New Report: Analysis of Kentucky’s Residential Foster Care  

Featuring Interviews of Youth with Lived Experience and Recommendations 

LOUISVILLE, KY – Residential and institutional facilities are meant for youth experiencing crises, yet these settings are often over-utilized due to lack of family-based foster care rather than a clinical need for the placement. The Residential Foster Care Analysis Report, released today by Kentucky Youth Advocates, examines issues often seen in residential and institutional placements and offers recommendations to improve the outcomes of the youth in foster care. 

“As someone who aged out of the foster care system, I know how important it is to feel heard and understood. While we all have different experiences, both good and bad, there is a common theme for foster care alumni – the feeling of not being informed and not feeling listened to. That is when it came to treatment plans to placements and to our options once we leave the system. This report begins to share those experiences and our ideas for change,” said Cynthia Schepers, Peer Coach Coordinator with Kentucky Youth Advocates and True Up Kentucky. 

Kentucky Youth Advocates and True Up Kentucky, with the support of Casey Family Programs, conducted in-person and video interviews with 46 young adults between the ages of 18-26 in order to better understand their experience within institutional and residential foster care settings in Kentucky. A small cohort representing the perspective of those providing care, including current and former employees of residential or institutional foster care facilities and foster parents, were also interviewed.  

In 2020, over 8,000 Kentucky children were placed in foster care and roughly one in 10 of those youth resided in group homes or institutional placements – at disproportional rates for youth of color and older youth. From the spread of COVID-19 to the implementation of the federal Family First Act, to the recent deaths of children in residential facilities, including seven-year-old Ja’Ceon Terry in Louisville, the utilization of these settings weighs heavily on the child welfare system. 

By highlighting the lived experiences of young people, key findings from the Residential Foster Care Analysis Report include themes of systematic failures, specifically:  

  • Failure to respond appropriately to both basic and comprehensive needs of the youth in care;  
  • Failure to prepare youth aging out of care for independence in adulthood, and; 
  • Failure to support and properly equip staff working on the frontlines with youth in residential or institutional care facilities. 

“Throughout the research process, we overwhelmingly heard calls for changes needed within residential care facilities, from those who have been residents to those who have cared for those young people. To address failures that too many foster youth have experienced, we proposed a number of recommendations, including requiring Mental Health First Aid and other trainings such as QPR on suicide prevention, displaying the Foster Youth Bill of Rights, and increasing opportunities for youth to enter into relative or fictive kin placements. All youth in foster care deserve to feel loved and cared for,” said Eltuan Dawson, member of the True Up Peer Network. 

The federal Family First Prevention Services Act promotes the prioritization of family-based settings when out-of-home foster care is needed. Kentucky is among the first to take steps to reduce the number of youth entering group care settings and re-prioritize funds for preventative services, such as mental health services, substance use treatment, and parent skill-building services. Yet, the child welfare system’s continued reliance on residential and institutional care has created challenges that will necessitate incremental change that, at the root, will require a direct focus on the outcomes of the children rather than the bottom line of budgets.  

“The child welfare system faces undeniable crises that will not be reversed without continued fundamental reform. There are unprecedented challenges of childhood trauma, including exploding community needs ranging from the opioid epidemic to deep poverty, to a workforce supply and retention dysfunction that threatens the system, as well as case tragedies that rip apart the heart. And that is why this report is so important,” said Dr. Terry Brooks, executive director of Kentucky Youth Advocates. “Leaders in every branch of government – from front line social workers to legislators to judges to candidates for Governor – simply must listen to the voices that this report represents. These courageous young people share their firsthand experience in institutional foster care settings, giving us answers that can be as transformative as they are practical.” 

Among the many policy and practice recommendations featured in the report, the following solutions call for changes to state policy: 

  • Establish an independent Ombudsman that provides oversight of the child welfare system by investigating concerns of safety and well-being, identifying systemic issues related to administration or practice, and making recommendations for improvements 
  • Require training for residential and other non-clinical facility staff in Mental Health First Aid, including common symptoms and appropriate responses  
  • Extend access to healthcare coverage beyond age 26 for young people who have residential or institutional placements due to dependency, neglect or abuse 
  • Increase opportunities for youth in residential or institutional care to enter into relative or fictive kin placements with robust transitional supports for the youth and their families, like the Kinship Treatment Foster Care Initiative 
  • Ensure that education programming for youth in state care (A6 programs) is accountable and equitable in terms of finance, governance, and learning outcomes and take into account provisions included in the Every Student Succeeds Act (ESSA) 
  • Require teachers at A6 programs within residential or institutional placements to receive trauma-informed care training 
  • Review and study the current Medicaid reimbursement rates provided for needed services to ensure children have access to high-quality services provided by high-quality staff 

To access the Residential Foster Care Analysis Report and to view the full list of recommendations, visit View an executive summary of the report here and watch the panel discussion with our Young Adult Research Team here and below.


About Kentucky Youth Advocates
Kentucky Youth Advocates believes all children deserve to be safe, healthy, and secure. As THE independent voice for Kentucky’s children, we work to ensure policymakers create investments and policies that are good for children. Learn more at