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) in-
troduced the following bill; which was referred to the Committee on En-
ergy 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Quality Foster Care 
Services Act of 2014’’. 
SEC. 2. INCLUSION OF THERAPEUTIC FOSTER CARE AS 
MEDICAL ASSISTANCE. 
(a) IN GENERAL.—Section 1905 of the Social Secu-
rity Act (42 U.S.C. 1396d) is amended— 
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(1) in subsection (a)— 
(A) in paragraph (28), by striking ‘‘and’’ 
at the end; 
(B) by redesignating paragraph (29) as 
paragraph (30); and 
(C) by inserting after paragraph (28) the 
following new paragraph: 
‘‘(29) therapeutic foster care services described 
in subsection (ee); and’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(ee)(1) For purposes of subsection (a)(29), subject 
to subparagraph (C), therapeutic foster care services de-
scribed in this subsection are services provided for children 
who have not attained age 21, and who, as a result of 
mental illness, other emotional or behavioral disorders, 
medically fragile conditions, or developmental disabilities, 
need the level of care provided in an institution (including 
a psychiatric residential treatment facility) or nursing fa-
cility the cost of which could be reimbursed under the 
State plan but who can be cared for or maintained in a 
community placement, through a qualified therapeutic fos-
ter care program described in paragraph (2). 
‘‘(2) A qualified therapeutic foster care program de-
scribed in this paragraph is a program that— 
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‘‘(A) is licensed by the State and accredited by 
the Joint Commission on Accreditation of Health-
care Organizations, the Commission on Accreditation 
of Rehabilitation Facilities, the Council on Accredi-
tation, or by another equivalent accreditation agency 
(or agencies) as the Secretary may recognize; 
‘‘(B) provides structured daily activities, includ-
ing the development, improvement, monitoring, and 
reinforcing of age-appropriate social, communication 
and behavioral skills, trauma-informed and gender- 
responsive services, crisis intervention and crisis sup-
port services, medication monitoring, counseling, and 
case management, and may furnish other intensive 
community services; and 
‘‘(C) provides foster care parents with special-
ized training and consultation in the management of 
children with mental illness, trauma, other emotional 
or behavioral disorders, medically fragile conditions, 
or developmental disabilities, and specific additional 
training on the needs of each child provided such 
services. 
‘‘(3) In making coverage determinations under para-
graph (1), a State may employ medical necessity criteria 
that are similar to the medical necessity criteria applied 
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to coverage determinations for other services and supports 
under this title. 
‘‘(4) The services described in this subsection do not 
include the training referred to in paragraph (2)(C).’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply to calendar quarters beginning 
on or after the date of enactment of this Act. 
Æ 
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