Justice Department says Alabama institutionalizes too many children with disabilities

[January 17, 2025]  MONTGOMERY, Ala. (AP) — Alabama children with physical disabilities are being unnecessarily institutionalized in nursing homes, the U.S. Justice Department said Thursday, warning it would file suit against the state unless changes are made to allow more of these children to live at home.

A Justice Department investigation found Alabama is violating the requirement of the Americans with Disabilities Act to administer services to individuals with disabilities in the setting most appropriate to the person’s needs.

“Many children with physical disabilities in Alabama are unnecessarily institutionalized or are at serious risk of unnecessary institutionalization,” Assistant U.S. Attorney General Kristen Clarke wrote to state officials.

Clarke announced the probe's findings in a letter to the Alabama Department of Human Resources, the Alabama Medicaid Agency and the Alabama Department of Senior Services. It listed changes the state should make to provide more community services and threatened a federal lawsuit if action isn't taken.

Alabama’s Gov. Kay Ivey’s office referred questions to the state agencies. The Department of Human Resources did not immediately respond to an email Thursday seeking comment.

The federal investigation found that Alabama policies effectively limit community-based services, or long-term support services, which allow children with physical disabilities to live at home.

Federal officials said the state has not adequately developed its community-based workforce. The Justice Department also said Alabama fails to support foster parents who care for, or are considering caring for, children with physical disabilities.

Alabama parents too often face a difficult choice of sending their children to nursing homes for life or quitting their jobs to become full-time caregivers, the Justice Department wrote.

“Some children who could otherwise be cared for in family homes have spent their formative years growing up in nursing homes, separated from their families and communities. Others live on the brink of such institutionalization, as their families struggle physically, financially, and emotionally to keep them at home,” Clarke wrote.

P.J. Alexander said he and his wife were one of those Alabama families. Their son Kyle was born with a complex set of medical issues, including genetic conditions and cerebral palsy.

“We were able to keep him at home, just barely,” he said.

They had considered moving to another state that provides more resources for families caring for profoundly disabled children. Kyle passed away suddenly Nov. 25 at age 10 from cardiac failure, Alexander said.

“He was such a happy boy, he’d always smile. For someone who had so many struggles," Alexander said.

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