Cots and beds fill a basketball court in the gym at Child Haven on June 7. The center for abused, neglected or abandoned children has told local hospitals to hold all medical referrals until space is available. Photo by K.M. Cannon.

Child wards of Clark County courts with nowhere to go: population 17.

For those 17 children, most of them infants, hospitals are the only refuge as they wait for the Clark County Department of Family Services to place them in emergency shelter. Their numbers are expected to increase because foster homes and beds at the county's Child Haven campus remain in short supply.

"We can give a baby basic care," said Rick Plummer, spokesman for Valley Health System, which was holding seven infants for the county at two hospital sites during the last week of June. "But a hospital nursery can't replace a family environment."

Most of the infants now in hospital custody tested positive for exposure to illegal substances at birth. The law requires hospitals to report and refer those cases to family services. But on June 2, the county placed a hold on those referrals. Since then, displaced infants have been stacking up at local hospitals.

At the beginning of June, Sunrise Hospital and Medical Center had three infants in need of emergency placement. By the last week of June, the hospital had eight children in the same circumstance.

Valley Hospital Medical Center began with two infants in need of county placement. Within four weeks, it had three.

Spring Valley Hospital started June with one displaced infant and ended the month with four. University Medical Center had four children waiting for space at Child Haven. By Thursday, that number had decreased to two.

"Everyone here is very sensitive to the seriousness of the issues we have," said Nancy McLane, interim director of family services.

But capacity at Child Haven, which serves as a temporary shelter until children can be matched with foster families or reunited with their own parents, continues to be a problem. When the county enacted the hold on hospital referrals on June 2, Child Haven was caring for 50 babies in its infant cottage. McLane said Child Haven was ending June with 54 infants in custody. The shelter is also still using its gymnasium as a temporary dormitory for boys. When asked how long the situation is expected to continue, McLane said that would be difficult to predict.

"It depends on our population at Child Haven and our ability to place children with foster families," McLane said.

The temporary stay on hospital referrals is just one part of the problem, McLane explained. Child Haven's population and the demand on the foster-care system continues to increase because children are still brought in by police or Child Protective Services because of potentially dangerous home situations.

Local child advocates watching the situation develop call it a community crisis that needs a response from every level. Louise Helton, an advocate for children in poverty and a member of the county's Citizens Advisory Committee for Juvenile Justice, said she hopes people ask questions about what's driving the growing population of abused and neglected children. Drug use by parents is fueling part of it, Helton said, as is the lack of services in other areas such as mental health. An adult with untreated mental health problems cannot be a fit parent for a child, she said.

"These problems are all joined at the hip," Helton said. "The government should step in and do what has to be done to create emergency facilities for these children now. These babies are refugees and they are totally dependent on us."

Bill Grimm, senior attorney for the California-based nonprofit National Center for Youth Law, has waged a public campaign to improve the quality of family services in Nevada and Clark County. The current crisis, he said, may be unique in the country.

"I've not heard of this kind of so-called backup, where the system was telling hospitals to keep children," Grimm said. "Is seems like a fairly unusual situation."

It's also an appalling situation, Grimm said, that should have been anticipated and planned for by county officials.

"This, to me, is reflective of a larger problem," Grimm said. "The county government doesn't look to these children as they would their own children. Why are these conditions tolerated for children who need better care and more attention than the average child?"

McLane said that the county is working on short-term and long-term solutions to address placement problems. In the short term, the county is continuing a sustained recruitment drive for foster parents willing to take children who are not legally free for adoption. Those interested in becoming foster parents can obtain an information packet by calling 455-0181.

Family services has also begun asking licensed foster parents only interested in adoption to reconsider and open their homes to temporary foster placements.

The county is also working with nonprofit providers to expand the number of available beds, although private agencies such as Boys Town and St. Jude's Ranch for Children do not accept infants.

Longer-term fixes include contracting out for the specialized care of medically fragile children and siblings.

Marion Hancock, manager of child and family services at Sunrise hospital, said foster parent volunteers need to understand exactly what they're getting into. Many of the infants now in care will likely be reunited with their families at some point. So those who take them in have to be willing to work with social workers and birth parents. And infant care is demanding, she said. It almost requires someone who is a stay-at-home parent.

"Sheltering is difficult work," Hancock said. "They may have the child for a day, a week, two weeks or a month."

Accommodating their tiny indefinite residents is a challenge for hospital staff geared toward providing medical care, not custodial care. Hancock said that nurses often bring the babies out to sit with them at their desks or hold them while filling out patient charts. Parents are allowed to visit if that's been approved by family services. If at all possible, social workers try and place the infants in the care of a relative or extended family member, Hancock said.

Plummer said that hospital volunteers are helping staff at Valley and Spring Valley care for the babies who've been removed from parental custody. They come in to hold and rock the infants, Plummer said, and have played a critical role in providing much-needed attention to the newborns.

"We haven't staffed up for this," Plummer said. "Our biggest fear is that we may have a lack of space. We're, in essence, just housing them until they have some place to go."