Congregate Care Outcomes After the Continuum of Care Reform

The Continuum of Care Reform (CCR) aimed to reduce California's reliance on congregate care by expanding behavioral health services for youth in family-like placements. This is the first study to leverage population-level data to explore this policy's impact despite its implementation a decade ago. Using a sample of 17,344 adolescents in California's foster care system, this study examined changes in congregate care outcomes following the CCR. Results indicated that youth in care after the CCR had a lower likelihood of congregate care placement and fewer congregate care placements overall. However, they experienced a greater risk of out-of-county congregate care placements, and the amount of time spent in congregate care remained unchanged. Findings suggest the CCR has yielded mixed results, highlighting opportunities to integrate behavioral health services across all placement types. Further collaboration between child welfare and behavioral health systems may be needed to fully realize the CCR's vision.