At least 83 children living in residential treatment facilities that contract with the Tennessee Department of Children's Services to provide round-the-clock therapeutic care have tested positive for COVID-19 since July 1, part of a surge in childhood infections across the state.

The nonprofit and for-profit organizations that provide psychiatric, behavioral and other care to abused and neglected children in state custody are given guidance from the Department of Children's Services.

But the facilities make their own decisions about how to care for children during the pandemic, not subject to the kinds of public debates taking place around the state about schoolchildren and the virus.

Most of the facilities provide their own on-site classrooms. Children sleep, eat, play, study and live together 24-7. Some also house children who are not in custody.

As of Aug. 31, 154 children in these facilities were in quarantine, while another 48 were awaiting COVID-19 test results, according to data provided by DCS.

At Youth Villages, a nonprofit that provides residential care to children, 29 are in quarantine after potential coronavirus exposure and three girls remain in isolation with positive tests at their Rose Center for Girls facility in Bartlett, Tennessee. The organization operates in 14 cities across Tennessee.

Tamara Williams, Rose Center's director, said Youth Villages has implemented its own mask requirement for youth and staff, requires social distancing, frequent hand-washing and increased cleaning and disinfecting as recommended by the U.S. Centers for Disease Control and Prevention.

Youth Villages campuses house children 8 and older in individual living clusters. When children are required to be quarantined after potential exposure to COVID-19, they are kept with children in those housing groups to prevent transmission, she said.

"A strict plan has been implemented anytime there is concern of possible exposure to include quarantine, isolation and contact tracing," Williams said. "When it comes to quarantine for non-positive COVID youth, it has been our experience that it is best to quarantine groups of children together as a precaution to reduce transmission. So, children who are in the same cottage, courtyard or group home remain together with frequent assessments by our nursing staff."

Youth Villages also has "taken advantage of vaccinations for all eligible candidates," she said.

At the Center for Success and Independence, a residential treatment facility providing mental health, drug and alcohol treatment to youth who've interacted with the Department of Children's Services, 65 children have tested positive since the onset of the pandemic; 47 children remain in quarantine after potential exposures.

At New Beginnings Academy in Roane County, a 56-bed mental health treatment center for boys ages 12 to 17 years old who have been abused or neglected, 35 boys remain in quarantine. Fifty-three children have contracted COVID since the pandemic began.

At least 10 boys have coronavirus and another 24 remain in quarantine at Standing Tall Music City, a residential facility for boys 12 to 18 years old near downtown Nashville. The facility, like others that contract with DCS, has its own on-site classrooms on a campus that has a 50-bed dorm facility capacity.

No one at these three facilities responded to requests for information about their COVID policies.

Wilder Youth Development Center in Fayette County, the only residential facility for children operated by DCS, reported no current COVID cases or quarantines. The 120-bed, locked-down facility houses boys 13-18 years old who have been committed to state custody by juvenile courts. Since the start of the pandemic, 75 children have contracted COVID.

DCS guidance to privately run facilities housing children in state custody tells each facility to "develop their own internal protocol/procedures for mask requirements, screening of visitors and staff and number of people allowed during campus visits. DCS continues to encourage all providers to follow the latest CDC and TN Department of Health guidance when developing requirements."

It includes no mandated COVID protocols.

DCS, like all state child welfare agencies, has been given its own guidance by federal authorities on COVID protocols, including vaccination and outreach efforts.

The department has thus far failed to respond to requests from two Democratic lawmakers about its vaccination efforts. Federal vaccine guidance issued by the Department of Human Services Administration for Children and Families to DCS include urging by federal child welfare officials to take immediate steps to ensure children in state custody, and those who have recently aged out after turning 18, receive a COVID vaccine.

Rep. Gloria Johnson, D-Knoxville, and Sen. Heidi Campbell, D-Nashville, in July sought "up-to-date data on COVID-19 vaccinations amongst the children who are wards of DCS, whether incarcerated, in state foster care or in the care of a third-party home" and the "department's plan to ensure all eligible children receive a vaccine moving forward."

They have received no answers, Johnson said last week.

In response to Tennessee Lookout questions about each of the recommendations by the federal agency, spokeswoman Jennifer Donnals said the department "will continue to take the appropriate steps to help keep our children, staff and providers safe and healthy. The department has issued guidance on vaccines to DCS staff, providers and foster parents. We have updated our policy regarding routine health care of the children in our custody."

The federal guidance to child welfare agencies was issued July 7.

After the federal guidance to DCS was issued, DCS issued its own recommendations to private providers caring for children in state custody. The guidance eliminates wording about the critical importance of vaccines, replaced instead with more neutral wording.

A previous version of its guidance, dated March 18, says: "vaccinations against this infection have been determined to be critically important in controlling the pandemic and getting 'back to normal.' Vaccines are deemed to be highly effective in prevention severe infections and death."

The updated guidance eliminates nearly all information about the vaccine. It says, "Foster parents and other care providers are entrusted with authority and responsibility for the daily upbringing and care of children in their care consistent with the child's individualized circumstances and in consultation with the child's medical provider, including routine authority for matters such as well-care treatment, vaccination, vision, and hearing."

The revamped guidelines came eight days after a widely publicized controversy over providing vaccine outreach to eligible children ended in the firing of Dr. Michelle Fiscus, the state's former top vaccine official with the Department of Health.

Fiscus said she was made a scapegoat by her bosses at the Tennessee Department of Health after some Republican lawmakers got angry over state efforts to provide vaccine information to teens, including information about the mature minor doctrine, a legal precedent allowing children over the age of 14 to get vaccines without their parents' permission.