JUN 11, 1996 Ms. Marcia Beach Executive Director Advocacy Center for Persons with Disabilities, Inc.

2671 Executive Center Circle West Suite 100 Tallahassee, Florida 32301-9071 Dear Ms. Beach: Your letter to Attorney General Janet Reno has been referred to me for response. Your letter indicates that the Florida State legislature is considering a proposal to reallocate funding for such care of individuals with developmental disabilities from one program ("ICF/DD") to another (Home and Community Based Waiver Act) without changing the type of services provided, and to cut the amount of funding. You allege that this action would violate the Federal medicaid statute and the Americans with Disabilities Act (ADA). Please excuse our delay in responding. The issues that you raise primarily involve Florida's administration of the Federal Medicaid program. Inquiries and complaints regarding the implementation of Medicaid program requirements should be directed to the Department of Health and Human Services at: Health Care Financing Administration Department of Health and Humans Services 230 Independence Avenue, S.W. Room 5400 Cohen Building Washington, D.C. 20201. Title II of the ADA requires States to administer services, programs, and activities, "in the most integrated setting appropriate to the needs of qualified individuals with disabilities." 28 C.F.R. S 35.130(d). In some circumstances it may be a violation of the ADA for a State only to provide services to an individual with a disability in an institutional, as opposed to a community, setting. Helen L. v. Didario, 46 F. 3d 325 (3d Cir. 1995). cc: Records, Chrono, Wodatch, McDowney, Hill, FOIA

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01-04285 -2An individual with a disability may take action under title II by filing a private suit in Federal district court or by filing a complaint with the Department of Justice or the appropriate "designated agency." The regulation implementing title II designates the U.S. Department of Health and Human Services (HHS) as the agency responsible for investigating alleged violations of title II by providers of health care and social services. The address for filing complaints with HHS is: Office for Civil Rights Department of Health & Human Services 330 Independence Avenue, S.W. Room 5400 Cohen Building Washington, D.C. 20201. I hope this information is helpful to you. Sincerely, John L. Wodatch Chief Disability Rights Section

01-04286 Advocacy Center FOR PERSONS WITH DISABILITIES, INC. 2671 EXEC. CENTER CIRC. W. * SUITE 100 TALLAHASSEE, FL 32301-5092 (904) 488-9071 (904) 488-8640 (FAX) April 29, 1996 (800) 342-0823 (VOICE) (800) 346-4127 (TDD ONLY) 3101 MAGUIRE BLVD. SUITE 150 ORLANDO, FL 32803 (407) 897-2760 The Honorable Janet Reno (407) 897-2763 (FAX) Office of the Attorney General (800) 408-3074 U.S. Department of Justice (VOICE OR TDD) 10th and Constitution Avenue, NW 2901 STIRLING ROAD Washington, DC 20530 SUITE 206 FT. LAUDERDALE, FL 33312 (954) 967-1493 Dear Madam Attorney General: (954) 967-1496 (FAX) (800) 350-4566 (VOICE, TDD OR ESPANOL) Florida is preparing, in the last few days of the

legislative 1996 session, to grossly violate the provisions of both the ICF/DD and Home and Community Based Waiver Acts (HCBW). They are doing so in a way that is harmful to individuals with DD and that violates the rights of individuals with DD under those acts and under the Americans with Disabilities Act. They are doing so in violation of the terms of Florida's waiver approved by the U.S. Department of Health and Human Services in 1992. Florida is planning to eliminate all ICF/DD funding used to finance nursing home-type supports in private institutions and totally replace such funding with a greatly reduced amount of funding under the Home and Community Based Waiver. They are totally disregarding the fact that the purpose of the HCBW is to allow individuals to move from institutional and nursing home settings such as most ICF/DD's in Florida, into inclusive community settings. Florida will not be moving the individuals into the community - just changing the funding. Because of the drastic reduction in funding by the Florida Legislature (a cut of over 35 million dollars from the Developmental Services program), the same services that are presently available to the individuals under the ICF/DD program will not be available to them. Most individuals will be left without adequate supports in the same 64 bed nursing hometype ICF's and other similar structures. Further violated will be the right of individuals under the ICF/DD program to be informed about the Home and Community Based Waiver and given a choice of either institutional (ICF/DD) services or home and community based 01-04287​ The Honorable Janet Reno April 29, 1996 Page 2 services. As you know, Federal law does not allow a state to force individuals into the HCBW program. This is particularly harmful to individuals when there are insufficient funds to provide necessary services under the HCBW. The Advocacy center supports the phasedown and closure of public and private institutions that confine individuals

with developmental disabilities. However, this proposal does not provide for phasedown or closure of any institution(s). It simply uses funds approved for that purpose. The legislature is scheduled to Sine die in three days. We urgently request that you notify Florida of this imminent violation which we believe could jeopardize all medicaid funding to Florida. Sincerely, Marcia Beach Executive Director MB:mkk cc: Governor Lawton Chiles Senate President Jim Scott House of Representatives Speaker Peter Rudy Wallace HRS Secretary Ed Feaver HRS Dept. Secretary Charles Kimber HRS Dept. Asst. Secretary Donna Allen Parker Thomson, Esq., President, Board of Directors Board of Directors Dexter Douglas, Esq., General Counsel to the Governor