‘Who Cares’ Project also finds fewer foster homes and a high rate of Qualified Residential Treatment Programs

The Imprint’s annual data collection from state child welfare agencies finds that the number of youth in foster care continues to decline, as do the number of licensed foster homes in America. And in several states, the share of licensed foster homes that are kinship caregivers is on the rise.
You can access all of the 2023 state data collected by The Imprint on our “Who Cares” project website, which includes national displays as well as individual profiles for all 50 states. We will be updating other federal indicators included in the Who Cares project in the near future.
Following is a breakdown of some of the topline findings from our state-collected datasets from 2023, along with a few thoughts from Youth Services Insider on all fronts.
Fewer Youth in Foster Care
The federal government is even later than usual in releasing its annual tally of youth in foster care, which will reveal the number of youth who were in foster care at the end of September 2022.
But data collected directly from states by The Imprint indicate that the number of youth in foster care declined last year, and continued to drop in 2023.
There were 355,032 youth in traditional foster care settings as of the spring of 2023, a 7% decrease from the 2022 data collected through our project, and it is 9% lower than the federal count for 2021, which is included in the annual public report from the Adoption and Foster Care Analysis and Reporting System (AFCARS).
Full disclosure: While 49 states and Washington, D.C., responded to this question, Pennsylvania is having difficulty responding due to some data snags in one fairly large county. Until we can get a figure from the state, we are applying the 49-state percent decrease to their 2022 reported number.
Analysis: In 2020, as the COVID-19 pandemic shut society down and kept kids out of school and at home, the number of youth in foster care plummeted (it was already on the decline, but the drop from 2019 was steep). Professionals from across the philosophical child welfare spectrum assumed a rebound was inevitable.
So far, not the case. We are now three years out from the 2020 numbers and the use of foster care continues to decrease.
One enormous caveat though: Since 2020 we have come to know more about the use of “hidden foster care,” the practice of shifting the physical custody of a child by way of CPS intervention without formally removing them via a court action. One fairly unknowable question from the data is: Are systems just favoring such hidden movements more than before, meaning less youth are in formal foster care but just as many kids are living outside of their homes?
There certainly is evidence to suggest that a rise in hidden foster care is at least part of the equation. Just before Thanksgiving, Ben Paviour of Virginia Public Media reported on concerns over informal placements in the state, and includes this passage about Virginia’s child welfare director Danny Avula addressing the state’s Commission on Youth:
Avula noted Virginia’s rate of placement with relatives is less than half of the national average — a statistic he said is skewed by the fact that local social services departments in the state prioritize informal placements with relatives before sending a child into the foster care system.
“The upside of that is that it keeps our overall numbers of kids in formal foster care low,” Avula said.
One thing that our project does not get into is entries and exits from care, and we will soon get a look at that from the 2022 AFCARS report. The post-COVID decline from 2019 to 2021 was fueled by a nearly 20% drop in entries to foster care, which has more than offset the fact that exits from foster care decreased by about 14%.
Fewer Than 200,000 Foster Homes
For the first time since The Imprint began collecting state data on foster care capacity in 2018, the number of licensed foster homes is below 200,000. The number of licensed homes has dropped every year since 2019, when it was just over 220,000, and now stands at 195,404. The 2019 total does not include Virginia, which did not provide an answer that year, so the decline is even more pronounced.
Full disclosure: While 49 states and Washington, D.C. responded to this question, Texas refuses to provide The Imprint with an in-year total of homes. Until we can get a figure from the state, we are applying the 49-state percent decrease to their 2022 reported number.
More Licensed Kin?
While the overall number of licensed foster homes continues to drop, the share of those homes that are kinship placements appears to be on the rise.
The aforementioned Virginia Public Media article also cites that state child welfare director Danny Avula noted a doubling of the rate of foster care placements into fully licensed kinship homes since 2019.
The numbers collected by The Imprint suggest a similar experience in many states. We ask each state to identify how many licensed foster homes are non-relatives; most, but not all, are able to disaggregate the information in that way.
Of the 39 states for which we could make a comparison between 2019 and 2023, there was an average decrease of 16% in the amount that are non-relatives. For many states the decrease in the share of non-relatives was far higher, and that national average factors in a few states that actually saw a pronounced increase in the share of non-relatives.
It’s worth noting that the Biden administration has finalized a new federal rule to ease the process of licensing kin and supporting them with federally-backed foster care payments. A group of national advocates have already formed a model standard that they hope to use in working with states to increase the reliance on kin within formal foster care.
Less Congregate Care, QRTPs Already a Big Faction
Forty-eight states reported 1,508 less congregate care providers — group homes, residential care, institutions and shelters — in 2023 as compared to 2019, a 25% decrease. The pace of decline appears to continue: 49 states showed a 15% decrease between 2021 and 2023.
This year, we asked each state how many of its congregate care providers have been accredited as Qualified Residential Treatment Programs (QRTP), a recently developed federal designation that was created as part of the Family First Prevention Services Act. That law limits federal funding for group placements to two weeks, but QRTP sites are an exception so long as courts are regularly reviewing the appropriateness of the youth being there. The reason: because QRTPs are supposed to be set up to serve youth with acute health needs and work with their families to step them back into the community after treatment.
State responses show that overall, about one in five congregate care providers in the United States have been accredited as QRTP. In actuality, it’s likely much higher. Here’s what we found:
-There are a cumulative 942 QRTPs that were identified by states. It is probably not exactly apples to apples, but that represents 21% of the 4,559 congregate care providers reported in the country.
-But two large states, California and Massachusetts, reported zero, with an interesting caveat. Both indicated that they had their own established designation that was akin to QRTP, and was thus approved as an exception under the Family First Act. In California, the Department of Social Services said 356 of its 477 congregate care providers essentially count as QRTP. Adding those into the total brings the national ratio of QRTP to congregate care providers to 28%.
-The QRTPs in the country are heavily concentrated in five states. If you factor in California, more than half are in the Golden State, Indiana, New York and Ohio. On the flip side, 14 states reported no QRTPs, including some very large systems such as North Carolina and Pennsylvania. Georgia was the only state that did not respond to the question.