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The 67-year-old photographer has been confined to a nursing home for five years, the victim of a stroke that paralyzed his left party. And he’s angry.

“Most of the people get to here to die, so you want to die,” he said. “It is a prison. I can’t escape it.”

Lee is among the Medicaid recipients across Florida challenging the nightmare of the old and disabled: to be forced from comfort and familiarity into a nursing home.

They say the state is illegally forcing them to live in nursing homes whenever they should be able to live to which place they select. Advocates charge that nursing homes, afraid of losing standard of value, have successfully pressured politicians to make qualifying against community care more herculean. They have filed a federal lawsuit seeking class-action status on interest of nearly 8,500 institutionalized Floridians.

Whether the lawsuit gets Lee and others moved out of nursing homes remains to be seen. But at the very least, it has illuminated the frustration qualified by older people or those with disabilities who say they’re shuttled into nursing homes when they are healthy enough to brilliant at household, with relatives, or in other less institutional settings.

“There are very, very, very few people who cannot be cared for outside in the community,” said Stephen Gold, a Philadelphia disability lawyer who, along by AARP attorneys and others, is representing the clump. “Why should the state give a damn whether you put the money in the left pocket of the nursing home or the right pocket of the community?”

Americans who qualify for Medicaid and get indisposed or disabled enough to require substantial care typically have mean point to be solved gaining admission to a nursing home-born. But obtaining Medicaid-supported services at home, such as visits from each aide, is substantially harder and often involves a long waiting list, even though it may cost the form of sovereignty less.

Advocates in opposition to the elderly and disabled had hoped a 1999 Supreme Court case would change that. The Olmstead decision, of the same kind with it is known, involved two Georgia women, both Medicaid beneficiaries by mental retardation who wanted community-based services, but were refused and were treated in institutions.

The high court ruled unjustified isolation of the disabled in institutions amounted to penetration under the Americans with Disabilities Act. It said states mould provide community services if patients want them, if they be possible to be accommodated and if it’s appropriate. Medicaid is the state-federal partnership that provides hale condition coverage and nursing home care to the poor.

“There’s a lot of concern that the nursing home industry is very powerful in many states and has made fully convinced that a allotment of Medicaid dollars go to institutional care during the time that opposed to home and community-based have regard,” related Toby Edelman, an attorney at the Center for Medicare Advocacy.

States require been putting more money into common services, but not nearly sufficiency to meet the demand of people who would rather stay at home than be of use to a dexterity. Nationally, case Medicaid payments for long-term community care have skyrocketed since the Olmstead decision, from $17.4 billion in 1999 to $42.8 billion hindmost year, though spending steady nursing homes and other institutions is still stoutly higher.

A full of $59.5 billion was spent last year on institutional care end Medicaid.

The Florida Agency for Health Care Administration, the Florida Department of Elder Affairs and Gov. Charlie Crist’s office — the three defendants — all declined to comment on the litigation. So did the attorney general’s room, which is representing the defendants.

In court filings, the defendants be delivered of claimed the plaintiffs shortness standing since they haven’t proven that management professionals deemed community-based care appropriate for each patient.

“Plaintiffs are not alleging that Florida’s Medicaid program has failed to cover their medically necessary services,” the defendants wrote. “Instead, plaintiffs want this court to second-guess the carriage by that Florida’s elected officials and policymakers have chosen to constitution those services available in light of the state’s available available means.”

The American Association of Homes and Services for the Aging represents in various places 5,700 not-for-profit organizations from nursing homes to adult generation care to in-home aides. A spokeswoman, Lauren Shaham, said there is “an institutional bias” in the Medicaid program that limits fireside and community care, but also noted nursing homes are needed for some of society’s frailest or most disabled.

The American Health Care Association, that represents about 11,000 nursing homes and long-term care facilities, a majority of them for-profit, too said of that kind institutions were often most appropriate for round-the-clock care. Spokeswoman Susan Feeney distinguished, “You don’t want to be there but once for health reasons beyond your control, you have to be.”

John Boyd, 50, has been in a nursing home for the last nine years. He hates them. He became a quadriplegic 36 years ago when he bring to the ground off a wall and broke his neck.

“I can’t choose what meal I lack, I can’t have a visitor after 8 o’clock — it’s just like a prison without bars,” he said. “People are making decisions for and hither and thither me that don’t even know me or even care about me. All they care about is the money they’re getting according to me.”