Florida could easily help protect older people from COVID-19 — if it would

Gov. Ron DeSantis’ announcement of suspected COVID-19 in 19 long-term care facilities on Wednesday is a harbinger of many more cases to come. There is a particular injustice in the face of this threat: Many older people in nursing facilities in Florida shouldn’t be there in the first place. They were forced there by bad state policy.

Florida limits the number of older people who can receive Medicaid-funded services — such as a daily visit from a home health aide — in their homes and communities to 62,000. The Sunshine State is home to more than five and-a-half million people age 60 and over – more than 26% of the state’s population. With the cap, low-income older adults and adults with disabilities who rely on Medicaid face average waiting times upward of 30 months to receive essential home-based services.

Many cannot wait this long to get the services that they need at home, so the only choice is to move into an institution. There they can be exposed to poor emergency management, or other risks to their health, dignity and life.

As more people join older age groups, the urgency to respect their rights to live independently — where they want and with whom —increases in urgency. What’s more, services and support at home are often cheaper for the public purse than nursing facilities.

Under federal law, including the Americans with Disabilities Act, and under international human rights law, older people who need services and support to live independently should be able to get them. Having to move into an institution to get those services, potentially cut off from the rest of the community and even from family in an emergency situation, isn’t a decision anyone should be forced to make.

A statewide class action lawsuit against the state of Florida brought by low-income older adults and adults with disabilities alleges that these limits on home-based support violate the ADA’s requirement that people are entitled to receive services in the ”most integrated setting appropriate,” meaning that providing services at home and in the community should take priority over care in institutional settings.

Florida’s leadership can choose to change before this lawsuit is decided. It should revise its policies and provide the choice for low-income older Floridians to have home and community-based services and supports on an equal basis with others.

The risk COVID-19 poses to the lives of older people living in nursing facilities should force state governments around the country to take a hard look at whether their home- and community-based services and support are promoting older people’s rights or driving them into institutions and potential situations of risk.

What future do you want? A future with support to live where you choose on an equal basis with others, to stay safe, and to stay connected to your community? So do we all.