What is Congregate Care?

‘Congregate care’ refers to a wide range of out-of-home placement settings including: Group homes, residential treatment facilities, emergency shelters, and in-patient hospitals1. Under the Family First Act (FFA), congregate care settings must be licensed as Qualified Residential Treatment Programs, to receive funding through FFA.

The Family First Act and Congregate Care

The Family First Act impacted congregate care settings by: Establishing requirements for placement in residential treatment programs; improving the quality and oversight of services; allowing federal reimbursement for care in certain residential treatment programs for children with emotional and behavioral disturbance requiring special treatment.

The Family First Act did this due to lived experience leaders, with experience in foster care and congregate care, expressing the need to reduce reliance on congregate care due to over-reliance on congregate care and its impact on young people.

What are lived experience leaders saying about congregate care?

  • Restrictions placed on youth in congregate care add additional challenges when the youth ages out

I came from an incredibly restrictive setting and went to college where there was no restrictions whatsoever. That transition was a nightmare…it took two years to adjust. 

– Michael

  • Congregate care is often used as an alternative placement, when a family setting cannot be located, versus using congregate care solely for therapeutic reasons

...My sister and I were placed into (a) sibling group home because there were no available placement options that can take a sibling group of two. We were discharged after 3 months as they found no clinical reasons to keep us in congregate care.

— Madison

  • Congregate care negatively impacts youth’s education

School was a huge obstacle. You are placed with several other kids in these group homes, all with different ages, educational backgrounds, etc. So when you are placed there, there is only so much that one teacher can do with all these different youth(s). You are not challenged like you would be in a normal school setting... 

– Michelle

  • Congregate care is an unstable placement option for youth

One of my placements included a treatment foster care facility. This placement included the most difficult situations I ever encountered in my years. It was not stable. The home had anywhere between 4­7 girls at one time with high turnover rates…Youth are moved from place to place as a means to solve conflict. – Shakela

Sources:

Quotes from lived experience leaders were pulled from the National Foster Care Youth and Alumni Council’s priorities: