Cook County’s public guardian sued the Illinois Department of Children and Family Services on Thursday, alleging the beleaguered child welfare agency is causing “immense harm” to mentally ill foster children by keeping them in psychiatric hospitals beyond medical discharge dates as it struggles to find them homes with appropriate services.
“It’s hard to imagine anything that says to a child more, ‘You don’t matter,’ than being in a locked psychiatric hospital when there’s absolutely no reason for you to be there,” said Charles Golbert, the county’s acting public guardian.
The federal class-action lawsuit, which seeks an end to the practice, was filed on behalf of more than a dozen Illinois foster youths against DCFS and several employees, including the estates of two deceased past agency directors.
The suit alleges that state officials have known for decades about the lack of suitable placements, and that they worsened the tragic circumstances of the children’s lives by repeatedly cutting budgets for appropriate treatment facilities and foster homes.
The “inhumane” practice, known as “beyond medical necessity,” costs taxpayers more than $125,000 a month, the suit alleges. From 2015 through 2017, more than 800 children were held this way, including more than 30 percent of children in DCFS care who were hospitalized, the suit states.
The problem is so well known, according to the suit, that in 2015 state lawmakers directed DCFS to formally track children and teens in foster care who languish after being medically cleared for discharge. The lawsuit also follows a ProPublica Illinois investigation into the problem published in June.
Two 19-year-old plaintiffs shared their experiences at a news conference about the suit. The Tribune is not using full names to protect the privacy of the teens, who remain under DCFS guardianship.
Skylar L. was 15 when she stayed in a psychiatric hospital for 79 days beyond medical necessity, according to the lawsuit. In the six months she spent there in 2015, Skylar said she was allowed to go outdoors only once.
“I felt like a prisoner,” she said at a news conference at the Loevy & Loevy law firm, which helped bring the suit. “I felt very depressed. … I don’t want anybody to go through what I went through.”
Skylar, who now lives in Des Plaines, said she received just one hour of daily schooling, which she said consisted of doing word puzzles.
Burl F. entered DCFS care after experiencing extreme abuse from his father and was placed in a psychiatric hospital in 2008, according to the suit. He stayed in the hospital for about two months beyond his discharge date.
“I didn’t get a chance to see my family,” said Burl, who now resides in Calumet City. “I was behind in school. There were days I woke up feeling I was at home and just realizing I was at the hospital. I stayed there Christmas. I missed my birthday. It was hard.”
DCFS spokesman Neil Skene said the agency had no comment on the lawsuit. He called it a “very complex challenge” to find placements for youths with severe behavioral or mental health needs. Some of these children may display adverse behaviors, including fire-setting and self-harm practices, that get them rejected from private providers, foster homes or their own families, he said.
“The availability of community resources and facilities to handle complex behavioral and physical health needs of children and teenagers is a serious need in Illinois,” Skene said in a statement. “This is a decades-long problem in Illinois that has now fallen to the current leadership of DCFS. We are at the deep end of a challenge within the health care system. … Rebuilding the capacity of the mental health system will require more than a lawsuit.”
Also Thursday, a federal judge put a hold on a U.S. government attempt to cut off funding for an Uptown psychiatric hospital that is struggling to survive amid complaints that young patients face unsafe conditions. Chicago Lakeshore Hospital had gone to court to try to stop a Saturday cutoff date for the facility to continue billing Medicare and Medicaid for new patients.
At a hearing, Meredith Duncan, an attorney for the hospital, said an abrupt cutoff federal funding would eliminate a unique facility that “takes the most difficult cases, the youth that other providers cannot and will not take.”
Duncan said Chicago Lakeshore has put in place a corrective action plan and substantial changes already have been made to the way it handles allegations of abuse. The hospital presented the changes to the government, but officials have refused to even consider it and the two sides “are at an absolute impasse,” she said.
Assistant U.S. Attorney Valerie Raedy, who represents the government, said “there is damage being done” by having children remain in the hospital’s care. She said the facility has repeatedly failed to take corrective action even after the issues were exposed in the media.
“(The hospital) was unable to keep its patients — vulnerable young kids — safe from sexual and physical abuse,” Raedy said. “They were aware of the ProPublica and Chicago Tribune reports and still were not in compliance.”
U.S. District Judge Sharon Johnson Coleman opted to keep the federal money flowing while the issues are sorted out. The next court date is Jan. 2.
DCFS stopped admitting children in its care to Chicago Lakeshore several weeks ago amid an increased number of calls to the state’s child abuse hotline this year. The final DCFS teen was transferred out Nov. 30.
The child welfare agency has launched at least 20 hotline investigations in 2018. Many of the complaints alleged inadequate supervision by staff as young patients fought or engaged in sexual activity. In some investigations, staff members were accused of being physically or sexually abusive. A Nov. 19 complaint involved a 9-year-old patient who accused a staff member of choking her while trying to restrain the child.
Most of the hospital’s inspection violations this year related to regulatory issues such as the length of telephone cords or improperly secured doors. But a Nov. 21 inspection cited the child abuse investigations and found hospital policies and procedures were inadequate and constituted an “immediate threat to patient health and safety.”
Chicago Lakeshore is one of the largest hospitals for psychiatric services in Illinois, serving more than 5,000 patients a year in two buildings, including one for children and teens. An estimated one-quarter of DCFS children who need inpatient psychiatric services are treated there, with many languishing beyond their scheduled discharge date as the state agency struggles to find them homes.
This was the second time in recent months that the hospital asked a federal judge to intervene. After an earlier threat to cut off government funding, the hospital filed a similar request Sept. 27, then promptly withdrew it when regulators agreed to give the hospital more time.
In their latest legal filing, hospital officials said they have appealed directly to federal officials but cannot get a hearing until February — weeks after the Dec. 15 deadline. The hospital has another 30 days after this weekend’s deadline to bill for current patients.
Hospital administrators said they installed new security cameras in early November, replacing an old system that at times resulted in inoperable cameras and crippled complaint investigations.
“The expectation of allegation-free acute psychiatric care to traumatized children and adolescents, especially those who are a product of the public system, is unequivocally unrealistic,” Dr. Peter Nierman, the hospital’s chief medical officer, wrote in an attachment in this week’s court filing. “While it is incumbent upon our staff to limit the opportunities for abuse and neglect to occur, an expectation of zero tolerance for allegations constitutes a complete lack of understanding of the psychopathology of what we do as providers in this field.”
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