Youth treated in a residential treatment center (RTC) receive an array of services to address their mental health and behavioral issues, including psychotherapy and medication. Prior studies have shown that youth continue to receive a considerable number of services after discharge from a RTC. This study describes the characteristics of children and youth served in Florida’s Medicaid-funded residential treatment facilities, examines whether family involvement in treatment is associated with discharge to a family-like setting, and assesses continuity of treatment after discharge. Data for this study were obtained from the SIPP Provider Monthly Report Database from January 2005 through December 2011. These data contain information on family involvement during treatment. Post-discharge data were from Medicaid enrollment/claims files and Prepaid Mental Health Plan encounters. Results of this study suggest that family contacts for interventions and treatment planning are associated with a greater likelihood of discharge to a family-like setting. Among youth discharged to a family-like setting, family involvement during treatment was associated with receiving follow-up outpatient care. Results support the continued emphasis on including family members in the treatment of youth with mental health needs to ensure better outcomes and continuity of treatment.