Federal judge cites SP2 dean’s testimony in landmark decision upholding disability rights

The expert testimony of Dean Sara S. Bachman of Penn’s School of Social Policy & Practice (SP2) is cited throughout a major ruling upholding the rights of children with complex medical needs. In an outcome that coincides with the 33rd anniversary of the Americans With Disabilities Act (ADA), a federal judge ruled that Florida violated the ADA by failing to provide eligible families with at-home medical care.

Appearing as a witness for the U.S. Department of Justice in a case against the State of Florida, Dean Bachman presented research she conducted that indicates a widespread denial of access to private duty nursing. Such services would allow children with disabilities to live in their homes rather than in institutions.

“Dr. Bachman has extensive expertise in evaluating Medicaid programs throughout the country and is one of the nation’s leading experts in Medicaid program policy, structure, and financing,” writes U.S. District Court Judge Donald M. Middlebrooks in his decision.

“Based on her evaluation of the documents, data analysis, and deposition testimony, Dr. Bachman concluded that ‘Florida does not sufficiently serve children with medical complexity in the community in terms of the provision of private duty nursing services.’ (DE 909 at 120). Based upon her testimony and the State’s expert, . . . that of the parents, and all of the witnesses including those called by the State, I find that to be undoubtedly true.”

Dean Bachman testified about her recommendations in the areas below as evidence that reasonable accommodations could be made by the state. These recommendations formed the basis for the judge’s finding that Florida violated the ADA:

• Conduct more robust data collection and analysis
• Investigate what kinds of network adequacy standards would improve access to private duty nursing
• Examine reimbursement rates for private duty nursing

The U.S. Department of Justice hails the decision as a victory for disability rights. “The court’s decision, coming after nearly a decade of litigation, marks a major turning point in the treatment of children with disabilities in Florida and vindicates their right to community integration,” says the department in a press release.

Dean Bachman’s expertise focuses on health care financing and organization innovation, especially with respect to Medicaid and alternative payment strategies. She has over twenty years’ experience with health policy research and program evaluation in the areas of health care finance, health reform, social work, health equity, and state health policy for individuals with disabilities or complex health and social conditions, including children and youth with special health care needs. 

She has directed multiple associated national efforts, including the Catalyst Center, the U.S. Health Resources and Services Administration (HRSA) national center on financing health care for children and youth with special health care needs; the HRSA Health Care Delivery System Innovations for Children with Medical Complexity; and a national HRSA initiative to integrate Community Health Workers into Ryan White Care settings, among others.