NASHVILLE, Tenn. (WTVF) — Children in state custody spend months in Tennessee hospitals because the Department of Children Services has nowhere else to put them.
Children have been medically cleared, but they tie up hospital beds that could be used by others, especially during times of high demand.
A child spent more than nine months – 276 days – living in a children’s hospital after he should have been released.
Some hospital officials say NewsChannel 5 is investigating they become a repository 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 “represent many hundreds of additional days where hospital care is not needed.”
TennCare covers the cost of hospital care for children in DCS custody, but won’t disclose how much taxpayers spend on the extended stay.
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 other children have.
It often starts in a pediatric emergency room.
A DCS caseworker takes 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 can go, DCS says they have nowhere for the child to go.
State Sen. Heidi Campbell, D-Nashville, was disturbed by the details I showed her.
“Our state is failing. I think we failed these kids, and frankly, we failed DCS,” Campbell said.
Examples include a 10-year-old with muscular dystrophy who stayed for 103 days at East Tennessee Children’s Hospital in Knoxville.
DCS was unable to find a foster home for the child after his mother died of 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 eventually sent to an out-of-state facility because DCS didn’t have a place for him.
And an insulin-dependent diabetic stayed for days because hospital notes reveal that “DCS would not take him (the child) to the office because of the insulin shots required.”
“Choosing between offices 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 at 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 about children staying long.
“These are young people who are extremely difficult to place,” Quin said.
“They’re staying 100 days in hospitals and they’re not seriously ill, but they can’t sit in an office and they’re not appropriate in transitional housing,” Quin told the governor.
DCS has a shortage of foster homes and as a result has been forced to put some children to sleep in office buildings.
A DCS attorney said that “children in wheelchairs can also be difficult to place. The most difficult situations are those with both medical and behavioral/mental health needs.”
Commissioner Quin requested more than $8.7 million to fund “Assessment Treatment Homes,” which would be located throughout the state and would house some of the medically difficult children to place.
“They really need specialized care and we just don’t have the appointments 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 absolutely no reason why we can’t make sure we’re taking care of our most vulnerable,” Campbell said.
Lee signaled in the budget hearing that he is willing to fund requests from DCS for more money.
But even if the budget request is approved, assistance is still months away – raising questions about what can be done now.
“These are issues that we should be able to address within the Department of Children’s Services without sending children 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 people presenting with 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 admitted to our state’s children’s hospitals are those in DCS custody. These youngsters 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 to find appropriate placement options, thereby delaying discharge. While these children remain in hospitals, they tie up resources that could be used by other children. Hospital stays across the state range from a few days to months, with one children’s hospital reporting the longest stay at 276 days.
Collectively, these patients account for many hundreds of additional days where hospital care is not required. 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 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 such as more funding and increased training and increased support for case workers.
Mary Nell Bryan, president of the Tennessee Children’s Hospital Alliance, said, “The Tennessee Children’s Hospital Alliance appreciates the hard work of the Department of Children’s Services staff to meet the challenges of finding foster homes for children who are fragile in medically or dealing with chronic medical conditions such as diabetes… Sometimes there are not enough suitable places for such transfers to happen quickly. We appreciate Commissioner Quin calling for more funding and outlining a plan that includes increased training and support for caseworkers. The work of DCS caseworkers and other DCS employees is vitally important. As can be said of those who work in hospitals, while this work can be challenging, it is also extremely rewarding. We urge families to consider placement for children who are medically fragile or dealing with a chronic condition such as diabetes.”