Many children with disabilities receive therapies at school, in a clinic setting, or at home to support their access to education and build skills for their long-term development. The medical, behavioral, and/or mental health treatment they receive helps support their routines at school and at home. However, this isn’t the case for all families. When a child’s mental health or medical needs require extensive support beyond what can be offered in any other setting, families might consider residential placement, where the child lives away from home while receiving treatment.
For more information about what residential placement is and how it works, we spoke to Non-Attorney Education Advocate Hadassah Lynn Foster; Education Consultant, Advocate, and Director of Healthy Minds Consulting Kelly Rain Collin; Senior Staff Attorney at Learning Rights Law Center Diana Maltz; and Special Education Attorney Tania Whiteleather.
Children with a residential placement live full-time in a facility outside their parents’ home. They might receive educational services within that same facility, or they might attend a public school while receiving therapeutic services at their residential facility, depending on the program. Collin says, “Residential placement is typically a location where students would both learn and live on the same campus where they would get educational services, so schooling and mental health services on campus.”
Students in a residential placement scenario have significant support needs that they cannot safely get met anywhere else. “Oftentimes,” Collin says, “the situations that might lead to [residential placement] are very significant and chronic behavioral challenges that are not able to be mitigated and supported effectively in a less restrictive setting, or very significant mental health needs that need a lot of support and a lot of intervention that’s beyond what can be provided outpatient or in the home setting.”
Foster explains, “Essentially, we have a population of students whose disabilities impact them so seriously that they really cannot stay at home. They cannot access their education if they’re living at home and going to school during the day. It’s unfortunate, but that’s where we are.”
Note that there is a difference between children being placed in residential programs out of necessity vs. adults with disabilities choosing independent or supported living arrangements.
In this article, we’ll cover two main types of residential placement:
Residential placement through an IEP: the school team and the parents decide together that the child’s education would best be accessed in a residential treatment center, and the school district helps coordinate and fund the placement. Most often, this is due to the child’s extraordinary needs in areas of behavior and/or mental health.
Long-term hospitalization: if a child must spend an extended amount of time in a hospital for mental health or other medical needs, the school district closest to that medical facility will be in charge of educational services.
While residential placement is not right for every student or family, it is right for some, especially when it is no longer safe for the student to stay at home.
For all children with IEPs, placement is a key component of discussion with the IEP team. Special education law requires that children be educated in the least restrictive environment that can meet their needs, ranging from general education with accommodations to specific classes for kids with disabilities or non-public schools designed for therapeutic support.
Residential placement is the most restrictive placement option that school teams may discuss. It is considered for students with disabilities when less restrictive options, such as the local public school system or a non-public school, cannot effectively meet their needs.
A residential school can be an affiliate of a non-public school that supports students with higher-level needs. Residential programs for students with disabilities typically combine specialized education with additional supportive services. Collin says, “There are residential placements that specialize in different areas, too. Some specialize in working with individuals with developmental disabilities, some specialize in individuals with mental health needs, some with addiction, some with a variety of challenges.”
In a therapeutic facility or residential treatment center (RTC), students have 24/7 access to therapeutic care onsite. Any services specified as necessary in the IEP will be offered, which can include things like speech therapy, occupational therapy, and counseling, both individual and group. Foster says that most students receive mental health counseling at least once a week from a licensed professional, including family sessions.
Students do not go to public school in these types of placements. The educational programs within an RTC might differ from school to school. But even if the facility is out of state, the curriculum will be similar, as all RTCs licensed with the state must comply with the state graduation requirements. Even so, Foster says, “When students are having difficulties with their mental health, it’s just harder to learn. So they’re not going to be capable of making the same kind of progress that they could make if they weren’t having the interference of coping with their mental health.”
Students are able to earn a high school diploma while in residential care. The diploma is through the local district that funds their placement. For example, if a California student is at an out-of-state placement, “the home district is still responsible for ensuring that they’re receiving an appropriate education under their home district guidelines,” says Collin.
Foster cautions that many residential placement facilities tell parents they cannot serve their child past age 18, but the school district is responsible for special education services until age 21 for students who need more time to complete their diploma.
Foster says, “How do you get to the point where the school district is going to say, ‘Yes, let’s do a residential placement. We think that would be better’? It’s generally parents coming to the school district, not the school district coming to the parents. Because the school district sees the child at school, and the school is very structured, so a lot of times, the difficulties that the family is having [at home] aren’t seen at school. It takes a while before the school comes to see how home is different, and why there’s a need.”
A child’s IEP team may consider a residential placement if:
Foster says, “Students who get placed in such a placement are only there because there truly is no other place that they can be to access their education, and the question is always about accessing their education.”
In this clip, Collin gives an overview of what it looks like to decide on residential placement through the IEP:
When an IEP team determines that the student’s need cannot be met in another setting and that residential placement is appropriate, a formal referral is completed and submitted to the Special Education Local Plan Area (SELPA) or Local Education Agency (LEA) office on behalf of the student. Once this is done, the school district will gather a list of all potential placements that they can find.
Then, parents will sign releases for the schools that they would like to have their child’s documents sent to, including the IEP, recent assessments, disciplinary records, and other documents. Foster advises, “As a parent, you should be signing for particular schools, not just a blanket release. Just know where your child’s information is going.” Based on that information, the residential schools will decide whether they can meet that student’s needs.
Collin explains that in her experience, the school district will offer a number of different placements and/or will contact various placements based on the student’s needs, as identified in the IEP. This is done in an effort to find a residential treatment center that might specialize in the specific challenges that a student is experiencing so that the right match can be made. Some families may want to work with an education consultant or a school placement specialist to help them review the placements offered and weed out those that wouldn’t be a good fit.
After placements have been contacted, an interview process begins so that there’s an opportunity for the family to learn more about the residential placement and for the programs to learn more about the student. Ideally, they work together to figure out whether it feels like it’s going to be a right match, meaning whether the residential program can actually meet that student’s needs effectively.
Foster says, “The really great schools will get onto a Zoom call with you and the school so that you as the parent can ask questions. And the best circumstance is when you have two or three schools who’ve said, ‘Yes, we can meet your child’s needs.’” It’s sometimes the case that only one program will have an opening, so families will need to consider carefully whether that program is appropriate.
See our section “Questions parents should ask when considering residential placement” below for topics to review during an interview with a potential residential program.
Parents should expect the process to take some time. “When the IEP team and parents are both in agreement that the residential treatment center is needed, the biggest pitfall we run into is timing because the placement process is not a particularly short one,” Maltz says. It takes time to figure out what type of program is appropriate, to prepare and submit applications to those programs, and for those programs to review the applications. Often, parents will get a handful of rejections, and it can take several months to find a placement. Maltz says that the biggest pitfall she sees is assuming that things are going to go quickly and not having a backup or temporary interim plan in place.
There are a lot of different ways you can put in place an interim plan, and it depends on the child’s specific needs. Parents can get short-term residential placements or hospitalizations funded by medical insurance, there can be home-based programs, or families can explore other solutions. Maltz emphasizes that it is important to try to replicate the residential treatment center setting as best as possible to make the pending transition to an RTC smoother.
Whiteleather advises that parents go over admissions papers in great detail before signing. She says there will be a master contract through the IEP, but there should also be an individual services agreement where the RTC might detail their policies and procedures, which parents should read carefully before signing. Admissions papers are not always given to parents, but the IEP document must be signed and consented to by the parent. If there is anything in those admissions documents that raises an alarm, parents should make sure to ask about it and negotiate.
Note that some residential facilities specialize in judicial placement — i.e., placement ordered by a judge. These programs are typically not a good fit for children in special education.
Special education law still governs the IEP, and it governs the school district’s responsibility. Maltz says, “Parents still have the same rights under the IDEA. They have the right to participate in the decision-making process regarding the provision of special education to their child; they have the right to grant or not grant consent to implementation of various parts of the IEP. Really, all of the parent rights remain the same.” Even if your child is in an out-of-state RTC, your state’s laws still apply with respect to the school district’s obligation because your home school district is providing the placement, and often the residential school will have signed a contract agreeing to comply with the home state’s laws.
The school or facility still needs parental consent to treatment when a child is living there, unless it’s an emergency where it wouldn’t be practical or safe to wait to receive consent.
And if a placement isn’t working, parents can request a new one. “One of the benefits of this is that it is voluntary,” Collin says. “With regard to the parents, they have the right to say, ‘No, this isn’t working. We need to change this.’” Here’s how the process might look:
For the transition home, there needs to be an IEP meeting to change placement.
A residential school placement should be located within close proximity to the county you reside in. However, if no nearby placement is identified, there is a chance that your school district could recommend a residential school hours away or out of state.
For California families, many placements are out of state when arranged through the IEP. This is because California does not allow for locked facilities, which limits options. Maltz says, “I would say the biggest reason why kids end up going out of state rather than staying in state is that we don’t have locked facilities in California, and that can present danger for kids who are prone to elopement, particularly in older children and young adults. The reality is there are kids who will elope and who will get hurt because of that.”
Whiteleather says that school districts will tell parents that they have to try everything in California first before out-of-state residential placement is explored, but that is not true. “If a child needs a locked facility, there is no requirement that you try everything in California first,” she says.
California does have a few therapeutic residential placement programs, including Community Treatment Facilities (CTF); however, those programs are better suited for students who don’t pose risk of elopement. Foster notes that placement in those is hard to get because space is limited.
The process for a student placed in a residential facility for medical needs can look different. If a child needs to be hospitalized long-term or if their medical needs require additional support that cannot be accessed at home, then an out-of-home placement may be decided on by the family and their health care provider(s).
Accessing education in these cases differs from doing so in a residential placement through the IEP. When a student is in the hospital for an extended period of time or moves into a group home, the school district in which the hospital or group home is located will be responsible for providing schooling for the student — whether it is online school, transportation to a local public school, or schooling on-site.
Foster says, “Wherever the hospital is located, the school district in that area is required to continue providing education.“ She continues, “If someone is a client of the Regional Center in California, they could live in a group home and go to public school. From your perspective as a parent, it’s going to look a lot like a therapeutic residential placement because your child is going to have services around the clock.”
It is possible that if a child is placed in a hospital or group home in another state that the school district responsible for the child’s education would switch to the district local to that placement. This would mean the student would be unenrolled from their original school district for the time being. Once the child is released from the hospital and back into the care of their parents, they would be re-enrolled into their home school district.
Note that this is different from home hospital, where a student stays with their home school district while taking a temporary absence from school to recover from an illness either at home or in a hospital setting.
What counts as short-term hospitalization?
During mental health crises, youth are often placed on a 5150 or 5585 hold in a psychiatric unit short-term; insurance may cover anywhere between 7 and 30 days to provide mental health support and hospitalization. This is not a residential placement. However, if a child poses extreme risk to themselves or others, a residential placement could be recommended to the school district by outside agencies or professionals.
“Honestly, if your child is in need of emergency mental health care, get them the mental health care. We can always come back to the educational piece,” Foster says.
Placing a child in residential care is not easy for any parent. Maltz encourages families to truly look through what their options are and research possible placements that will support their child: “Make sure you understand what your priorities are and find a program that matches those needs, rather than just looking into whether people say positive things about this one or negative things about that one.”
Because residential treatment programs vary depending on different needs, one person’s or family’s experience might not be another’s, so parents should trust their instincts and knowledge of their child when deciding on a placement. “RTCs are not all the same. One RTC might be appropriate for one child but inappropriate for another,” Maltz says.
Here are some key questions that our experts recommended parents ask when reviewing a potential residential program.
Phone calls and visits are allowed but can be hard to coordinate depending on the facility. Collin encourages parents to always ask about that ahead of time and talk about what the program’s visitation policy is. Ask:
Some facilities have very strict rules about contact with families, especially in the first 30 days, which is important to know upfront. Collin cautions, “Many of the programs I’ve seen have a rewards program where the students have to earn certain things. For me personally, it doesn’t feel good to have to earn connection to your family, but I think it’s worth looking into and finding out because there are sometimes limitations put on that by the residential treatment center themselves.”
Staff training and certifications can differ from state to state, but Maltz suggests asking whether the staff have Crisis Prevention Institute (CPI) training and about the certifications for any behavior staff. Foster recommends asking your school district whether you can attend CPI training as a parent to better understand it; parent training can be written into your child’s IEP.
Also, for programs that offer onsite schooling, all the teachers should be qualified with the appropriate credentialing, more specifically special education credentialing. Ask:
When going through the interview process, be sure to ask the facility how they would handle your child’s specific behavioral challenges and whether they have dealt with students in similar situations. Foster says that this is not the time to present your child as the sweet angel that they really can be. When your child is at their worst, how is that school going to handle it? Ask:
Restraint and seclusion practices should be limited to emergency situations only. However, it is important to ask an RTC in the interview process what its policies are and how the staff is trained for these moments.
Maltz says, “Laws do vary state by state, but regardless of the individual state laws, the repeated use of restraints and seclusion can be a denial of FAPE under IDEA if it impedes the student’s rights or educational progress.” Maltz says it is extremely important that parents work with their child’s behavior team to develop a comprehensive behavior intervention plan.
Inquiring about behavior staff qualifications and training will help you assess whether the RTC meets your child’s specific behavioral needs. You can also seek independent evaluations and then advocate for the inclusion of those expert recommendations in the child’s programs. This should reduce the number of opportunities there would be to implement interventions such as restraints or seclusion.
For students placed through their IEP, their home school district should have oversight. Whiteleather says, “The school district that is placing the student is still responsible for their education. They should be getting progress reports on IEP goals, which may include therapy goals. Maybe there’s a goal to take medication, to not elope, to be able to talk about issues. All of those should be shared with the district.” If there’s a problem and the student is not making progress on goals, the law requires the district to hold an IEP meeting and see what changes need to be made.
Residential placements contracted with California school districts must be registered and comply with California laws, and they are monitored by the California Department of Education; however, Foster, Maltz, and Whiteleather have some concerns about how well they are overseen. Maltz and Whiteleather say that there have been reports about RTCs having lack of appropriate staffing, abuse, and mistreatment, as well as failing to report to parents behavioral incidents or injuries when they happen. Foster encourages parents to stay engaged by speaking with their children and the school regularly.
Collin recommends doing some research about the facility online and asking other parents in social media groups. She advises, “I would look at media articles that have been written about that specific residential facility and find out about it. If there’s something that’s pretty yucky in their past, maybe ask directly about it and find out. ‘What have you done since then? What have you done to mitigate these kinds of challenges?’”
A new California law (SB 373) that will take effect starting in the 2026-27 school year will strengthen oversight and safety protections for California students with disabilities who attend non-public schools located outside the state.
Under SB 373, before approving or renewing any out-of-state school, the California Department of Education must review its restraint and seclusion policies to ensure they meet California’s standards.
State and local education officials will be required to interview each student with an IEP during monitoring visits to check on their progress, health, and safety, using a new state-developed interview tool.
Schools must also allow students to speak privately and confidentially with their local district or the state’s Constituent Services Office. In addition, districts must hold quarterly private phone check-ins with students and share key certification information with parents before any IEP team decides on an out-of-state placement.
Overall, the bill aims to make sure students placed in out-of-state programs are safe, supported, and heard.
The professionals we talked to emphasize that the key questions parents should ask about a residential placement will vary greatly depending on the child. As the people who know their child best, parents should ask questions related to their child’s specific needs and how the residential placement will address them. Foster says, “I personally think that that tells me a lot about a school. If somebody will take the time to answer the questions that I have, then I’m already feeling like the communication is better.”
Here are some key questions to ask RTCs during the interview process:
Whiteleather says that parents should insist on touring a campus before sending their child there. “It’s a very tough decision, but knowing what it looks like and where [the child is] and the people there makes it a little bit easier.”
The organization responsible for funding will depend primarily on the reason for the child’s residential placement and who determines that residential placement is necessary.
When the placement is an IEP team decision, the whole cost is funded through the student’s local school district.
Sometimes, residential placements are jointly funded by the school district and county mental health department, especially when emotional disability is the primary disability category in the IEP. According to Maltz, usually the residential treatment center works with the school district and the family’s insurance to coordinate who funds which services.
“It is not terribly uncommon, but if the school district doesn’t want to provide it, there might be a bit of a scuffle over who has to pay and who has to pay for what,” Maltz says.
If the school district is resisting residential placement when there is documentation of problems and/or a recommendation from a therapist or medical doctor, Whiteleather suggests that parents move forward with residential placement and file for a hearing if possible. She says, “A 10-day notice is required from the parents to the district, stating that parents are privately placing their child in a placement outside of the district and will be seeking reimbursement for any and all costs.”
Who pays for family visits?
When residential placement is decided through the IEP process, school districts will pay for family visits. According to Foster, this often looks like reimbursing parents for airfare or gas mileage and possibly overnight accommodations. “Parents in California are typically given four visits a year,” Whiteleather says. “That’s the practice, that’s not the law. The law says it’s whatever is appropriate for the student.”
Collin says, “It doesn’t mean the family can’t visit more often. It’s just a matter of how often the district is going to reimburse or cover the cost.” She encourages families to negotiate with the school district during the IEP process so they know up front what will be reimbursed. “Let the district know if that’s not feasible. The family should not have to put out expenses that they can’t afford in order to visit their own child.”
When a child needs a residential placement due to medical needs, families can suddenly find themselves navigating a confusing maze of “Who pays for what?” Families often end up caught between medical and educational funding streams that don’t always coordinate well, leaving parents to advocate, push for clarity, and fight for coverage while also caring for their child. Whiteleather says this can get even murkier when insurance says it won’t cover treatment out of state.
For California families, Medi-Cal, private insurance, or SSI will cover part of residential or hospital costs when the placement is chosen for medical purposes, rather than for behavioral or educational purposes. If insurance doesn’t cover the whole cost, then Regional Center may help with the remaining cost. For more information, see How Residential Placement Impacts California Public Benefits.
Families faced with a decision to place their child in a residential treatment program often experience grief and guilt. There might be no better option for children who are not safe in their home due to expressing violent behavior toward their parents or younger siblings and/or self-harming.
The system is designed to keep individuals with disabilities, especially children, in the family home, which often makes residential placement feel to everyone concerned like “giving up.” But in some circumstances, it may be the best option and can lead to recovery.
Accept that it is sometimes necessary
Foster says, “It is not being a bad parent to say, ‘I don’t want my kid to hit me.’ You’re not a bad parent to say, ‘My kid’s mental health issues are such that they cannot control themselves, and they’re hurting me.’ That doesn’t make you a bad parent, and it doesn’t make your kid a bad kid.”
“Placement in an RTC is a very scary and overwhelming process for parents and for kids,” Maltz says. “But sometimes residential placement is just necessary. Sometimes, kids’ needs cannot be met in another setting. We want to make sure everyone gets the help they need.”
Collin says, “Every family wants to do best by their child and has the best intentions. I think it helps looking at it from the perspective of ‘I’m doing everything I can to support my child,’ instead of looking at it as ‘I’m failing my child.’”
Get parent support
Collin advises, “I would suggest talking with a counselor, a therapist, your best friend — get some support, whether that’s professional help or connection with somebody that you can talk through the feelings and connect and express those things. Because those are very common feelings. If you’re surrounded by other families who have had similar experiences and can talk through it with them, sometimes that can be helpful as well.”
To manage feelings of guilt and stigma around residential placement, Foster advises that parents ask the school district about providing mental health services.
Don’t be afraid to ask questions and trust your instincts
As a parent, you might be worried when your child is away, wondering whether they’re safe. You know your child, so Whiteleather recommends talking to your child often and keeping an eye on any changes in their behavior:
Some families establish a “safe word” that the child can use when they need a private conversation with their parents ASAP.
“Ask questions and keep your spidey senses on. A good school is prepared to answer your questions,” Foster says.
Work on a plan for transitions
To maintain family connection during and after placement, it is important to create constant and transparent communication between the residential treatment center, the parents, and the child.
Parents and RTCs should work together to decide how to best transition the student into (and out of) the program to ensure that it is manageable and not overwhelming. Communicate about behavioral strategies that work, including recommendations from a mental health professional who knows your child. You can work with your school district to come up with a to-do list for the smoothest possible transition to the facility and then back home when it’s determined appropriate.
Collin emphasizes that teams need to plan for an effective transition from 24/7 care back to the home setting: “Having a really good plan for how we are going to transition this student from this very highly structured, intensive setting into a less structured setting and feel supported and nurtured and like they’re ensuring their needs are met throughout that process is really important.”
We know all of this information can feel overwhelming, but we also want you to know that you’re not alone. Some Undivided parents have children in residential placements, including out-of-state placements, so we’re here to provide community and support. To get started, we recommend joining our free parents-only Facebook group and scheduling a free session with an Undivided Navigator.
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