CW: Institutionalization
It started with rooms most people never saw. In 2023, Brittany Hayes’s son, then five years old, had been in a crib for hours every day since birth. Brittany Hayes said the video chats she had with her son were difficult. She comforted him as much as she could over a screen in the room where he had lived his entire life.
Another child named Dalton was placed at Kidz Korner as an infant. He was born premature and had a tracheostomy and a feeding tube. Sadly, his muscles were so underdeveloped that he could not sit up, not because of his diagnoses, but because he seldom left his crib.
In 2023, Cayden Armour’s father said he had spent most of his life in a Florida nursing home. Employees hardly ever checked on him, and he was often left sitting in dirty diapers.
When a state fails to deliver home-based nursing care and medically fragile children can’t live with their families, this is what happens. The children were not living in these facilities because they needed to be there. They were there because of Florida’s Medicaid system.
Florida’s Medicaid program wasn’t delivering the private-duty nursing hours doctors ordered. Families had to wait weeks or months for shifts to be filled. Low pay and heavy workloads caused nurses to leave, and agencies had trouble hiring enough staff. If hours weren’t filled, parents were told institutional care was the only option.
These institutions weren’t designed for children. They were meant for long-term care. Cribs were lined up in hallways, and toys were hard to find. The staff’s schedules determined what happened every day, not the children’s needs. The broken system, rather than the children themselves, put childhood on hold.
U.S. v. Florida is the result of a fourteen-year fight over whether medically complex children can receive the private-duty nursing care their doctors prescribe. This case is about childhood and what happens when the system fails to protect it.
By 2023, the consequences of that failure were painfully clear. A federal court ordered Florida to deliver at least 90 percent of the prescribed nursing hours. The Washington Post reported that Florida’s inability to deliver those hours had pushed children into institutions unnecessarily and that the ruling was finally sending many of them home.
The Eleventh Circuit upheld the injunction in 2026, citing the Olmstead decision and reaffirmed a long-held principle of disability rights: children have the right to grow up in their homes and communities, not in facilities. The federal landscape has changed. The Justice Department is stepping back from Olmstead enforcement, withdrawing from integration cases, and retreating from disability rights oversight. Advocates describe it as a historic pullback that changes the conditions under which long-running cases like U.S. v. Florida can continue.
For families relying on federal enforcement to hold states accountable, this shift is more than a procedural change. It changes the situation for them. Now more than ever, the responsibility to safeguard community living falls on the states, advocates, and families who have never stopped fighting for their children’s right to grow up at home, where childhood is meant to be lived.
Sources:
Diament, Michelle. “Justice Department Backs off Disability Rights Enforcement.” Disability Scoop, 20 Aug. 2026, http://www.disabilityscoop.com/2026/08/20/justice-department-backs-off-disability-rights-enforcement/32138.
Miller, Carol Mabin. “‘Just Another Baby for Them’: Parents, Feds Fight for Kids Stuck in Florida Nursing Homes.” The Miami Herald, 7 May 2023, http://www.miamiherald.com/news/health-care/article273784385.html.
Morris, Amanda. “Florida Kept Disabled Kids in Institutions. A Judge Is Sending Them Home.” The Washington Post, 20 July 2023, http://www.washingtonpost.com/wellness/2023/07/19/florida-disabled-kids-institutions-judge-ruling/.