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DCFS responds to yet another explosive report

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Illinois

A 9-year-old girl was locked up in a psychiatric hospital for weeks after her care was complete. The overstay racked up tens of thousands of dollars in bills.

CBS 2’s Chris Tye reported that the state used money left by her dead father to pay themselves back for that care and that the case was raced in front of a judge late on Wednesday.

CBS 2 has reported on kids being left in offices and hospitals for weeks or months because there was no place to put them.

But the Cook County Public Guardian said this girl’s case is a first: taking money from the accounts of vulnerable kids, money left by their deceased parents to reimburse for pricey nights in the hospital that the kids didn’t need.

Kids in the care of the Department of Children and Family Services, or DCFS, the state’s child welfare agency, can linger for months inside psychiatric hospitals after their care is complete and there’s nowhere to move them.

Kids in the care of the Department of Children and Family Services, or DCFS, the state’s child welfare agency, can linger for months inside psychiatric hospitals after their care is complete and there’s nowhere to move them.

The Cook County Public Guardian told CBS 2 a 9-year-old girl was left at one hospital, locked up in the psychiatric ward unnecessarily for about one month beyond medical necessity in 2019.

The unnecessary stay came with a price tag of $34,200.

But in the case of this girl, DCFS also managed her money.

When the girl’s father died in 2014, she became the beneficiary of his social security benefits, which have grown to over $118,000. Because that 2019 hospital overstay wasn’t medically necessary, Medicaid refused to pay. DCFS was on the line for it, so they dipped into the girl’s inheritance to pay themselves back.

“It’s just outrageous,” said Cook County Public Guardian Charles Golbert. “So last week, we sent DCFS a letter saying ‘Hey, just do the right thing.’”

In the letter, the public guardian’s office called on DCFS to repay the $34,200 by Tuesday, May 30. They added that all dollars, “should have stayed in the account and be made available to her adoptive parents … instead, the account has been drained.”

“And DCFS wrote to us last night and said no,” Golbert said. “So we’re going to court this afternoon to get this little girl her money.”

Keep in mind that this happened four years ago. Also, since then, a new state law has taken effect which requires the state to set aside between 40-80 percent of SSI money the kids receive, depending on their age.

* DCFS responds…

Federal mandate

Federal guidelines are clear, SSI benefits are required to be used to offset the costs of the care of the youth, no matter what setting the youth is in, including a foster or residential setting. In other words, the OPG is critiquing DCFS for action the Department took in 2019 that the department was federally mandated to take.

Overall response

I cannot stress enough that the health and welfare of our children is our primary concern, and we are always seeking the most appropriate placement. In some cases, it may take the agency time to find the appropriate placement for a child, and we are working diligently (often around the clock) to ensure the optimal care, transition services, and other necessary resources and requirements when that child, who often has complex issues and high acuity, is ready to exit the hospital.

The allegations in the complaint we would like comment on:

• Is it true: “DCFS left her locked up in the psychiatric ward unnecessarily for about one month [beyond medical necessity].”? If so, why?

No. After a youth’s hospitalization, DCFS attempts to return them to their prior placement, if it remains clinically appropriate. In this case, during the hospital stay, M.M.’s clinical designation changed, and she therefore required a more specialized placement. DCFS was informed of this change on the day she no longer required 24/7 psychiatric services at the hospital and immediately began working to identify a suitable placement. This work was completed as soon as possible, and the youth was moved to a specialized foster care with her sister.

• Is it true: “DCFS’s inaction caused [her] to remain locked in the hospital…unable to see her family, attend school, or play outside.” If so, why?

No. DCFS worked diligently to find this youth appropriate placement and did so as soon as possible.

• Is it true “DCFS’s failure also caused Hartgrove [hospital] to bill DCFS for that portion of [her] hospital stay that was medically unnecessary and not covered by Medicaid.”

DCFS complied with all state and federal rules around reimbursement of its cost of care for this youth.

• Is it true DCFS reimbursed itself $34,200 in April 2020 for expenses related to her inpatient hospitalization that was beyond medical necessity? If so, why?

In this case, MM required hospitalization and a new specialized placement, and costs were incurred and reimbursed as a result. There are federal and state rules that govern where funding to cover these costs comes from. DCFS follows these rules and any claims to the contrary are false and disingenuous.

• Why has DCFS refused repayment of these funds — and will the department offer up an audit of the $83,000 of other federal benefit dollars spent related to her care?

Annual accounting of this youth’s benefits is required under Illinois law, and DCFS must adhere to all federal and state rules. An accounting has previously been provided to the GAL and OPG.

Thoughts?

posted by Rich Miller
Thursday, Jun 1, 23 @ 2:13 pm

Comments

A complete lack of contrition, buck-passing, no sense of urgency - DCFS is broken and beyond repair. The legislature needs to completely build something different.

Comment by RKFD guy Thursday, Jun 1, 23 @ 2:46 pm
Same as it ever was DCFS is a terrible agency

Comment by Frida’s boss Thursday, Jun 1, 23 @ 2:50 pm
Mom is likely rolling in her grave. That’s not the DCFS she worked for.

Comment by RNUG Thursday, Jun 1, 23 @ 3:00 pm
The law Rich provided calls for a report to General Assembly that was supposed to be filed 2-28-2023. Some items not needed until 12-31-2023. I’ve looked on DCFS website and can’t find a report that would match these requirements. Hmmmm

” (i) Reporting. No later than February 28, 2023, the Department shall file a report with the General Assembly providing the following information for State Fiscal Years 2019, 2020, 2021, and 2022 and annually beginning February 28, 2023, for the preceding fiscal year:
(1) The number of youth entering care.
(2) The number of youth entering care receiving each

of the following types of benefits: Social Security benefits, Supplemental Security Income, Veterans benefits, Railroad Retirement benefits.
(3) The number of youth entering care for whom the

Department filed an application for each of the following types of benefits: Social Security benefits, Supplemental Security Income, Veterans benefits, Railroad Retirement benefits.
(4) The number of youth entering care who were

awarded each of the following types of benefits based on an application filed by the Department: Social Security benefits, Supplemental Security Income, Veterans benefits, Railroad Retirement benefits.
(j) Annually beginning December 31, 2023, the Department shall file a report with the General Assembly with the following information regarding the preceding fiscal year:
(1) the number of conserved accounts established and

maintained for youth in care;
(2) the average amount conserved by age group; and
(3) the total amount conserved by age group.”

Comment by Hoping for Rational Thought Thursday, Jun 1, 23 @ 3:24 pm
The problem is that fundamentally DCFS doesn’t have the ability to mandate placement of high-need kids. They don’t run their own facilities. They require third parties (whether independent residential/specialized facilities or willing foster parents) to accept the kids. Those beds don’t grow on trees. Unless or until the state runs its own programs that can mandate placement, this will keep happening.

I don’t know the details of the money side, but depending on where the funding came from, DCFS could be completely correct that they are required to do this under federal law. It is hard to believe that they would straight up lie about that.

Comment by Former DCFS Thursday, Jun 1, 23 @ 4:38 pm
I’m not going to pretend that I can fully grasp the overall context and the timeline (the four years) to what this report is saying in the immediate.

To this post, it’s a reminder, these are children. We are talking about children, human beings, and all that can be done, needs to be done within the constrains, responsibilities, funding, and mission.

I’ll leave it there

Comment by Oswego Willy Thursday, Jun 1, 23 @ 6:02 pm
I’m astounded that they can say “no” to many of these questions when the answer is clearly “yes”, even if they have a justification to add.

Comment by Jibba Thursday, Jun 1, 23 @ 10:40 pm