NASHVILLE, Tenn. (WTVF) — Children in state custody are spending months in Tennessee hospitals because the Department of Children Services has nowhere else to put them.
The children have been medically cleared, but they are occupying hospital beds that could be used by others, especially during times of increased demand.
One child spent more than nine months – 276 days – in a children’s hospital when he should have been discharged.
Some hospital officials say NewsChannel 5 investigates they become a dumping ground for children 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 “account for several hundred additional days when hospital care is not needed.” .
TennCare covers the cost of hospital care for children in DCS custody, but will not disclose how much taxpayers spend for 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 have done other children.
It often begins in a pediatric emergency room.
A DCS social worker takes 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 said the child could leave, DCS said he had no place to go.
State Sen. Heidi Campbell, a Nashville Democrat, was disturbed by the details we showed her.
“Our state is failing. I think we’ve failed these kids and we’ve frankly failed DCS,” Campbell said.
Examples include a 10-year-old with muscular dystrophy who stayed 103 days at Children’s Hospital of East Tennessee in Knoxville.
DCS was unable to find a placement for the child after his mother died from COVID and his father was unable to care for him.
Another 10-year-old child with severe autism was housed for 51 days in the same hospital.
He was ultimately sent to an out-of-state facility because DCS did not have room for him.
And an insulin-dependent diabetic stayed for days because hospital notes reveal “DCS did not take (the child) to the office due to needed insulin injections.”
“Choosing between offices and hospitals is not a reasonable choice,” said Senator Campbell.
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 had received calls from hospitals concerned about children’s stay long-term.
“These are extremely difficult young people 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 suitable for halfway houses,” Quin told the governor.
DCS lacks foster homes and has therefore been forced to have some children sleep in office buildings.
A DCS attorney said “children in wheelchairs can also be difficult to place. The most difficult situations are those with both medical and behavioral/mental needs.”
Commissioner Quin requested more than $8.7 million to fund “assessment treatment homes” that would be located across the state and keep some of the medically difficult-to-place children.
“They really need specialized care, and we just don’t have programs for them,” Commissioner Quin said during the budget hearing.
Senator Campbell can’t believe the state often has to choose between offices and hospital rooms.
“Let’s be responsible and give DCS the money we need to take care of the children,” Campbell said.
“Our state currently has more money in reserves than we have had in decades, and there is absolutely no reason why we cannot ensure we are taking care of our most vulnerable.” Campbell said.
Lee signaled during the budget hearing that he was willing to fund DCS’s requests for more money.
But even if the budget request is approved, it will still take months to deliver aid, raising questions about what can be done now.
“These are issues that we absolutely should be able to resolve within 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. Over the past decade or so, children’s hospitals, in Tennessee and nationally, have seen an increase significant increase in the number of young people with a primary mental health diagnosis, due to the lack of readily available services and a fragmented delivery system for these services.
Another group of children admitted to our state’s children’s hospitals are children in DCS custody. These young people are often brought to the pediatric emergency room because of a true medical or behavioral need. However, when they are ready to be released, DCS teams struggle to find suitable placement options, thus delaying their release. As long as these children remain in the hospital, this takes up resources that could be used by other children. Length of hospital stays across the state range from several days to several months, with one children’s hospital reporting the longest stay at 276 days.
Collectively, these patients represent several hundred additional days during which hospital care is not required. DCS frequently cites limited, if any, placement options and struggles with insufficient resources to adequately staff and support these children in their care. New DCS Commissioner Margie Quin recently acknowledged the problem of long hospital stays for some children and outlined a plan to address this and other issues facing DCS through important measures like as increased funding, increased training and increased support for social workers.
Mary Nell Bryan, president of the Tennessee Children’s Hospital Alliance, said, “The Tennessee Children’s Hospital Alliance appreciates that the employees of the Department of Children’s Services are working hard to meet the challenges associated with looking for foster homes for children who are medically fragile or facing health issues. chronic diseases, such as diabetes. Sometimes there are not enough suitable locations for such transfers to happen quickly. We appreciate that Commissioner Quin has called for more funding and presented a plan that includes increased training and support for social workers. The work of DCS caseworkers and other DCS staff is vitally important. As can also be said about those who work in hospitals, although this work can be challenging, it is also extremely rewarding. We urge families to consider fostering children who are medically fragile or have a chronic illness such as diabetes.
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