A recent article in the AARP magazine’s “The Law” column caught my eye. The case discussed was “Should Medicaid beneficiaries with disabilities be forced to live in nursing homes?”

John Boyd, who is fighting the policy in Florida, is an educated man who, because of his disability-related needs (he is a quadriplegic) and Florida Medicaid policies, must live in a nursing home. Florida Medicaid rules “force some adults with disabilities to stay in nursing homes.” John and five others are pursuing a lawsuit that will force Florida to look at the way funding for long-term care is spent. Apparently, the state is far behind the national average for funding community-based services. The lawsuit addresses the fact that the ADA requires that programs for people with disabilities are in the most integrated settings, which nursing homes are not.An issue brought up in this case, and one that rings familiar, is that residents in nursing homes who are Medicaid recipients receive limited personal allowance funds. This limits their ability to enjoy things so many take for granted, such as access to transportation, entertainment, dining out, and even telephone service.

The restrictions of nursing home life create a situation that “perpetuates segregation of persons with disabilities”, as brought up in the lawsuit.
In addition to these inequities, there is also the cost factor. In Florida, the cost of nursing home care is approximately $25,000 more per year per person than the cost of assisted living or community-based care.

Florida has not joined other states which have been moving people with disabilities as well as older Medicaid recipients from nursing homes to community-based care.

While the ADA requires services in the “most integrated setting” appropriate to their needs, which for most would be their own homes and communities, Florida continues to place restrictions on the choices for those people with disabilities who are Medicaid recipients.
Finally, the article quotes the argument of state attorneys who want this case dismissed. They argue that Boyd wants “this court to second-guess the manner in which Florida’s elected officials and policymakers have chosen to make medically necessary services available in light of the State’s available resources.”

This should be an interesting case to watch.