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

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

The children have been medically cleared, but they tie up hospital beds that could be used by others, especially at times of high 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 the children “result in many hundreds of additional days where hospital care is not required.”

Hospitals become a "dumping ground" for children in DCS custody

TennCare covers the cost of hospital care for children in DCS custody but won’t disclose how much taxpayers spend on extended stays.

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

It often begins in a pediatric emergency room.

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

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

But once the hospital says the child can leave, DCS says they have no place for the child to go.

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

“Our state is failing. I think we’ve failed these kids, and frankly, we’ve 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.

He was eventually sent to an out-of-state facility because DCS had no room for him.

And an insulin-dependent diabetic was left for days because hospital notes reveal that “DCS would not bring (the child) into the office due to the insulin injections required.”

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

DCS left 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 Johnson City hospital 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, R-Tennessee, during budget hearings that the agency has received calls from hospitals concerned that children stay long term.

“They are young people who are extremely difficult to place,” Quin said.

“They’re in hospitals for 100 days and they’re not seriously ill, but they can’t stay in an office and they’re not suitable for transitional housing,” Quin told the governor.

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

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

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

“They really need specialized care, and we just don’t have programming 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 take care of the kids,” Campbell said.

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

Lee indicated at the budget hearing that he was willing to fund DCS’s 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 deal with in the Department of Children’s Services without sending kids to the hospital,” Senator Campbell said.

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 about a decade, children’s hospitals, in TN and nationally, have seen a significant increase in the number of young who have a primary mental health diagnosis, due to a lack of readily available services and a fragmented delivery system for these services.

Another group of children who are admitted to our state’s children’s hospitals are those in DCS custody. These youngsters are often brought to pediatric emergency rooms for an actual medical or behavioral need. However, when they are ready for discharge, DCS teams are challenged to find appropriate placement options, thereby delaying discharge. While these children remain in hospitals, it ties up resources that could be used by other children. Lengths of hospital stays across the state range from several days to months, with one children’s hospital reporting the longest stay at 276 days.

Together, these patients represent many hundreds of additional days in which hospital care is not required. DCS often cites limited or no placement options and struggles with insufficient resources to adequately provide and support these children in its care. New DCS Commissioner Margie Quin recently acknowledged the problem of long hospital stays for some children and has outlined a plan to address this and other issues facing DCS through major measures such as more funding and increased training and support for caseworkers.

Mary Nell Bryan, president of the Tennessee Children’s Hospital Alliance, said, “The Tennessee Children’s Hospital Alliance appreciates the hard work of the employees of the Department of Children’s Services to meet the challenges of finding foster homes for children who are medically fragile or dealing with chronic medical conditions such as diabetes… Sometimes there are not enough suitable places for these transfers to happen quickly.We appreciate Commissioner Quin calling for more funding and has outlined a plan that includes increased training and support for caseworkers. The work of DCS caseworkers and other DCS staff is vitally important. As can be said of those who work in hospitals, if While this work can be challenging, it is also very rewarding. We urge families to consider fostering children who are medically frail or suffer from a chronic condition such as diabetes.”

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