II 

117TH CONGRESS 

2D SESSION S. 3761 

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

purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 3, 2022 

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

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 or family-based setting, which may 

24 adopt a trauma-informed and gender-responsive ap25 proach and may include services addressing the deVerDate Sep 11 2014 03:45 Mar 05, 2022 Jkt 029200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3761.IS S3761

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1 velopment, improvement, monitoring, and reinforcing 

2 of age-appropriate social, communication, and be3 havioral skills, crisis intervention and crisis support 

4 services, medication monitoring, counseling, and case 

5 management, for children enrolled in any Medicaid 

6 eligibility group (as such term is defined for pur7 poses of the Medicaid or CHIP program) who have 

8 not attained age 21, and who, as a result of mental 

9 illness, other emotional or behavioral disorders, 

10 medically fragile conditions, or developmental dis11 abilities, need additional or specialized care, the cost 

12 of which could be reimbursed under the State Med13 icaid program or the title IV–E program but who 

14 can receive services in a home-based or family-based 

15 setting. 

16 (b) GUIDANCE ON TREATMENT FAMILY CARE SERV17 ICES.— 

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

19 after the date of enactment of this Act, the Sec20 retary, in consultation with the Administrator of the 

21 Centers for Medicare & Medicaid Services and the 

22 Assistant Secretary of the Administration for Chil23 dren and Families, shall develop and issue guidance 

24 to States and Indian tribes identifying opportunities 


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1 to fund treatment family care services for children 

2 enrolled in any Medicaid eligibility group. 

3 (2) ADDITIONAL REQUIREMENTS.—The guid4 ance required under paragraph (1) shall include de5 scriptions of the following: 

6 (A) Existing opportunities and flexibilities 

7 under the Medicaid or CHIP program, includ8 ing under waivers authorized under section 

9 1115 or 1915 of the Social Security Act (42 

10 U.S.C. 1315, 1396n), for States to receive Fed11 eral funding under that program for the provi12 sion of treatment family care services for chil13 dren enrolled in any Medicaid eligibility group, 

14 and as requested by States and subject to ap15 proval by the Secretary. 

16 (B) Funding opportunities and flexibilities 

17 under the title IV–E program, including for 

18 specialized training and consultation for biologi19 cal parents, relative and kinship caregivers, 

20 adoptive parents, and foster parents, adminis21 trative costs related to in-home prevention serv22 ices to candidates for foster care and their par23 ents or kin caregivers, and reunification services 

24 for youth returning from foster care, as well as 

25 other services identified by the Secretary. 


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1 (C) How States can employ and coordinate 

2 funding provided under the Medicaid or CHIP 

3 program, the title IV–E program, and other 

4 programs administered by the Secretary to sup5 port the provision of treatment family care 

6 services. 

7 (c) BEST PRACTICES FOR ESTABLISHING PROGRAMS

8 TO PROVIDE TREATMENT FAMILY CARE SERVICES.— 

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

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

11 consultation with the Administrator of the Centers 

12 for Medicare & Medicaid Services and the Assistant 

13 Secretary of the Administration for Children and 

14 Families, shall develop and issue guidance to States 

15 identifying best practices for establishing programs 

16 to provide treatment family care services. 

17 (2) COLLABORATION REQUIRED.—Before 

18 issuing guidance on best practices, the Secretary 

19 shall solicit input from representatives of States and 

20 Indian tribes, health care providers with expertise in 

21 child trauma and child development, children with 

22 mental illness, or other emotional or behavioral dis23 orders, recipients of treatment family care services, 

24 foster and kinship care families, and other relevant 

25 experts and stakeholders. 


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1 (3) ADDITIONAL REQUIREMENTS.—The guid2 ance required under paragraph (1) shall include the 

3 following: 

4 (A) Best practices for the organization and 

5 provision of treatment family care services and 

6 supports. 

7 (B) Identification of services and supports 

8 included in successful programs that provide 

9 treatment family care services. 

10 (C) Descriptions of State standards for li11 censing and accrediting programs that provide 

12 treatment family care services to ensure pro13 viders are appropriately licensed and trained to 

14 provide high-quality treatment family care serv15 ices, including best practices concerning State 

16 requirements for such licensure and accredita17 tion by recognized national independent, not18 for-profit entities that accredit health care orga19 nizations or by any other independent, not-for20 profit accrediting organizations approved by the 

21 State. 

22 (4) RULE OF CONSTRUCTION.—Nothing in this 

23 subsection shall be construed as requiring the Sec24 retary to establish an advisory committee subject to 


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1 the provisions of the Federal Advisory Committee 

2 Act (5 U.S.C. App.). 

3 (d) GAO STUDY AND REPORT.—Not later than 2 

4 years after the date of enactment of this Act, the Comp5 troller General of the United States shall conduct a study 

6 and submit a report to Congress assessing States’ and 

7 Tribes’ progress in taking steps to ensure foster parents 

8 and other caregivers who are eligible for training for which 

9 Federal payments are available under the title IV–E pro10 gram are provided with necessary and appropriate train11 ing to meet the individual needs of foster children placed 

12 in their care, consistent with the requirements of sections 

13 471(a)(24) and 477(b)(3)(D) of the Social Security Act 

14 (42 U.S.C. 671(a)(24), 677(b)(3)(D)). Such assessment 

15 shall also include an analysis of, and recommendations, 

16 if any, to relevant Federal agencies to improve, State re17 view, approval and oversight of all such training (whether 

18 provided directly by the State or under contract with a 

19 public or private agency responsible for finding, placing, 

20 or monitoring the placement of children in foster family 

21 homes). 

Æ 


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