In a long-running dispute stemming from concerns about “medically fragile” children being placed in nursing homes, a federal appeals court this week backed the U.S. Department of Justice’s authority to pursue a lawsuit against Florida over alleged violations of the Americans with Disabilities Act.
A three-judge panel of the 11th U.S. Circuit Court of Appeals, in a 2-1 decision Tuesday, overturned a lower-court ruling that said the Department of Justice did not have legal standing in the case.
The issue of care for medically fragile children, who have severe health conditions, drew attention in 2012 after a Department of Justice investigation found Florida was unnecessarily institutionalizing children with disabilities in nursing homes. The department also said the state’s Medicaid program placed other children at risk of institutionalization.
The Florida Agency for Health Care Administration, which runs much of the state’s Medicaid program, vehemently disputed the allegations.
Attorneys for a group of children filed a federal lawsuit alleging, in part, that the state was violating the Americans with Disabilities Act by failing to provide services that would allow children with severe medical problems to stay in their homes and communities. The Department of Justice tried to negotiate an agreement with the state but wound up filing a lawsuit in July 2013, Wednesday’s ruling said.
In addition to finding that the Department of Justice did not have standing, a lower-court judge in 2017 ruled against the group of plaintiffs because of changes Florida made in the Medicaid program. Senior U.S. District Judge William Zloch approved recommendations from a magistrate who wrote that the plaintiffs could no longer show they were in danger of being denied medically necessary private-duty nursing services — a key issue in the case — or that they were at risk of institutionalization.
That ruling against the plaintiffs was upheld in April by the same panel of the 11th U.S. Circuit Court of Appeals that issued Tuesday’s decision. But the question of whether the Department of Justice had the legal authority to sue the state over compliance with part of the Americans with Disabilities Act remained unresolved.
The panel’s majority issued a 58-page ruling Tuesday that reversed the lower-court decision and backed the Department of Justice’s ability to file lawsuits under what is known as Title II of the Americans with Disabilities Act. The majority pointed to other laws that had been incorporated into that part of the Americans with Disabilities Act and that allow the Department of Justice to pursue lawsuits.
“The express statutory language in Title II adopts federal statutes that use a remedial structure based on investigation of complaints, compliance reviews, negotiation to achieve voluntary compliance, and ultimately enforcement through ‘any other means authorized by law’ in the event of noncompliance,” Judge Danny Boggs wrote in an opinion joined by Judge Jill Pryor. “In the other referenced statutes, the attorney general may sue. The same is true here.”
But Judge Elizbeth Branch dissented, arguing that the disputed part of the Americans with Disabilities Act does not explicitly give the right to the Department of Justice to file a lawsuit. Instead, she said it refers to a “person alleging discrimination.” — and that the U.S. attorney general, who heads the Department of Justice, doesn’t meet that definition.
“Because the text of Title II is determinative, and because that text does not provide the attorney general with a cause of action to enforce Title II against the state of Florida, I would affirm the order of the district court,” Branch wrote.