Even if you don’t have any experience with foster care, you’ll know it can be bleak. Foster systems in any state are continuously struggling with issues like overwhelming caseloads, high staff turnover, and a chronic shortage of foster homes. But in Alaska, where vast geography and rural isolation complicate service delivery, the situation is even more dire than in other states.
Alaska’s Foster Fiasco
Alaska’s state agency responsible for child welfare is the Office of Children’s Services (OCS). Reports from as early as the 1990s flagged that OCS was unable to meet even basic professional standards for supervising children in its care. By 2017, federal Child and Family Services Reviews (CFSRs) conducted by the U.S. Department of Health and Human Services (HHS) found Alaska out of compliance with nearly every key measure of safety, permanency, and well-being.
As a result, Alaska Native children are vastly overrepresented in foster care, making up about two-thirds of all children in custody--despite being a fraction of the state’s child population. Caseworker turnover can be anywhere from 50-60% per year. Many caseworkers juggle caseloads double or triple the national standard. This workforce instability leads to delayed investigations and missed visits, leaving children languishing in temporary placements or cycling through institutional settings. This has led to what HHS describes as a “triage approach to case management” where overwhelmed caseworkers are forced to prioritize only the most urgent or severe cases, often at the expense of comprehensive, individualized care for all children in their custody.
A Psych Hospital Pipeline
One of the most glaring symptoms of this broken system is Alaska’s reliance on psychiatric hospitals as placements for foster youth — in particular, North Star Behavioral Health in Anchorage. OCS has used North Star as a “dumping ground” for children who have nowhere else to go. Children are often admitted after expressing fleeting suicidal thoughts or acting out in foster homes, not necessarily because they meet clinical criteria for inpatient psychiatric care. Many report being held far longer than medically necessary (months or even years) simply because OCS cannot find an alternative placement.
The financial incentives are stark: Medicaid pays nearly $1,000 per night for each child at North Star. From 2017 to 2022 alone, Alaska Medicaid paid North Star $119 million for foster youth admissions. Even when Medicaid reviewers determined that continued hospitalization was not medically necessary, OCS sometimes continued to pay out-of-pocket just to keep children off the streets.
Investigations and Publicity
These issues drew the attention of the U.S. Department of Justice. By 2020, the DOJ had launched an investigation into whether Alaska was violating Title II of the Americans with Disabilities Act (ADA) by unnecessarily institutionalizing children with behavioral health disabilities. The findings, published in a 2022 report, were damning. Alaska was indeed violating federal law by failing to provide community-based services that would allow children to remain in family-like settings rather than psych hospitals or inpatient facilities.
The DOJ report highlighted how hundreds of children (including disproportionate numbers of Alaska Native youth) were sent not only to North Star but also to out-of-state institutions as far away as Texas and Utah. Many could have been served at home or in their communities if appropriate services existed. The report concluded that Alaska’s system was “heavily biased toward institutions,” perpetuating unnecessary segregation and trauma.
It wasn’t just policy reports and audits that painted a picture of systemic dysfunction. Investigative journalists played a crucial role in bringing these stories into public view. Julia Lurie’s exposé in Mother Jonesrevealed how private hospital chains (like the one that owns North Star) profited from this arrangement, marketing aggressively to agencies like OCS while racking up millions in Medicaid payments.
Former foster youth also spoke up. Survivors went public about how institutionalization became self-perpetuating: once labeled a “treatment kid,” they cycled through hospitals and group homes instead of finding stability in family settings. The lack of available foster homes meant that even when they didn’t truly need inpatient care or after they were stabilized psychiatrically, they remained locked up simply because there was nowhere else for them to go. These voices galvanized public outrage and legal action.
Class Actions Take Shape
Against this backdrop, legal advocates began building cases on behalf of Alaska’s foster youth. Civil rights lawyers from organizations like A Better Childhood, Northern Justice Project, Disability Law Center of Alaska, and firms like Perkins Coie joined forces. In July 2022, they filed a lawsuit in federal court. The complaint cataloged OCS’s many failures. In addition to the many problems previously described, it detailed its neglect of kinship caregivers (especially unlicensed relatives) and its disregard for ICWA placement preferences.
The suit asked the court to force Alaska to comply with constitutional requirements, federal child welfare statutes, ICWA mandates for Native children, and disability rights law. It demanded reforms ranging from hiring more caseworkers to expanding community-based mental health services so that institutionalization becomes truly a last resort.
At the same time, a related class action was brought that focused specifically on ADA violations. In particular, it brought up the “integration mandate”— alleging that OCS policies create a serious risk that disabled foster youth will be unnecessarily institutionalized or retained in restrictive settings after their conditions have stabilized. Recently, a district court denied summary judgment for that class action, meaning the case will continue.
Will It Change Anything?
Both lawsuits are similar in arguing that every other avenue for reform had failed. Internal audits were ignored, legislative fixes went unenforced, and federal warnings went unheeded. As of July 2025, both cases remain active in federal court. The claims about the unnecessary institutionalization will be moving to trial at the end of this month, unless it settles.
One of the judges has already acknowledged in an order that the ongoing harm justifies federal intervention, saying that Alaska’s state resources are not doing enough. But Alaska is not alone in facing such lawsuits; similar class actions have been filed across the country. Many are led by legal teams with experience enforcing consent decrees over decades-long reform efforts. One in New Jersey reached a settlement after a long time in court. But many have not been successful, like one in West Virginia that the court dismissed.
A later lawsuit in Alaska, however, did result in some success. The Alaska Supreme Court held that the State’s failure to promptly notify parties of a foster child’s psychiatric hospitalization, and the 46-day delay before a judicial hearing on the hospitalization’s necessity, violated procedural due process. The court also found that while OCS had statutory authority to hospitalize the child without using civil commitment procedures, minors’ bodily autonomy deserves strong protection.
All the legal challenges and public pressure also succeeded in causing the state’s legislature to take action. This past March, the Alaska House of Representatives unanimously passed House Bill 36, which requires that foster youth admitted to acute psychiatric facilities receive a court hearing within seven days—a significant reduction from the previous 30-day requirement.
While HB 36 still awaits Senate approval, it represents tangible progress. And while some of the lawsuits still have a way to go, they provide hope for change to some soon.
Related Resources:
- Foster Children With Disabilities or Medical Issues (FindLaw's Learn About the Law)
- Foster Care: Background and History (FindLaw's Learn About the Law)
- The Law On Healthcare for Transgender Youth Across America (FindLaw's Courtside)
