This paper reflects the viewpoint of the Association of Children’s Residential Centers (ACRC) regarding efforts underway around the nation to redesign the role of residential treatment in local communities. Founded in 1956, ACRC is the oldest national association focused on the needs of children with serious mental and behavioral problems who are in residential or other milieu-based placements. ACRC has approximately 100 member agencies nationwide. The paper will first discuss the background for rethinking residential and then present ideas and considerations for the field, policymakers, advocates, and other stakeholders to incorporate into their ongoing work.