There are hundreds of out-of-home placement options for children in crisis in Virginia that range from locked, secured hospital-type facilities to traditional foster care homes where children live with a family. With this wide spectrum of services that include both for-profit and not-for-profit organizations, finding the least restrictive care for nearly 5,500 of these children each year is an important endeavor. VHBG’s Group Care Services program is near the end of the spectrum just before a child is ready to transition back to their biological family, adoption, or a traditional foster home. Often, these young people are unable to move into traditional foster care due to a variety of factors, including the unavailability of foster homes for teenagers in Virginia; the intimacy of a family environment that triggers reactive behavior in traumatized youth; and the need for a trauma-informed transitional environment when stepping down from a mental health treatment facility (while family reunification is facilitated). Multiple placement disruptions re-traumatize young people and increase the likelihood of youth developing long- term social, emotional, behavioral, and psychological disorders. Young people in states of transition need to be in a trauma-informed, least restrictive environment that keeps them safe, addresses their mental health needs, and allows them to interact with the community as much as possible. Many times, DSS-licensed Group Care (like VHBG’s) is all that is necessary to best meet a youth and family’s current needs. Transitional services offer a structured, stable, therapeutic (trauma-informed) approach to help teach and guide a transitioning youth and family along their way to a more permanent home setting. At VHBG, our Group Care Services program covers the gap between placing a child in foster care before they are ready and placing a child in a medical model program funded by Medicaid that they don’t need.