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May 2021Vol. 22, No. 5Reducing Reliance on Institutional Care Placements for Children in the Child Welfare System

Research shows that children and youth experience better outcomes when they are placed in more family-like settings rather than institutional care. A report by the Children's Bureau found that 41 percent of children placed in institutional care had no documented clinical or behavioral need to warrant the placement. The National Center for State Courts published a report, Every Kid Needs a Family: Safely Reducing Reliance on Institutional Care Placements for Children in the Child Welfare System, that explores the role that the legal system plays in placing children and how legal professionals can reduce placement in institutional care.

This report provides judges, attorneys, advocates, and other professionals involved in child welfare and the legal system with information to assist them in making better placement decisions, such as what constitutes a quality placement, what circumstances might require institutional placement, and what practices and strategies they can incorporate into the decision-making process. It also includes case studies as examples of these principles in practice.

Judges can find guidance to help them with their placement decision-making, including how they can take the following steps:

  • Use their leadership role to influence positive change in the use of institutional care placements for children in the child welfare system
  • Hold other stakeholders accountable to quality practice standards that reflect proper assessment in individual cases
  • Communicate and collaborate with the child welfare agency and service providers to ensure their community has access to a sufficient level of family-based placement options
  • Establish process and outcome measures to monitor their placement decisions
  • Ensure the court system implements the letter and spirit of the Family First Prevention Services Act in approving placements

The executive and legislative branches can benefit from the following suggestions to guide reform efforts:

  • Prohibiting the placement of children younger than a specified age or prohibiting placement of children under a specified age with defined exceptions
  • Developing enhanced admission criteria or facility requirements for children under a specified age
  • Requiring justification for residential placement
  • Requiring prior supervisory or departmental approval for residential placement
  • Developing case plans and placement criteria that specify the purpose of the placement, the length of stay, and regular review
  • Mandating the closure of facilities or limiting the capacity of institutional care placements
  • Implementing explicit funding restrictions
  • Implementing better oversight and administration of psychotropic medications for children in congregate care
  • Improving state oversight and licensing of residential facilities
  • Creating three-branch task forces on residential care
  • Limiting approval of rates for additional facilities or additional capacity