KARA reports on real world conditions for foster children.
The following are their stories, metrics,
and articles about life in Child Protective Services.
Jump to: A Few Facts | What Has Gotten Worse | What Is Actually Working | What We Can Do About It
<h2 id=”facts”>A few facts</h2>
Children who have been through foster care are 40 to 50 percent more likely to experience homelessness (https://www.wilder.org/wilder_research/the-impact-of-homelessness-on-youth-with-out-of-home-placement-history/).
They face violence and multiple forms of abuse at once, not one at a time. Almost two thirds of children who are victimized are victimized in more than one way, and nearly 40 percent of maltreated children are poly-victims (https://www.unh.edu/ccrc/sites/default/files/media/2022-02/-poly-victimization-in-a-national-sample-of-children-youth.pdf).
Up to 60 percent have a chronic illness or developmental delay (https://pmc.ncbi.nlm.nih.gov/articles/PMC3541235/), and they carry more physical and chronic conditions than their peers in nearly every body system (https://pubmed.ncbi.nlm.nih.gov/38142889/).
They are prescribed psychotropic medications at 6.8 times the odds of other children on Medicaid (https://pubmed.ncbi.nlm.nih.gov/37204275/), and at two to four times the rate in the five states GAO examined (https://www.collins.senate.gov/newsroom/-troubling-cost-medicating-america%E2%80%99s-foster-children).
89 percent meet criteria for at least one psychiatric diagnosis (https://pmc.ncbi.nlm.nih.gov/articles/PMC3541235/). As adults, one in four carries PTSD, nearly double the rate of U.S. war veterans (https://www.casey.org/media/AlumniStudies_NW_Report_ES.pdf).
31 percent visited an emergency room or urgent care in the past year (https://pubmed.ncbi.nlm.nih.gov/15780011/). Emergency room visits for suicide, self-injury and fractures climb in the months before a child is ever removed from the home (https://news.cuanschutz.edu/department-of-medicine/foster-care-health-research).
About 25 percent attempt suicide (https://imprintnews.org/top-stories/foster-youth-are-at-great-risk-for-suicide-as-they-prepare-to-leave-the-system-california-study-finds/256210).
Among gay foster youth, 45 percent attempted suicide in the past year if their school was not affirming. At an affirming school it was 26 percent (https://www.thetrevorproject.org/wp-content/uploads/2021/07/LGBTQ-Youth-with-a-History-of-Foster-Care_-May-2021.pdf).
About half have been sexually abused (https://www.casey.org/media/StateFosterCare_TX_fr.pdf).
Among girls in the juvenile justice system, 81 percent in South Carolina had been sexually abused, and in Oregon 93 percent had been sexually or physically abused (https://genderjusticeandopportunity.georgetown.edu/wp-content/uploads/2020/06/The-Sexual-Abuse-To-Prison-Pipeline-The-Girls%E2%80%99-Story.pdf).
<h2 id=”worse”>What has gotten worse</h2>
Children are sleeping in office buildings. On 03/09/2026, Kentucky’s state auditor released a 129 page examination finding that 304 foster children spent a combined 1,577 days in state office buildings, hotels, state parks and other unlicensed settings over 22 months, at a cost of at least $6.1 million. None of the nine office buildings the auditors visited had showers. One 17 year old girl walked out of a state office and was missing for 51 days before she was found sleeping in a tent with a man wanted for murder. One child reported being sex trafficked after fleeing her placement (https://www.auditor.ky.gov/PressRoom/Pages/Auditor-Ball%E2%80%99s-Examination-of-Children-Sleeping-in-CHFS-Office-Buildings-Reveals-System-Rife-with-Abuse,-and-More.aspx and https://www.lpm.org/news/2026-03-10/kentucky-housed-children-in-unsafe-settings-with-little-oversight-auditor-finds).
The facilities that take the hardest cases. The Marshall Project published an investigation on 08/25/2026 into residential treatment centers, following one facility in Ohio owned by a Fortune 500 health care company. Children as young as five arrive through foster care or court order and are shipped hundreds of miles from everyone they know (https://www.themarshallproject.org/2026/08/25/youth-residential-treatment-centers-abuse-investigation). GAO has been reporting on abuse in these facilities for more than twenty years (https://www.gao.gov/products/gao-24-107625).
Food assistance for former foster youth. Young people with foster care history used to be exempt from SNAP work requirements and time limits. Under H.R. 1 they no longer are. When a 19 year old leaving care loses food assistance, housing and school go with it (https://www.ylc.org/federal-youth-policy-briefing-may-2026/). Former foster youth just lost their exemption from SNAP work rules, and while college vouchers and housing vouchers survived this year, both are rationed to the point that states run out of money mid-year and unused housing vouchers get clawed back, which means a 19 year old with no family can lose food first and then lose the two things that were supposed to keep her off the street.
Funding freezes. In January 2026 HHS froze Social Services Block Grant funds in five states. SSBG pays for child protective services caseworkers, foster care support and family crisis help (https://firstfocus.org/update/the-trump-administrations-freeze-on-funding-for-child-care-and-other-services-punishes-americas-children/).
In the five states where those block grants were frozen, the money that pays for child protective services caseworkers and family crisis help stopped moving. This means that increases in abuse cases piles more cases onto existing high caseloads. It’s important to note that because outcome data on the freeze needs to be reported to know the results of caseload and response-time effects.
Cash. This is the most useful finding in child welfare research right now, and almost nobody outside the field knows it. Neglect, not abuse, is what most children are removed for, and neglect tracks material hardship. Studies find that every 1 percent increase in SNAP caseloads is associated with 2 to 3 percent fewer children in foster care with substantiated maltreatment, and that for every additional $1,000 a family receives as a tax refund, state maltreatment referral rates fall about 5 percent (https://www.cbpp.org/research/poverty-and-inequality/increasing-families-incomes-helps-meet-childrens-needs-and-reduces). Not everyone agrees on how strong the causal evidence is, and the counterargument is worth reading (https://www.aei.org/research-products/report/does-cash-prevent-child-abuse-and-neglect-a-critical-review-of-the-evidence/).
Kinship licensing. A 2023 federal rule let states write separate, simpler licensing standards for grandmothers, aunts and family friends, and required that they be paid the same as a stranger would be. As of April 2026, 20 state plans have been approved (https://acf.gov/cb/map/state-territories-separate-licensing-standards). South Dakota reported in May 2026 that licensed Native American foster homes grew 44 percent and children in licensed kinship care rose 80 percent in about seven months (https://www.kotatv.com/2026/05/28/rule-changes-kinship-care-boost-number-native-american-foster-homes-state-says/). KARA is concerned that
Licensing standards exist because they catch things a caseworker in a hurry will not, and the families most likely to need a waiver are often the same families the child was removed from, meaning a grandmother who could not protect her daughter is now being approved to raise her granddaughter under a lower bar. Paying kin at full foster rates with less training and less scrutiny also creates a financial incentive to place children with relatives who are not equipped for them, and when that placement fails, the child absorbs another move.
The honest rebuttal is that children in kinship care still show better stability and mental health outcomes on average, so the question is whether tailored standards or looser standards are what states are actually writing.
Not throwing them out at 18. Each additional year a young person stays in extended foster care raises the probability of finishing high school by 8 percent, raises the probability of enrolling in college by 11.7 percent, and lowers the odds of homelessness or couch surfing by about 19 percent and of arrest by about 28 percent. Researchers found no evidence of harm from staying (https://www.chapinhall.org/research/calyouth-efc-outcomes-age23/ and https://www.aecf.org/resources/the-evidence-for-extended-foster-care-and-a-new-standard-of-care-for-older-youth).
Prevention money is finally flowing. As of early 2026, 46 states, D.C., Puerto Rico and four tribes had approved Title IV-E prevention plans under the Family First Act, meaning federal dollars can now pay to keep a family together instead of only paying after a child is removed. Alabama, Alaska and Texas have not submitted plans (https://www.congress.gov/crs_external_products/IF/PDF/IF10590/IF10590.54.pdf).
What we can do about it
None of this is fate. It is the predictable result of a system that stays hidden and underfunded until a child is already broken. The single biggest change is to stop treating child protection as a closed proceeding. Juvenile court is sealed in most states in the name of protecting children, and the practical effect is that no reporter, no legislator and no taxpayer ever sees what happens inside. Kentucky’s numbers only exist because an auditor went looking. Open the data. Publish caseloads, placement moves, medication rates and outcomes by county, the way we publish school test scores.
Then fund the front end. The research above shows children arriving in care already sick, already medicated, already in the emergency room. Emergency visits spike about four months before removal. Those are visible warnings that nobody is authorized to act on. Home visiting nurses and trained community mentors, real substance abuse treatment for parents, cash support for families in hardship, and caseworkers with caseloads under 15 prevent far more damage than any placement does.
Inside the system, four fixes carry most of the weight. License and pay grandmothers and aunts the way we pay strangers. Cap placement moves, because instability drives almost every bad number on this page. Require independent review before a child is prescribed multiple psychotropic drugs. Train and certify foster homes and schools as affirming for LGBTQ youth, which cuts the suicide attempt rate nearly in half on its own. And stop discharging children into homelessness at 18 when the evidence on extended care is this clear.
And keep telling the stories. Numbers move budgets, but a name and a face move the people who vote on them. Volunteer as a CASA guardian ad litem or make a solid effort to share KARA reporting with your State Representative. Ask your legislator how many children moved three or more times last year, and how many slept in an office. If they cannot answer, that is the problem.
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