Georgia lawmakers are confronting a growing child welfare crisis: children with serious mental and behavioral health needs being left behind at emergency rooms and psychiatric facilities because families say they have run out of options.

Hospitals told legislators they are aware of more than 20 children abandoned at ERs or psychiatric facilities across the state so far this year. At the same time, the Georgia Department of Family and Children Services (DFCS) is dealing with a projected $85 million budget shortfall, raising fresh concerns about access to the services many of these children rely on.

Advocates told lawmakers parents “aren’t walking away lightly.” Many families describe years of repeated hospitalizations, dangerous behavior at home, long waitlists for treatment, and insurance denials — a situation some have called “trading custody for care.”

State officials say DFCS is tracking roughly 500 children in its custody with complex behavioral health needs. Without early treatment, lawmakers heard, behaviors can escalate — creating safety risks for siblings and caregivers as children grow older and stronger.

State Rep. Katie Dempsey, who led a House study committee on the issue, said the word “abandonment” often oversimplifies what families are experiencing. She said parents frequently reach a breaking point after exhausting every available option. The committee issued 17 recommendations, including expanding in-state treatment capacity, adding step-down outpatient services, improving real-time data sharing between agencies and hospitals, holding insurers accountable for denying medically necessary care, and using federal prevention funding for earlier intervention such as family therapy, parent education, and respite care.

But those reforms come as DFCS warns it is running out of money. Providers also told lawmakers a new approval process is slowing access to critical services — putting the state in a difficult spot as needs rise and budgets tighten.

Dempsey said the cost of inaction could be even higher, warning that when systems fail families in crisis, children can end up stuck in hospitals long after they are stabilized — with no clear path home.