I 

113TH CONGRESS 

2D SESSION H. R. 4016 

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

of therapeutic foster care services in Medicaid. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 6, 2014 

Ms. DELAURO (for herself, Mr. COLE, Ms. BASS, and Mr. BUTTERFIELD) introduced the following bill; which was referred to the Committee on Energy and Commerce 

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— 


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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 foster care services described 

9 in subsection (ee); and’’; and 

10 (2) by adding at the end the following new sub11 section: 

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

13 to subparagraph (C), therapeutic foster care services de14 scribed in this subsection are services provided for children 

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

16 mental illness, other emotional or behavioral disorders, 

17 medically fragile conditions, or developmental disabilities, 

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

19 a psychiatric residential treatment facility) or nursing fa20 cility the cost of which could be reimbursed under the 

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

22 community placement, through a qualified therapeutic fos23 ter care program described in paragraph (2). 

24 ‘‘(2) A qualified therapeutic foster care program de25 scribed in this paragraph is a program that— 


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1 ‘‘(A) is licensed by the State and accredited by 

2 the Joint Commission on Accreditation of Health3 care Organizations, the Commission on Accreditation 

4 of Rehabilitation Facilities, the Council on Accredi5 tation, or by another equivalent accreditation agency 

6 (or agencies) as the Secretary may recognize; 

7 ‘‘(B) provides structured daily activities, includ8 ing the development, improvement, monitoring, and 

9 reinforcing of age-appropriate social, communication 

10 and behavioral skills, trauma-informed and gender11 responsive services, crisis intervention and crisis sup12 port services, medication monitoring, counseling, and 

13 case management, and may furnish other intensive 

14 community services; and 

15 ‘‘(C) provides foster care parents with special16 ized training and consultation in the management of 

17 children with mental illness, trauma, other emotional 

18 or behavioral disorders, medically fragile conditions, 

19 or developmental disabilities, and specific additional 

20 training on the needs of each child provided such 

21 services. 

22 ‘‘(3) In making coverage determinations under para23 graph (1), a State may employ medical necessity criteria 

24 that are similar to the medical necessity criteria applied 


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1 to coverage determinations for other services and supports 

2 under this title. 

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

4 include the training referred to in paragraph (2)(C).’’. 

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

6 subsection (a) shall apply to calendar quarters beginning 

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

Æ 


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