Almost 10 years ago, nine children who had been in the Texas foster care system filed a class action lawsuit alleging that the system failed to protect them from an unreasonable risk of harm. In 2015, U.S. District Court Judge Janis Jack took the state to task for operating a system where “rape, abuse, psychotropic medication and instability are the norm,” and children “almost uniformly leave state custody more damaged than when they entered.” Many of those children were placed in rural foster homes. M.D. v. Abbott. 

By definition, many children in foster care have experienced trauma due to abuse or neglect. Their health or mental health may be severely compromised. Significant communication technologies have enhanced access to health and social services in rural areas. Even so, it is difficult to say that these innovations have brought measurable quality consequences to foster children living in rural areas.