Six disabled and elderly Floridians are suing the state over alleged violations of the Americans with Disabilities Act.
The case involves long wait times of up to 3½ years for access to in-home health care through Medicaid.
The plaintiffs are among some 50,000 disabled and elderly people who are on a wait list to get Medicaid approval for in-home services.
The suit alleges that the patients face hardships without these services, said Regan Bailey, litigation director for Justice in Aging, which is representing the plaintiffs along with Disability Rights Florida and the Southern Legal Counsel.
“They can end up going to a nursing facility and as you can see in our complaint, thousands have died while they are on the waiting list,” Bailey said. “But there is also just the suffering of not getting the care you need, the strain on the families as they try to meet the individual's needs.”
Florida’s in-home, long-term health care services that are available through Medicaid are part of a capped system with a limited amount of space. Patients have to be accepted into the long-term care program to become eligible for services.
Florida's Medicaid system makes it easier for patients to go into long-term care facilities even though home-based services can cost up to four times less.
“You can go into a nursing facility quickly, there’s no wait there,” Bailey said. “The wait is for the home- and community-based services.”
The system can force people who would rather stay in their homes with their families into nursing facilities.
That is a violation of the Olmstead decision under the ADA, which found that people with disabilities (including older adults) have a right to receive services in the most integrated setting appropriate to their needs, Bailey said.
A majority of the people on the waiting list are over 60, with more than half over 74, according to Justice in Aging.
About 22 percent of Florida’s Medicaid spending for long-term care goes to home- and community-based services, placing the state among the worst in the nation. The national average is 45 percent.
With its lawsuit, Justice in Aging wants the state to develop more in-home care services for people and increase the capacity of the services it has.
That could include in-home nurses or aids that can help patients with personal care, such as bathing, changing clothes or using the bathroom.
“It’s a population that’s growing, it’s a need that’s growing,” Bailey said. “And the way to meet that need is to provide more community-based services because you can serve many more people for the same money in the community versus in a nursing facility.”