• May 2010
  • Vol. 11, No. 4

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The Benefits of Reducing Reliance on Congregate Care

Reducing States' reliance on congregate care for children in the child welfare system has potential benefits for both child well-being and child welfare costs. A new report, Rightsizing Congregate Care: A Powerful First Step in Transforming Child Welfare Systems, describes how the Annie E. Casey Foundation worked with Louisiana, Maine, New York, and Virginia to reduce reliance on congregate care. Each State implemented changes in at least two of the following five identified levers of change:

  • Composition of services (e.g., reduce congregate beds and increase community-based services)
  • Frontline practice (e.g., engage young people in talking about placement references and identify potential kinship homes earlier)
  • Finances (e.g., create financial disincentives for congregate care and redirect resulting savings to community-based services)
  • Performance management (e.g., use permanency and well-being outcomes to evaluate congregate care providers and phase out contracts with providers that have poor performance)
  • Policy (e.g., limit use of independent living as a case goal and require prior authorization and utilization reviews for entry into congregate care)

The report includes an analysis on the outcomes associated with these implementation efforts. It suggests that a reduced reliance on congregate care leads to better outcomes for children and families; children tend to spend more time in family settings and less time in institutional settings. Furthermore, reducing congregate care use supports community-based services that strengthen neighborhoods and provides cost savings that can be re-invested into evidence-based family supports. The report also indicates that reforming congregate care can lead to larger systems transformations, as evidenced by reductions in the number of children in foster care in areas where the levers of change are implemented.

The full report is available on the Foundation website:


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