies to get CILs involved in the transitions. Capitalizing on the expertise that Centers for Independent Living have with nursing home transition the CILs applied to become Medicaid providers so that they could enroll people onto the Medicaid waiver. At the same time, the state made more waiver funding available specifically for people who were in nursing homes.  

At the end of 2010 the plaintiff’s attorneys went back to the judge asserting that the state had not made significant progress and in 2011 the class action suit went to trial. In the meantime across Florida people with disabilities are moving out of nursing homes and starting new lives among family and friends.  PW is one of those people. When she was 46 years old a combination of disability issues led to a health crisis and having no family support or resources she wound up in a nursing home. She was institutionalized, not because she needed the full range of nursing care, but, because the little bit of care that she did need was not available anywhere else. In 2010 with the help of the Ability 1st Center for Independent Living in Tallahassee she got onto the Medicaid waiver which provides her moderate support services, and moved into her own apartment. In the four months since she’s left the nursing home she has evolved into a new person.  She no longer needs a wheel chair and walks without assistance, she exercises and she has lost 20 pounds. Around her neck she wears a Lifeline device that she can use to call for help  in an emergency. “This is my dream come true. I look forward to having a good life with someone… meeting new people… and getting my GED so I can go back to school. I’m so grateful to Ability1st for giving me a future.”

When people with disabilities live in their communities they benefit, and the state benefits as well. Community based care for Medicaid eligible persons is on average more cost effective than nursing home care. The average the cost of nursing home care is $60,000 per person per year, the cost of community based care averages $30,000 per person per year. For every 100 people that CILs transition from institutions into the community the state saves an average of three million dollars per year.

If the judge rules in favor of the plaintiffs, Florida will be required to continue the program it has started and CILs in Florida will help more people like PW achieve their independent living dream.