USA v. State of Florida

Circuit 11Mar 31, 2026

Split Score

SplitScore: 81/100

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.

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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

Circuit 2Circuit 4Circuit 6Circuit 7Circuit 9Circuit 10Circuit 11(this circuit)

Serious risk of institutionalization is actionable discrimination under Title II/Olmstead.

Circuit 5

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.

Parties & Counsel

Parties

Appellant:State of Florida
Appellee:United States of America