Children in foster care are incredibly vulnerable. Some have intense mental health needs, yet poor access to psychosocial services. Children in foster care are prescribed psychotropic medications at much higher rates than other children receiving Medicaid; they also have high rates of polypharmacy, use in very young children, off-label use, and doses exceeding recommendations. Beyond these healthcare disparities is the overarching disempowerment felt by youth in foster care and their caregivers. Our goal is to promote connections with relevant stakeholders such as those formerly in foster care; foster, adoptive, and birth parents; child welfare leaders; prescribing clinicians; advocates; and other professionals to develop a patient-centered comparative effectiveness research question and proposal centered on creating more patient-centered psychiatric practices. These stakeholders are well-represented within our local core team, and core team members will continue to regularly partner with existing groups consisting of parents, youth, clinicians, researchers, and other professionals and advocates, both within our state of New Hampshire and beyond. A national advisory team also helps govern and support the project. In Tier I, we developed a strong core team, which met three times. We also held two national advisory meetings, and joined two meetings of an existing parent partner group. In full collaboration with our partners, we developed our governance structure and recruitment strategies, and we brainstormed nearly 20 comparative effectiveness research ideas. In Tier II, we hope to strengthen our partnerships and perform more outreach to partners and stakeholders as we narrow our questions to one or two viable research ideas.