II 

115TH CONGRESS 

1ST SESSION S. 1357 

To amend title XIX of the Social Security Act to provide a standard definition 

of therapeutic family care services in Medicaid. 

IN THE SENATE OF THE UNITED STATES 

JUNE 14, 2017 

Ms. BALDWIN (for herself, Mr. PORTMAN, Ms. STABENOW, and Mr. BLUNT) 

introduced the following bill; which was read twice and referred to the 

Committee on Finance 

A BILL 

To amend title XIX of the Social Security Act to provide 

a standard definition of therapeutic family care services 

in Medicaid. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Family-Based Care 

5 Services Act’’. 

6 SEC. 2. INCLUSION OF THERAPEUTIC FAMILY CARE AS 

7 MEDICAL ASSISTANCE. 

8 (a) IN GENERAL.—Section 1905 of the Social Secu9 rity Act (42 U.S.C. 1396d) is amended— 


rfrederick on DSK3GLQ082PROD with BILLS
2 

•S 1357 IS

1 (1) in subsection (a)— 

2 (A) in paragraph (28), by striking ‘‘and’’ 

3 at the end; 

4 (B) by redesignating paragraph (29) as 

5 paragraph (30); and 

6 (C) by inserting after paragraph (28) the 

7 following new paragraph: 

8 ‘‘(29) therapeutic family care services (to the 

9 extent allowed and as defined in subsection (ee)); 

10 and’’; and 

11 (2) by adding at the end the following new sub12 section: 

13 ‘‘(ee)(1) For purposes of subsection (a)(29), subject 

14 to the succeeding paragraphs of this subsection, the term 

15 ‘therapeutic family care services’ means services provided 

16 for children who have not attained age 21, and who, as 

17 a result of mental illness, other emotional or behavioral 

18 disorders, medically fragile conditions, or developmental 

19 disabilities, need the level of care provided in an institution 

20 (including a psychiatric residential treatment facility) or 

21 nursing facility the cost of which could be reimbursed 

22 under the State plan but who can be cared for or main23 tained in a community placement, through a qualified 

24 therapeutic family care program described in paragraph 

25 (2). 


rfrederick on DSK3GLQ082PROD with BILLS
3 

•S 1357 IS

1 ‘‘(2) A qualified therapeutic family care program de2 scribed in this paragraph is a program that— 

3 ‘‘(A) not later than 3 years after the date of en4 actment of this subsection, is licensed by the State 

5 and accredited by the Joint Commission on Accredi6 tation of Healthcare Organizations, the Commission 

7 on Accreditation of Rehabilitation Facilities, the 

8 Council on Accreditation, or by any other inde9 pendent, not-for-profit accrediting organization ap10 proved by the Secretary; 

11 ‘‘(B) provides structured daily activities, includ12 ing the development, improvement, monitoring, and 

13 reinforcement of age-appropriate social, communica14 tion and behavioral skills, trauma-informed and gen15 der-responsive services, crisis intervention and crisis 

16 support services, medication monitoring, counseling, 

17 and case management, and may furnish other inten18 sive community services; and 

19 ‘‘(C) provides biological parents, relative and 

20 kinship caregivers, adoptive parents, foster parents 

21 and, as appropriate, other members of such parents 

22 or caregivers homes with specialized training and 

23 consultation in the management of children with 

24 mental illness, other emotional or behavioral dis25 orders, medically fragile conditions, developmental 


rfrederick on DSK3GLQ082PROD with BILLS
4 

•S 1357 IS

1 disabilities, the impact of trauma on child and care2 giver, including trauma from substance abuse by a 

3 child or caregiver, and specific additional training on 

4 the needs of each child provided such services. 

5 ‘‘(3) In making coverage determinations in accord6 ance with paragraph (1), a State may employ medical ne7 cessity criteria that are similar to the medical necessity 

8 criteria applied to coverage determinations for other serv9 ices and supports under this title. 

10 ‘‘(4) For purposes of subsection (a)(29) and this sub11 section, therapeutic family care services shall not include 

12 reimbursement for any training referred to in paragraph 

13 (2)(C).’’. 

14 (b) EFFECTIVE DATE.—The amendments made by 

15 subsection (a) shall apply to medical assistance furnished 

16 in calendar quarters beginning on or after the date of en17 actment of this Act. 

18 (c) GAO STUDY AND REPORT.—Not later than 1 

19 year after the date of enactment of this Act, the Comp20 troller General of the United States shall conduct a study 

21 and submit a report to Congress evaluating State efforts 

22 to ensure foster parents and other caregivers who are eligi23 ble for training described in paragraph (2)(C) of section 

24 1905(ee) of the Social Security Act (42 U.S.C. 1396d(ee)) 

25 (as added by subsection (a)(2)) through a qualified theraVerDate Sep 11 2014 01:12 Jun 20, 2017 Jkt 069200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1357.IS S1357

rfrederick on DSK3GLQ082PROD with BILLS
5 

•S 1357 IS

1 peutic family care program described in such section and 

2 for which Federal payments are available under part E 

3 of title IV of the Social Security Act (42 U.S.C. 670 et 

4 seq.) are provided with such training as is necessary and 

5 appropriate to meet the individual needs of children placed 

6 in their care, consistent with the requirements of sections 

7 471(a)(24) and 477(b)(3)(D) of the Social Security Act 

8 (42 U.S.C. 671(a)(24), 677(b)(3)(D)). The report shall 

9 include an analysis of, and recommendations to improve, 

10 State review, approval and oversight of all such training 

11 (whether provided directly by the State or under contract 

12 with a public or private agency responsible for finding, 

13 placing, or monitoring the placement of children in foster 

14 family homes). 

Æ 


rfrederick on DSK3GLQ082PROD with BILLS