The Decline of Congregate Care in the United States Foster Care System, 2004-2024

The use of congregate care (CC) has declined substantially in the US in the past 20 years. The Family First Prevention Services Act of 2018 (FFPSA), which sought to curb the use of CC, is often understood to be a central driver in this decline. However, much of the decline occurred in the years preceding FFPSA. The nature of the decline in the years preceding and following FFPSA remains unknown.

To understand how agencies reduced CC from 136,000 placements in 2004 to 48,000 placements in 2024.

All children in out-of-home care in 2004, 2018, and 2024 in the US.

This study uses federal foster care census files and decomposition analysis to examine national and state-specific changes in CC placements before and after FFPSA, which limited federal cost sharing for CC placements. We decompose the difference in CC placements between 2004 and 2018 (pre-FFPSA) and the difference between 2018 and 2024 (post-FFPSA).

CC placements declined by 69,411 between 2004 and 2018, driven by reduced shares of older, behaviorally-complex children in the foster care system and reduced use of CC for younger, lower-needs children. CC placements declined by 18,803 between 2018 and 2024, overwhelmingly due to decreases in the foster care population size rather than reduced use of CC within foster care.

Agencies' capacity to maintain older and behaviorally-complex children into kinship or other family foster care remains limited following FFPSA; rather, those children are less likely to enter foster care at all.