Imagine a child who is living in a hospital for weeks, months, even a year at a time, sometimes in a room by themselves but too often in the emergency department, not because they are battling a long-term illness, but because there is no other place for them. No access to school, appropriate therapy, or family and friends.
For dozens of foster kids with highly complex emotional needs this is a reality. Foster children in the care of the State who find themselves checked into a hospital for a medical reason are often left there by the State after the medical reason has passed because there are no available placements in group homes, residential treatment centers, or other settings. Federal law requires that states place foster kids in the most appropriate, least restrictive settings, according to pro bono attorneys who have wanted to file a class action lawsuit against the State of Maryland for years.
Promises not kept
The only thing that has stopped them from filing is the Hogan Administration’s promise to do better, which they have consistently failed to do. This problem has been going on for years, but those same attorneys say that under the Hogan Administration it’s worse than it’s ever been. On average, there have been about 50 children living in Maryland’s hospitals “waiting for appropriate placement.” This doesn’t include the number of kids living in hotel rooms or sleeping on the floor of local Social Services offices when a hospital bed wasn’t available, or the department couldn’t concoct a legitimate excuse to have them checked in.
For years, my colleagues and I in the legislature have begged the department to open more “beds.” We’ve appropriated money, passed bills making it easier to issue licenses, and threatened them with punitive legislation. This year, after years of trying to work with them, I filed just such legislation.
The Administration didn’t oppose the legislation in either written or oral testimony in either chamber. They didn’t submit testimony that was “Favorable with Amendment.” They didn’t even submit a “Letter of Concern.” But the Department of Human Services, one of the departments responsible for the care and safety of these children, secretly and successfully worked to kill the bill in a secondary committee in the Senate.
We did manage to get some success. Credit goes to Del. Mike McKay, R-Allegany, who asked the Department of Budget and Management to add money to the budget to help pay for new placements. I was successfully able to convince the Administration to increase provider rates because no appropriated funding in the world will help if the rates to providers who operate these facilities cannot cover their costs, a major reason why new beds weren’t available. Del. McKay and I managed to do this over the course of a week and half a dozen phone calls. The Department of Human Services had not bothered in almost eight years.
New system behind schedule, over budget
What have they been doing? In the face of massive staffing shortages, children being left in hospitals, and years when the poorest of our State were being dumped from SNAP, TANF, and other benefit enrollment for the slightest reason, the Department of Human Services has focused almost exclusively on rolling out the MD THINK data management system.
MD THINK, or Maryland’s Total Human-services Integrated Network, was proposed seven years ago by the Administration as a one-stop human services system to work across all departments and for all benefit recipients. Except after seven years, the project is nearly 70% over budget and is still not fully rolled out, four years after it was originally promised. DHS staff also tell me that they received almost no training on the new system and that it doesn’t work more often than it does. I guess a few hundred million dollars doesn’t buy what it used to.
In the meantime, children are languishing in hospitals, taking vital space and resources away from those with actual medical necessity. With eight months left in this Administration, the Department of Human Services is assuring us that with the new appropriation and new provider rates they will finally fix the problem. I sincerely hope so, because if not, class action lawsuits are sure to follow.