II 

114TH CONGRESS 

1ST SESSION S. 429 

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 10, 2015 

Ms. BALDWIN (for herself, Mr. PORTMAN, Ms. STABENOW, Mr. CASEY, and 

Mr. BROWN) 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 ‘‘Family-Based Foster 

5 Care Services Act’’. 

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 (to the 

9 extent allowed and as defined in subsection (ee)); 

10 and’’; and 

11 (2) by adding at the end the following new sub12 section: 

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

14 to the succeeding paragraphs of this subsection, the term 

15 ‘therapeutic foster care services’ means services provided 

16 for children who have not attained age 21, and who, as 

17 a result of mental illness, other emotional or behavioral 

18 disorders, medically fragile conditions, or developmental 

19 disabilities, need the level of care provided in an institution 

20 (including a psychiatric residential treatment facility) or 

21 nursing facility the cost of which could be reimbursed 

22 under the State plan but who can be cared for or main23 tained in a community placement, through a qualified 

24 therapeutic foster care program described in paragraph 

25 (2). 


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1 ‘‘(2) A qualified therapeutic foster care program de2 scribed in this paragraph is a program that— 

3 ‘‘(A) not later than 3 years after the date of en4 actment of this subsection, is licensed by the State 

5 and accredited by the Joint Commission on Accredi6 tation of Healthcare Organizations, the Commission 

7 on Accreditation of Rehabilitation Facilities, the 

8 Council on Accreditation, or by another equivalent 

9 accreditation agency (or agencies) as the Secretary 

10 may recognize; 

11 ‘‘(B) provides structured daily activities, includ12 ing the development, improvement, monitoring, and 

13 reinforcement of age-appropriate social, communica14 tion and behavioral skills, trauma-informed and gen15 der-responsive services, crisis intervention and crisis 

16 support services, medication monitoring, counseling, 

17 and case management, and may furnish other inten18 sive community services; and 

19 ‘‘(C) provides biological parents, kinship care20 givers, and foster care parents with specialized train21 ing and consultation in the management of children 

22 with mental illness, other emotional or behavioral 

23 disorders, medically fragile conditions, developmental 

24 disabilities, the impact of trauma on child and careVerDate Sep 11 2014 00:14 Feb 18, 2015 Jkt 049200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S429.IS S429

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1 giver, and specific additional training on the needs 

2 of each child provided such services. 

3 ‘‘(3) In making coverage determinations in accord4 ance with paragraph (1), a State may employ medical ne5 cessity criteria that are similar to the medical necessity 

6 criteria applied to coverage determinations for other serv7 ices and supports under this title. 

8 ‘‘(4) For purposes of subsection (a)(29) and this sub9 section, therapeutic foster care services shall not include 

10 reimbursement for any training referred to in paragraph 

11 (2)(C).’’. 

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

13 subsection (a) shall apply to medical assistance furnished 

14 in calendar quarters beginning on or after the date of en15 actment of this Act. 

Æ 


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