A legal battle will continue about whether Florida's Medicaid program has provided proper services to children with severe medical conditions.
Attorneys for children and the U.S. Department of Justice gave notice this week that they will take the five-year battle to the 11th U.S. Circuit Court of Appeals in Atlanta. The move came after a federal district judge in June sided with the state Agency for Health Care Administration and the state Department of Health and dismissed the case.
The case has centered on allegations that the state violated the Americans with Disabilities Act and other laws by failing to provide services that would allow medically complex children to stay in their homes and communities. It was filed on behalf of children who had been placed in nursing homes or who were considered at risk of going into such facilities.
Senior U.S. District Judge William Zloch in the June ruling approved the recommendations of a magistrate judge, who focused on changes the Medicaid program had made. U.S. Magistrate Judge Patrick Hunt 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.
The notices of appeal, as is common, do not detail the arguments that the children's attorneys and the U.S. Department of Justice will make at the appeals court. But the notices, filed Monday, indicate that several rulings in the case will be challenged, including Zloch's June dismissal order.
The Department of Justice also will challenge a September 2016 ruling by Zloch that the department lacked legal standing to file its complaint under part of the Americans with Disabilities Act.
The overall legal fight dates to 2012, when attorneys for the children filed suit against the state in federal court in South Florida. The Department of Justice filed a lawsuit in 2013, and the cases later were consolidated.
Zloch last year turned down a request to have the case certified as a class action, finding that “a particular Medicaid recipient's risk of institutionalization will often turn on individualized circumstances, such as the recipient's particular medical condition and the recommendations of her physicians. Plaintiffs offer no objective measure by which to gauge the persons included within the class.”
In their notice of appeal filed Monday, attorneys for the children indicated they will also challenge that rejection of a class action.
The children in the case need intensive medical attention because of issues such as relying on tracheotomy tubes and having conditions such as cerebral palsy, according to court documents. They are identified only by initials.