Trapped in the System: Alaska’s Foster Youth Face Isolation, Over-Institutionalization, and Systemic Neglect
In the vast and remote state of Alaska, the child welfare system is gripped by a long-standing and deepening crisis. While foster care systems across the United States struggle with common issues—such as insufficient staff, high turnover, and a chronic shortage of foster families—Alaska’s challenges are amplified by its extreme geography and the isolation of rural communities.
The result is a system teetering on the edge of collapse, where the very agency tasked with protecting vulnerable children, the Office of Children’s Services (OCS), has repeatedly failed to meet even the most basic professional standards.
Reports of dysfunction within OCS date back to the 1990s. A 2017 federal Child and Family Services Review (CFSR) conducted by the U.S. Department of Health and Human Services found Alaska out of compliance on nearly every metric concerning child safety, stability, and well-being.
Turnover among child welfare caseworkers reaches staggering levels—50% to 60% annually—while many workers handle caseloads two to three times the national standard. This level of workforce instability leads to delayed investigations, missed home visits, and children being stranded in temporary placements or shuffled endlessly through institutional facilities.
The crisis disproportionately affects Alaska Native children, who comprise nearly two-thirds of the foster care population despite representing a much smaller share of the state's child population. OCS often overlooks or fails to support kinship caregivers, particularly unlicensed relatives, exacerbating the overrepresentation of Native youth in institutional placements.
Cultural insensitivity and systemic bias against placing children within their communities further entrench the problem, as Native children are removed from familiar environments and thrust into a cycle of disconnection and trauma.
One of the most disturbing outcomes of this broken system is Alaska’s heavy reliance on psychiatric hospitals to house foster youth. North Star Behavioral Health, a private facility in Anchorage, has become a default placement option—what many now call a “dumping ground” for children the system cannot accommodate elsewhere.
Youth are admitted for transient suicidal ideation or behavioral challenges, often without meeting the medical criteria for inpatient psychiatric care. Even after they stabilize, many remain institutionalized for months or even years due to the state’s failure to find alternative housing.
The financial incentives for this practice are stark. From 2017 to 2022, Alaska’s Medicaid program paid $119 million to North Star alone, with nightly costs approaching $1,000 per child. Even when Medicaid reviewers concluded that hospitalization was no longer medically necessary, OCS sometimes continued to pay out of pocket to avoid releasing children onto the streets. The result is a system where institutionalization is not the last resort—it’s the default.
This alarming pattern prompted a formal investigation by the U.S. Department of Justice (DOJ) in 2020 into whether Alaska was violating Title II of the Americans with Disabilities Act (ADA). The DOJ’s findings, released in 2022, concluded that the state was indeed unlawfully institutionalizing children with behavioral health disabilities and failing to provide adequate community-based alternatives.
Hundreds of children—particularly Alaska Native youth—were being sent not only to North Star, but also to distant out-of-state facilities in Texas and Utah. The report emphasized that many of these children could have remained in their homes or communities if proper support systems were in place.
Journalists also played a pivotal role in exposing the crisis. Investigative reports, such as Julia Lurie’s exposé in Mother Jones, revealed how private hospital corporations profited from these institutional placements.
These companies actively marketed their services to child welfare agencies like OCS, knowing that a broken system would generate significant profits through Medicaid reimbursements. Meanwhile, former foster youth came forward to share harrowing personal stories of how being labeled a “treatment kid” led to years of unnecessary confinement in psychiatric institutions and group homes, despite not requiring such intensive care.
These revelations spurred a wave of legal action. In July 2022, civil rights attorneys representing foster youth—backed by organizations such as A Better Childhood, the Northern Justice Project, the Disability Law Center of Alaska, and national law firm Perkins Coie—filed a federal class action lawsuit against OCS.
The complaint cataloged the agency’s systemic failures, including its neglect of kinship placements and violations of the Indian Child Welfare Act (ICWA). Plaintiffs demanded sweeping reforms, including increasing the number of caseworkers and expanding community-based mental health services to ensure institutionalization is a true last resort.
Around the same time, a second class action lawsuit was filed focusing specifically on violations of the ADA’s “integration mandate.” The suit argued that OCS policies put children with disabilities at serious risk of unnecessary and prolonged institutionalization, even after they no longer required intensive care. A federal district court recently denied the state’s motion for summary judgment in this case, meaning the case will proceed to trial.
These lawsuits come after years of failed internal audits, ignored legislative reforms, and unmet federal standards. Legal advocates argue that court intervention is now the only viable path to meaningful change. One judge has already acknowledged that the continued harm to children justifies federal oversight, noting that the state’s current resources and policies are insufficient to protect foster youth.
Although many such lawsuits across the country face long timelines and mixed outcomes—some, like the case in New Jersey, resulted in lasting reforms, while others, like a case in West Virginia, were dismissed—Alaska has already seen legal decisions begin to shape new policy.
In a landmark ruling, the Alaska Supreme Court held that the state violated a foster child’s constitutional rights by failing to provide timely judicial review after psychiatric hospitalization.
The child in question waited 46 days before a court hearing—a delay the court deemed a violation of procedural due process. Although the court upheld OCS’s authority to initiate hospitalizations without civil commitment procedures, it emphasized that minors’ bodily autonomy must be protected.
Public pressure and legal challenges have also catalyzed action within the state legislature. In March 2025, the Alaska House of Representatives unanimously passed House Bill 36, which mandates that any foster youth admitted to a psychiatric facility receive a court hearing within seven days.
This is a dramatic improvement over the previous 30-day timeline and represents the most significant legal protection for institutionalized youth in the state to date. Though the bill still awaits Senate approval, it signals a shift in how Alaska approaches mental health and foster care policy.
Alaska’s foster care crisis exposes not only a localized administrative failure but also a broader systemic disregard for the rights and dignity of vulnerable children. The voices of former foster youth, the persistence of legal advocates, and the scrutiny of investigative journalists have begun to crack open a long-shuttered system.
While major challenges remain and court battles continue, there is now a growing hope that a new chapter is possible—one where children are not abandoned to institutions, but embraced by communities, supported by professionals, and treated with the respect and care they deserve.