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'Monopoly' Status Of For-Profit Group Home Reconsidered

Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.
The Florida Channel
Leon County Judge John Cooper on June 30, 2022, in a screen grab from The Florida Channel.

Florida legislators are looking to end what one lawmaker calls a “monopoly” written into state law that benefits a for-profit company with a history of abuse at group homes for the disabled.
AdvoServ’s sprawling Carlton Palms Educational Center in Central Florida houses nearly 30 percent of all state residents who are in group homes because of developmental and intellectual disabilities and challenging behavior. Roughly 200 adults and children live there.

In December, a ProPublica investigation detailed how AdvoServ has used its deep pockets to bully regulators and shape the rules it plays by in the three states where it operates.

Our investigation also showed a record that includes harsh tactics and outright abuse at AdvoServ’s schools and group homes going back decades. The company has long embraced mechanical restraints — such as ankle shackles and a device similar to a full-body straightjacket — that are widely shunned by other providers. Staff at Carlton Palms used such measures on residents roughly 28,000 times in less than five years, according to state records.

AdvoServ officials have said there is no pattern of abuse at its homes, and that the company takes action against employees who mistreat residents. Executives say restraints are only used as a last resort.

The facility has enjoyed a special status — and higher Medicaid payments from the state — because of language embedded in Florida law.

Until last year, law said the state should continue to contract with facilities licensed before 1989, when Carlton Palms was already in operation.

Instead of needing to prove it offered the highest quality care in the most cost-effective way, Carlton Palms continued to get the state’s business automatically. The only way the state could have stopped doing business with Carlton Palms would have been for public officials to prove the facility had broken state laws or regulations.

Last year, the Florida legislature passed a temporary provision to lift the obligation to work with Carlton Palms. But the measure, approved through a budget bill, expires in July.

The bills now before the state House and Senate would make the change permanent.

“The goal of my bill is to remove the statutory monopoly,” said Republican Rep. Ray Rodrigues, who sponsored one of the bills under consideration. “I believe introducing competition would benefit the patients.”

The legislation would also require Carlton Palms to keep video recordings of common areas for at least 60 days, so officials could review them if a problem occurred. The requirement — already part of a settlement agreement between Carlton Palms and the state — comes after the facility’s officials said they accidentally deleted hours of video from the night a 14-year-old girl died in 2013. Paige Lunsford was strapped to a bed and chair despite suffering from a stomach illness.

Because Carlton Palms is supposed to be a temporary placement, the bills also propose requiring a clinical review of any resident who has stayed there for more than two years, in order to make sure the placement is still appropriate.

Through a spokesman, AdvoServ officials declined to comment on the legislation.

A spokeswoman with the Florida Agency for Persons with Disabilities, which licenses Carlton Palms, said the agency would decline to discuss the bills until the legislative session is over.