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Florida Child Advocacy Attorneys Named ‘Most Effective Lawyers’; Pro Bono Win Helps Seriously Ill Child, Family

December 7th, 2013   No Comments   Advocacy, News & Events

Howard Talenfeld, a Fort Lauderdale child child abuse and child advocacy attorney and shareholder with Colodny, Fass, Talenfeld, Karlinsky, Abate & Webb P.A., along with firm associate Nicole Coniglio, have been named the Daily Business Review’s Most Effective Lawyers in the Public Interest category.

The two child advocacy and Florida foster child attorneys were recognized specifically for their pro bono work representing a child and her family in an Agency for Health Care Administration hearing. The family was contesting AHCA’s denial of vital services for the child. As a result of their representation, the hearing officer determined AHCA was required to provide 24-hour, in-home care by skilled registered nurses, and not the part-time care by licensed practical nurses AHCA had been providing.

“We are honored to receive this honor, but more importantly to have helped this child and her family and many others in similar circumstances,” Talenfeld said. “Their story was like so many other children and families who struggle with trying to keep medically fragile children at home instead of placing them in nursing homes. Now, the child can remain at home and receive the care she needs from practitioners skilled in delivering that care.”

The child, now 11, was born with Marshall Smith Syndrome, a tragic and potentially life-threatening genetic disorder that causes craniofacial abnormalities and severe respiratory impairments. The girl has gastroesophageal reflux disease, chronic lung disease, severe global developmental delay, seizures, muscle spasms, post-tethered cord status, and severe scoliosis. Non-verbal and non-ambulatory, she has undergone more than 20 surgeries and requires a tracheostomy to breathe; a gastrostomy tube to receive nutrition, water and medications; and a ventricular peritoneal shunt to drain cranial fluids.

Though the condition can be fatal in early childhood, given appropriate, skilled nursing care, children have been known to live into adulthood. This was one of those cases. Because the mother was not capable of handling such care or emergencies without huge risk to the child and because she worked full time, the girl’s doctor prescribed ’round-the-clock care by a registered nurse. In April 2012, AHCA sent notice approving only limited private duty nursing care, with the expectation the mother would provide the highly skilled care during the times nurses were not present. The mother appealed.

Not only did the family prevail, after the hearing officer’s ruling, the agency in February 2013 changed its policies to allow all families in Florida who did not have the skill to care for the complex needs of their child to raise these facts when AHCA makes decisions of this nature. This affects hundreds of medically vulnerable children statewide where family members no longer would be expected to perform the complex medical care and procedures.

Moreover, the case highlighted the pressing need for legal counsel for medically fragile children who were in foster care. Soon after their win, Talenfeld through Florida’s Children First, a state wide advocacy group that he helped form, helped convince the Florida Legislature to approve $323,000 to provide legal counsel and representation to the state’s medically fragile foster children in foster care.

“AHCA rule changes benefit many families forced to provide ongoing, highly skilled care for their children or families,” Talenfeld said. “In the pursuit of delivering the greatest degree of ‘normalcy’ in the lives of medically fragile children, such outcomes cannot be overstated. This child remains in her family’s home, cared for by a mother who can both work or live her life and with the support of medically experienced staff.”

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