Location, Location, Location: Examining out-of-County and out-of-State Congregate Care Placements Among Adolescents In California Foster Care

Background/Purpose

California’s 2015 Continuum of Care Reform (CCR) resulted in the closure of nearly 50% of its group homes (California Department of Social Services, 2024). Following these closures, foster youth needing residential treatment were increasingly placed in out-of-county facilities and, in some cases, out-of-state facilities. Although California banned out-of-state congregate care placements in 2020, out-of-county congregate care placements remain common (Gómez, 2026). Since placement location can influence continuity of care and family visitation, it is important to understand how out-of-county and out-of-state placements shape permanency outcomes for youth in congregate care. This study examines: (1) how the CCR and subsequent ban on out-of-state congregate care placements affected rates of out-of-county and out-of-state placements; and (2) the relationship between congregate care location and permanency.

Method

We used administrative records from California’s Child Welfare Services Case Management System. The sample includes 9,549 youths placed in congregate care on or after their 14th birthday. Youth were assigned to one of three mutually exclusive cohorts based on when they turned 18: pre-CCR (2013-2014; n = 4,044), post-CCR (2018-2019; n = 3,794), or post-ban of out-of-state congregate care (2024-2025; n = 1,711). Three binary outcomes measured whether youth were placed in out-of-county congregate care, out-of-state congregate care, and whether they achieved legal permanency before age 18 through reunification, guardianship, or adoption.

We used multilevel logistic regression (level 1 = youth, level 2 = county) to examine changes in the odds of out-of-county and out-of-state congregate care and permanency across cohorts, adjusting for demographic and child welfare characteristics. Out-of-county and out-of-state congregate care indicators were included in the final model to assess their associations with permanency. Intraclass correlations (ICCs) are provided to quantify the proportion of variance in each outcome explained by between-county differences. Reported odds ratios (ORs) are significant at p < .01.

Results

Lifetime rates of out-of-county congregate care increased across the pre-CCR (30.7%), post-CCR (43.4%), and post-ban (54.4%) cohorts. Rates of out-of-state congregate care increased from 1.4% to 4.1% between the pre- and post-CCR cohorts. None of the youth in the post-ban cohort were placed in out-of-state congregate care. Permanency rates were 26.8%, 27.2%, and 20.8% across the pre-CCR, post-CCR, and post-ban cohorts, respectively.

Compared to the pre-CCR cohort, the post-CCR (OR = 1.76) and post-ban (OR = 2.49) cohorts had higher odds of out-of-county congregate care (ICC = 0.36). Post-CCR youth had greater odds of out-of-state congregate care (OR = 3.25; ICC = 0.32). While there were no differences in the permanency rates between cohorts, out-of-county (OR = 0.51) and out-of-state (OR = 0.48) congregate care placements were associated with lower odds of achieving permanency (ICC = 0.06).

Conclusions/Implications

Findings showed that out-of-county and out-of-state congregate care placements not only increased after the CCR but also reduced youths’ likelihood of achieving permanency. As other states implement congregate care reforms in the wake of the Family First Prevention Services Act, these findings underscore the importance of prioritizing placements in facilities near youth’s communities of origin.