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Finding Better Living Options for Medicaid Beneficiaries

The issue: How can Medicaid beneficiaries living in nursing homes find better options?

As many as 8,500 residents of Florida nursing homes now may be able to move home or to community-based assisted living facilities. Florida’s Department of Elder Affairs and the Agency for Health Care Administration agreed to spend $27 million moving residents from nursing homes as part of an agreement in a class action lawsuit brought in U.S. District Court by AARP attorneys.

“We are pleased to have reached an agreement and are confident that the defendants will meet their obligations,” said Bruce Vig­nery, a senior attorney for AARP Foundation Litigation and an attorney on the case. “We think they have the will and expertise to develop a successful transition program.”

The case, filed in January 2008, alleged that the state violated the Americans With Disabilities Act (ADA) because it prevented people with disabilities from moving into family homes or less restrictive community settings such as assisted living facilities.

The U.S. Supreme Court ruled more than a decade ago that the ADA requires public entities to administer programs in the most integrated setting appropriate, which for many people means living in the place they have long called home, in the communities to which they have become accustomed.

Florida nursing home residents get only $35 a month in spending money, so they can’t afford transportation, phones or food purchases, the suit says. Sometimes they face curfews. This “perpetuates the segregation of persons with disabilities,” the lawsuit argued.

Nursing home care in Florida is also expensive for taxpayers—roughly $65,000 a year per person versus an average of $39,000 a year in assisted living. Other community options are even less expensive, Vignery said.

The district court suspended the case for up to 12 months while Florida implements the settlement. The court has the option of ordering a trial if the state fails to fully comply.

What it means to you: To move from a nursing home to community-based housing, ask a nursing home social worker, the state Medicaid agency or a local independent living center about available transition programs.

Emily Sachar is a journalist and author based in Brooklyn, N.Y.

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