The best setting for abused or neglected children who are removed from their homes is a family-based setting, such as with a relative or in licensed foster care. Because it is not family-based, congregate care, such as emergency shelters, group homes, and residential treatment centers, is the least preferred placement option. However, the number of Arizona children and the length of time they are in congregate care has increased and as a result, the costs for this placement type nearly doubled between fiscal years 2009 and 2013. Contributing to the increase in congregate care use is an inadequate supply of foster care homes; various state practices, including some related to permanency goals and activities; and inadequate access to behavioral health services. Although the Arizona Department of Child Safety has taken some steps to reduce the use of congregate care, it should consider other states’ experiences to identify multiple strategies for reducing its use.