A 17-year-old girl walked out of a state office where she was being housed and remained missing for 51 days before she was discovered sleeping in a tent with an adult man who had an active warrant for murder.
A 13-year-old girl with significant cognitive impairments was slammed to the ground, resulting in a black eye and bruising, while in an emergency shelter placement after a verbal altercation with staff.
One child who escaped a non-traditional placement reported that she then became a victim of sex-trafficking, trading sexual favors for money and drugs with at least two different adult men, she reported.
Kentucky’s Republican Auditor Allison Ball’s office investigated the cases of more than 300 children who had been placed in so-called “non-traditional placement” — like government office buildings, state parks or hotels — when they were unable to place kids in normal care settings.
The report, created by the Office of the Ombudsmen, identified widespread issues within the system that showed poor documentation, unsafe facilities and instability for the children placed there. Ranging from mere infants to older teens, children across the state were placed in such settings. The report, which the auditor’s ombudsmen conducted, looked at the group of children placed in the abnormal settings between Jan. 2023 and Oct. 2024.
“We've been doing this for years now, and it was supposed to be a short term crisis problem. It's now becoming a part of the system, and it should not happen anymore,” Ball told Kentucky Public Radio. “We need to do whatever we can to make sure this is resolved, because it is not helping the young children, the babies who are put in office buildings. It's not helping these teenage kids that have some very, very serious issues. They need treatment, and they do need loving care.”
Initially spurred by media reports in Louisville of children housed in office buildings, Ball said the report found most cases were outside of the state’s largest city and included both children who required high levels of care and children who had never been placed before.
In 2023, The Courier Journal reported some children were being housed in an “inappropriate” Louisville office building, in part because of a shortage of foster families willing to take them in. The next year, WDRB reported the practice continued and the auditor’s office said it would investigate.
“At first, we were told it's just the high acuity kids. It's kids who are violent, they have very aggressive behaviors,” Ball said. “We did find there were 17 children during this period of time, 17 children that were six and under…. Four of them were infants under the age of one.”
Most of the children who stayed in non-traditional placements for long periods of time were diagnosed with complex behavioral and medical issues, including ADHD, physical aggression, substance abuse and a history of running away.
Ball said she is recommending a number of solutions — both to alleviate the situation and ensure child safety in the short term and to move toward eliminating the non-traditional placements in the long-term.
The Cabinet for Health and Family Services did not respond to requests for comment in time for publication. They have the next two weeks, under statute, to review the report and prepare a formal response to the auditor’s report.
Ball said she was frequently frustrated by lack of cooperation from the cabinet. She said there was some initial collaboration which quickly dropped off.
“I'm hopeful that now that they have seen this report, they can see all the details it covers, all of the state, that it will then put them in a frame of mind where they're like, ‘You know what? This problem is so serious, we will work with everyone to make sure we resolve this problem,’” Ball said.
While the report covers a 22-month span ending in 2024, Ball said the problem remains ongoing. Children were still being held in non-traditional placements as of March 6, Ball said.
‘Major oversight problems’ in Kentucky non-traditional foster placement
Over the course of the 129-page report, the auditor’s office laid out how children are routinely denied access to essential care, services and the oversight required in other settings.
In just over 80% of cases, the medical care, medication management, continued therapy or school attendance of children housed in the nontraditional settings wasn’t appropriately documented or didn’t happen.
“We found only six documents showing that kids have received medical care out of all of the 300 and some children that we reviewed,” Ball said. “We had a couple of instances where we had sketchy here-and-there documentation of their prescriptions. But what we did have was alarming in and of itself, because it would show the wrong dosage of their prescription, or a missed dosage or — and this one really alarms me — double dosage of their prescription.”
Through onsite visits, the report documents buildings that were ill-equipped for housing children and “failed to meet even basic child safety expectations.” Case files noted children sleeping on couches or air mattresses. None of the nine office buildings that the auditor’s staff visited had on-site showers — children were transported miles to other facilities just to meet their basic hygiene needs. However, the report also found that cabinet staff did the best they could in difficult circumstances.
“It was evident that frontline staff made reasonable and good-faith efforts to ensure child safety under difficult circumstances,” the report reads. “However, these employees can only adequately complete tasks as they are trained and equipped to, and many are not trained in medication dispensation, behavioral intervention, and other necessary skills.”
Security too was lacking, according to the report, with little to prevent children leaving without authorization. The report noted other safety issues, like sharp objects and choking hazards.
“We did find locations where there were children who had suicidal ideation and risks of suicide, and there were cords for the blinds where they could strangle themselves,” Ball said. “Some of it is very simple, like make sure you're getting a prescription, make sure you're going to school. Some of it is being very sensitive to the needs of children.”
While not all children placed in the nontraditional housing had special medical needs or severe behavioral issues, many of those who did spent longer there and sometimes bounced between them. Ball said the instability that created likely exacerbated existing problems.
“Sometimes you'll have a child who, they may not be doing that badly when they get there, but it begins a cycle of problems. We don't want our involvement, the Commonwealth of Kentucky's involvement, to be part of what happens to them on their road that makes things more difficult for their lives,” Ball said. “We should be fixing the problems. We should be a safe space.”
The cabinet’s own data also revealed that in more than half of all cases, “guardians ad litem” were not notified that the children had been placed in the non-traditional settings. The guardians are the legal representatives appointed solely to represent the child’s interests in the legal system. There was also no policy about notifying parents who still have parental rights that their child was being housed in an unlicensed setting.
The Cabinet for Health and Family also has no formal written policy about how children should be placed in non-traditional housing. Ball said, in the short term, the housing needs to be regulated to ensure child safety and make sure care continues uninterrupted.
Recommendations for improving and replacing non-traditional foster placement in Kentucky
Ball said other states have had similar problems recruiting foster parents, especially for the most high-acuity children, but she said other states “have done a better job than us resolving it.”
In the report, her team lays out a number of solutions, including recruiting more kinship caregivers. She calls once again for the administration, led by Democratic Gov. Andy Beshear, to implement a bipartisan bill that would allow more kinship caregivers to receive state foster care support. Beshear has refused to implement Senate Bill 151 from 2024, saying lawmakers didn’t appropriate enough money for him to do so.
Ball also called for both a long-term plan from the cabinet including the potential for a new therapeutic facility, a plan to better retain the “mass exodus” of foster parents from the system and an assessment of the daily rates paid to high-acuity foster homes.
“We probably do need to be paying more money for foster care parents, especially for therapeutic foster care. We need to be doing more to get treatment locations. We absolutely need to be doing more on this,” Ball said.
In the short term, Ball said the cabinet needs to establish clear regulations to make sure children who need to be placed in these alternative settings are safe, going to school and receiving the medical care they need.
The report also points to solutions implemented in other states that have proven successful, like Washington’s Foster Family Constellation Project, which creates small communities of foster and kinship families built around a “Hub Home” with more experience to provide support and share resources, especially in times of crisis.
Ball also noted a “glimmer of hope,” with the cabinet partnering with the faith-based community to make housing available that’s more suitable for children in lieu of traditional homes and facilities. She pointed to a partnership between the cabinet’s office in Warren County and the Living Hope Church, which led to the opening of the Foster House.
“The government does not have to do this alone,” Ball said. “There are people around Kentucky who want to help.”
