USA v. State of Florida
Split Score
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Case Summary
Disposition
Affirmed in Part
The Eleventh Circuit largely upheld a district-court judgment finding that Florida’s Medicaid program violates Title II of the ADA by both unnecessarily institutionalizing medically complex children and putting thousands of others at serious risk of such placement. It affirmed most of an extensive injunction requiring Florida to provide at least 90 % of authorized in-home nursing hours, improve care coordination, and adopt transition-planning and data-collection measures, but vacated or trimmed several provisions and remanded for further proceedings.
Circuit Split Identified
Legal Issue
Whether Title II of the ADA prohibits only actual unjustified institutionalization or also prohibits a 'serious risk' of institutionalization for individuals currently receiving community-based services.
Circuit Positions
Serious risk of institutionalization is actionable discrimination under Title II/Olmstead.
Only actual or imminent institutionalization is actionable; mere risk is not.
Conflict Summary
Most circuits (2d, 4th, 6th, 7th, 9th, 10th, and now the 11th) hold that a plaintiff may bring an ADA/Olmstead claim by showing that a state program places disabled persons at a serious risk of future institutionalization, even if they are not yet institutionalized. The Fifth Circuit rejects that view, holding that only actual or imminent institutionalization constitutes actionable discrimination under Olmstead.