II 

113TH CONGRESS 

2D SESSION S. 1992 

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

of therapeutic foster care services in Medicaid. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 4, 2014 

Ms. BALDWIN (for herself and Mr. PORTMAN) 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 foster 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 ‘‘Quality Foster Care 

5 Services Act of 2014’’. 

6 SEC. 2. INCLUSION OF THERAPEUTIC FOSTER CARE AS 

7 MEDICAL ASSISTANCE. 

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

10 (1) in subsection (a)— 


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

2 at the end; 

3 (B) by redesignating paragraph (29) as 

4 paragraph (30); and 

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

6 following new paragraph: 

7 ‘‘(29) therapeutic foster care services described 

8 in subsection (ee); and’’; and 

9 (2) by adding at the end the following new sub10 section: 

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

12 to subparagraph (C), therapeutic foster care services de13 scribed in this subsection are services provided for children 

14 who have not attained age 21, and who, as a result of 

15 mental illness, other emotional or behavioral disorders, 

16 medically fragile conditions, or developmental disabilities, 

17 need the level of care provided in an institution (including 

18 a psychiatric residential treatment facility) or nursing fa19 cility the cost of which could be reimbursed under the 

20 State plan but who can be cared for or maintained in a 

21 community placement, through therapeutic foster care 

22 programs that— 

23 ‘‘(A) are licensed by the State and accredited 

24 by the Joint Commission, the Commission on Ac25 creditation of Rehabilitation Facilities, the Council 


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1 on Accreditation, or by another equivalent accredita2 tion agency (or agencies) as the Secretary may rec3 ognize; 

4 ‘‘(B) provide structured daily activities, includ5 ing the development, improvement, monitoring, and 

6 reinforcing of age-appropriate social, communication 

7 and behavioral skills, trauma-informed and gender8 responsive services, crisis intervention and crisis sup9 port services, medication monitoring, counseling, and 

10 case management, and may furnish other intensive 

11 community services; and 

12 ‘‘(C) provide foster care parents with special13 ized training and consultation in the management of 

14 children with mental illness, trauma, other emotional 

15 or behavioral disorders, medically fragile conditions, 

16 or developmental disabilities, and specific additional 

17 training on the needs of each child provided such 

18 services. 

19 ‘‘(2) In making coverage determinations under para20 graph (1), a State may employ medical necessity criteria 

21 that are similar to the medical necessity criteria applied 

22 to coverage determinations for other services and supports 

23 under this title. 

24 ‘‘(3) The services described in this subsection do not 

25 include the training referred to in paragraph (1)(C).’’. 


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

2 subsection (a) shall apply to calendar quarters beginning 

3 on or after the date of enactment of this Act. 

Æ 


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