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June 2022Vol. 23, No. 5The Implications of Family-Based Versus Institutional Care for Foster Children

recent brief explores the role of institutional care for children in foster care, outlining reforms made under the Family First Prevention Services Act that limit the financing of these residential facilities. In the brief, the authors argue that children fare better in family settings than in institutional care. The brief links to several reports and studies that document the overuse and harm of institutional care for children in foster care. It also points to evidence that family-based care contributes to improved well-being. Since children sometimes have behavioral needs that cannot be provided for in a family setting, the writers argue that there are appropriate circumstances for children to receive residential treatment.

The brief outlines two recommendations associated with these findings:

  • Qualified residential treatment programs should remain small, with fewer than 17 beds, to protect children from the harms of institutional care and to allow states to leverage federal Medicaid funding. 
  • Family-based foster care and community-based services are necessary to fulfill the vision of the Family First Act. 
The brief was developed by the American Academy of Pediatrics, the Children's Defense Fund, FosterClub, Think of Us, and the Youth Law Center.

Read the brief, "The Path to Well-Being for Children and Youth in Foster Care Relies on Quality Family-Based Care," for more information, including links to relevant studies and reports.