Opportunities to counter the foster care placement crisis – do we have the political will?

Things can progress very quickly in the closing days of the Maryland General Assembly. Chances can open up to tackle critical issues many years in the making. Some promising measures did cross the finish line this session, and now we just need to do the work. For example, CPMC members - as volunteers or as representatives of their organizations - pressed for law makers to learn more about our state’s foster care placement crisis, and committee members responded in hearings with probing questions of state agencies and seeking solutions.

For the past several years, numerous articles have been published about Maryland’s foster youth stuck in hotels and other unlicensed settings, “boarding” in emergency rooms, or abandoned in psychiatric units past their discharge dates. Decades ago, hoteling children was a full-blown crisis that resulted in the urgent opening of a residential respite program – one of many now long gone. Today? Lots of denial, handwringing, and few solutions.

We had been warned it was only a matter of time before Maryland’s “hoteling” of foster youth — placing children in hotels due to a lack of proper care settings — would result in a tragic, preventable incident. That time has come. Since then, there are reports of a child who overdosed on medication, alleged sexual assaults and physical violence, and now alarm bells are ringing about youth at risk of sex trafficking.

The pattern is clear: Maryland’s most vulnerable children are being failed. Older youth with complex behavioral and developmental needs are warehoused in unsafe, temporary spaces; restrictive hospital settings; and worse, literally living in emergency rooms, while child-serving state agencies deny there are problems to be solved.

According to the Governor’s Office for Crime Control and Prevention’s Out-of-Home Placement Dashboard, over the past three years, 810 children have been hospitalized for an average of 70 days (in-patient admissions are typically less than a week). We also learned only five providers with an average of 20 bed spaces each serve children with an IQ below 57 – and no residential treatment centers. Children with developmental disabilities and serious behavioral health needs are consistently the hardest to place. According to the Department of Human Services (DHS), 235 children and youth were placed in unlicensed settings in 2024 with an average of 73 days. Hoteling a child roughly costs $1,400 a day to cover expenses for 1:1 aides, lodging, food, transportation, and other expenses. We should be investing those funds in therapeutic services and appropriate community-based settings instead of failing the very children we are charged with protecting.

This session, chairs of the House Health & Government Operations and the Senate Finance Committees voted out HB0962/SB0696 which seeks to create two coordinator positions housed in DHS and Maryland Department of Health (MDH) to help pediatric overstay patients be placed in more appropriate settings to meet continuing therapeutic and safety needs. The legislation also calls for a workgroup bringing together the child-serving agencies of DHS, MDH, and the Department of Juvenile Services (DJS) with advocates to share data and develop a comprehensive resource development plan and timeline to resolve the foster care placement crisis. MDH oversees licensing of treatment centers and group homes, where we have lost 500 beds over the last decade. DJS has a role when child welfare intersects with juvenile justice-involved youth. Yet, we expect DHS – the child welfare system – to shoulder it all.

Meanwhile, there has been little progress from DHS in restoring transparency following the 2023 discontinuation of monthly reports that had been publicly available for over 30 years.

Luckily, due to detailed analysis by the Department of Legislative Services and stern questioning by House Appropriations and Senate Budget & Taxation Committee members, the recently passed 2026 state budget calls for $850,000 to be withheld from DHS unless it shares data about the children subjected to hospital overstays and unlicensed settings, as well as other aspects of child welfare. There is an urgent need for greater transparency regarding the reasons behind family separations, as well as clear data on Child Protective Services calls, investigation results, Family Preservation, Agency Resource Parents, and Out-of-Home Placements entries and exits. And - the public deserves renewed confidence in DHS reporting on child fatalities. If we had prioritized more in the collection and use of comprehensive data, maybe Maryland would have fought harder and maintained more licensed, supportive, and appropriate settings.

In light of the Moore-Miller Administration’s promise to be data-driven and heart-led, here are rich opportunities to genuinely demonstrate a commitment to both and make a real difference for Maryland’s children.

Our children deserve more — they need commitment, cooperation, and a clear plan to be safe and thrive. Now, it is time to prove we have the political will to take the data seriously and create meaningful solutions.