I 

116TH CONGRESS 

1ST SESSION H. R. 3649 

To support the provision of treatment family care services, and for other 

purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 9, 2019 

Ms. DELAURO (for herself, Mr. COLE, Ms. BASS, Mr. MULLIN, and Ms. 

DEGETTE) introduced the following bill; which was referred to the Committee on Ways and Means, and in addition to the Committee on Energy 

and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To support the provision of treatment family care services, 

and for other purposes. 

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 ‘‘Treatment Family 

5 Care Services Act’’. 

6 SEC. 2. SUPPORTING THE PROVISION OF TREATMENT FAM7 ILY CARE SERVICES. 

8 (a) DEFINITIONS.—In this section: 


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1 (1) INDIAN TRIBE.—The term ‘‘Indian tribe’’ 

2 has the meaning given that terms in section 4 of the 

3 Indian Health Care Improvement Act (25 U.S.C. 

4 1603). 

5 (2) MEDICAID PROGRAM.—The term ‘‘Medicaid 

6 program’’ means the program for grants to States 

7 for medical assistance programs established under 

8 title XIX of the Social Security Act (42 U.S.C. 1396 

9 et seq.). 

10 (3) SECRETARY.—The term ‘‘Secretary’’ means 

11 the Secretary of Health and Human Services. 

12 (4) STATE.—The term ‘‘State’’ has the mean13 ing given that term in section 1101 of the Social Se14 curity Act (42 U.S.C. 1301) for purposes of titles IV 

15 and XIX of such Act (42 U.S.C. 601 et seq., 1396 

16 et seq.). 

17 (5) TITLE IV–E PROGRAM.—The term ‘‘title 

18 IV–E program’’ means the program for foster care, 

19 prevention, and permanency established under part 

20 E of title IV of the Social Security Act (42 U.S.C. 

21 670 et seq.). 

22 (6) TREATMENT FAMILY CARE SERVICES.—The 

23 term ‘‘treatment family care services’’ means struc24 tured daily services and interventions provided in a 

25 home-based setting for children who have not atVerDate Sep 11 2014 21:35 Jul 16, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3649.IH H3649

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1 tained age 21, and who, as a result of mental illness, 

2 other emotional or behavioral disorders, medically 

3 fragile conditions, or developmental disabilities, need 

4 the level of care provided in a psychiatric residential 

5 treatment or congregate care facility the cost of 

6 which could be reimbursed under the State Medicaid 

7 program or the title IV–E program but who can re8 ceive services in a family-based setting. 

9 (b) GUIDANCE ON TREATMENT FAMILY CARE SERV10 ICES.— 

11 (1) IN GENERAL.—Not later than 180 days 

12 after the date of enactment of this Act, the Sec13 retary, in consultation with the Administrator of the 

14 Centers for Medicare & Medicaid Services and the 

15 Assistant Secretary of the Administration for Chil16 dren and Families, shall develop and issue guidance 

17 to States and Indian tribes identifying opportunities 

18 to fund treatment family care services. 

19 (2) ADDITIONAL REQUIREMENTS.—The guid20 ance required under paragraph (1) shall include de21 scriptions of the following: 

22 (A) Existing opportunities and flexibilities 

23 under the Medicaid program, including under 

24 waivers authorized under section 1115 or 1915 

25 of the Social Security Act (42 U.S.C. 1315, 


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1 1396n), for States to receive Federal funding 

2 under that program for the provision of treat3 ment family care services, including services ad4 dressing the development, improvement, moni5 toring, and reinforcing of age-appropriate so6 cial, communication and behavioral skills, trau7 ma-informed and gender-responsive services, 

8 crisis intervention and crisis support services, 

9 medication monitoring, counseling, and case 

10 management, and other intensive community 

11 services identified by the Secretary. 

12 (B) Funding opportunities and flexibilities 

13 under the title IV–E program, including for 

14 specialized training and consultation for biologi15 cal parents, relative and kinship caregivers, 

16 adoptive parents, and foster parents, adminis17 trative costs related to in-home prevention serv18 ices to candidates for foster care and their par19 ents or kin caregivers, and reunification services 

20 for youth returning from foster care, as well as 

21 other services identified by the Secretary. 

22 (C) How States can employ and coordinate 

23 funding provided under the Medicaid program, 

24 the title IV–E program, and other programs adVerDate Sep 11 2014 21:35 Jul 16, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3649.IH H3649

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1 ministered by the Secretary to support the pro2 vision of treatment family care services. 

3 (c) BEST PRACTICES FOR ESTABLISHING PROGRAMS

4 TO PROVIDE TREATMENT FAMILY CARE SERVICES.— 

5 (1) IN GENERAL.—Not later than 2 years after 

6 the date of enactment of this Act, the Secretary, in 

7 consultation with the Administrator of the Centers 

8 for Medicare & Medicaid Services and the Assistant 

9 Secretary of the Administration for Children and 

10 Families, shall develop and issue guidance to States 

11 identifying best practices for establishing programs 

12 to provide treatment family care services. 

13 (2) COLLABORATION REQUIRED.—Before 

14 issuing guidance on best practices, the Secretary 

15 shall solicit input from representatives of States and 

16 Indian tribes, health care providers with expertise in 

17 child trauma and child development, children with 

18 mental illness, or other emotional or behavioral dis19 orders, recipients of treatment family care services, 

20 foster and kinship care families, and other relevant 

21 experts and stakeholders. 

22 (3) ADDITIONAL REQUIREMENTS.—The guid23 ance required under paragraph (1) shall include the 

24 following: 


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1 (A) Best practices for the organization and 

2 provision of treatment family care services and 

3 supports. 

4 (B) Identification of services and supports 

5 included in successful programs that treatment 

6 family care services. 

7 (C) Descriptions of State standards for li8 censing and accrediting programs that provide 

9 treatment family care services to ensure pro10 viders are appropriately licensed and trained to 

11 provide high-quality treatment family care serv12 ices, including best practices concerning State 

13 requirements for such licensure and accredita14 tion by recognized national independent, not15 for-profit entities that accredit health care orga16 nizations or by any other independent, not-for17 profit accrediting organizations approved by the 

18 State. 

19 (d) GAO STUDY AND REPORT.—Not later than 1 

20 year after the date of enactment of this Act, the Comp21 troller General of the United States shall conduct a study 

22 and submit a report to Congress evaluating State efforts 

23 to ensure foster parents and other caregivers who are eligi24 ble for training for which Federal payments are available 

25 under the title IV–E program are provided with necessary 


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1 and appropriate training to meet the individual needs of 

2 foster children placed in their care, consistent with the re3 quirements of sections 471(a)(24) and 477(b)(3)(D) of 

4 the Social Security Act (42 U.S.C. 671(a)(24), 

5 677(b)(3)(D)), including an analysis of, and recommenda6 tions to improve, State review, approval and oversight of 

7 all such training (whether provided directly by the State 

8 or under contract with a public or private agency respon9 sible for finding, placing, or monitoring the placement of 

10 children in foster family homes). 

Æ 


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