DCS: Kids sent to hospitals for up to 100 days because there is no place to put them

For months, children taken from their families as a result of abuse or neglect allegations have been forced to sleep on office floors – supervised overnight by already-overworked social workers. 

On Thursday, the Department of Children’s Services chief asked Gov. Bill Lee for a $156 million boost to the department’s $1.1 billion budget to address the crisis in Tennessee’s child welfare system.

In doing so, Commissioner Margie Quin revealed a cascade of system-wide failures, including some that have not been previously made public. They include: 

• Children in DCS custody who become too “disruptive” when forced to sleep in offices are being sent to hospitals – in some cases for up to 100 days –  because the agency lacks appropriate places to care for them. DCS could not immediately say how many children were affected or which hospitals are housing them. 
• Private residential facilities in Tennessee, primarily for children with behavioral issues, are filled with kids from out-of-state because Tennessee pays them so little; meanwhile, Tennessee kids are being sent to other states. Currently, 75 Tennessee kids are being housed out of state.
• A “pretty horrific turnover rate” among social workers, deterred by low pay, high caseloads and increasingly stressful working conditions. Nearly half (48%) of starting caseworkers left in their first year on the job.  There are currently 486 vacancies.
• The staff and space shortages come as DCS contends with the record numbers of kids in foster care, and in the state’s juvenile justice systems.

To help alleviate the need for sending kids with high mental health needs out of state or sleeping in offices and hospitals, Quin is seeking $6.9 million to fund temporary homes where kids can be better assessed.

“These are youth that are extraordinarily difficult to place,” she said.  “In some cases they are so disruptive in offices, we are having to serve them into hospitals. They’re staying long term in hospitals and they do not belong in hospitals. They’re not acutely ill but they can’t stay in an office. They’re not appropriate in transitional home. They really need specialized care and we don’t have programming for them.”

Quin also made the case for salary increases for caseworkers to “stem the tide” of social workers quitting their jobs, particularly in high cost-of-living areas like Nashville.

“It is no secret that DCS has failed to hire and retain staff and as a result has seen unusually high caseload averages throughout the state,” said Quin, who was tapped for the job by Gov. Bill Lee in September to address mounting problems. 

Quin is also seeking additional state funding to outsource social work services — at least temporarily.

“We’re having a hard time keeping up with the number of times kids have to be seen each month while sitting in offices and responding to calls for service,” Quin said. “We cannot fail to do our job. At some point we have to have additional help. This is a great solution for that, a temporary privatization of case management. We think that for two years this is a great solution for us.”

Quin is also seeking a pay hike for officers at Wilder Youth Development Center, which houses kids  who have committed crimes. A recent report detailed numerous allegations of abuse of teens by staff. Starting salaries are $27,000; Quin is seeking a $1 million budget increase to bring salaries in line with Tennessee Department of Corrections officers, which begins at $45,000 annually.

And Quin is seeking a total of $30 million in additional funding to increase payments to private residential facility providers, some of whom currently house more out-of-state children than children from Tennessee.  One large provider, whom Quin did not name, was serving 56% of kids in its care from out of state; just 35% of children served by another large provider were in DCS custody, she said.

“We don’t have a shortage of bed capacity in the state,” she said. “DCS does not have the funds to pay competitive rate to get our kids in a provider placement beds, so kids are in offices or transitional houses while the majority of beds go to out of state children or private pay.:

The Department investigates allegations of child abuse and neglect, runs the state’s foster care system and oversees kids found delinquent by juvenile courts. It is funded through a combination of federal and state funding. About half of the budget increase DCS is seeking — about $75 million – would come from Tennessee taxpayers.

Lee appeared receptive to the budget requests, at one point questioning whether Quin was asking enough. 

“Obviously we know we have a real challenge on our hands and we are trying to be very proactive in serving these kids, and I know you’ve been tasked with that,” Lee said. “I would encourage us to move forward aggressively…you all have a very important role and huge challenges.”