When no other options are available to house Maryland foster children removed from their homes due to abuse or neglect, they’re placed in hotels — a practice that comes at a high cost for the youth, their caregivers and the state.

Some children just sit in the hotel rooms, playing video games. Others roam the streets. One child reportedly overdosed on their prescribed medication, which was easily accessible. Another child attempted to stab their caregiver and was moved to a hospital — then went back to a hotel, continuing the cycle.

“I would argue that the hoteling is not safe for either the youth or the staff person that is assigned to them,” said Jennifer Stine, executive director of Court Appointed Special Advocates, or CASA, of Baltimore County.

It also comes with a high cost; the price tag more than doubled in the past several years.

Though the Department of Human Services, which operates Maryland’s foster care system, is working to limit the practice and using it only as a last resort, several hundred foster children were temporarily placed in hotels from the start of fiscal 2023 to partway through fiscal 2025, according to DHS data included in a Department of Legislative Services fiscal analysis.

DHS estimated that the cost per child per stay is roughly $96,000, according to a Department of Legislative Services analysis of the agency’s budget. The cost per child per day is about $1,400 for food, shelter, caregiving and more.

Expenditures associated with hotel placements increased significantly over two fiscal years, according to analysts. Spending associated with hotel placements in fiscal year 2022 was $26.1 million. In fiscal year 2024, it was $59.5 million.

However, DHS did not have a formal data collection process for the number of foster children housed in hotels until fiscal 2024. That year, 180 foster children were placed in the transitory housing, a slight uptick from 154 children in fiscal 2023 — though that figure may not account for the true number of children housed in hotels.And while iImproved data reporting may account for some of the increased numbers of children housed in hotels, fiscal analysts said, the increased spending indicates that more children have been placed in hotels if the agency’s expenditures have been consistently reported.

Bringing the number of children living in hotels to zero is one of DHS’ highest priorities, said Lillian Price, a DHS spokesperson. As of March 10, there were 17 foster youth housed in hotels, she said — down from the 28 reported Feb. 6.

An ‘unrealistic world’

Concerns about housing foster children in hotels is not new, though the practice has come into the spotlight recently following reports that a foster youth who was staying in an Owings Mills hotel was accused of rape last year.

That doesn’t change how advocates feel about the practice.

Life in a hotel sets up an “unrealistic world” for the foster children placed there, said Judith Schagrin, a social worker who spent 20 years as the administrator of Baltimore County’s foster care program.

“They have no expectations, no real rules. They can kind of come and go, maybe they go to school and maybe they don’t,” she said. “And then attempting to place them elsewhere has become a challenge.”

Even if a placement in a program is an option, some children get accustomed to the freedom of a hotel and push back.

“There is a lot of opportunity for community engagement and working and finishing school, but that feels very restrictive to them at that point, and so a lot of them will refuse placement,” said Robert Basler, associate vice president of Arrow Child & Family Ministries, which provides foster care and community-based services. “There’s not a whole lot the workers are able to do about it.”

While children who end up in hotel stays after all other options have been exhausted can be challenging, advocates emphasize that they’re not bad — they just have higher-intensity needs.

“That’s sort of part of the tragedy of the whole thing, these children are not born like this,” said Ted Gallo, executive director of the State Council on Child Abuse and Neglect. “They have, often, nine times out of 10, experienced something themselves, so they are kind of being punished for being the victim in so many ways, which adds to the frustration of this.”

Finding a longer-term solution to the placement crisis isn’t easy, but DHS is taking some steps to reduce hotel stays.

Along with better data collection on foster youths housed in hotels and implementation of new rates for residential care providers, DHS has also issued new guidance for local departments of social services for foster youths housed in hotels or hospitals.

The policy, which went into effect March 3, requires local departments to notify the DHS secretary and Social Services Administration of a child’s stay in a hotel within 24 hours and to track it on a spreadsheet. Under the new guidance, youth will be visited in person weekly by their local case worker or a family support worker in addition to monthly in-person caseworker visits. The policy also outlines expectations for a child’s education and well-being, Price said.

Advocates worry that it could add additional work without a real solution.

“It’s all bureaucracy, bureaucracy and documents,” Schagrin said.

Slow legislative solutions

Those who work in child welfare have looked to House Bill 962 and Senate Bill 696 to address part of the problem.

The legislation, sponsored by Del. Joseline Peña-Melnyk and Sen. Pamela Beidle, would require the Maryland Department of Health and DHS to ensure that pediatric hospital overstay patients — those who remain in a hospital inpatient unit or emergency department for more than 24 hours after being medically cleared to leave — are transferred to and treated in the least restrictive settings possible.

The bill would establish a pediatric hospital overstay coordinator in the Governor’s Office for Children to advocate for those patients, make recommendations and maintain data on those patients. It would also require the governor to include enough funding in the fiscal 2027 budget — about $4.6 million — to fill all vacancies at regional institutes for children and adolescents, also known as RICAs.

Peña-Melnyk, a Democrat who chairs the House Health and Government Operations Committee, acknowledged that her bill didn’t deal with children staying in hotels, but urged her fellow lawmakers to take action on the measure.

“This crisis didn’t appear overnight, and we’re not going to solve it overnight,” she said of children staying in hospitals. “But we cannot afford to wait, we cannot adjourn on April 7 and not take care of these children, because no one’s caring.”

The Coalition to Protect Maryland’s Children, which advocates for child welfare reform, proposed amending the measure to look at all unlicensed settings, including hotels and hospital overstays, as well as a report with a timeline and plans to end the practice of housing youth in hotels. Advocates are still waiting to see if the amendment will be accepted, said Diana Philip, a coordinator and consultant for the group.

“Just getting everybody together, including the Department of Juvenile Services, getting the three state child-serving agencies together in the same room with advocates that are on the ground and they understand the scope of the problem — I think it’s the only chance we’ve really got to try to solve this,” Philip said.

Schagrin feels a “systems change” could be the solution.