Woman sues for potential unnecessary institutionalization

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The graphic is an outline of the state of Florida with the key portions of the Florida state flag within it.A Medicaid-eligible woman with spinal cord injuries is challenging a Florida requirement that she enter a nursing home for 60 days before receiving community-based services.

On June 9, the U.S. District Court for the Middle District of Florida granted a preliminary injunction to block to temporarily block the requirement from going into effect.

The plaintiff in the lawsuit injured her spinal cord in a motorcycle accident in 2007. She needs assistance with many basic activities, including transferring in and out of bed, bathing and basic hygiene needs, dressing, preparing meals and eating.

Since the injury, she had resided in her community despite not receiving the Medicaid-funded services she requested following the injury. But her caregiver situation had recently changed, and when she applied again, the state informed her she would have to enter an unnecessarily segregated setting, a nursing home, to be eligible to eventually receive home services. According to the lawsuit, this forced segregation from society would violate the Supreme Court’s 1999 Olmstead decision, which prohibits “unjustified isolation.”

The state could not provide services immediately because the number of people eligible for its Traumatic Brain Injury/Spinal Cord Injury Waiver is capped at 375 through 2012.

In an amicus brief filed in May, the Justice Department challenged the state’s “fundamental alteration” defense that it could not afford to expand its community-based services. It estimated that it would cost the state roughly half as much to provide home services, as opposed to services in the nursing home. This defense is one of the exceptions to implementation written in the Olmstead decision.

A trial was held in August.