25 Investigates: DCF kids ‘stuck’ in hospitals with no place else to go

BOSTON — When it comes to children seeking mental health services, 25 Investigates found certain kids are getting stuck in hospitals or inpatient psychiatric facilities, even if they’re ready to be discharged. A new survey revealed kids involved with state agencies, like the Department of Children and Families [DCF] are often left with no place to go.

Now some Massachusetts lawmakers are pushing state agencies to ensure these children have access to the services they need.

Stuck with no place to go

“They’re having to apply for resources that aren’t easily accessible. They’re having to wait for resources that are very limited. Some kids are being left behind for sure,” said Amara Anosike, the Director of Behavioral health policy and advocacy at Boston Children’s Hospital.

Boston Children’s, like many hospitals across the state, is on the front lines of the youth mental health crisis as children can end up waiting days or weeks in hospital for the services they need elsewhere.

But, for children with acute mental health needs who are also involved with state agencies, like DCF, Anosike says some are not getting enough support and advocacy.

“Oftentimes get stuck in a system and all these state agencies are fighting over who’s supposed to pay for it,” Anosike says.

It could be DCF, another state agency, a school district or a combination of several.

25 Investigates obtained a new report that reveals dozens of state agency-involved children are getting stuck in hospitals with no place to go.

The Massachusetts Health & Hospital Association and the Massachusetts Association for Behavioral Health Systems surveyed 29 hospitals and five freestanding psychiatric facilities in Massachusetts in December 2022. They found there were 69 ‘stuck’ patients. 57 were involved with DCF or 83%.

“Let’s not think about who’s who, what agency provides what. Let’s just look at this child and say, what does this child need and how do we make it happen,” says Massachusetts State Representative Marjorie Decker.

Decker, a Cambridge Democrat, says that’s the crux of her new legislation, an ‘Act to Ensure Access to Behavioral Health Services for Children Involved with State Agencies.’ She says it will ensure kids involved with state agencies, like DCF, have access to the care they need and a place to go to receive it.

“Too often, children and adolescents lose their place in a group home.” Decker says in some cases the state is closing out their placements, in a group home or foster home, once the child leaves them seeking medical care.

“We’re also going to presume that the child or the adolescent is going to go back to that to that home and that care, as long as it’s still safe,” Decker said.

Decker, who chairs the state’s Joint Committee of Public Health says her legislation would require DCF to maintain the child’s original placement while their medical needs are determined.

25 Investigates asked DCF about the children in their care waiting in hospitals or other facilities with no place to go. The agency says their placements a reviewed on a case-by-case basis, and that it works closely with hospitals, insurance, and partner state agencies to find clinically appropriate and safe placements for children.

Decker says her bill also eliminates some red tape about how agencies should respond.

“If you don’t name who’s responsible, then everyone’s responsible or no one’s responsible,” Decker said. “Without DCF being there to pull together the agencies and advocate, it doesn’t get done.”

The survey said more than half of the pediatric stuck patients waited more than 10 days. The longest wait times were between 61 and 100 days.

DCF said it asks congregate care programs to hold a child’s bed when it is thought a child may be able to safely return to a residential program from the hospital but did not directly address the report of the children who are getting ‘stuck.’

In an emailed statement a DCF spokesperson said;

“In Massachusetts, and across the nation, the mental health impact of the COVID-19 public health emergency has resulted in more individuals of all ages seeking emergency psychiatric care and has resulted in a significant increase in Emergency Department boarding. In January 2023, the Executive Office of Health and Human Services launched elements of the Roadmap for Behavioral Health Reform, including the Behavioral Health Help Line and Community Behavioral Health Centers, which are designed to improve access to treatment for all residents in Massachusetts and reduce dependence on emergency departments through coordinated efforts of multiple state agencies. For children in custody of the Department of Children and Families (DCF) who require a higher level of mental or behavioral health treatment than DCF foster care can provide, DCF works with multiple state agencies to find appropriate placements.”

“I don’t think anyone who works at these agencies is turning their backs on any child,” Decker said.

“I think that systemically that the bureaucracy actually creates these silos.”

Decker says her bill will also require that data be collected on how many kids are boarding, for how long, and what agencies are involved and whether that child was denied the opportunity to return to their original placement.

25 Investigates will keep an eye on how this bill progresses in the legislature.

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