The Herald has reported that AHCA’s own records show many medically complex children are being essentially warehoused: Despite requirements that children receive an appropriate education, inspections show many kids are parked in front of televisions or sit in their beds all day. Some children have experienced grave neglect — including Freyre, whose caregivers did not provide her with her life-sustaining anti-seizure drugs.

In an interview with The Herald Tuesday night, Digre said his agency already has visited and reviewed the cases of every foster child who is living in a nursing home. Such reviews will continue, with caseworkers re-examining the care plans for every child monthly. The goal will be to find homes — either through reunification with birth parents or adoption — for every child in state care who has medical complexities.

Digre said his agency also wants to expand the use of medical foster homes, in which medically fragile children can live with families trained to use feeding and breathing tubes. “There is general consensus that recent efforts for expanding foster parents for medical licensure have lagged, and this is an excellent opportunity to invigorate our recruitment in this area,” he wrote.

Going forward, caseworkers will need the approval of Digre himself before moving a foster child into a nursing home, or from one nursing home to another.

Spudeas, at Florida’s Children First, said Tuesday that simply slowing down the movement of kids into nursing homes isn’t enough. DCF, the legal “parent” for foster children, “should also take out the kids who already are stuck there.” As well, she added, the state needs to move quickly to remove all children from institutions.

“It’s a travesty,” Spudeas said. “There is no doubt at all that children need proper supports in the home environment.”

As concern over the institutionalization of disabled children intensified, DCF launched an internal accounting in recent weeks. Records obtained by the newspaper show that many foster children in institutions have no social interaction except with caregiving and medical staff.

A caseworker who visited one Port St. Lucie-area child in a Broward nursing home wrote this, for example: “R.W. has no visitors.” Under “visitors” for a Tampa-area child, D.C., also in Broward, a report noted “None other than her case manager.”

At the Plantation Kidz Korner nursing home in Broward, DCF inspectors described the pediatric wing as “run down” and in need of “touching up in most areas.” During a recreation period, a report said, the children were “completely packed” in a small space watching caregivers make brownies, “which truly had nothing to do with the children.”

“We asked if specific items were used to stimulate the children, but did not see any being used,” a report said. “Not sure how these children benefit from making brownies.”

Since the parents of most of the kids had lost their parental rights, the children had virtually no visitors “for years,” the report said, except foster care case workers, who usually see the children only monthly. One child, the report said, had been at the nursing home since 2003, and had seen family members only once.

A representative of Miami-Dade’s privately run foster care agency, Our Kids, wrote bluntly in her report to DCF: “The facilities do not offer adequate activities to the children.”

She added: “Case workers should visit these children more frequently, and the visits should be unannounced.”