Emails Show Tensions Between DCS And Vanderbilt Hospital Over Child Placements

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The Tennessee Conservative [By Paula Gomes] –

Emails obtained through a public records request show that tensions have arisen between the Tennessee Department of Children’s Services (DCS) and Monroe Carell Jr. Children’s Hospital at Vanderbilt (VCH).

Last month, DCS Commissioner Margie Quin requested $156 million in additional funding from the state and disclosed that children were being forced to sleep in offices or being sent to hospitals for extended periods of time because the state did not have any other options for housing them.

According to the emails obtained by the Tennessean, DCS has an average of 3 children placed at VCH at any given time. 

DCS has resorted to placing the children they have taken into state custody with significant medical or behavioral needs in hospitals around the state for weeks and even months at a time due to a shortage of appropriate placements.

In September, Dr. Deborah Lowen, the Deputy Commissioner of Child Health at DCS, wrote to newly appointed DCS Commissioner Margie Quin to report the criticism she received from VCH’s Chief of Staff Dr. John Thomas. 

Lowen had been expecting a call from Thomas due to DCS making preparations to place a child at VCH because his foster family was no longer able to meet his complex medical needs. 

When Thomas called on September 1st, Lowen said that for nearly 20 minutes he “ranted at me about how full the hospital is (true), these kids are taking up much-needed beds (true), we’re not doing enough to find placements (not really true), VCH is the dumping ground, etc.”

In the email to Quin, Lowen also outlined that lack of communication was responsible for frustration among other hospitals within the state, and admitted that this was sometimes indeed the case. 

Lowen wrote, “When the communication falls off, hospitals feel like we’re using them as holding areas and not looking too hard for placements. (In some cases, that was/is actually true, though.)”

In response, Quin called the conversation between Thomas and Lowen “truly unfortunate, but understandable.”

While the average number of children at VCH is typically 3 – with at least one being “a behavioral kid” – Lowen reported that there were 4-5 children at the hospital in early September who were “all medical” cases. 

Jessica Pasley, a spokesperson for VCH stated that hospital staff “continue to work diligently with DCS officials to ensure that the children in their care requiring medical services receive the attention needed.”

“Our goal is to care for the mental and physical health needs of these youth, and, working with DCS, have them return to an appropriate placement once medically cleared,” Pasley said. “Often discharge can be delayed due to a lack of available placement options, tying up hospital resources that could be used by other children and impacting bed capacity, particularly during periods of heightened demand for care.”

During the November budget hearing, Quin reported that the department was experiencing “horrific” staff turnover at a 47.7% turnover rate for first-year case managers. Quin said that Davidson County especially was “woefully understaffed.” Out of the $156 million funding increase that she asked for, $15.8 million is earmarked for salary increases for case managers.

Over the last five years, the head of DCS has come to the General Assembly every year and asked for an average of another $50 million dollars. The budget reached its current $1 billion plus last year under ex-Commissioner Jennifer Nichols. 

However, the number of children subject to involvement with a child welfare agency in Tennessee has decreased according to statistics derived from the Department of Health and Human Services and the national data bank Kids Count which is supported by the Anne E. Casey Foundation. 

These statistics show that from 2016 to 2020 child maltreatment victims decreased from 9,685 to 8,687. During this same time children in foster care only slightly increased from 8,333 to 8,839. Tennessee children living in poverty (most often the cause of child removal) decreased dramatically from 121,000 to 90,000.

About the Author: Paula Gomes is a Tennessee resident and reporter for The Tennessee Conservative. You can reach Paula at paula@tennesseeconservativenews.com.