Three months after the Department of Children's Services announced it had ended the practice of taking abused and neglected children to state offices overnight, solutions are proving difficult to sustain.
Several faith-based shelters have closed, and some children remain in hospitals for lack of other options.
Children are sleeping in church-run facilities and spaces opened by community groups while they await more permanent housing. And a few children with serious medical or mental health needs have been moved out of hospitals — where they were routinely kept for as many as eight months for lack of a home to go to.
Those children — five in total — are now living temporarily in state-run cottages formerly used to provide round-the-clock care to people with intellectual disabilities. State officials hope to bring more wards into those homes.
But deep challenges remain in finding places for children to go in the first days and weeks they are taken into custody and before more permanent housing can be found for them in foster care, a residential treatment facility or in their return home to families.
"I think bed capacity is still a major area of concern for us," DCS Commissioner Margi Quin said via email. "The state has closed facilities, but we have not opened any new facilities."
STILL IN HOSPITALS
Children between the ages of 6 and 15 are still being kept in Tennessee hospitals 10 days to seven weeks after being cleared for discharge while DCS officials seek alternatives, according to a spokesperson. DCS did not provide a number of children still hospitalized while they await a spot somewhere else.
Meanwhile some of the temporary faith-based shelters that volunteered to take children in have since pulled back.
(READ MORE: Tennessee DCS reports hiring new caseworkers, end to children sleeping on office floors)
In Middle Tennessee, for example, three faith-based community groups that initially stepped forward to fill the void in temporary housing pulled back weeks later, leaving — in one instance — caseworkers with no other option than to drive four children 200 miles to Memphis for a place to sleep.
A temporary shelter that opened in a church space in Rutherford County closed June 13. Another shelter in Williamson County paused its services on May 29 but remains in discussions with state officials on possibly reopening it. Another shelter in Wilson County has asked to pre-approve any children and youth brought there.
Some churches and community groups that stepped forward to provide temporary shelter have found some children's behavior difficult to accommodate. In one instance, four girls were driven from one Middle Tennessee shelter to Memphis after a fight broke out, according to Alex Denis, an agency spokesperson.
Denis noted some of the faith-based shelters that have volunteered to take children agreed to do so for a limited time period only, and the roster of organizations hosting children overnight frequently changes.
ACROSS COUNTY LINES
There are 27 such shelters across Tennessee, down from 29 in April, to temporarily house children coming into custody. The spaces serve Tennessee's 95 counties. By necessity, caseworkers and children must continue to drive across county lines for temporary housing, a DCS spokesperson said.
"If beds are filled in a region, we must go to the next closest available," Denis said. "It's not always the most convenient option. We understand that and are working to add to our placement options."
In all instances, caseworkers must drive children to and from shelters and remain with them as long as they are in a temporary situation.
Quin said state officials are close to finalizing a plan to provide more space as soon as this month.
Quin was tapped by Gov. Bill Lee in September to address the rising chaos within the state's $1 billion child welfare agency, which left children not only sleeping on office floors and hospital beds but left in dangerous or abusive circumstances in state care, a detailed and damning report from the Tennessee Comptroller found last year.
Addressing the immediate needs of children when they first come into custody is only one of the problems highlighted by the comptroller. The practice of putting children to sleep on office floors was first highlighted in a report by the Tennessee Lookout, which published video of children sleeping without bedding or mattresses on an office floor in August 2021.
ACUTE NEEDS
Children with acute and ongoing needs — those with tracheotomies, in wheelchairs, with developmental disabilities, with mental health needs waiting on a bed in a mental health treatment facility and those with behavioral problems that include violence — are among the most difficult to care for at any point they come into state custody.
DCS has worked with the state's Department of Intellectual and Developmental Disabilities to begin transferring children with high medical needs out of hospitals and into Tennessee Strong Homes, former small residential facilities that had previously housed people transitioning out of state-run institutions that closed down nearly a decade ago.
(READ MORE: Audit finds Tennessee children in state custody in jeopardy)
The children being moved to those facilities are medically fragile with chronic health conditions that may confine them to wheelchairs, require feeding or breathing tubes, may have vision, hearing or communication challenges and are often developmentally disabled, according to Dr. Deborah Lowen, Deputy Commissioner of Child Health for DCS.
The homes are a temporary way station until children can be reunified with families or enter foster care, with DCS footing the bill for room and board while TennCare, the state's Medicaid program, covers the cost of medical care.
SENSE OF NORMALCY
Child advocates say they're concerned about moving children to facilities staffed by professional caregivers, instead of families.
"We know children do better in families and communities," said Michele Johnson, executive director of the Tennessee Justice Center, which advocates for children's access to safety net programs, including health care. "It's taking them away from parents and any sense of normalcy ... Who is advocating for these children to grow up in communities?"
In her work trying to connect families with TennCare, Johnson said she often hears about parents' struggles to get in-home services covered for severely ill or disabled children. Some families have been encouraged to turn their children over to DCS to get them the care they need, she said.
Some of those children may wind up getting that care away from their families in hospitals or in DCS temporary homes.
A DCS spokesperson acknowledged there have been a "couple" of children placed in DCS custody "because the parent(s) could no longer care for the child in the home due to their intense needs." Most of the children are suspected victims of abuse or neglect, while some have been involved in the juvenile justice system, she said.
Lowen said specially trained caregivers work hard "in ensuring that these children receive the care — and love — they deserve."
Read more at TennesseeLookout.com.