Through State Auditor Allison Ball’s office, the Commonwealth Office of the Ombudsman recently released a new report examining Kentucky’s use of nontraditional placements (NTPs) for children in foster care. The Kentucky Finance and Administration Cabinet Office of the Inspector General released a separate report that provides additional context on the use of nontraditional placements and reinforces the challenges related to placement instability and gaps in the placement continuum. 

Nontraditional placements occur when a child in the custody of the Cabinet for Health and Family Services (CHFS) cannot immediately be placed in a licensed foster home, kinship home, or residential treatment facility, and is instead temporarily housed in locations that are not intended to serve as living environments for youth. 

While this has been a recurring issue for many years, variables including a loss of foster parents during the COVID-19 pandemic, changes to the juvenile justice system, and workforce issues appear to be exacerbating the problem. 

Scale of the Problem

The report identified 304 children who experienced a nontraditional placement between January 2023 and October 2024, totaling 321 placement episodes and 1,577 total days spent in these settings. A majority of these occurred in CHFS offices (269), though children also stayed in hotels, state parks, community centers, and hospitals where they were not admitted when other placements could not be located.

The Ombudsman’s Office also noted a stark contrast between two types of stays:

Short-term NTP stays

  •  130 children stayed one day
  •  Average age: 13
  •  58.5% male and 41.5% female
  •  Average prior placements: 4.7

Extended NTP stays

  •  174 children remained for multiple days
  •  Average age: 15
  •  64% male and 36% female
  •  Average prior placements 9.6

Across all cases, the average time spent in nontraditional placements was 5.2 days. Forty-six children spent 10 or more days and one child spent a total of 55 days in a NTP. Additionally, Black and bi-racial children were more likely than White children to both remain in NTPs for more than one day and experience longer stays on average.

Impact on Children

Children who experience nontraditional placements often have already faced significant placement instability in foster care. Youth in the report had an average of 7.5 prior placements, compared to 3 placements for children in foster care overall.

Many youth placed in nontraditional placements also have significant behavioral and mental health needs that require structured environments, trained caregivers, and consistent therapeutic support. These needs can affect placement availability when providers are unable to accept youth with more complex needs. Among adolescents in NTPs, the report identified high rates of:

  • ADHD (57%)
  • Physical aggression (51%) and verbal aggression (39%)
  • Substance use (40%)
  • Leaving Placement without Authorization (39%)
  • PTSD (35%) and anxiety (32%)
  • Suicidal thoughts or behaviors (28%)

However, the environments used for nontraditional placements were not designed to meet these needs. For example, 83 children with suicidal thoughts and behaviors were housed in office buildings without psychiatric care, suicide safe design, or trained clinical supervision. In addition, it was not clear that youth were receiving medical care, medication management, therapy, or attending school while housed in NTPs in 81% of reviewed cases. 

The report also found that CHFS does not have consistent statewide policies or standards for the use of nontraditional placements, contributing to inconsistent conditions and services for youth placed in them. All together, these findings illustrate how youth in Kentucky’s child welfare system who have experienced the greatest instability and who have some of the highest behavioral health needs may not receive placements capable of meeting those needs.

Ombudsman’s Report Recommendations

The Ombudsman’s Office outlined several recommendations intended to address both the immediate use of nontraditional placements and the broader systemic challenges within Kentucky’s child welfare system, including calling on CHFS to:

  • Implement 2024’s Senate Bill 151 and expand targeted recruitment for kinship and fictive kin caregivers.
  • Develop and publish a comprehensive statewide plan to stabilize Kentucky’s child welfare system, including strategies to address gaps in the state’s placement continuum.
  • Establish a secure therapeutic facility with mandatory acceptance for youth whose needs exceed the capacity of traditional foster homes or residential placements.
  • Create formal statewide policies, regulations, and procedures governing the use of nontraditional placement.

The full report includes additional recommendations related to improving data tracking and documentation of NTPs, increasing transparency in how these placements are utilized, and strengthening coordination to ensure youth continue receiving education, medical care, and other essential services while placements are being located. 

Office of Inspector General Review

The Office of Inspector General’s report outlines steps taken by CHFS to reduce reliance on nontraditional placements. The OIG found that in 2025, the number of NTP episodes, total days spent in these settings, and the number of youth experiencing NTPs all decreased by approximately 50% compared to 2024. These improvements are attributed to increased foster care rates, expanded staffing and training, enhanced collaboration across agencies, and a greater focus on data and placement coordination. 

Similar to the Ombudsman’s report, the Inspector General includes recommendations for DCBS to further reduce the reliance and address the concerns around nontraditional placements. DCBS Commissioner Lesa Dennis provided a response to each recommendation within the report. 

What You Can Do

While it is ultimately up to Kentucky’s elected and appointed leaders to work together to address the challenges facing our child welfare system, everyone in the Commonwealth has a role to play in advocating for our most vulnerable youth.

  • Contact your state legislators and encourage them to prioritize policies and funding that strengthen Kentucky’s child welfare continuum of care, including expanded support for kinship families, foster care, high acuity youth, and services for youth with complex needs.
  • Share information about how to support kinship and foster care providers in the community, including becoming a resource parent or connecting to agencies who provide foster care.
  • Watch or listen to the recent Making Kids Count Podcast episode with Auditor Ball discussing the NTP report.
  • Monitor KYA’s General Assembly Bill Tracker for updates on legislation that impacts the child welfare system and all of Kentucky’s kids.