Hospitals become a “dumping ground” for children in DCS custody

NASHVILLE, Tenn. (WTVF) — Children in state custody spend months in Tennessee hospitals because the Department of Children’s Services has nowhere else to put them.

The children have received medical clearance but are occupying hospital beds that could be used by others, especially at times of peak demand.

A child spent more than nine months (276 days) living in a children’s hospital after he should have been discharged.

Some hospital officials say NewsChannel 5 investigates they are becoming a dumping ground for children that DCS cannot place.

The Children’s Hospital Alliance of Tennessee (CHAT), which represents children’s hospitals across the state, said in a statement that children “represent many hundreds of additional days in which hospital care is not needed.”

TennCare covers the cost of hospital care for children in DCS custody, but doesn’t disclose how much taxpayers spend on long-term stays.

The Department of Children’s Services said these children are difficult to place in foster homes and because they are medically fragile, they cannot remain in DCS office buildings as other children have been doing.

It often starts in a pediatric emergency room.

A DCS social worker brings a child to the hospital with a real medical problem.

Usually, the children have just been removed from an abusive or neglectful home.

But once the hospital says the child is free to go, DCS says they have nowhere to go.

State Sen. Heidi Campbell, D-Nashville, was disturbed by the details we showed her.

“Our state is failing. I think we have failed these kids and, frankly, we have failed DCS,” Campbell said.

Examples include a 10-year-old boy with muscular dystrophy who stayed for 103 days at East Tennessee Children’s Hospital in Knoxville.

DCS was unable to find a placement for the boy after his mother died of COVID and his father was unable to care for him.

Another 10-year-old boy with severe autism was housed for 51 days at the same hospital.

Ultimately, he was sent to an out-of-state facility because DCS did not have a place for him.

And an insulin-dependent diabetic stayed for days because hospital notes reveal that “DCS did not bring him (the boy) to the office because of the required insulin injections.”

“Choosing between office and hospital floors is not a reasonable choice,” said Senator Campbell.

DCS placed a child with a mental health diagnosis at Vanderbilt Children’s Hospital for 270 days.

The child occupied a room from May 2021 to February 2022.

The agency left another child in a hospital in Johnson City for 243 days, long after the child should have been released.

DCS Commissioner Margie Quin, who took over the agency in September, told Gov. Bill Lee, a Tennessee Republican, during budget hearings that the agency has been receiving calls from hospitals concerned about children’s extended stays. .

“These are youngsters that are extremely difficult to place,” Quin said.

“They stay 100 days in hospitals and they’re not seriously ill, but they can’t stay in an office and they’re not appropriate in transitional homes,” Quin told the Governor.

DCS has a shortage of foster homes and has been forced to have some children sleep in office buildings as a result.

A DCS attorney said that “children in wheelchairs can also be difficult to locate. The most difficult situations are those with medical and behavioral/mental health needs.”

Commissioner Quin requested more than $8.7 million to fund “Assessment Treatment Homes” that would be located throughout the state and would hold some of the medically difficult to locate children.

“They really need specialized care and we just don’t have programs for them,” Commissioner Quin said at the budget hearing.

Senator Campbell can’t believe the state often chooses between office floors and hospital rooms.

“Let’s be responsible and give DCS the money we need to care for the children,” Campbell said.

“Our state has more money right now than we’ve had in decades, in reserves, and there’s absolutely no reason why we can’t make sure we’re taking care of the most vulnerable,” Campbell said.

Lee signaled at the budget hearing that he was willing to fund DCS requests for more money.

But even if the budget request is approved, help is months away, raising questions about what can be done now.

“These are issues that we absolutely should be able to address at the Department of Children’s Services without sending children to the hospital,” said Senator Campbell.

Here is the full statement from the Children’s Hospital Alliance of Tennessee (CHAT):

“Children’s hospitals serve as a safety net for the physical and mental health and well-being of children and adolescents. For nearly a decade, children’s hospitals, in TN and nationally, have seen a significant increase in the number of youth presenting with a primary illness mental health diagnosis, due to a lack of readily available services and a fragmented delivery system for those services.

Another group of children who find themselves admitted to our state’s children’s hospitals are those in DCS custody. These youth are often brought to pediatric ERs due to a true medical or behavioral need. However, when ready for discharge, DCS teams are challenged to find suitable placement options, delaying discharge. While these children remain in hospitals, resources are tied up that could be used by other children. The length of hospital stays across the state range from several days to months, with one children’s hospital reporting the longest stay of 276 days.

Collectively, these patients represent many hundreds of additional days in which hospital care is not needed. DCS frequently cites limited or no placement options and struggles with insufficient resources to adequately staff and support these children in their care. New DCS Commissioner Margie Quin recently recognized the problem of long hospital stays for some children and has outlined a plan to address this and other issues facing DCS through important measures such as more funding, increased training and Greater support for social workers.

Mary Nell Bryan, President of the Children’s Hospital Alliance of Tennessee, said, “The Children’s Hospital Alliance of Tennessee appreciates that the employees of the Department of Children’s Services work hard to address the challenges of finding foster homes for children who are medically fragile or facing medical conditions. chronic medical conditions, such as diabetes Sometimes there are not enough appropriate places for such transfers to be made quickly We appreciate Commissioner Quin asking for more funding and outlining a plan that includes more training and support for social workers The work of DCS caseworkers and other DCS staff is vitally important. As can also be said of those who work in hospitals, while this job can be challenging, it is also extremely rewarding. We urge families to consider fostering to children who are medically fragile or dealing with a chronic condition like diabetes.”