New report on factors influencing the use of congregate care
Despite the mandate to place children in foster care in the least restrictive environment possible, the practice of placing children in congregate care settings persists in most places around the country. The question is why and what can be done, from a policy perspective, to ensure that group care is used for the children and youth who need it most. Answering that question begins with learning how the use of group care varies in different parts of the country and why.
In the new research brief Within and Between State Variation in the Use of Congregate Care we illustrate how reliance on group care placement differs throughout the country and explore how child characteristics (age, race/ethnicity, and gender) influence the odds of being placed in a group setting. We then take that analysis to the next level by examining how attributes of place such as urbanicity and socioeconomic characteristics contribute to the likelihood of placement in group care. The contextual approach adds a critical perspective to conversations regarding the allocation of congregate care resources as it raises important questions about how system dynamics shape agencies’ ability to match the supply of congregate care resources to their true demand.
Read the Executive Summary below or click here to download the full report.
Despite the mandate to place children in the least restrictive setting possible, the practice of placing children in group and other forms of congregate care persists in most places around the country. Research has illuminated the potentially negative effects of congregate care, especially for young children; at the same time, residential care has its place on the placement continuum. The question is what can be done, from a policy perspective, to ensure that group care is used for the children and youth who need it most. Although the current discourse suggests the use of congregate care exceeds what is necessary, there are few arguments put forward that suggest the true demand for congregate care is zero. If that is indeed the case – that the true demand for congregate care is below current utilization but not zero – then we are well served if we understand more clearly how much congregate care is used, where it is used and with whom, and then use those patterns to guide policy, practice, and resource allocation.
To explore patterns in congregate care use, we ask two sets of research questions. First, how does the likelihood of placement in congregate care vary from state to state and from county to county? Second, given that group care use varies so widely from place to place, what factors predict placement in non-family setting? Specifically, how do child characteristics and ecological factors interact to produce trends in congregate care placement?
Data for this study come from the Multistate Foster Care Data Archive (FCDA)—a longitudinal archive containing the foster care records of approximately 3 million children nationwide. We begin by using the FCDA to illustrate how congregate care use varies among states and counties. Then, using a subset of children from 961 counties in 14 states, we use multilevel modeling techniques to examine how child characteristics (age, gender, and race/ethnicity) and county attributes (urbanicity and socioeconomic disadvantage) interact to influence the likelihood that a child in foster care will be placed in a non-family setting.
Nationally, about 20 percent of children in foster care experience a congregate care placement at some point during their time in care; however, reliance on group care varies widely, both between and within states. At the state level, the likelihood that a child will enter foster care directly to a congregate care setting ranges from four to 44 percent. Variation exists within states, as well. We observed counties that use very little congregate care and counties where nearly nine out of ten children entering out-of-home care were placed in a non-family setting.
Univariate analyses show that certain child and county characteristics are associated with an increased likelihood placement in congregate care. Teenagers are more likely to enter a group setting than younger children, males are more likely than females, and African Americans more likely than children from other racial/ethnic backgrounds. Urban counties use more congregate care than non-urban counties. Economically disadvantaged counties are less likely to place children in group care than areas classified as better off. The multilevel model, however, reveals a more complex pattern. Specifically, when we account for the effects of urbanicity and county socioeconomic character, the direct effect of race on congregate care placement reflects the fact that African American children live predominantly in urban areas. In other words, while it is true that African American children are more likely to experience group care, that trend appears to be a function of the fact that they are more likely to live in cities.
This research adds an important perspective to conversations regarding the allocation of congregate care resources as it raises questions about how system dynamics shape agencies’ ability to match the supply of congregate care to its true demand. We know that urban areas are more likely to use group care than non-urban areas, but we know little about how, given that context, local child welfare agencies use policy to organize their efforts to reserve high-end care for only those who need it.
Generally speaking, policies that strive to reduce the unnecessary use of congregate care target case-level decisions. Although children will certainly benefit from better assessment and level-of-care assignments, our research suggests that it will take more than clinical and casework improvements to ensure children’s placement in the least restrictive environment. For one, agencies will need to appreciate the economics of how group care is distributed throughout the state. For instance, lower rates of residential placement in non-urban areas could be a function of the fact that the real demand for group care, whatever that might be, is too small to maintain a diverse supply of beds. Where that is the case, it may be that young people who would otherwise benefit from a placement in a residential setting are in effect denied that benefit on the basis of supply. As states endeavor to address dynamics like these in their own jurisdictions, future research should aim to shed light on which combinations of state and local policies promote responsive congregate care use in the face of both clinical need and systemic pressures.