Why Do Children Return to Care? Predictors of Foster Care Re-Entry Among Children In the U.S.

Background/Purpose: Re-entry into foster care following a positive permanency exit exposes already vulnerable children to repeated cycles of family separation, placement instability, and cumulative developmental harm(Jones & Jonson-Reid, 2025; Kimberlin et al., 2009; Wulczyn, 2004). Despite federal policy prioritizing permanent family placement through the Adoption and Safe Families Act (1997) and the Family First Prevention Services Act (2018), children who exit foster care to reunification consistently show substantially higher rates of re-entry than those who exit to adoption (Esposito et al., 2022; Kimberlin et al., 2009). Yet the child welfare field lacks a nationally representative understanding of which child, family, and placement characteristics drive that disparity across permanency pathways. Prior research has been limited by analytic designs that do not adequately account for exit-type heterogeneity. This study addresses the question: which child, family, and placement characteristics are independently associated with re-entry after a positive exit and what are their implications for support, services, and economic resources?

Methods: Data were analyzed from the Adoption and Foster Care Analysis Reporting System (AFCARS) FY2018–FY2024, yielding a primary analytic cohort of 1,212,374 positive exits. Re-entry within 12 months was operationalized as a documented removal date within 365 days of discharge. The primary models used multivariable logistic regression with absorbed state and year fixed effects (Bergé, 2018), built sequentially across four covariate blocks: exit type and year; child demographics and disability; placement history; and removal reasons and family characteristics. Stratified models were estimated separately by exit type.

Results: Across over 1.3 million positive exits, 36,930 children re-entered care within 12 months. Re-entry rates differed substantially by permanency type but declined consistently over the study period from FY2018 to FY2023, with no COVID-19-associated elevation, and varied markedly by state (range: 0.77% - 6.05%). In the fully adjusted model, the strongest predictors of re-entry were child behavior problems as a removal reason (AOR = 2.98; 95% CI: 2.89–3.07), behavioral/emotional need (AOR = 1.64), prior removal episode (AOR = 1.56), and court-ordered removal (AOR = 1.40), while all three non-reunification exit types retained significantly lower re-entry odds: adoption (AOR = 0.018), guardianship (AOR = 0.25), and kinship care (AOR = 0.70). Black/African American (AOR = 1.41; 95% CI: 1.16–1.71) and Hispanic children (AOR = 1.32; 95% CI: 1.10–1.59) faced significantly higher re-entry odds relative to White children net of all covariates. Subgroup analyses revealed heterogeneity in predictors across exit types, with parental substance use as a removal reason unexpectedly protective among kinship care ‘exiters.’

Conclusions and Implications: Permanency type and the differential post-exit support is a primary determinant of re-entry risk independent of child and family characteristics, reinforcing the importance of achieving legal permanency as soon as possible. Persistent racial disparities in re-entry net of all measured covariates implicate structural inequities in post-exit service access requiring explicit policy attention(Dettlaff & Boyd, 2020; Roberts, 2022). Consistent association of behavioral need and prior removal history with re-entry across all exit types identifies a high-risk subgroup for whom post-exit integrated family support services are urgently warranted.