Federal officials are threatening legal action after an investigation found hundreds of kids with developmental disabilities needlessly relegated to nursing homes designed to serve the elderly.

The state of Florida is confining children — some just babies — to institutional settings even though they could be appropriately served at home or in more integrated environments with proper supports, according to a U.S. Department of Justice investigation.

In a letter to the state’s attorney general last week, U.S. Assistant Attorney General Thomas Perez said that Florida needs to take corrective action to come into compliance with the Americans with Disabilities Act. Otherwise, Perez said the Justice Department may file a lawsuit.

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“The state’s reliance on nursing facilities to serve these children violates their civil rights and denies them the full opportunity to develop bonds with family and friends and partake in education, social and recreational activities in the community,” Perez wrote.

Justice Department investigators visited six large nursing homes in Florida where over 200 children with a variety of disabilities are housed. They also spoke with parents, many of whom indicated that they would prefer to care for their kids at home, but have been unable to secure assistance from the state to do so.

In many cases, kids living in the facilities are limited to specific areas and spend little time outside of the homes which resemble hospitals, investigators said. Some children are hundreds of miles from their families.

While the average length of stay was three years at the locations visited, investigators found kids who had been in nursing homes for more than a decade.

What’s more, Perez noted that other children are at risk of similar placements because of the “state’s policies and practices.”

Over the last several years, Florida has cut programs designed to provide community supports for those with developmental disabilities while increasing pay to nursing homes who serve kids, the letter says. Facilities often receive over $500 a day to care for kids, more than double the rate for elderly residents.

Florida officials, however, fiercely denied the allegations in Perez’s letter.

“The decision of where a child receives care is up to the parents, in conjunction with the child’s doctor,” said Elizabeth Dudek, secretary of Florida’s Agency for Health Care Administration, in a statement. “The agency will never interfere with a family’s choice for the location of their child’s care. The agency uses a professional, rigorous, federally-approved, quality control system to ensure every family receives the appropriate level of care for their child.”

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