Hospitals becoming a ‘dumping ground’ for kids in DCS custody

NASHVILLE, Tenn. (WTVF) — Children in state custody are spending months in Tennessee hospitals because the Department of Children’s Services has no place else to put them.

The children have been medically cleared but tie up hospital beds that could be used by others, especially during times of heightened demand.

One child spent more than nine months — 276 days — living at a children’s hospital after he should have been released.

Some hospital officials tell NewsChannel 5 Investigates they are becoming a dumping ground for kids DCS cannot place.

The Children’s Hospital Alliance of Tennessee (CHAT), which represents children’s hospitals statewide, said in a statement the children “account for 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 would not disclose how much taxpayers are spending on the extended stays.

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

It often starts in a pediatric emergency room.

A DCS caseworker takes a child to the hospital with a true medical problem.

Usually the 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 children and we’ve quite frankly failed DCS,” Campbell said.

Examples include a 10-year-old with Muscular Dystrophy who stayed for 103 days at the East Tennessee Children’s Hospital in Knoxville.

DCS could not find a placement for the child after his mother died of COVID and his father could not care for him.

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

He was eventually sent to a facility out of state because DCS did not have a place for him.

And an insulin-dependent diabetic stayed for days because hospital notes reveal “DCS would not take (the child) to office due to insulin shots required.”

“To choose between office floors and hospitals is not a reasonable choice,” Sen. 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 of 2021 through February of 2022.

The agency left another child at 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, R-Tennessee, during budget hearings the agency has been getting calls from hospitals concerned about kids staying long-term.

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

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

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

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

Commissioner Quin requested more than $8.7 million to fund “Assessment Treatment Homes” that would be located across the state and would keep some of the medically hard-to-place kids.

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

Sen. Campbell can’t believe the state is often choosing between office floors and hospital rooms.

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

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

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

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

“These are issues we should absolutely 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 the 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 youth presenting with a primary mental health diagnosis, because of the lack of readily available services and a fragmented delivery system for those services.

Another group of children finding themselves admitted to the children’s hospitals in our state are those in DCS custody. These youth are often brought to pediatric emergency rooms because of a true medical or behavioral need. However, when they are ready for discharge, DCS teams are challenged with finding 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 of 276 days.

Collectively, these patients account for many hundreds of additional days in which hospital care is not needed. DCS frequently cites limited to no 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 issue of long hospital stays for some children and has outlined a plan to tackle this and other issues DCS faces through important measures such as more funding and increased training and increased support for case 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 challenges in finding foster homes for children who are medically fragile or dealing with chronic medical conditions, such as diabetes.. There are sometimes not enough appropriate places for such transfers to happen quickly. We appreciate that Commissioner Quin has requested more funding and outlined a plan that includes increased training and increased support for case workers. The work of DCS case workers and other DCS staffers is vitally important. As can also be said about those who work in hospitals, while this work can present challenges, it is also extremely rewarding. We urge families to consider fostering children who are medically fragile or who are dealing with a chronic condition such as diabetes.”