II 

116TH CONGRESS 

1ST SESSION S. 1880 

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

purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 18, 2019 

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

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

Committee on Finance 

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: 

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

10 has the meaning given that term in section 4 of the 


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

2 1603). 

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

4 program’’ means the program for grants to States 

5 for medical assistance programs established under 

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

7 et seq.). 

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

9 the Secretary of Health and Human Services. 

10 (4) STATE.—The term ‘‘State’’ has the mean11 ing given that term in section 1101 of the Social Se12 curity Act (42 U.S.C. 1301) for purposes of titles IV 

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

14 et seq.). 

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

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

17 prevention, and permanency established under part 

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

19 670 et seq.). 

20 (6) TREATMENT FAMILY CARE SERVICES.—The 

21 term ‘‘treatment family care services’’ means struc22 tured daily services and interventions provided in a 

23 home-based setting for children who have not at24 tained age 21, and who, as a result of mental illness, 

25 other emotional or behavioral disorders, medically 


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1 fragile conditions, or developmental disabilities, need 

2 the level of care provided in a psychiatric residential 

3 treatment or congregate care facility the cost of 

4 which could be reimbursed under the State Medicaid 

5 program or the title IV–E program but who can re6 ceive services in a family-based setting. 

7 (b) GUIDANCE ON TREATMENT FAMILY CARE SERV8 ICES.— 

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

10 after the date of enactment of this Act, the Sec11 retary, in consultation with the Administrator of the 

12 Centers for Medicare & Medicaid Services and the 

13 Assistant Secretary of the Administration for Chil14 dren and Families, shall develop and issue guidance 

15 to States and Indian tribes identifying opportunities 

16 to fund treatment family care services. 

17 (2) ADDITIONAL REQUIREMENTS.—The guid18 ance required under paragraph (1) shall include de19 scriptions of the following: 

20 (A) Existing opportunities and flexibilities 

21 under the Medicaid program, including under 

22 waivers authorized under section 1115 or 1915 

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

24 1396n), for States to receive Federal funding 

25 under that program for the provision of treatVerDate Sep 11 2014 05:15 Jun 19, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1880.IS S1880

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1 ment family care services, including services ad2 dressing the development, improvement, moni3 toring, and reinforcing of age-appropriate so4 cial, communication and behavioral skills, trau5 ma-informed and gender-responsive services, 

6 crisis intervention and crisis support services, 

7 medication monitoring, counseling, and case 

8 management, and other intensive community 

9 services identified by the Secretary. 

10 (B) Funding opportunities and flexibilities 

11 under the title IV–E program, including for 

12 specialized training and consultation for biologi13 cal parents, relative and kinship caregivers, 

14 adoptive parents, and foster parents, adminis15 trative costs related to in-home prevention serv16 ices to candidates for foster care and their par17 ents or kin caregivers, and reunification services 

18 for youth returning from foster care, as well as 

19 other services identified by the Secretary. 

20 (C) How States can employ and coordinate 

21 funding provided under the Medicaid program, 

22 the title IV–E program, and other programs ad23 ministered by the Secretary to support the pro24 vision of treatment family care services. 


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1 (c) BEST PRACTICES FOR ESTABLISHING PROGRAMS

2 TO PROVIDE TREATMENT FAMILY CARE SERVICES.— 

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

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

5 consultation with the Administrator of the Centers 

6 for Medicare & Medicaid Services and the Assistant 

7 Secretary of the Administration for Children and 

8 Families, shall develop and issue guidance to States 

9 identifying best practices for establishing programs 

10 to provide treatment family care services. 

11 (2) COLLABORATION REQUIRED.—Before 

12 issuing guidance on best practices, the Secretary 

13 shall solicit input from representatives of States and 

14 Indian tribes, health care providers with expertise in 

15 child trauma and child development, children with 

16 mental illness, or other emotional or behavioral dis17 orders, recipients of treatment family care services, 

18 foster and kinship care families, and other relevant 

19 experts and stakeholders. 

20 (3) ADDITIONAL REQUIREMENTS.—The guid21 ance required under paragraph (1) shall include the 

22 following: 

23 (A) Best practices for the organization and 

24 provision of treatment family care services and 

25 supports. 


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1 (B) Identification of services and supports 

2 included in successful programs that treatment 

3 family care services. 

4 (C) Descriptions of State standards for li5 censing and accrediting programs that provide 

6 treatment family care services to ensure pro7 viders are appropriately licensed and trained to 

8 provide high-quality treatment family care serv9 ices, including best practices concerning State 

10 requirements for such licensure and accredita11 tion by recognized national independent, not12 for-profit entities that accredit health care orga13 nizations or by any other independent, not-for14 profit accrediting organizations approved by the 

15 State. 

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

17 year after the date of enactment of this Act, the Comp18 troller General of the United States shall conduct a study 

19 and submit a report to Congress evaluating State efforts 

20 to ensure foster parents and other caregivers who are eligi21 ble for training for which Federal payments are available 

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

23 and appropriate training to meet the individual needs of 

24 foster children placed in their care, consistent with the re25 quirements of sections 471(a)(24) and 477(b)(3)(D) of 


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

2 677(b)(3)(D)), including an analysis of, and recommenda3 tions to improve, State review, approval and oversight of 

4 all such training (whether provided directly by the State 

5 or under contract with a public or private agency respon6 sible for finding, placing, or monitoring the placement of 

7 children in foster family homes). 

Æ 


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