Over the years, several strategies have been implemented to decrease children and youth placed in residential care settings. These strategies included implementing the Children's Services System Transformation initiative, a tiered, "incentive" match rate system in CSA designed to encourage serving children and youth in community-based settings, and the transition by Medicaid to a managed care approach to these services. In FY2020, the steady downward trend in the number of children served in residential care continued (overall decrease of 4% from FY2019), but the total CSA cost of these services increased by 5%. The number of youth in psychiatric residential treatment placements (PRTF) decreased by 7%, while those placements' costs increased by 4%. Group home (GH) placements decreased by 1%, while those placements' costs increased by 13%. Possible explanations of the changes in costs include increased lengths of stay (up 8% in GHs and 6% PRTFs) and increased cost of individual placements, perhaps due to a larger number of more costly out-of-state placements that are often not eligible for Medicaid reimbursement.