357 
orous quasi-experimental research 
design); and 
‘‘(cc) was carried out in a 
usual care or practice setting; and 
‘‘(II) the study described in sub-
clause (I) established that the practice 
has a sustained effect (when compared 
to a control group) for at least 6 
months beyond the end of the treat-
ment. 
‘‘(v) WELL-SUPPORTED PRACTICE.—A 
practice shall be considered to be a ‘well- 
supported practice’ if— 
‘‘(I) the practice is superior to an 
appropriate comparison practice using 
conventional standards of statistical 
significance (in terms of demonstrated 
meaningful improvements in validated 
measures of important child and par-
ent outcomes, such as mental health, 
substance abuse, and child safety and 
well-being), as established by the re-
sults or outcomes of at least two studies 
that—
358 
‘‘(aa) were rated by an inde-
pendent systematic review for the 
quality of the study design and 
execution and determined to be 
well-designed and well-executed; 
‘‘(bb) were rigorous random- 
controlled trials (or, if not avail-
able, studies using a rigorous 
quasi-experimental research de-
sign); and 
‘‘(cc) were carried out in a 
usual care or practice setting; and 
‘‘(II) at least one of the studies de-
scribed in subclause (I) established that 
the practice has a sustained effect 
(when compared to a control group) for 
at least 1 year beyond the end of treat-
ment. 
‘‘(D) GUIDANCE
ON
PRACTICES
CRITERIA 
AND PRE-APPROVED SERVICES AND PROGRAMS.— 
‘‘(i) IN GENERAL.—Not later than Oc-
tober 1, 2018, the Secretary shall issue guid-
ance to States regarding the practices cri-
teria required for services or programs to 
satisfy the requirements of subparagraph
359 
(C). The guidance shall include a pre-ap-
proved list of services and programs that 
satisfy the requirements. 
‘‘(ii) UPDATES.—The Secretary shall 
issue updates to the guidance required by 
clause (i) as often as the Secretary deter-
mines necessary. 
‘‘(E) OUTCOME ASSESSMENT AND REPORT-
ING.—The State shall collect and report to the 
Secretary the following information with respect 
to each child for whom, or on whose behalf men-
tal health and substance abuse prevention and 
treatment services or in-home parent skill-based 
programs are provided during a 12-month pe-
riod beginning on the date the child is deter-
mined by the State to be a child described in 
paragraph (2): 
‘‘(i) The specific services or programs 
provided and the total expenditures for each 
of the services or programs. 
‘‘(ii) The duration of the services or 
programs provided. 
‘‘(iii) In the case of a child described 
in paragraph (2)(A), the child’s placement 
status at the beginning, and at the end, of
360 
the 1-year period, respectively, and whether 
the child entered foster care within 2 years 
after being determined a candidate for fos-
ter care. 
‘‘(5) STATE PLAN COMPONENT.— 
‘‘(A) IN GENERAL.—A State electing to pro-
vide services or programs specified in paragraph 
(1) shall submit as part of the State plan re-
quired by subsection (a) a prevention services 
and programs plan component that meets the re-
quirements of subparagraph (B). 
‘‘(B) PREVENTION
SERVICES
AND
PRO-
GRAMS PLAN COMPONENT.—In order to meet the 
requirements of this subparagraph, a prevention 
services and programs plan component, with re-
spect to each 5-year period for which the plan 
component is in operation in the State, shall in-
clude the following: 
‘‘(i) How providing services and pro-
grams specified in paragraph (1) is ex-
pected to improve specific outcomes for chil-
dren and families. 
‘‘(ii) How the State will monitor and 
oversee the safety of children who receive 
services and programs specified in para-
361 
graph (1), including through periodic risk 
assessments throughout the period in which 
the services and programs are provided on 
behalf of a child and reexamination of the 
prevention plan maintained for the child 
under paragraph (4) for the provision of the 
services or programs if the State determines 
the risk of the child entering foster care re-
mains high despite the provision of the serv-
ices or programs. 
‘‘(iii) With respect to the services and 
programs specified in subparagraphs (A) 
and (B) of paragraph (1), information on 
the specific promising, supported, or well- 
supported practices the State plans to use to 
provide the services or programs, including 
a description of— 
‘‘(I) the services or programs and 
whether the practices used are prom-
ising, supported, or well-supported; 
‘‘(II) how the State plans to im-
plement the services or programs, in-
cluding how implementation of the 
services or programs will be continu-
ously monitored to ensure fidelity to
362 
the practice model and to determine 
outcomes achieved and how informa-
tion learned from the monitoring will 
be used to refine and improve prac-
tices; 
‘‘(III) how the State selected the 
services or programs; 
‘‘(IV) the target population for the 
services or programs; and 
‘‘(V) how each service or program 
provided will be evaluated through a 
well-designed and rigorous process, 
which may consist of an ongoing, 
cross-site evaluation approved by the 
Secretary. 
‘‘(iv) A description of the consultation 
that the State agencies responsible for ad-
ministering the State plans under this part 
and part B engage in with other State 
agencies 
responsible 
for 
administering 
health programs, including mental health 
and substance abuse prevention and treat-
ment services, and with other public and 
private agencies with experience in admin-
istering child and family services, including
363 
community-based organizations, in order to 
foster a continuum of care for children de-
scribed in paragraph (2) and their parents 
or kin caregivers. 
‘‘(v) A description of how the State 
shall assess children and their parents or 
kin caregivers to determine eligibility for 
services or programs specified in paragraph 
(1). 
‘‘(vi) A description of how the services 
or programs specified in paragraph (1) that 
are provided for or on behalf of a child and 
the parents or kin caregivers of the child 
will be coordinated with other child and 
family services provided to the child and the 
parents or kin caregivers of the child under 
the State plans in effect under subparts 1 
and 2 of part B. 
‘‘(vii) Descriptions of steps the State is 
taking to support and enhance a competent, 
skilled, and professional child welfare work-
force to deliver trauma-informed and evi-
dence-based services, including— 
‘‘(I) ensuring that staff is quali-
fied to provide services or programs
364 
that are consistent with the promising, 
supported, or well-supported practice 
models selected; and 
‘‘(II) developing appropriate pre-
vention plans, and conducting the risk 
assessments required under clause (iii). 
‘‘(viii) A description of how the State 
will provide training and support for case-
workers in assessing what children and 
their families need, connecting to the fami-
lies served, knowing how to access and de-
liver the needed trauma-informed and evi-
dence-based services, and overseeing and 
evaluating the continuing appropriateness 
of the services. 
‘‘(ix) A description of how caseload size 
and type for prevention caseworkers will be 
determined, managed, and overseen. 
‘‘(x) An assurance that the State will 
report to the Secretary such information 
and data as the Secretary may require with 
respect to the provision of services and pro-
grams specified in paragraph (1), including 
information and data necessary to deter-
mine the performance measures for the
365 
State under paragraph (6) and compliance 
with paragraph (7). 
‘‘(C) 
REIMBURSEMENT
FOR
SERVICES 
UNDER THE PREVENTION PLAN COMPONENT.— 
‘‘(i) LIMITATION.—Except as provided 
in subclause (ii), a State may not receive a 
Federal payment under this part for a 
given promising, supported, or well-sup-
ported practice unless (in accordance with 
subparagraph (B)(iii)(V)) the plan includes 
a well-designed and rigorous evaluation 
strategy for that practice. 
‘‘(ii) WAIVER
OF
LIMITATION.—The 
Secretary may waive the requirement for a 
well-designed and rigorous evaluation of 
any well-supported practice if the Secretary 
deems the evidence of the effectiveness of the 
practice to be compelling and the State 
meets the continuous quality improvement 
requirements included in subparagraph 
(B)(iii)(II) with regard to the practice. 
‘‘(6) PREVENTION SERVICES MEASURES.— 
‘‘(A) ESTABLISHMENT; ANNUAL UPDATES.— 
Beginning with fiscal year 2021, and annually 
thereafter, the Secretary shall establish the fol-
366 
lowing prevention services measures based on in-
formation and data reported by States that elect 
to provide services and programs specified in 
paragraph (1): 
‘‘(i) PERCENTAGE OF CANDIDATES FOR 
FOSTER CARE WHO DO NOT ENTER FOSTER 
CARE.—The percentage of candidates for 
foster care for whom, or on whose behalf, the 
services or programs are provided who do 
not enter foster care, including those placed 
with a kin caregiver outside of foster care, 
during the 12-month period in which the 
services or programs are provided and 
through the end of the succeeding 12-month 
period. 
‘‘(ii) PER-CHILD SPENDING.—The total 
amount of expenditures made for mental 
health and substance abuse prevention and 
treatment services or in-home parent skill- 
based programs, respectively, for, or on be-
half of, each child described in paragraph 
(2). 
‘‘(B) DATA.—The Secretary shall establish 
and annually update the prevention services 
measures—
367 
‘‘(i) based on the median State values 
of the information reported under each 
clause of subparagraph (A) for the 3 then 
most recent years; and 
‘‘(ii) taking into account State dif-
ferences in the price levels of consumption 
goods and services using the most recent re-
gional price parities published by the Bu-
reau of Economic Analysis of the Depart-
ment of Commerce or such other data as the 
Secretary determines appropriate. 
‘‘(C) PUBLICATION OF STATE PREVENTION 
SERVICES MEASURES.—The Secretary shall an-
nually make available to the public the preven-
tion services measures of each State. 
‘‘(7) MAINTENANCE OF EFFORT FOR STATE FOS-
TER CARE PREVENTION EXPENDITURES.— 
‘‘(A) IN GENERAL.—If a State elects to pro-
vide services and programs specified in para-
graph (1) for a fiscal year, the State foster care 
prevention expenditures for the fiscal year shall 
not be less than the amount of the expenditures 
for fiscal year 2014 (or, at the option of a State 
described in subparagraph (E), fiscal year 2015 
or fiscal year 2016 (whichever the State elects)).
368 
‘‘(B) STATE FOSTER CARE PREVENTION EX-
PENDITURES.—The term ‘State foster care pre-
vention expenditures’ means the following: 
‘‘(i) TANF; IV–B; SSBG.—State ex-
penditures for foster care prevention services 
and activities under the State program 
funded under part A (including from 
amounts made available by the Federal 
Government), under the State plan devel-
oped under part B (including any such 
amounts), or under the Social Services 
Block Grant Programs under subtitle A of 
title XX (including any such amounts). 
‘‘(ii) OTHER STATE PROGRAMS.—State 
expenditures for foster care prevention serv-
ices and activities under any State program 
that is not described in clause (i) (other 
than any State expenditures for foster care 
prevention services and activities under the 
State program under this part (including 
under a waiver of the program)). 
‘‘(C) STATE
EXPENDITURES.—The term 
‘State expenditures’ means all State or local 
funds that are expended by the State or a local 
agency including State or local funds that are
369 
matched or reimbursed by the Federal Govern-
ment and State or local funds that are not 
matched or reimbursed by the Federal Govern-
ment. 
‘‘(D) 
DETERMINATION
OF
PREVENTION 
SERVICES AND ACTIVITIES.—The Secretary shall 
require each State that elects to provide services 
and programs specified in paragraph (1) to re-
port the expenditures specified in subparagraph 
(B) for fiscal year 2014 and for such fiscal years 
thereafter as are necessary to determine whether 
the State is complying with the maintenance of 
effort requirement in subparagraph (A). The Sec-
retary shall specify the specific services and ac-
tivities under each program referred to in sub-
paragraph (B) that are ‘prevention services and 
activities’ for purposes of the reports. 
‘‘(E) STATE DESCRIBED.—For purposes of 
subparagraph (A), a State is described in this 
subparagraph if the population of children in the 
State in 2014 was less than 200,000 (as deter-
mined by the Bureau of the Census). 
‘‘(8) PROHIBITION AGAINST USE OF STATE FOS-
TER CARE PREVENTION EXPENDITURES AND FEDERAL 
IV–E PREVENTION FUNDS FOR MATCHING OR EXPEND-
371 
services or programs under this subsection are 
provided for more than 6 months while in the 
home of a kin caregiver, and who would satisfy 
the AFDC eligibility requirement of section 
472(a)(3)(A)(ii)(II) but for residing in the home 
of the caregiver for more than 6 months, is 
deemed to satisfy that requirement for purposes 
of determining whether the child is eligible for 
foster care maintenance payments under section 
472.’’. 
(b) DEFINITION.—Section 475 of such Act (42 U.S.C. 
675) is amended by adding at the end the following: 
‘‘(13) The term ‘child who is a candidate for fos-
ter care’ means, a child who is identified in a preven-
tion plan under section 471(e)(4)(A) as being at im-
minent risk of entering foster care (without regard to 
whether the child would be eligible for foster care 
maintenance payments under section 472 or is or 
would be eligible for adoption assistance or kinship 
guardianship assistance payments under section 473) 
but who can remain safely in the child’s home or in 
a kinship placement as long as services or programs 
specified in section 471(e)(1) that are necessary to 
prevent the entry of the child into foster care are pro-
vided. The term includes a child whose adoption or
372 
guardianship arrangement is at risk of a disruption 
or dissolution that would result in a foster care place-
ment.’’. 
(c) PAYMENTS UNDER TITLE IV–E.—Section 474(a) 
of such Act (42 U.S.C. 674(a)) is amended— 
(1) in paragraph (5), by striking the period at 
the end and inserting ‘‘; plus’’; and 
(2) by adding at the end the following: 
‘‘(6) subject to section 471(e)— 
‘‘(A) for each quarter— 
‘‘(i) subject to clause (ii)— 
‘‘(I) beginning after September 
30, 2019, and before October 1, 2026, 
an amount equal to 50 percent of the 
total amount expended during the 
quarter for the provision of services or 
programs specified in subparagraph 
(A) or (B) of section 471(e)(1) that are 
provided in accordance with prom-
ising, supported, or well-supported 
practices that meet the applicable cri-
teria specified for the practices in sec-
tion 471(e)(4)(C); and 
‘‘(II) beginning after September 
30, 2026, an amount equal to the Fed-
373 
eral 
medical 
assistance 
percentage 
(which shall be as defined in section 
1905(b), in the case of a State other 
than the District of Columbia, or 70 
percent, in the case of the District of 
Columbia) of the total amount ex-
pended during the quarter for the pro-
vision of services or programs specified 
in subparagraph (A) or (B) of section 
471(e)(1) that are provided in accord-
ance with promising, supported, or 
well-supported practices that meet the 
applicable criteria specified for the 
practices in section 471(e)(4)(C) (or, 
with respect to the payments made 
during the quarter under a cooperative 
agreement or contract entered into by 
the State and an Indian tribe, tribal 
organization, or tribal consortium for 
the administration or payment of 
funds under this part, an amount 
equal to the Federal medical assistance 
percentage that would apply under sec-
tion 479B(d) (in this paragraph re-
ferred to as the ‘tribal FMAP’) if the
374 
Indian tribe, tribal organization, or 
tribal consortium made the payments 
under a program operated under that 
section, unless the tribal FMAP is less 
than the Federal medical assistance 
percentage that applies to the State); 
except that 
‘‘(ii) not less than 50 percent of the 
total amount expended by a State under 
clause (i) for a fiscal year shall be for the 
provision of services or programs specified 
in subparagraph (A) or (B) of section 
471(e)(1) that are provided in accordance 
with well-supported practices; plus 
‘‘(B) for each quarter specified in subpara-
graph (A), an amount equal to the sum of the 
following proportions of the total amount ex-
pended during the quarter— 
‘‘(i) 50 percent of so much of the ex-
penditures as are found necessary by the 
Secretary for the proper and efficient ad-
ministration of the State plan for the provi-
sion of services or programs specified in sec-
tion 471(e)(1), including expenditures for 
activities approved by the Secretary that
375 
promote the development of necessary proc-
esses and procedures to establish and imple-
ment the provision of the services and pro-
grams for individuals who are eligible for 
the services and programs and expenditures 
attributable to data collection and report-
ing; and 
‘‘(ii) 50 percent of so much of the ex-
penditures with respect to the provision of 
services and programs specified in section 
471(e)(1) as are for training of personnel 
employed or preparing for employment by 
the State agency or by the local agency ad-
ministering the plan in the political sub-
division and of the members of the staff of 
State-licensed or State-approved child wel-
fare agencies providing services to children 
described in section 471(e)(2) and their par-
ents or kin caregivers, including on how to 
determine who are individuals eligible for 
the services or programs, how to identify 
and provide appropriate services and pro-
grams, and how to oversee and evaluate the 
ongoing appropriateness of the services and 
programs.’’.
376 
(d) TECHNICAL ASSISTANCE AND BEST PRACTICES, 
CLEARINGHOUSE, AND DATA COLLECTION AND EVALUA-
TIONS.—Section 476 of such Act (42 U.S.C. 676) is amend-
ed by adding at the end the following: 
‘‘(d) TECHNICAL ASSISTANCE AND BEST PRACTICES, 
CLEARINGHOUSE, DATA COLLECTION, AND EVALUATIONS 
RELATING TO PREVENTION SERVICES AND PROGRAMS.— 
‘‘(1) TECHNICAL ASSISTANCE AND BEST PRAC-
TICES.—The Secretary shall provide to States and, as 
applicable, to Indian tribes, tribal organizations, and 
tribal consortia, technical assistance regarding the 
provision of services and programs described in sec-
tion 471(e)(1) and shall disseminate best practices 
with respect to the provision of the services and pro-
grams, including how to plan and implement a well- 
designed and rigorous evaluation of a promising, sup-
ported, or well-supported practice. 
‘‘(2) CLEARINGHOUSE
OF
PROMISING, 
SUP-
PORTED, 
AND
WELL-SUPPORTED
PRACTICES.—The 
Secretary shall, directly or through grants, contracts, 
or interagency agreements, evaluate research on the 
practices specified in clauses (iii), (iv), and (v), re-
spectively, of section 471(e)(4)(C), and programs that 
meet the requirements described in section 427(a)(1), 
including culturally specific, or location- or popu-
377 
lation-based adaptations of the practices, to identify 
and establish a public clearinghouse of the practices 
that satisfy each category described by such clauses. 
In addition, the clearinghouse shall include informa-
tion on the specific outcomes associated with each 
practice, including whether the practice has been 
shown to prevent child abuse and neglect and reduce 
the likelihood of foster care placement by supporting 
birth families and kinship families and improving 
targeted supports for pregnant and parenting youth 
and their children. 
‘‘(3) DATA COLLECTION AND EVALUATIONS.—The 
Secretary, directly or through grants, contracts, or 
interagency agreements, may collect data and conduct 
evaluations with respect to the provision of services 
and programs described in section 471(e)(1) for pur-
poses of assessing the extent to which the provision of 
the services and programs— 
‘‘(A) reduces the likelihood of foster care 
placement; 
‘‘(B) increases use of kinship care arrange-
ments; or 
‘‘(C) improves child well-being. 
‘‘(4) REPORTS TO CONGRESS.—
378 
‘‘(A) IN
GENERAL.—The Secretary shall 
submit to the Committee on Finance of the Sen-
ate and the Committee on Ways and Means of 
the House of Representatives periodic reports 
based on the provision of services and programs 
described in section 471(e)(1) and the activities 
carried out under this subsection. 
‘‘(B) PUBLIC AVAILABILITY.—The Secretary 
shall make the reports to the Congress submitted 
under this paragraph publicly available. 
‘‘(5) APPROPRIATION.—Out of any money in the 
Treasury of the United States not otherwise appro-
priated, there are appropriated to the Secretary 
$1,000,000 for fiscal year 2018 and each fiscal year 
thereafter to carry out this subsection.’’. 
(e) APPLICATION TO PROGRAMS OPERATED BY INDIAN 
TRIBAL ORGANIZATIONS.— 
(1) IN GENERAL.—Section 479B of such Act (42 
U.S.C. 679c) is amended— 
(A) in subsection (c)(1)— 
(i) in subparagraph (C)(i)— 
(I) in subclause (II), by striking 
‘‘and’’ after the semicolon;
379 
(II) in subclause (III), by striking 
the period at the end and inserting ‘‘; 
and’’; and 
(III) by adding at the end the fol-
lowing: 
‘‘(IV) at the option of the tribe, 
organization, or consortium, services 
and programs specified in section 
471(e)(1) to children described in sec-
tion 471(e)(2) and their parents or kin 
caregivers, in accordance with section 
471(e) and subparagraph (E).’’; and 
(ii) by adding at the end the following: 
‘‘(E) PREVENTION
SERVICES
AND
PRO-
GRAMS FOR CHILDREN AND THEIR PARENTS AND 
KIN CAREGIVERS.— 
‘‘(i) IN GENERAL.—In the case of a 
tribe, organization, or consortium that 
elects to provide services and programs spec-
ified in section 471(e)(1) to children de-
scribed in section 471(e)(2) and their par-
ents or kin caregivers under the plan, the 
Secretary shall specify the requirements ap-
plicable to the provision of the services and 
programs. The requirements shall, to the
380 
greatest extent practicable, be consistent 
with the requirements applicable to States 
under section 471(e) and shall permit the 
provision of the services and programs in 
the form of services and programs that are 
adapted to the culture and context of the 
tribal communities served. 
‘‘(ii) PERFORMANCE MEASURES.—The 
Secretary shall establish specific perform-
ance measures for each tribe, organization, 
or consortium that elects to provide services 
and programs specified in section 471(e)(1). 
The performance measures shall, to the 
greatest extent practicable, be consistent 
with the prevention services measures re-
quired for States under section 471(e)(6) 
but shall allow for consideration of factors 
unique to the provision of the services by 
tribes, organizations, or consortia.’’; and 
(B) in subsection (d)(1), by striking ‘‘and 
(5)’’ and inserting ‘‘(5), and (6)(A)’’. 
(2) CONFORMING AMENDMENT.—The heading for 
subsection (d) of section 479B of such Act (42 U.S.C. 
679c) is amended by striking ‘‘FOR FOSTER CARE
381 
MAINTENANCE
AND
ADOPTION
ASSISTANCE
PAY-
MENTS’’. 
(f) APPLICATION TO PROGRAMS OPERATED BY TERRI-
TORIES.—Section 1108(a)(2) of the Social Security Act (42 
U.S.C. 1308(a)(2)) is amended by striking ‘‘or 413(f)’’ and 
inserting ‘‘413(f), or 474(a)(6)’’. 
SEC. 2622. FOSTER CARE MAINTENANCE PAYMENTS FOR 
CHILDREN WITH PARENTS IN A LICENSED 
RESIDENTIAL FAMILY-BASED TREATMENT FA-
CILITY FOR SUBSTANCE ABUSE. 
(a) IN GENERAL.—Section 472 of the Social Security 
Act (42 U.S.C. 672) is amended— 
(1) in subsection (a)(2)(C), by striking ‘‘or’’ and 
inserting ‘‘, with a parent residing in a licensed resi-
dential family-based treatment facility, but only to 
the extent permitted under subsection (j), or in a’’; 
and 
(2) by adding at the end the following: 
‘‘(j) CHILDREN PLACED WITH A PARENT RESIDING IN 
A LICENSED RESIDENTIAL FAMILY-BASED TREATMENT FA-
CILITY FOR SUBSTANCE ABUSE.— 
‘‘(1) IN
GENERAL.—Notwithstanding the pre-
ceding provisions of this section, a child who is eligi-
ble for foster care maintenance payments under this 
section, or who would be eligible for the payments if
382 
the eligibility were determined without regard to 
paragraphs (1)(B) and (3) of subsection (a), shall be 
eligible for the payments for a period of not more 
than 12 months during which the child is placed with 
a parent who is in a licensed residential family-based 
treatment facility for substance abuse, but only if— 
‘‘(A) the recommendation for the placement 
is specified in the child’s case plan before the 
placement; 
‘‘(B) the treatment facility provides, as part 
of the treatment for substance abuse, parenting 
skills training, parent education, and individual 
and family counseling; and 
‘‘(C) the substance abuse treatment, par-
enting skills training, parent education, and in-
dividual and family counseling is provided 
under an organizational structure and treatment 
framework that involves understanding, recog-
nizing, and responding to the effects of all types 
of trauma and in accordance with recognized 
principles of a trauma-informed approach and 
trauma-specific interventions to address the con-
sequences of trauma and facilitate healing. 
‘‘(2) APPLICATION.—With respect to children for 
whom foster care maintenance payments are made
383 
under paragraph (1), only the children who satisfy 
the requirements of paragraphs (1)(B) and (3) of sub-
section (a) shall be considered to be children with re-
spect to whom foster care maintenance payments are 
made under this section for purposes of subsection (h) 
or section 473(b)(3)(B).’’. 
(b) CONFORMING AMENDMENT.—Section 474(a)(1) of 
such Act (42 U.S.C. 674(a)(1)) is amended by inserting 
‘‘subject to section 472(j),’’ before ‘‘an amount equal to the 
Federal’’ the first place it appears. 
SEC. 2623. TITLE IV–E PAYMENTS FOR EVIDENCE-BASED 
KINSHIP NAVIGATOR PROGRAMS. 
Section 474(a) of the Social Security Act (42 U.S.C. 
674(a)), as amended by section 2621(c) of this Act, is 
amended— 
(1) in paragraph (6), by striking the period at 
the end and inserting ‘‘; plus’’; and 
(2) by adding at the end the following: 
‘‘(7) an amount equal to 50 percent of the 
amounts expended by the State during the quarter as 
the Secretary determines are for kinship navigator 
programs that meet the requirements described in sec-
tion 427(a)(1) and that the Secretary determines are 
operated in accordance with promising, supported, or 
well-supported practices that meet the applicable cri-
384 
teria 
specified 
for 
the 
practices 
in 
section 
471(e)(4)(C), without regard to whether the expendi-
tures are incurred on behalf of children who are, or 
are potentially, eligible for foster care maintenance 
payments under this part.’’. 
Subchapter B—Enhanced Support Under 
Title IV–B 
SEC. 2631. ELIMINATION OF TIME LIMIT FOR FAMILY RE-
UNIFICATION SERVICES WHILE IN FOSTER 
CARE AND PERMITTING TIME-LIMITED FAM-
ILY 
REUNIFICATION 
SERVICES 
WHEN 
A 
CHILD RETURNS HOME FROM FOSTER CARE. 
(a) IN GENERAL.—Section 431(a)(7) of the Social Se-
curity Act (42 U.S.C. 629a(a)(7)) is amended— 
(1) in the paragraph heading, by striking 
‘‘TIME-LIMITED
FAMILY’’ and inserting ‘‘FAMILY’’; 
and 
(2) in subparagraph (A)— 
(A) by striking ‘‘time-limited family’’ and 
inserting ‘‘family’’; 
(B) by inserting ‘‘or a child who has been 
returned home’’ after ‘‘child care institution’’; 
and 
(C) by striking ‘‘, but only during the 15- 
month period that begins on the date that the
385 
child, pursuant to section 475(5)(F), is consid-
ered to have entered foster care’’ and inserting 
‘‘and to ensure the strength and stability of the 
reunification. In the case of a child who has been 
returned home, the services and activities shall 
only be provided during the 15-month period 
that begins on the date that the child returns 
home’’. 
(b) CONFORMING AMENDMENTS.— 
(1) Section 430 of such Act (42 U.S.C. 629) is 
amended in the matter preceding paragraph (1), by 
striking ‘‘time-limited’’. 
(2) Subsections (a)(4), (a)(5)(A), and (b)(1) of 
section 432 of such Act (42 U.S.C. 629b) are amended 
by striking ‘‘time-limited’’ each place it appears. 
SEC. 2632. REDUCING BUREAUCRACY AND UNNECESSARY 
DELAYS WHEN PLACING CHILDREN IN HOMES 
ACROSS STATE LINES. 
(a) STATE PLAN REQUIREMENT.— 
(1) IN GENERAL.—Section 471(a)(25) of the So-
cial Security Act (42 U.S.C. 671(a)(25)) is amend-
ed— 
(A) by striking ‘‘provide’’ and inserting 
‘‘provides’’; and
386 
(B) by inserting ‘‘, which, in the case of a 
State other than the Commonwealth of Puerto 
Rico, the United States Virgin Islands, Guam, 
and American Samoa, not later than October 1, 
2027, shall include the use of an electronic inter-
state case-processing system’’ before the first 
semicolon. 
(2) EXEMPTION
OF
INDIAN
TRIBES.—Section 
479B(c) of such Act (42 U.S.C. 679c(c)) is amended 
by adding at the end the following: 
‘‘(4) INAPPLICABILITY OF STATE PLAN REQUIRE-
MENT TO HAVE IN EFFECT PROCEDURES PROVIDING 
FOR THE USE OF AN ELECTRONIC INTERSTATE CASE- 
PROCESSING
SYSTEM.—The requirement in section 
471(a)(25) that a State plan provide that the State 
shall have in effect procedures providing for the use 
of an electronic interstate case-processing system shall 
not apply to an Indian tribe, tribal organization, or 
tribal consortium that elects to operate a program 
under this part.’’. 
(b) FUNDING FOR THE DEVELOPMENT OF AN ELEC-
TRONIC INTERSTATE CASE-PROCESSING SYSTEM TO EXPE-
DITE THE INTERSTATE PLACEMENT OF CHILDREN IN FOS-
TER CARE OR GUARDIANSHIP, OR FOR ADOPTION.—Section
387 
437 of such Act (42 U.S.C. 629g) is amended by adding 
at the end the following: 
‘‘(g) FUNDING FOR THE DEVELOPMENT OF AN ELEC-
TRONIC INTERSTATE CASE-PROCESSING SYSTEM TO EXPE-
DITE THE INTERSTATE PLACEMENT OF CHILDREN IN FOS-
TER CARE OR GUARDIANSHIP, OR FOR ADOPTION.— 
‘‘(1) PURPOSE.—The purpose of this subsection 
is to facilitate the development of an electronic inter-
state case-processing system for the exchange of data 
and documents to expedite the placements of children 
in foster, guardianship, or adoptive homes across 
State lines. 
‘‘(2) REQUIREMENTS.—A State that seeks fund-
ing under this subsection shall submit to the Sec-
retary the following information: 
‘‘(A) A description of the goals and out-
comes to be achieved, which goals and outcomes 
must result in— 
‘‘(i) reducing the time it takes for a 
child to be provided with a safe and appro-
priate permanent living arrangement across 
State lines; 
‘‘(ii) improving administrative proc-
esses and reducing costs in the foster care 
system; and
388 
‘‘(iii) the secure exchange of relevant 
case files and other necessary materials in 
real time, and timely communications and 
placement decisions regarding interstate 
placements of children. 
‘‘(B) A description of the activities to be 
funded in whole or in part with the funds, in-
cluding the sequencing of the activities. 
‘‘(C) A description of the strategies for inte-
grating programs and services for children who 
are placed across State lines. 
‘‘(D) Such other information as the Sec-
retary may require. 
‘‘(3) FUNDING AUTHORITY.—The Secretary may 
provide funds to a State that complies with para-
graph (2). In providing funds under this subsection, 
the Secretary shall prioritize States that are not yet 
connected with the electronic interstate case-processing 
system referred to in paragraph (1). 
‘‘(4) USE OF FUNDS.—A State to which funding 
is provided under this subsection shall use the fund-
ing to support the State in connecting with, or en-
hancing or expediting services provided under, the 
electronic interstate case-processing system referred to 
in paragraph (1).
389 
‘‘(5) EVALUATIONS.—Not later than 1 year after 
the final year in which funds are awarded under this 
subsection, the Secretary shall submit to the Congress, 
and make available to the general public by posting 
on a website, a report that contains the following in-
formation: 
‘‘(A) How using the electronic interstate 
case-processing system developed pursuant to 
paragraph (4) has changed the time it takes for 
children to be placed across State lines. 
‘‘(B) The number of cases subject to the 
Interstate Compact on the Placement of Children 
that were processed through the electronic inter-
state case-processing system, and the number of 
interstate child placement cases that were proc-
essed outside the electronic interstate case-proc-
essing system, by each State in each year. 
‘‘(C) The progress made by States in imple-
menting the electronic interstate case-processing 
system. 
‘‘(D) How using the electronic interstate 
case-processing system has affected various 
metrics related to child safety and well-being, in-
cluding the time it takes for children to be placed 
across State lines.
390 
‘‘(E) How using the electronic interstate 
case-processing system has affected administra-
tive costs and caseworker time spent on placing 
children across State lines. 
‘‘(6) DATA
INTEGRATION.—The Secretary, in 
consultation with the Secretariat for the Interstate 
Compact on the Placement of Children and the States, 
shall assess how the electronic interstate case-proc-
essing system developed pursuant to paragraph (4) 
could be used to better serve and protect children that 
come to the attention of the child welfare system, by— 
‘‘(A) connecting the system with other data 
systems (such as systems operated by State law 
enforcement and judicial agencies, systems oper-
ated by the Federal Bureau of Investigation for 
the purposes of the Innocence Lost National Ini-
tiative, and other systems); 
‘‘(B) simplifying and improving reporting 
related to paragraphs (34) and (35) of section 
471(a) regarding children or youth who have 
been identified as being a sex trafficking victim 
or children missing from foster care; and 
‘‘(C) improving the ability of States to 
quickly comply with background check require-
ments of section 471(a)(20), including checks of
391 
child abuse and neglect registries as required by 
section 471(a)(20)(B).’’. 
(c) RESERVATION OF FUNDS TO IMPROVE THE INTER-
STATE PLACEMENT OF CHILDREN.—Section 437(b) of such 
Act (42 U.S.C. 629g(b)) is amended by adding at the end 
the following: 
‘‘(4) IMPROVING
THE
INTERSTATE
PLACEMENT 
OF
CHILDREN.—The 
Secretary 
shall 
reserve 
$5,000,000 of the amount made available for fiscal 
year 2018 for grants under subsection (g), and the 
amount so reserved shall remain available through 
fiscal year 2022.’’. 
SEC. 2633. ENHANCEMENTS TO GRANTS TO IMPROVE WELL- 
BEING 
OF 
FAMILIES 
AFFECTED 
BY 
SUB-
STANCE ABUSE. 
Section 437(f) of the Social Security Act (42 U.S.C. 
629g(f)) is amended— 
(1) in the subsection heading, by striking ‘‘IN-
CREASE THE WELL-BEING OF, AND TO IMPROVE THE 
PERMANENCY OUTCOMES FOR, CHILDREN AFFECTED 
BY’’ and inserting ‘‘IMPLEMENT IV–E PREVENTION 
SERVICES, AND IMPROVE THE WELL-BEING OF, AND 
IMPROVE PERMANENCY OUTCOMES FOR, CHILDREN 
AND FAMILIES AFFECTED BY HEROIN, OPIOIDS, AND 
OTHER’’;
392 
(2) by striking paragraph (2) and inserting the 
following: 
‘‘(2) REGIONAL PARTNERSHIP DEFINED.—In this 
subsection, the term ‘regional partnership’ means a 
collaborative agreement (which may be established on 
an interstate, State, or intrastate basis) entered into 
by the following: 
‘‘(A) MANDATORY PARTNERS FOR ALL PART-
NERSHIP GRANTS.— 
‘‘(i) The State child welfare agency 
that is responsible for the administration of 
the State plan under this part and part E. 
‘‘(ii) The State agency responsible for 
administering the substance abuse preven-
tion and treatment block grant provided 
under subpart II of part B of title XIX of 
the Public Health Service Act. 
‘‘(B) MANDATORY PARTNERS FOR PARTNER-
SHIP GRANTS PROPOSING TO SERVE CHILDREN 
IN OUT-OF-HOME PLACEMENTS.—If the partner-
ship proposes to serve children in out-of-home 
placements, the Juvenile Court or Administrative 
Office of the Court that is most appropriate to 
oversee the administration of court programs in 
the region to address the population of families
393 
who come to the attention of the court due to 
child abuse or neglect. 
‘‘(C) OPTIONAL PARTNERS.—At the option 
of the partnership, any of the following: 
‘‘(i) An Indian tribe or tribal consor-
tium. 
‘‘(ii) Nonprofit child welfare service 
providers. 
‘‘(iii) For-profit child welfare service 
providers. 
‘‘(iv) Community health service pro-
viders, including substance abuse treatment 
providers. 
‘‘(v) Community mental health pro-
viders. 
‘‘(vi) Local law enforcement agencies. 
‘‘(vii) School personnel. 
‘‘(viii) Tribal child welfare agencies 
(or a consortia of the agencies). 
‘‘(ix) Any other providers, agencies, 
personnel, officials, or entities that are re-
lated to the provision of child and family 
services under a State plan approved under 
this subpart.
394 
‘‘(D) EXCEPTION FOR REGIONAL PARTNER-
SHIPS WHERE THE LEAD APPLICANT IS AN IN-
DIAN TRIBE OR TRIBAL CONSORTIA.—If an In-
dian tribe or tribal consortium enters into a re-
gional partnership for purposes of this sub-
section, the Indian tribe or tribal consortium— 
‘‘(i) may (but is not required to) in-
clude the State child welfare agency as a 
partner in the collaborative agreement; 
‘‘(ii) may not enter into a collaborative 
agreement only with tribal child welfare 
agencies (or a consortium of the agencies); 
and 
‘‘(iii) if the condition described in 
paragraph (2)(B) applies, may include trib-
al court organizations in lieu of other judi-
cial partners.’’; 
(3) in paragraph (3)— 
(A) in subparagraph (A)— 
(i) by striking ‘‘2012 through 2016’’ 
and inserting ‘‘2017 through 2021’’; and 
(ii) by striking ‘‘$500,000 and not 
more 
than 
$1,000,000’’ 
and 
inserting 
‘‘$250,000 and not more than $1,000,000’’; 
(B) in subparagraph (B)—
395 
(i) in the subparagraph heading, by 
inserting ‘‘; PLANNING’’ after ‘‘APPROVAL’’; 
(ii) in clause (i), by striking ‘‘clause 
(ii)’’ and inserting ‘‘clauses (ii) and (iii)’’; 
and 
(iii) by adding at the end the fol-
lowing: 
‘‘(iii) SUFFICIENT PLANNING.—A grant 
awarded under this subsection shall be dis-
bursed in two phases: a planning phase (not 
to exceed 2 years) and an implementation 
phase. The total disbursement to a grantee 
for the planning phase may not exceed 
$250,000, and may not exceed the total an-
ticipated funding for the implementation 
phase.’’; and 
(C) by adding at the end the following: 
‘‘(D) LIMITATION ON PAYMENT FOR A FIS-
CAL YEAR.—No payment shall be made under 
subparagraph (A) or (C) for a fiscal year until 
the Secretary determines that the eligible part-
nership has made sufficient progress in meeting 
the goals of the grant and that the members of 
the eligible partnership are coordinating to a
396 
reasonable degree with the other members of the 
eligible partnership.’’; 
(4) in paragraph (4)— 
(A) in subparagraph (B)— 
(i) in clause (i), by inserting ‘‘, par-
ents, and families’’ after ‘‘children’’; 
(ii) in clause (ii), by striking ‘‘safety 
and permanence for such children; and’’ 
and inserting ‘‘safe, permanent caregiving 
relationships for the children;’’; 
(iii) in clause (iii), by striking ‘‘or’’ 
and inserting ‘‘increase reunification rates 
for children who have been placed in out-of- 
home care, or decrease’’; and 
(iv) by redesignating clause (iii) as 
clause (v) and inserting after clause (ii) the 
following: 
‘‘(iii) improve the substance abuse 
treatment outcomes for parents including 
retention in treatment and successful com-
pletion of treatment; 
‘‘(iv) facilitate the implementation, de-
livery, and effectiveness of prevention serv-
ices and programs under section 471(e); 
and’’;
397 
(B) in subparagraph (D), by striking 
‘‘where appropriate,’’; and 
(C) by striking subparagraphs (E) and (F) 
and inserting the following: 
‘‘(E) A description of a plan for sustaining 
the services provided by or activities funded 
under the grant after the conclusion of the grant 
period, including through the use of prevention 
services and programs under section 471(e) and 
other funds provided to the State for child wel-
fare and substance abuse prevention and treat-
ment services. 
‘‘(F) Additional information needed by the 
Secretary to determine that the proposed activi-
ties and implementation will be consistent with 
research or evaluations showing which practices 
and approaches are most effective.’’; 
(5) in paragraph (5)(A), by striking ‘‘abuse 
treatment’’ and inserting ‘‘use disorder treatment in-
cluding medication assisted treatment and in-home 
substance abuse disorder treatment and recovery’’; 
(6) in paragraph (7)— 
(A) by striking ‘‘and’’ at the end of sub-
paragraph (C); and
398 
(B) by redesignating subparagraph (D) as 
subparagraph (E) and inserting after subpara-
graph (C) the following: 
‘‘(D) demonstrate a track record of success-
ful collaboration among child welfare, substance 
abuse disorder treatment and mental health 
agencies; and’’; 
(7) in paragraph (8)— 
(A) in subparagraph (A)— 
(i) by striking ‘‘establish indicators 
that will be’’ and inserting ‘‘review indica-
tors that are’’; and 
(ii) by striking ‘‘in using funds made 
available under such grants to achieve the 
purpose of this subsection’’ and inserting 
‘‘and establish a set of core indicators re-
lated to child safety, parental recovery, par-
enting capacity, and family well-being. In 
developing the core indicators, to the extent 
possible, indicators shall be made consistent 
with the outcome measures described in sec-
tion 471(e)(6)’’; and 
(B) in subparagraph (B)— 
(i) in the matter preceding clause (i), 
by inserting ‘‘base the performance meas-
399 
ures on lessons learned from prior rounds of 
regional partnership grants under this sub-
section, and’’ before ‘‘consult’’; and 
(ii) by striking clauses (iii) and (iv) 
and inserting the following: 
‘‘(iii) Other stakeholders or constitu-
encies as determined by the Secretary.’’; 
(8) in paragraph (9)(A), by striking clause (i) 
and inserting the following: 
‘‘(i) SEMIANNUAL REPORTS.—Not later 
than September 30 of each fiscal year in 
which a recipient of a grant under this sub-
section is paid funds under the grant, and 
every 6 months thereafter, the grant recipi-
ent shall submit to the Secretary a report 
on the services provided and activities car-
ried out during the reporting period, 
progress made in achieving the goals of the 
program, the number of children, adults, 
and families receiving services, and such 
additional information as the Secretary de-
termines is necessary. The report due not 
later than September 30 of the last such fis-
cal year shall include, at a minimum, data 
on each of the performance indicators in-
400 
cluded in the evaluation of the regional 
partnership.’’; and 
(9) in paragraph (10), by striking ‘‘2012 
through 2016’’ and inserting ‘‘2017 through 2021’’. 
Subchapter C—Miscellaneous 
SEC. 2641. REVIEWING AND IMPROVING LICENSING STAND-
ARDS FOR PLACEMENT IN A RELATIVE FOS-
TER FAMILY HOME. 
(a) IDENTIFICATION OF REPUTABLE MODEL LICENS-
ING STANDARDS.—Not later than October 1, 2018, the Sec-
retary of Health and Human Services shall identify rep-
utable model licensing standards with respect to the licens-
ing of foster family homes (as defined in section 472(c)(1) 
of the Social Security Act). 
(b) STATE PLAN REQUIREMENT.—Section 471(a) of 
the Social Security Act (42 U.S.C. 671(a)) is amended— 
(1) in paragraph (34)(B), by striking ‘‘and’’ 
after the semicolon; 
(2) in paragraph (35)(B), by striking the period 
at the end and inserting a semicolon; and 
(3) by adding at the end the following: 
‘‘(36) provides that, not later than April 1, 2019, 
the State shall submit to the Secretary information 
addressing—
401 
‘‘(A) whether the State licensing standards 
are in accord with model standards identified by 
the Secretary, and if not, the reason for the spe-
cific deviation and a description as to why hav-
ing a standard that is reasonably in accord with 
the corresponding national model standards is 
not appropriate for the State; 
‘‘(B) whether the State has elected to waive 
standards established in 471(a)(10)(A) for rel-
ative foster family homes (pursuant to waiver 
authority provided by 471(a)(10)(D)), a descrip-
tion of which standards the State most com-
monly waives, and if the State has not elected to 
waive the standards, the reason for not waiving 
these standards; 
‘‘(C) if the State has elected to waive stand-
ards specified in subparagraph (B), how case-
workers are trained to use the waiver authority 
and whether the State has developed a process or 
provided tools to assist caseworkers in waiving 
nonsafety standards per the authority provided 
in 471(a)(10)(D) to quickly place children with 
relatives; and
402 
‘‘(D) a description of the steps the State is 
taking to improve caseworker training or the 
process, if any; and’’. 
SEC. 2642. DEVELOPMENT OF A STATEWIDE PLAN TO PRE-
VENT CHILD ABUSE AND NEGLECT FATALI-
TIES. 
Section 422(b)(19) of the Social Security Act (42 
U.S.C. 622(b)(19)) is amended to read as follows: 
‘‘(19) document steps taken to track and prevent 
child maltreatment deaths by including— 
‘‘(A) a description of the steps the State is 
taking to compile complete and accurate infor-
mation on the deaths required by Federal law to 
be reported by the State agency referred to in 
paragraph (1), including gathering relevant in-
formation on the deaths from the relevant orga-
nizations in the State including entities such as 
State vital statistics department, child death re-
view teams, law enforcement agencies, offices of 
medical examiners, or coroners; and 
‘‘(B) a description of the steps the State is 
taking to develop and implement a comprehen-
sive, statewide plan to prevent the fatalities that 
involves and engages relevant public and private
403 
agency partners, including those in public 
health, law enforcement, and the courts.’’. 
SEC. 2643. MODERNIZING THE TITLE AND PURPOSE OF 
TITLE IV–E. 
(a) PART HEADING.—The heading for part E of title 
IV of the Social Security Act (42 U.S.C. 670 et seq.) is 
amended to read as follows: 
‘‘PART E—FEDERAL PAYMENTS FOR FOSTER 
CARE, PREVENTION, AND PERMANENCY’’. 
(b) PURPOSE.—The first sentence of section 470 of 
such Act (42 U.S.C. 670) is amended— 
(1) by striking ‘‘1995) and’’ and inserting 
‘‘1995),’’; 
(2) by inserting ‘‘kinship guardianship assist-
ance, and prevention services or programs specified in 
section 471(e)(1),’’ after ‘‘needs,’’; and 
(3) by striking ‘‘(commencing with the fiscal 
year which begins October 1, 1980)’’. 
SEC. 2644. EFFECTIVE DATES. 
(a) EFFECTIVE DATES.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), subject to subsection (b), the amendments 
made by this chapter shall take effect on October 1, 
2018.
404 
(2) EXCEPTIONS.—The amendments made by 
sections 2621(d), 2641, and 2643 shall take effect on 
the date of enactment of this Act. 
(b) TRANSITION RULE.— 
(1) IN GENERAL.—In the case of a State plan 
under part B or E of title IV of the Social Security 
Act which the Secretary of Health and Human Serv-
ices determines requires State legislation (other than 
legislation appropriating funds) in order for the plan 
to meet the additional requirements imposed by the 
amendments made by this chapter, the State plan 
shall not be regarded as failing to comply with the re-
quirements of such part solely on the basis of the fail-
ure of the plan to meet such additional requirements 
before the first day of the first calendar quarter begin-
ning after the close of the first regular session of the 
State legislature that begins after the date of enact-
ment of this Act. For purposes of the previous sen-
tence, in the case of a State that has a 2-year legisla-
tive session, each year of the session shall be deemed 
to be a separate regular session of the State legisla-
ture. 
(2) APPLICATION TO PROGRAMS OPERATED BY 
INDIAN TRIBAL ORGANIZATIONS.—In the case of an 
Indian tribe, tribal organization, or tribal consortium
405 
which the Secretary of Health and Human Services 
determines requires time to take action necessary to 
comply with the additional requirements imposed by 
the amendments made by this chapter (whether the 
tribe, organization, or tribal consortium has a plan 
under section 479B of the Social Security Act or a co-
operative agreement or contract entered into with a 
State), the Secretary shall provide the tribe, organiza-
tion, or tribal consortium with such additional time 
as the Secretary determines is necessary for the tribe, 
organization, or tribal consortium to take the action 
to comply with the additional requirements before 
being regarded as failing to comply with the require-
ments. 
CHAPTER 2—ENSURING THE NECESSITY 
OF A PLACEMENT THAT IS NOT IN A 
FOSTER FAMILY HOME 
SEC. 2651. LIMITATION ON FEDERAL FINANCIAL PARTICIPA-
TION FOR PLACEMENTS THAT ARE NOT IN 
FOSTER FAMILY HOMES. 
(a) LIMITATION ON FEDERAL FINANCIAL PARTICIPA-
TION.— 
(1) IN GENERAL.—Section 472 of the Social Se-
curity Act (42 U.S.C. 672), as amended by section 
2622 of this Act, is amended—
406 
(A) in subsection (a)(2)(C), by inserting ‘‘, 
but only to the extent permitted under subsection 
(k)’’ after ‘‘institution’’; and 
(B) by adding at the end the following: 
‘‘(k) LIMITATION ON FEDERAL FINANCIAL PARTICIPA-
TION.— 
‘‘(1) IN
GENERAL.—Beginning with the third 
week for which foster care maintenance payments are 
made under this section on behalf of a child placed 
in a child-care institution, no Federal payment shall 
be made to the State under section 474(a)(1) for 
amounts expended for foster care maintenance pay-
ments on behalf of the child unless— 
‘‘(A) the child is placed in a child-care in-
stitution that is a setting specified in paragraph 
(2) (or is placed in a licensed residential family- 
based treatment facility consistent with sub-
section (j)); and 
‘‘(B) in the case of a child placed in a 
qualified residential treatment program (as de-
fined in paragraph (4)), the requirements speci-
fied in paragraph (3) and section 475A(c) are 
met.
407 
‘‘(2) SPECIFIED
SETTINGS
FOR
PLACEMENT.— 
The settings for placement specified in this paragraph 
are the following: 
‘‘(A) A qualified residential treatment pro-
gram (as defined in paragraph (4)). 
‘‘(B) A setting specializing in providing 
prenatal, post-partum, or parenting supports for 
youth. 
‘‘(C) In the case of a child who has attained 
18 years of age, a supervised setting in which the 
child is living independently. 
‘‘(D) A setting providing high-quality resi-
dential care and supportive services to children 
and youth who have been found to be, or are at 
risk of becoming, sex trafficking victims, in ac-
cordance with section 471(a)(9)(C). 
‘‘(3) ASSESSMENT TO DETERMINE APPROPRIATE-
NESS OF PLACEMENT IN A QUALIFIED RESIDENTIAL 
TREATMENT PROGRAM.— 
‘‘(A) DEADLINE FOR ASSESSMENT.—In the 
case of a child who is placed in a qualified resi-
dential treatment program, if the assessment re-
quired under section 475A(c)(1) is not completed 
within 30 days after the placement is made, no 
Federal payment shall be made to the State
408 
under section 474(a)(1) for any amounts ex-
pended for foster care maintenance payments on 
behalf of the child during the placement. 
‘‘(B) DEADLINE FOR TRANSITION OUT OF 
PLACEMENT.—If the assessment required under 
section 475A(c)(1) determines that the placement 
of a child in a qualified residential treatment 
program is not appropriate, a court disapproves 
such a placement under section 475A(c)(2), or a 
child who has been in an approved placement in 
a qualified residential treatment program is 
going to return home or be placed with a fit and 
willing relative, a legal guardian, or an adoptive 
parent, or in a foster family home, Federal pay-
ments shall be made to the State under section 
474(a)(1) for amounts expended for foster care 
maintenance payments on behalf of the child 
while the child remains in the qualified residen-
tial treatment program only during the period 
necessary for the child to transition home or to 
such a placement. In no event shall a State re-
ceive Federal payments under section 474(a)(1) 
for amounts expended for foster care mainte-
nance payments on behalf of a child who re-
mains placed in a qualified residential treat-
409 
ment program after the end of the 30-day period 
that begins on the date a determination is made 
that the placement is no longer the recommended 
or approved placement for the child. 
‘‘(4) QUALIFIED RESIDENTIAL TREATMENT PRO-
GRAM.—For purposes of this part, the term ‘qualified 
residential treatment program’ means a program 
that— 
‘‘(A) has a trauma-informed treatment 
model that is designed to address the needs, in-
cluding clinical needs as appropriate, of children 
with serious emotional or behavioral disorders or 
disturbances and, with respect to a child, is able 
to implement the treatment identified for the 
child by the assessment of the child required 
under section 475A(c); 
‘‘(B) subject to paragraphs (5) and (6), has 
registered or licensed nursing staff and other li-
censed clinical staff who— 
‘‘(i) provide care within the scope of 
their practice as defined by State law; 
‘‘(ii) are on-site in accordance with the 
treatment model referred to in subpara-
graph (A); and
410 
‘‘(iii) are available 24 hours a day and 
7 days a week; 
‘‘(C) to extent appropriate, and in accord-
ance with the child’s best interests, facilitates 
participation of family members in the child’s 
treatment program; 
‘‘(D) facilitates outreach to the family mem-
bers of the child, including siblings, documents 
how the outreach is made (including contact in-
formation), and maintains contact information 
for any known biological family and fictive kin 
of the child; 
‘‘(E) documents how family members are 
integrated into the treatment process for the 
child, including post-discharge, and how sibling 
connections are maintained; 
‘‘(F) provides discharge planning and fam-
ily-based aftercare support for at least 6 months 
post-discharge; and 
‘‘(G) is licensed in accordance with section 
471(a)(10) and is accredited by any of the fol-
lowing independent, not-for-profit organizations: 
‘‘(i) The Commission on Accreditation 
of Rehabilitation Facilities (CARF).
411 
‘‘(ii) The Joint Commission on Accred-
itation 
of 
Healthcare 
Organizations 
(JCAHO). 
‘‘(iii) The Council on Accreditation 
(COA). 
‘‘(iv) Any other independent, not-for- 
profit accrediting organization approved by 
the Secretary. 
‘‘(5) ADMINISTRATIVE COSTS.—The prohibition 
in paragraph (1) on Federal payments under section 
474(a)(1) shall not be construed as prohibiting Fed-
eral payments for administrative expenditures in-
curred on behalf of a child placed in a child-care in-
stitution and for which payment is available under 
section 474(a)(3). 
‘‘(6) RULE
OF
CONSTRUCTION.—The require-
ments in paragraph (4)(B) shall not be construed as 
requiring a qualified residential treatment program 
to acquire nursing and behavioral health staff solely 
through means of a direct employer to employee rela-
tionship.’’. 
(2) 
CONFORMING
AMENDMENT.—Section 
474(a)(1) of such Act (42 U.S.C. 674(a)(1)), as 
amended by section 2622(b) of this Act, is amended
412 
by striking ‘‘section 472(j)’’ and inserting ‘‘sub-
sections (j) and (k) of section 472’’. 
(b) DEFINITION OF FOSTER FAMILY HOME, CHILD- 
CARE INSTITUTION.—Section 472(c) of such Act (42 U.S.C. 
672(c)(1)) is amended to read as follows: 
‘‘(c) DEFINITIONS.—For purposes of this part: 
‘‘(1) FOSTER FAMILY HOME.— 
‘‘(A) IN GENERAL.—The term ‘foster family 
home’ means the home of an individual or fam-
ily— 
‘‘(i) that is licensed or approved by the 
State in which it is situated as a foster 
family home that meets the standards estab-
lished for the licensing or approval; and 
‘‘(ii) in which a child in foster care 
has been placed in the care of an indi-
vidual, who resides with the child and who 
has been licensed or approved by the State 
to be a foster parent— 
‘‘(I) that the State deems capable 
of adhering to the reasonable and pru-
dent parent standard; 
‘‘(II) that provides 24-hour sub-
stitute care for children placed away
413 
from their parents or other caretakers; 
and 
‘‘(III) that provides the care for 
not more than six children in foster 
care. 
‘‘(B) STATE FLEXIBILITY.—The number of 
foster children that may be cared for in a home 
under subparagraph (A) may exceed the numer-
ical limitation in subparagraph (A)(ii)(III), at 
the option of the State, for any of the following 
reasons: 
‘‘(i) To allow a parenting youth in fos-
ter care to remain with the child of the par-
enting youth. 
‘‘(ii) To allow siblings to remain to-
gether. 
‘‘(iii) To allow a child with an estab-
lished meaningful relationship with the 
family to remain with the family. 
‘‘(iv) To allow a family with special 
training or skills to provide care to a child 
who has a severe disability. 
‘‘(C) RULE OF CONSTRUCTION.—Subpara-
graph (A) shall not be construed as prohibiting 
a foster parent from renting the home in which
414 
the parent cares for a foster child placed in the 
parent’s care. 
‘‘(2) CHILD-CARE INSTITUTION.— 
‘‘(A) IN GENERAL.—The term ‘child-care in-
stitution’ means a private child-care institution, 
or a public child-care institution which accom-
modates no more than 25 children, which is li-
censed by the State in which it is situated or has 
been approved by the agency of the State respon-
sible for licensing or approval of institutions of 
this type as meeting the standards established for 
the licensing. 
‘‘(B) SUPERVISED SETTINGS.—In the case 
of a child who has attained 18 years of age, the 
term shall include a supervised setting in which 
the individual is living independently, in ac-
cordance with such conditions as the Secretary 
shall establish in regulations. 
‘‘(C) EXCLUSIONS.—The term shall not in-
clude detention facilities, forestry camps, train-
ing schools, or any other facility operated pri-
marily for the detention of children who are de-
termined to be delinquent.’’. 
(c) TRAINING FOR STATE JUDGES, ATTORNEYS, AND 
OTHER LEGAL PERSONNEL IN CHILD WELFARE CASES.—
415 
Section 438(b)(1) of such Act (42 U.S.C. 629h(b)(1)) is 
amended in the matter preceding subparagraph (A) by in-
serting ‘‘shall provide for the training of judges, attorneys, 
and other legal personnel in child welfare cases on Federal 
child welfare policies and payment limitations with respect 
to children in foster care who are placed in settings that 
are not a foster family home,’’ after ‘‘with respect to the 
child,’’. 
(d) ASSURANCE OF NONIMPACT ON JUVENILE JUSTICE 
SYSTEM.— 
(1) STATE PLAN REQUIREMENT.—Section 471(a) 
of such Act (42 U.S.C. 671(a)), as amended by section 
2641 of this Act, is further amended by adding at the 
end the following: 
‘‘(37) includes a certification that, in response to 
the limitation imposed under section 472(k) with re-
spect to foster care maintenance payments made on 
behalf of any child who is placed in a setting that is 
not a foster family home, the State will not enact or 
advance policies or practices that would result in a 
significant increase in the population of youth in the 
State’s juvenile justice system.’’. 
(2) GAO STUDY AND REPORT.—The Comptroller 
General of the United States shall evaluate the im-
pact, if any, on State juvenile justice systems of the
416 
limitation imposed under section 472(k) of the Social 
Security Act (as added by subsection (a)(1) of this 
section) on foster care maintenance payments made 
on behalf of any child who is placed in a setting that 
is not a foster family home, in accordance with the 
amendments made by subsections (a) and (b) of this 
section. In particular, the Comptroller General shall 
evaluate the extent to which children in foster care 
who also are subject to the juvenile justice system of 
the State are placed in a facility under the jurisdic-
tion of the juvenile justice system and whether the 
lack of available congregate care placements under the 
jurisdiction of the child welfare systems is a contrib-
uting factor to that result. Not later than December 
31, 2024, the Comptroller General shall submit to 
Congress a report on the results of the evaluation. 
SEC. 2652. ASSESSMENT AND DOCUMENTATION OF THE 
NEED FOR PLACEMENT IN A QUALIFIED RESI-
DENTIAL TREATMENT PROGRAM. 
Section 475A of the Social Security Act (42 U.S.C. 
675a) is amended by adding at the end the following: 
‘‘(c) ASSESSMENT, DOCUMENTATION, AND JUDICIAL 
DETERMINATION REQUIREMENTS FOR PLACEMENT IN A 
QUALIFIED RESIDENTIAL TREATMENT PROGRAM.—In the 
case of any child who is placed in a qualified residential
417 
treatment program (as defined in section 472(k)(4)), the fol-
lowing requirements shall apply for purposes of approving 
the case plan for the child and the case system review proce-
dure for the child: 
‘‘(1)(A) Within 30 days of the start of each 
placement in such a setting, a qualified individual 
(as defined in subparagraph (D)) shall— 
‘‘(i) assess the strengths and needs of the 
child using an age-appropriate, evidence-based, 
validated, functional assessment tool approved by 
the Secretary; 
‘‘(ii) determine whether the needs of the 
child can be met with family members or 
through placement in a foster family home or, if 
not, which setting from among the settings speci-
fied in section 472(k)(2) would provide the most 
effective and appropriate level of care for the 
child in the least restrictive environment and be 
consistent with the short- and long-term goals for 
the child, as specified in the permanency plan 
for the child; and 
‘‘(iii) develop a list of child-specific short- 
and long-term mental and behavioral health 
goals.
418 
‘‘(B)(i) The State shall assemble a family and 
permanency team for the child in accordance with the 
requirements of clauses (ii) and (iii). The qualified 
individual conducting the assessment required under 
subparagraph (A) shall work in conjunction with the 
family of, and permanency team for, the child while 
conducting and making the assessment. 
‘‘(ii) The family and permanency team shall 
consist of all appropriate biological family members, 
relative, and fictive kin of the child, as well as, as ap-
propriate, professionals who are a resource to the 
family of the child, such as teachers, medical or men-
tal health providers who have treated the child, or 
clergy. In the case of a child who has attained age 14, 
the family and permanency team shall include the 
members of the permanency planning team for the 
child that are selected by the child in accordance with 
section 475(5)(C)(iv). 
‘‘(iii) The State shall document in the child’s 
case plan— 
‘‘(I) the reasonable and good faith effort of 
the State to identify and include all such indi-
viduals on the family of, and permanency team 
for, the child;
419 
‘‘(II) all contact information for members of 
the family and permanency team, as well as con-
tact information for other family members and 
fictive kin who are not part of the family and 
permanency team; 
‘‘(III) evidence that meetings of the family 
and permanency team, including meetings relat-
ing to the assessment required under subpara-
graph (A), are held at a time and place conven-
ient for family; 
‘‘(IV) if reunification is the goal, evidence 
demonstrating that the parent from whom the 
child was removed provided input on the mem-
bers of the family and permanency team; 
‘‘(V) evidence that the assessment required 
under subparagraph (A) is determined in con-
junction with the family and permanency team; 
‘‘(VI) the placement preferences of the fam-
ily and permanency team relative to the assess-
ment that recognizes children should be placed 
with their siblings unless there is a finding by 
the court that such placement is contrary to their 
best interest; and 
‘‘(VII) if the placement preferences of the 
family and permanency team and child are not
420 
the placement setting recommended by the quali-
fied individual conducting the assessment under 
subparagraph (A), the reasons why the pref-
erences of the team and of the child were not rec-
ommended. 
‘‘(C) In the case of a child who the qualified in-
dividual conducting the assessment under subpara-
graph (A) determines should not be placed in a foster 
family home, the qualified individual shall specify in 
writing the reasons why the needs of the child cannot 
be met by the family of the child or in a foster family 
home. A shortage or lack of foster family homes shall 
not be an acceptable reason for determining that the 
needs of the child cannot be met in a foster family 
home. The qualified individual also shall specify in 
writing why the recommended placement in a quali-
fied residential treatment program is the setting that 
will provide the child with the most effective and ap-
propriate level of care in the least restrictive environ-
ment and how that placement is consistent with the 
short- and long-term goals for the child, as specified 
in the permanency plan for the child. 
‘‘(D)(i) Subject to clause (ii), in this subsection, 
the term ‘qualified individual’ means a trained pro-
fessional or licensed clinician who is not an employee
421 
of the State agency and who is not connected to, or 
affiliated with, any placement setting in which chil-
dren are placed by the State. 
‘‘(ii) The Secretary may approve a request of a 
State to waive any requirement in clause (i) upon a 
submission by the State, in accordance with criteria 
established by the Secretary, that certifies that the 
trained professionals or licensed clinicians with re-
sponsibility for performing the assessments described 
in subparagraph (A) shall maintain objectivity with 
respect to determining the most effective and appro-
priate placement for a child. 
‘‘(2) Within 60 days of the start of each place-
ment in a qualified residential treatment program, a 
family or juvenile court or another court (including 
a tribal court) of competent jurisdiction, or an ad-
ministrative body appointed or approved by the 
court, independently, shall— 
‘‘(A) consider the assessment, determination, 
and documentation made by the qualified indi-
vidual conducting the assessment under para-
graph (1); 
‘‘(B) determine whether the needs of the 
child can be met through placement in a foster 
family home or, if not, whether placement of the
422 
child in a qualified residential treatment pro-
gram provides the most effective and appropriate 
level of care for the child in the least restrictive 
environment and whether that placement is con-
sistent with the short- and long-term goals for 
the child, as specified in the permanency plan 
for the child; and 
‘‘(C) approve or disapprove the placement. 
‘‘(3) The written documentation made under 
paragraph (1)(C) and documentation of the deter-
mination and approval or disapproval of the place-
ment in a qualified residential treatment program by 
a court or administrative body under paragraph (2) 
shall be included in and made part of the case plan 
for the child. 
‘‘(4) As long as a child remains placed in a 
qualified residential treatment program, the State 
agency shall submit evidence at each status review 
and each permanency hearing held with respect to the 
child— 
‘‘(A) demonstrating that ongoing assessment 
of the strengths and needs of the child continues 
to support the determination that the needs of 
the child cannot be met through placement in a 
foster family home, that the placement in a
423 
qualified residential treatment program provides 
the most effective and appropriate level of care 
for the child in the least restrictive environment, 
and that the placement is consistent with the 
short- and long-term goals for the child, as speci-
fied in the permanency plan for the child; 
‘‘(B) documenting the specific treatment or 
service needs that will be met for the child in the 
placement and the length of time the child is ex-
pected to need the treatment or services; and 
‘‘(C) documenting the efforts made by the 
State agency to prepare the child to return home 
or to be placed with a fit and willing relative, 
a legal guardian, or an adoptive parent, or in 
a foster family home. 
‘‘(5) In the case of any child who is placed in 
a qualified residential treatment program for more 
than 12 consecutive months or 18 nonconsecutive 
months (or, in the case of a child who has not at-
tained age 13, for more than 6 consecutive or non-
consecutive months), the State agency shall submit to 
the Secretary— 
‘‘(A) the most recent versions of the evidence 
and documentation specified in paragraph (4); 
and
424 
‘‘(B) the signed approval of the head of the 
State agency for the continued placement of the 
child in that setting.’’. 
SEC. 2653. PROTOCOLS TO PREVENT INAPPROPRIATE DIAG-
NOSES. 
(a) 
STATE
PLAN
REQUIREMENT.—Section 
422(b)(15)(A) of the Social Security Act (42 U.S.C. 
622(b)(15)(A)) is amended— 
(1) in clause (vi), by striking ‘‘and’’ after the 
semicolon; 
(2) by redesignating clause (vii) as clause (viii); 
and 
(3) by inserting after clause (vi) the following: 
‘‘(vii) the procedures and protocols the 
State has established to ensure that children 
in foster care placements are not inappro-
priately diagnosed with mental illness, 
other emotional or behavioral disorders, 
medically fragile conditions, or develop-
mental disabilities, and placed in settings 
that are not foster family homes as a result 
of the inappropriate diagnoses; and’’. 
(b) EVALUATION.—Section 476 of such Act (42 U.S.C. 
676), as amended by section 2621(d) of this Act, is further 
amended by adding at the end the following:
425 
‘‘(e) EVALUATION OF STATE PROCEDURES AND PRO-
TOCOLS TO PREVENT INAPPROPRIATE DIAGNOSES OF MEN-
TAL ILLNESS OR OTHER CONDITIONS.—The Secretary shall 
conduct an evaluation of the procedures and protocols estab-
lished by States in accordance with the requirements of sec-
tion 422(b)(15)(A)(vii). The evaluation shall analyze the ex-
tent to which States comply with and enforce the procedures 
and protocols and the effectiveness of various State proce-
dures and protocols and shall identify best practices. Not 
later than January 1, 2020, the Secretary shall submit a 
report on the results of the evaluation to Congress.’’. 
SEC. 2654. ADDITIONAL DATA AND REPORTS REGARDING 
CHILDREN PLACED IN A SETTING THAT IS 
NOT A FOSTER FAMILY HOME. 
Section 479A(a)(7)(A) of the Social Security Act (42 
U.S.C. 679b(a)(7)(A)) is amended by striking clauses (i) 
through (vi) and inserting the following: 
‘‘(i) with respect to each such place-
ment— 
‘‘(I) the type of the placement set-
ting, including whether the placement 
is shelter care, a group home and if so, 
the range of the child population in the 
home, a residential treatment facility, 
a hospital or institution providing
426 
medical, rehabilitative, or psychiatric 
care, a setting specializing in pro-
viding prenatal, post-partum, or par-
enting supports, or some other kind of 
child-care institution and if so, what 
kind; 
‘‘(II) the number of children in 
the placement setting and the age, race, 
ethnicity, and gender of each of the 
children; 
‘‘(III) for each child in the place-
ment setting, the length of the place-
ment of the child in the setting, wheth-
er the placement of the child in the set-
ting is the first placement of the child 
and if not, the number and type of 
previous placements of the child, and 
whether the child has special needs or 
another diagnosed mental or physical 
illness or condition; and 
‘‘(IV) the extent of any specialized 
education, treatment, counseling, or 
other services provided in the setting; 
and
427 
‘‘(ii) separately, the number and ages 
of children in the placements who have a 
permanency plan of another planned per-
manent living arrangement; and’’. 
SEC. 2655. CRIMINAL RECORDS CHECKS AND CHECKS OF 
CHILD ABUSE AND NEGLECT REGISTRIES FOR 
ADULTS WORKING IN CHILD-CARE INSTITU-
TIONS AND OTHER GROUP CARE SETTINGS. 
(a) STATE PLAN REQUIREMENT.—Section 471(a)(20) 
of the Social Security Act (42 U.S.C. 671(a)(20)) is amend-
ed— 
(1) in each of subparagraphs (A)(ii) and 
(B)(iii), by striking ‘‘and’’ after the semicolon; 
(2) in subparagraph (C), by adding ‘‘and’’ after 
the semicolon; and 
(3) by inserting after subparagraph (C) the fol-
lowing: 
‘‘(D) provides procedures for any child care in-
stitution, including a group home, residential treat-
ment center, shelter, or other congregate care setting, 
to conduct criminal records checks, including finger-
print-based checks of national crime information 
databases (as defined in section 534(f)(3)(A) of title 
28, United States Code), and checks described in sub-
paragraph (B) of this paragraph, on any adult work-
428 
ing in a child-care institution, including a group 
home, residential treatment center, shelter, or other 
congregate care setting, unless the State reports to the 
Secretary the alternative criminal records checks and 
child abuse registry checks the State conducts on any 
adult working in a child-care institution, including a 
group home, residential treatment center, shelter, or 
other congregate care setting, and why the checks 
specified in this subparagraph are not appropriate 
for the State;’’. 
(b) TECHNICAL AMENDMENTS.—Subparagraphs (A) 
and (C) of section 471(a)(20) of the Social Security Act 
(42 U.S.C. 671(a)(20)) are each amended by striking ‘‘sec-
tion 534(e)(3)(A)’’ and inserting ‘‘section 534(f)(3)(A)’’. 
SEC. 2656. EFFECTIVE DATES; APPLICATION TO WAIVERS. 
(a) EFFECTIVE DATES.— 
(1) IN GENERAL.—Subject to paragraph (2) and 
subsections (b) through (d), the amendments made by 
this chapter shall take effect on January 1, 2018. 
(2) TRANSITION RULE.—In the case of a State 
plan under part B or E of title IV of the Social Secu-
rity Act which the Secretary of Health and Human 
Services determines requires State legislation (other 
than legislation appropriating funds) in order for the 
plan to meet the additional requirements imposed by
429 
the amendments made by this chapter, the State plan 
shall not be regarded as failing to comply with the re-
quirements of such part solely on the basis of the fail-
ure of the plan to meet the additional requirements 
before the first day of the first calendar quarter begin-
ning after the close of the first regular session of the 
State legislature that begins after the date of enact-
ment of this Act. For purposes of the previous sen-
tence, in the case of a State that has a 2-year legisla-
tive session, each year of the session shall be deemed 
to be a separate regular session of the State legisla-
ture. 
(b) LIMITATION ON FEDERAL FINANCIAL PARTICIPA-
TION FOR PLACEMENTS THAT ARE NOT IN FOSTER FAMILY 
HOMES AND RELATED PROVISIONS.— 
(1) IN GENERAL.—The amendments made by sec-
tions 2651(a), 2651(b), 2651(d), and 2652 shall take 
effect on October 1, 2019. 
(2) STATE OPTION TO DELAY EFFECTIVE DATE 
FOR NOT MORE THAN 2 YEARS.—If a State requests 
a delay in the effective date provided for in para-
graph (1), the Secretary of Health and Human Serv-
ices shall delay the effective date with respect to the 
State for the amount of time requested by the State 
not to exceed 2 years. If the effective date is so delayed
430 
for a period with respect to a State under the pre-
ceding sentence, then— 
(A) notwithstanding section 2644, the date 
that the amendments made by section 2621(c) 
take effect with respect to the State shall be de-
layed for the period; and 
(B) in applying section 474(a)(6) of the So-
cial Security Act with respect to the State, ‘‘on 
or after the date this paragraph takes effect with 
respect to the State’’ is deemed to be substituted 
for ‘‘after September 30, 2019’’ in subparagraph 
(A)(i)(I) of such section. 
(c) CRIMINAL RECORDS CHECKS
AND CHECKS
OF 
CHILD ABUSE AND NEGLECT REGISTRIES FOR ADULTS 
WORKING
IN
CHILD-CARE
INSTITUTIONS
AND
OTHER 
GROUP CARE SETTINGS.—The amendments made by sec-
tion 2655 shall take effect on October 1, 2018. 
(d) APPLICATION TO STATES WITH WAIVERS.—In the 
case of a State that, on the date of enactment of this Act, 
has in effect a waiver approved under section 1130 of the 
Social Security Act (42 U.S.C. 1320a–9), the amendments 
made by this chapter shall not apply with respect to the 
State before the expiration (determined without regard to 
any extensions) of the waiver to the extent the amendments 
are inconsistent with the terms of the waiver.
431 
CHAPTER 3—CONTINUING SUPPORT FOR 
CHILD AND FAMILY SERVICES 
SEC. 2661. SUPPORTING AND RETAINING FOSTER FAMILIES 
FOR CHILDREN. 
(a) SUPPORTING AND RETAINING FOSTER PARENTS AS 
A FAMILY SUPPORT SERVICE.—Section 431(a)(2)(B) of the 
Social Security Act (42 U.S.C. 631(a)(2)(B)) is amended 
by redesignating clauses (iii) through (vi) as clauses (iv) 
through (vii), respectively, and inserting after clause (ii) 
the following: 
‘‘(iii) To support and retain foster 
families so they can provide quality family- 
based settings for children in foster care.’’. 
(b) SUPPORT FOR FOSTER FAMILY HOMES.—Section 
436 of such Act (42 U.S.C. 629f) is amended by adding 
at the end the following: 
‘‘(c) SUPPORT FOR FOSTER FAMILY HOMES.—Out of 
any money in the Treasury of the United States not other-
wise appropriated, there are appropriated to the Secretary 
for fiscal year 2018, $8,000,000 for the Secretary to make 
competitive grants to States, Indian tribes, or tribal con-
sortia to support the recruitment and retention of high- 
quality foster families to increase their capacity to place 
more children in family settings, focused on States, Indian 
tribes, or tribal consortia with the highest percentage of
432 
children in non-family settings. The amount appropriated 
under this subparagraph shall remain available through fis-
cal year 2022.’’. 
SEC. 2662. EXTENSION OF CHILD AND FAMILY SERVICES 
PROGRAMS. 
(a) EXTENSION OF STEPHANIE TUBBS JONES CHILD 
WELFARE SERVICES PROGRAM.—Section 425 of the Social 
Security Act (42 U.S.C. 625) is amended by striking ‘‘2012 
through 2016’’ and inserting ‘‘2017 through 2021’’. 
(b) EXTENSION OF PROMOTING SAFE AND STABLE 
FAMILIES PROGRAM AUTHORIZATIONS.— 
(1) IN GENERAL.—Section 436(a) of such Act 
(42 U.S.C. 629f(a)) is amended by striking all that 
follows ‘‘$345,000,000’’ and inserting ‘‘for each of fis-
cal years 2017 through 2021.’’. 
(2) DISCRETIONARY GRANTS.—Section 437(a) of 
such Act (42 U.S.C. 629g(a)) is amended by striking 
‘‘2012 through 2016’’ and inserting ‘‘2017 through 
2021’’. 
(c) EXTENSION
OF FUNDING RESERVATIONS
FOR 
MONTHLY CASEWORKER VISITS AND REGIONAL PARTNER-
SHIP GRANTS.—Section 436(b) of such Act (42 U.S.C. 
629f(b)) is amended—
433 
(1) in paragraph (4)(A), by striking ‘‘2012 
through 2016’’ and inserting ‘‘2017 through 2021’’; 
and 
(2) in paragraph (5), by striking ‘‘2012 through 
2016’’ and inserting ‘‘2017 through 2021’’. 
(d) REAUTHORIZATION
OF
FUNDING
FOR
STATE 
COURTS.— 
(1) EXTENSION OF PROGRAM.—Section 438(c)(1) 
of such Act (42 U.S.C. 629h(c)(1)) is amended by 
striking ‘‘2012 through 2016’’ and inserting ‘‘2017 
through 2021’’. 
(2) EXTENSION
OF
FEDERAL
SHARE.—Section 
438(d) of such Act (42 U.S.C. 629h(d)) is amended by 
striking ‘‘2012 through 2016’’ and inserting ‘‘2017 
through 2021’’. 
(e) REPEAL OF EXPIRED PROVISIONS.—Section 438(e) 
of such Act (42 U.S.C. 629h(e)) is repealed. 
SEC. 2663. IMPROVEMENTS TO THE JOHN H. CHAFEE FOS-
TER CARE INDEPENDENCE PROGRAM AND 
RELATED PROVISIONS. 
(a) AUTHORITY TO SERVE FORMER FOSTER YOUTH 
UP TO AGE 23.—Section 477 of the Social Security Act (42 
U.S.C. 677) is amended— 
(1) in subsection (a)(5), by inserting ‘‘(or 23 
years of age, in the case of a State with a certifi-
434 
cation under subsection (b)(3)(A)(ii) to provide assist-
ance and services to youths who have aged out of fos-
ter care and have not attained such age, in accord-
ance with such subsection)’’ after ‘‘21 years of age’’; 
(2) in subsection (b)(3)(A)— 
(A) by inserting ‘‘(i)’’ before ‘‘A certifi-
cation’’; 
(B) by striking ‘‘children who have left fos-
ter care’’ and all that follows through the period 
and inserting ‘‘youths who have aged out of fos-
ter care and have not attained 21 years of age.’’; 
and 
(C) by adding at the end the following: 
‘‘(ii) If the State has elected under section 
475(8)(B) to extend eligibility for foster care to 
all children who have not attained 21 years of 
age, or if the Secretary determines that the State 
agency responsible for administering the State 
plans under this part and part B uses State 
funds or any other funds not provided under this 
part to provide services and assistance for youths 
who have aged out of foster care that are com-
parable to the services and assistance the youths 
would receive if the State had made such an elec-
tion, the certification required under clause (i)
435 
may provide that the State will provide assist-
ance and services to youths who have aged out 
of foster care and have not attained 23 years of 
age.’’; and 
(3) in subsection (b)(3)(B), by striking ‘‘children 
who have left foster care’’ and all that follows through 
the period and inserting ‘‘youths who have aged out 
of foster care and have not attained 21 years of age 
(or 23 years of age, in the case of a State with a cer-
tification under subparagraph (A)(i) to provide as-
sistance and services to youths who have aged out of 
foster care and have not attained such age, in accord-
ance with subparagraph (A)(ii)).’’. 
(b) 
AUTHORITY
TO
REDISTRIBUTE
UNSPENT 
FUNDS.—Section 477(d) of such Act (42 U.S.C. 677(d)) is 
amended— 
(1) in paragraph (4), by inserting ‘‘or does not 
expend allocated funds within the time period speci-
fied under section 477(d)(3)’’ after ‘‘provided by the 
Secretary’’; and 
(2) by adding at the end the following: 
‘‘(5) 
REDISTRIBUTION
OF
UNEXPENDED 
AMOUNTS.— 
‘‘(A) AVAILABILITY OF AMOUNTS.—To the 
extent that amounts paid to States under this
436 
section in a fiscal year remain unexpended by 
the States at the end of the succeeding fiscal 
year, the Secretary may make the amounts 
available for redistribution in the second suc-
ceeding fiscal year among the States that apply 
for additional funds under this section for that 
second succeeding fiscal year. 
‘‘(B) REDISTRIBUTION.— 
‘‘(i) IN GENERAL.—The Secretary shall 
redistribute the amounts made available 
under subparagraph (A) for a fiscal year 
among eligible applicant States. In this 
subparagraph, the term ‘eligible applicant 
State’ means a State that has applied for 
additional funds for the fiscal year under 
subparagraph (A) if the Secretary deter-
mines that the State will use the funds for 
the purpose for which originally allotted 
under this section. 
‘‘(ii) AMOUNT
TO
BE
REDISTRIB-
UTED.—The amount to be redistributed to 
each eligible applicant State shall be the 
amount so made available multiplied by the 
State foster care ratio, (as defined in sub-
section (c)(4), except that, in such sub-
437 
section, ‘all eligible applicant States (as de-
fined in subsection (d)(5)(B)(i))’ shall be 
substituted for ‘all States’). 
‘‘(iii) TREATMENT OF REDISTRIBUTED 
AMOUNT.—Any amount made available to a 
State under this paragraph shall be re-
garded as part of the allotment of the State 
under this section for the fiscal year in 
which the redistribution is made. 
‘‘(C) TRIBES.—For purposes of this para-
graph, the term ‘State’ includes an Indian tribe, 
tribal organization, or tribal consortium that re-
ceives an allotment under this section.’’. 
(c) EXPANDING AND CLARIFYING THE USE OF EDU-
CATION AND TRAINING VOUCHERS.— 
(1) IN GENERAL.—Section 477(i)(3) of such Act 
(42 U.S.C. 677(i)(3)) is amended— 
(A) by striking ‘‘on the date’’ and all that 
follows through ‘‘23’’ and inserting ‘‘to remain 
eligible until they attain 26’’; and 
(B) by inserting ‘‘, but in no event may a 
youth participate in the program for more than 
5 years (whether or not consecutive)’’ before the 
period.
438 
(2) 
CONFORMING
AMENDMENT.—Section 
477(i)(1) of such Act (42 U.S.C. 677(i)(1)) is amend-
ed by inserting ‘‘who have attained 14 years of age’’ 
before the period. 
(d) OTHER IMPROVEMENTS.—Section 477 of such Act 
(42 U.S.C. 677), as amended by subsections (a), (b), and 
(c) of this section, is amended— 
(1) in the section heading, by striking ‘‘INDE-
PENDENCE PROGRAM’’ and inserting ‘‘PROGRAM 
FOR
SUCCESSFUL
TRANSITION
TO
ADULT-
HOOD’’; 
(2) in subsection (a)— 
(A) in paragraph (1)— 
(i) by striking ‘‘identify children who 
are likely to remain in foster care until 18 
years of age and to help these children make 
the transition to self-sufficiency by pro-
viding services’’ and inserting ‘‘support all 
youth who have experienced foster care at 
age 14 or older in their transition to adult-
hood through transitional services’’; 
(ii) by inserting ‘‘and post-secondary 
education’’ after ‘‘high school diploma’’; and 
(iii) by striking ‘‘training in daily liv-
ing skills, training in budgeting and finan-
439 
cial management skills’’ and inserting 
‘‘training and opportunities to practice 
daily living skills (such as financial lit-
eracy training and driving instruction)’’; 
(B) in paragraph (2), by striking ‘‘who are 
likely to remain in foster care until 18 years of 
age receive the education, training, and services 
necessary to obtain employment’’ and inserting 
‘‘who have experienced foster care at age 14 or 
older achieve meaningful, permanent connections 
with a caring adult’’; 
(C) in paragraph (3), by striking ‘‘who are 
likely to remain in foster care until 18 years of 
age prepare for and enter postsecondary training 
and education institutions’’ and inserting ‘‘who 
have experienced foster care at age 14 or older 
engage in age or developmentally appropriate 
activities, positive youth development, and expe-
riential learning that reflects what their peers in 
intact families experience’’; and 
(D) by striking paragraph (4) and redesig-
nating paragraphs (5) through (8) as para-
graphs (4) through (7); 
(3) in subsection (b)—
440 
(A) in paragraph (2)(D), by striking ‘‘ado-
lescents’’ and inserting ‘‘youth’’; and 
(B) in paragraph (3)— 
(i) in subparagraph (D)— 
(I) by inserting ‘‘including train-
ing on youth development’’ after ‘‘to 
provide training’’; and 
(II) by striking ‘‘adolescents pre-
paring for independent living’’ and all 
that follows through the period and in-
serting ‘‘youth preparing for a success-
ful transition to adulthood and making 
a permanent connection with a caring 
adult.’’; 
(ii) in subparagraph (H), by striking 
‘‘adolescents’’ each place it appears and in-
serting ‘‘youth’’; and 
(iii) in subparagraph (K)— 
(I) by striking ‘‘an adolescent’’ 
and inserting ‘‘a youth’’; and 
(II) by striking ‘‘the adolescent’’ 
each place it appears and inserting 
‘‘the youth’’; and 
(4) in subsection (f), by striking paragraph (2) 
and inserting the following:
441 
‘‘(2) REPORT TO CONGRESS.—Not later than Oc-
tober 1, 2019, the Secretary shall submit to the Com-
mittee on Ways and Means of the House of Represent-
atives and the Committee on Finance of the Senate a 
report on the National Youth in Transition Database 
and any other databases in which States report out-
come measures relating to children in foster care and 
children who have aged out of foster care or left foster 
care for kinship guardianship or adoption. The report 
shall include the following: 
‘‘(A) A description of the reasons for entry 
into foster care and of the foster care experiences, 
such as length of stay, number of placement set-
tings, case goal, and discharge reason of 17-year- 
olds who are surveyed by the National Youth in 
Transition Database and an analysis of the com-
parison of that description with the reasons for 
entry and foster care experiences of children of 
other ages who exit from foster care before at-
taining age 17. 
‘‘(B) A description of the characteristics of 
the individuals who report poor outcomes at ages 
19 and 21 to the National Youth in Transition 
Database.
442 
‘‘(C) Benchmarks for determining what con-
stitutes a poor outcome for youth who remain in 
or have exited from foster care and plans the ex-
ecutive branch will take to incorporate these 
benchmarks in efforts to evaluate child welfare 
agency performance in providing services to chil-
dren transitioning from foster care. 
‘‘(D) An analysis of the association between 
types of placement, number of overall place-
ments, time spent in foster care, and other fac-
tors, and outcomes at ages 19 and 21. 
‘‘(E) An analysis of the differences in out-
comes for children in and formerly in foster care 
at age 19 and 21 among States.’’. 
(e) CLARIFYING DOCUMENTATION PROVIDED TO FOS-
TER YOUTH LEAVING FOSTER CARE.—Section 475(5)(I) of 
such Act (42 U.S.C. 675(5)(I)) is amended by inserting 
after ‘‘REAL ID Act of 2005’’ the following: ‘‘, and any 
official documentation necessary to prove that the child was 
previously in foster care’’.
443 
CHAPTER 4—CONTINUING INCENTIVES TO 
STATES TO PROMOTE ADOPTION AND 
LEGAL GUARDIANSHIP 
SEC. 2665. REAUTHORIZING ADOPTION AND LEGAL GUARD-
IANSHIP INCENTIVE PROGRAMS. 
(a) IN GENERAL.—Section 473A of the Social Security 
Act (42 U.S.C. 673b) is amended— 
(1) in subsection (b)(4), by striking ‘‘2013 
through 2015’’ and inserting ‘‘2016 through 2020’’; 
(2) in subsection (h)(1)(D), by striking ‘‘2016’’ 
and inserting ‘‘2021’’; and 
(3) in subsection (h)(2), by striking ‘‘2016’’ and 
inserting ‘‘2021’’. 
(b) EFFECTIVE DATE.—The amendments made by sub-
section (a) shall take effect as if enacted on October 1, 2017. 
CHAPTER 5—TECHNICAL CORRECTIONS 
SEC. 2667. TECHNICAL CORRECTIONS TO DATA EXCHANGE 
STANDARDS TO IMPROVE PROGRAM COORDI-
NATION. 
(a) IN GENERAL.—Section 440 of the Social Security 
Act (42 U.S.C. 629m) is amended to read as follows: 
‘‘SEC. 440. DATA EXCHANGE STANDARDS FOR IMPROVED 
INTEROPERABILITY. 
‘‘(a) DESIGNATION.—The Secretary shall, in consulta-
tion with an interagency work group established by the Of-
444 
fice of Management and Budget and considering State gov-
ernment perspectives, by rule, designate data exchange 
standards to govern, under this part and part E— 
‘‘(1) necessary categories of information that 
State agencies operating programs under State plans 
approved under this part are required under applica-
ble Federal law to electronically exchange with an-
other State agency; and 
‘‘(2) Federal reporting and data exchange re-
quired under applicable Federal law. 
‘‘(b) REQUIREMENTS.—The data exchange standards 
required by paragraph (1) shall, to the extent practicable— 
‘‘(1) incorporate a widely accepted, non-propri-
etary, searchable, computer-readable format, such as 
the Extensible Markup Language; 
‘‘(2) contain interoperable standards developed 
and maintained by intergovernmental partnerships, 
such as the National Information Exchange Model; 
‘‘(3) incorporate interoperable standards devel-
oped and maintained by Federal entities with author-
ity over contracting and financial assistance; 
‘‘(4) be consistent with and implement applica-
ble accounting principles;
445 
‘‘(5) be implemented in a manner that is cost- 
effective and improves program efficiency and effec-
tiveness; and 
‘‘(6) be capable of being continually upgraded as 
necessary. 
‘‘(c) RULE OF CONSTRUCTION.—Nothing in this sub-
section shall be construed to require a change to existing 
data exchange standards found to be effective and effi-
cient.’’. 
(b) EFFECTIVE DATE.—Not later than the date that 
is 24 months after the date of the enactment of this section, 
the Secretary of Health and Human Services shall issue 
a proposed rule that— 
(1) identifies federally required data exchanges, 
include specification and timing of exchanges to be 
standardized, and address the factors used in deter-
mining whether and when to standardize data ex-
changes; and 
(2) specifies State implementation options and 
describes future milestones. 
SEC. 2668. TECHNICAL CORRECTIONS TO STATE REQUIRE-
MENT TO ADDRESS THE DEVELOPMENTAL 
NEEDS OF YOUNG CHILDREN. 
Section 422(b)(18) of the Social Security Act (42 
U.S.C. 622(b)(18)) is amended by striking ‘‘such children’’
446 
and inserting ‘‘all vulnerable children under 5 years of 
age’’. 
CHAPTER 6—ENSURING STATES REINVEST 
SAVINGS RESULTING FROM INCREASE 
IN ADOPTION ASSISTANCE 
SEC. 2669. DELAY OF ADOPTION ASSISTANCE PHASE-IN. 
(a) IN GENERAL.—The table in section 473(e)(1)(B) 
of the Social Security Act (42 U.S.C. 673(e)(1)(B)) is 
amended by striking the last 2 rows and inserting the fol-
lowing: 
‘‘2017 through 2023 .................................
2024 ..........................................................
2 (or, in the case of a child for whom 
an adoption assistance agreement is 
entered into under this section on or 
after July 1, 2024, any age) 
2025 or thereafter ....................................
any age.’’. 
(b) EFFECTIVE DATE.—The amendment made by this 
section shall take effect on January 1, 2018. 
SEC. 2670. GAO STUDY AND REPORT ON STATE REINVEST-
MENT OF SAVINGS RESULTING FROM IN-
CREASE IN ADOPTION ASSISTANCE. 
(a) STUDY.—The Comptroller General of the United 
States shall study the extent to which States are complying 
with the requirements of section 473(a)(8) of the Social Se-
curity Act relating to the effects of phasing out the AFDC 
income eligibility requirements for adoption assistance pay-
ments under section 473 of the Social Security Act, as en-
447 
acted by section 402 of the Fostering Connections to Success 
and Increasing Adoptions Act of 2008 (Public Law 110– 
351; 122 Stat. 3975) and amended by section 206 of the 
Preventing Sex Trafficking and Strengthening Families Act 
(Public Law 113–183; 128 Stat. 1919). In particular, the 
Comptroller General shall analyze the extent to which 
States are complying with the following requirements under 
section 473(a)(8)(D) of the Social Security Act: 
(1) The requirement to spend an amount equal 
to the amount of the savings (if any) in State expend-
itures under part E of title IV of the Social Security 
Act resulting from phasing out the AFDC income eli-
gibility requirements for adoption assistance pay-
ments under section 473 of such Act to provide to 
children of families any service that may be provided 
under part B or E of title IV of such Act. 
(2) The requirement that a State shall spend not 
less than 30 percent of the amount of any savings de-
scribed in paragraph (1) on post-adoption services, 
post-guardianship services, and services to support 
and sustain positive permanent outcomes for children 
who otherwise might enter into foster care under the 
responsibility of the State, with at least 2⁄3 of the 
spending by the State to comply with the 30 percent
448 
requirement being spent on post-adoption and post- 
guardianship services. 
(b) REPORT.—The Comptroller General of the United 
States shall submit to the Committee on Finance of the Sen-
ate, the Committee on Ways and Means of the House of 
Representatives, and the Secretary of Health and Human 
Services a report that contains the results of the study re-
quired by subsection (a), including recommendations to en-
sure compliance with laws referred to in subsection (a). 
Subtitle B—Supporting Social Im-
pact Partnerships to Pay for Re-
sults 
SEC. 2681. SUPPORTING SOCIAL IMPACT PARTNERSHIPS TO 
PAY FOR RESULTS. 
Title XX of the Social Security Act (42 U.S.C. 1397 
et seq.) is amended— 
(1) in the title heading, by striking ‘‘TO 
STATES’’ and inserting ‘‘AND PROGRAMS’’; and 
(2) by adding at the end the following: 
‘‘Subtitle C—Social Impact Demonstration Projects 
‘‘PURPOSES 
‘‘SEC. 2051. The purposes of this subtitle are the fol-
lowing:
449 
‘‘(1) To improve the lives of families and indi-
viduals in need in the United States by funding so-
cial programs that achieve real results. 
‘‘(2) To redirect funds away from programs that, 
based on objective data, are ineffective, and into pro-
grams that achieve demonstrable, measurable results. 
‘‘(3) To ensure Federal funds are used effectively 
on social services to produce positive outcomes for 
both service recipients and taxpayers. 
‘‘(4) To establish the use of social impact part-
nerships to address some of our Nation’s most press-
ing problems. 
‘‘(5) To facilitate the creation of public-private 
partnerships that bundle philanthropic or other pri-
vate resources with existing public spending to scale 
up effective social interventions already being imple-
mented by private organizations, nonprofits, chari-
table organizations, and State and local governments 
across the country. 
‘‘(6) To bring pay-for-performance to the social 
sector, allowing the United States to improve the im-
pact and effectiveness of vital social services programs 
while redirecting inefficient or duplicative spending.
450 
‘‘(7) To incorporate outcomes measurement and 
randomized controlled trials or other rigorous meth-
odologies for assessing program impact. 
‘‘SOCIAL IMPACT PARTNERSHIP APPLICATION 
‘‘SEC. 2052. (a) NOTICE.—Not later than 1 year after 
the date of the enactment of this subtitle, the Secretary of 
the Treasury, in consultation with the Federal Interagency 
Council on Social Impact Partnerships, shall publish in the 
Federal Register a request for proposals from States or local 
governments for social impact partnership projects in ac-
cordance with this section. 
‘‘(b) REQUIRED OUTCOMES FOR SOCIAL IMPACT PART-
NERSHIP PROJECT.—To qualify as a social impact partner-
ship project under this subtitle, a project must produce one 
or more measurable, clearly defined outcomes that result in 
social benefit and Federal, State, or local savings through 
any of the following: 
‘‘(1) Increasing work and earnings by individ-
uals in the United States who are unemployed for 
more than 6 consecutive months. 
‘‘(2) Increasing employment and earnings of in-
dividuals who have attained 16 years of age but not 
25 years of age. 
‘‘(3) Increasing employment among individuals 
receiving Federal disability benefits.
451 
‘‘(4) Reducing the dependence of low-income 
families on Federal means-tested benefits. 
‘‘(5) Improving rates of high school graduation. 
‘‘(6) Reducing teen and unplanned pregnancies. 
‘‘(7) Improving birth outcomes and early child-
hood health and development among low-income fami-
lies and individuals. 
‘‘(8) Reducing rates of asthma, diabetes, or other 
preventable diseases among low-income families and 
individuals to reduce the utilization of emergency and 
other high-cost care. 
‘‘(9) Increasing the proportion of children living 
in two-parent families. 
‘‘(10) Reducing incidences and adverse con-
sequences of child abuse and neglect. 
‘‘(11) Reducing the number of youth in foster 
care by increasing adoptions, permanent guardian-
ship arrangements, reunifications, or placements with 
a fit and willing relative, or by avoiding placing chil-
dren in foster care by ensuring they can be cared for 
safely in their own homes. 
‘‘(12) Reducing the number of children and 
youth in foster care residing in group homes, child 
care institutions, agency-operated foster homes, or 
other non-family foster homes, unless it is determined
452 
that it is in the interest of the child’s long-term 
health, safety, or psychological well-being to not be 
placed in a family foster home. 
‘‘(13) Reducing the number of children returning 
to foster care. 
‘‘(14) Reducing recidivism among juvenile of-
fenders, individuals released from prison, or other 
high-risk populations. 
‘‘(15) Reducing the rate of homelessness among 
our most vulnerable populations. 
‘‘(16) Improving the health and well-being of 
those with mental, emotional, and behavioral health 
needs. 
‘‘(17) Improving the educational outcomes of spe-
cial-needs or low-income children. 
‘‘(18) Improving the employment and well-being 
of returning United States military members. 
‘‘(19) Increasing the financial stability of low- 
income families. 
‘‘(20) Increasing the independence and employ-
ability of individuals who are physically or mentally 
disabled. 
‘‘(21) Other measurable outcomes defined by the 
State or local government that result in positive so-
cial outcomes and Federal savings.
453 
‘‘(c) APPLICATION REQUIRED.—The notice described 
in subsection (a) shall require a State or local government 
to submit an application for the social impact partnership 
project that addresses the following: 
‘‘(1) The outcome goals of the project. 
‘‘(2) A description of each intervention in the 
project and anticipated outcomes of the intervention. 
‘‘(3) Rigorous evidence demonstrating that the 
intervention can be expected to produce the desired 
outcomes. 
‘‘(4) The target population that will be served by 
the project. 
‘‘(5) The expected social benefits to participants 
who receive the intervention and others who may be 
impacted. 
‘‘(6) Projected Federal, State, and local govern-
ment costs and other costs to conduct the project. 
‘‘(7) Projected Federal, State, and local govern-
ment savings and other savings, including an esti-
mate of the savings to the Federal Government, on a 
program-by-program basis and in the aggregate, if 
the project is implemented and the outcomes are 
achieved as a result of the intervention. 
‘‘(8) If savings resulting from the successful com-
pletion of the project are estimated to accrue to the
454 
State or local government, the likelihood of the State 
or local government to realize those savings. 
‘‘(9) A plan for delivering the intervention 
through a social impact partnership model. 
‘‘(10) A description of the expertise of each serv-
ice provider that will administer the intervention, in-
cluding a summary of the experience of the service 
provider in delivering the proposed intervention or a 
similar intervention, or demonstrating that the serv-
ice provider has the expertise necessary to deliver the 
proposed intervention. 
‘‘(11) An explanation of the experience of the 
State or local government, the intermediary, or the 
service provider in raising private and philanthropic 
capital to fund social service investments. 
‘‘(12) The detailed roles and responsibilities of 
each entity involved in the project, including any 
State or local government entity, intermediary, serv-
ice provider, independent evaluator, investor, or other 
stakeholder. 
‘‘(13) A summary of the experience of the service 
provider in delivering the proposed intervention or a 
similar intervention, or a summary demonstrating 
the service provider has the expertise necessary to de-
liver the proposed intervention.
455 
‘‘(14) A summary of the unmet need in the area 
where the intervention will be delivered or among the 
target population who will receive the intervention. 
‘‘(15) The proposed payment terms, the method-
ology used to calculate outcome payments, the pay-
ment schedule, and performance thresholds. 
‘‘(16) The project budget. 
‘‘(17) The project timeline. 
‘‘(18) The criteria used to determine the eligi-
bility of an individual for the project, including how 
selected populations will be identified, how they will 
be referred to the project, and how they will be en-
rolled in the project. 
‘‘(19) The evaluation design. 
‘‘(20) The metrics that will be used in the eval-
uation to determine whether the outcomes have been 
achieved as a result of the intervention and how the 
metrics will be measured. 
‘‘(21) An explanation of how the metrics used in 
the evaluation to determine whether the outcomes 
achieved as a result of the intervention are inde-
pendent, objective indicators of impact and are not 
subject to manipulation by the service provider, inter-
mediary, or investor.
456 
‘‘(22) A summary explaining the independence of 
the evaluator from the other entities involved in the 
project and the evaluator’s experience in conducting 
rigorous evaluations of program effectiveness includ-
ing, where available, well-implemented randomized 
controlled trials on the intervention or similar inter-
ventions. 
‘‘(23) The capacity of the service provider to de-
liver the intervention to the number of participants 
the State or local government proposes to serve in the 
project. 
‘‘(24) A description of whether and how the State 
or local government and service providers plan to sus-
tain the intervention, if it is timely and appropriate 
to do so, to ensure that successful interventions con-
tinue to operate after the period of the social impact 
partnership. 
‘‘(d) PROJECT
INTERMEDIARY
INFORMATION
RE-
QUIRED.—The application described in subsection (c) shall 
also contain the following information about any inter-
mediary for the social impact partnership project (whether 
an intermediary is a service provider or other entity): 
‘‘(1) Experience and capacity for providing or 
facilitating the provision of the type of intervention 
proposed.
457 
‘‘(2) The mission and goals. 
‘‘(3) Information on whether the intermediary is 
already working with service providers that provide 
this intervention or an explanation of the capacity of 
the intermediary to begin working with service pro-
viders to provide the intervention. 
‘‘(4) Experience working in a collaborative envi-
ronment across government and nongovernmental en-
tities. 
‘‘(5) Previous experience collaborating with pub-
lic or private entities to implement evidence-based 
programs. 
‘‘(6) Ability to raise or provide funding to cover 
operating costs (if applicable to the project). 
‘‘(7) Capacity and infrastructure to track out-
comes and measure results, including— 
‘‘(A) capacity to track and analyze program 
performance and assess program impact; and 
‘‘(B) experience with performance-based 
awards or performance-based contracting and 
achieving project milestones and targets. 
‘‘(8) Role in delivering the intervention. 
‘‘(9) How the intermediary would monitor pro-
gram success, including a description of the interim 
benchmarks and outcome measures.
458 
‘‘(e) FEASIBILITY STUDIES FUNDED THROUGH OTHER 
SOURCES.—The notice described in subsection (a) shall per-
mit a State or local government to submit an application 
for social impact partnership funding that contains infor-
mation from a feasibility study developed for purposes other 
than applying for funding under this subtitle. 
‘‘AWARDING SOCIAL IMPACT PARTNERSHIP AGREEMENTS 
‘‘SEC. 2053. (a) TIMELINE
IN AWARDING AGREE-
MENT.—Not later than 6 months after receiving an applica-
tion in accordance with section 2052, the Secretary, in con-
sultation with the Federal Interagency Council on Social 
Impact Partnerships, shall determine whether to enter into 
an agreement for a social impact partnership project with 
a State or local government. 
‘‘(b) CONSIDERATIONS IN AWARDING AGREEMENT.— 
In determining whether to enter into an agreement for a 
social impact partnership project (the application for which 
was submitted under section 2052) the Secretary, in con-
sultation with the Federal Interagency Council on Social 
Impact Partnerships and the head of any Federal agency 
administering a similar intervention or serving a popu-
lation similar to that served by the project, shall consider 
each of the following: 
‘‘(1) The recommendations made by the Commis-
sion on Social Impact Partnerships.
459 
‘‘(2) The value to the Federal Government of the 
outcomes expected to be achieved if the outcomes speci-
fied in the agreement are achieved as a result of the 
intervention. 
‘‘(3) The likelihood, based on evidence provided 
in the application and other evidence, that the State 
or local government in collaboration with the inter-
mediary and the service providers will achieve the 
outcomes. 
‘‘(4) The savings to the Federal Government if 
the outcomes specified in the agreement are achieved 
as a result of the intervention. 
‘‘(5) The savings to the State and local govern-
ments if the outcomes specified in the agreement are 
achieved as a result of the intervention. 
‘‘(6) The expected quality of the evaluation that 
would be conducted with respect to the agreement. 
‘‘(7) The capacity and commitment of the State 
or local government to sustain the intervention, if ap-
propriate and timely and if the intervention is suc-
cessful, beyond the period of the social impact part-
nership. 
‘‘(c) AGREEMENT AUTHORITY.— 
‘‘(1) AGREEMENT
REQUIREMENTS.—In accord-
ance with this section, the Secretary, in consultation
460 
with the Federal Interagency Council on Social Im-
pact Partnerships and the head of any Federal agen-
cy administering a similar intervention or serving a 
population similar to that served by the project, may 
enter into an agreement for a social impact partner-
ship project with a State or local government if the 
Secretary, in consultation with the Federal Inter-
agency Council on Social Impact Partnerships, deter-
mines that each of the following requirements are met: 
‘‘(A) The State or local government agrees 
to achieve one or more outcomes as a result of 
the intervention, as specified in the agreement 
and validated by independent evaluation, in 
order to receive payment. 
‘‘(B) The Federal payment to the State or 
local government for each specified outcome 
achieved as a result of the intervention is less 
than or equal to the value of the outcome to the 
Federal Government over a period not to exceed 
10 years, as determined by the Secretary, in con-
sultation with the State or local government. 
‘‘(C) The duration of the project does not 
exceed 10 years. 
‘‘(D) The State or local government has 
demonstrated, through the application submitted
461 
under section 2052, that, based on prior rigorous 
experimental evaluations or rigorous quasi-ex-
perimental studies, the intervention can be ex-
pected to achieve each outcome specified in the 
agreement. 
‘‘(E) The State, local government, inter-
mediary, or service provider has experience rais-
ing private or philanthropic capital to fund so-
cial service investments (if applicable to the 
project). 
‘‘(F) The State or local government has 
shown that each service provider has experience 
delivering the intervention, a similar interven-
tion, or has otherwise demonstrated the expertise 
necessary to deliver the intervention. 
‘‘(2) PAYMENT.—The Secretary shall pay the 
State or local government only if the independent 
evaluator described in section 2055 determines that 
the social impact partnership project has met the re-
quirements specified in the agreement and achieved 
an outcome as a result of the intervention, as speci-
fied in the agreement and validated by independent 
evaluation. 
‘‘(d) NOTICE OF AGREEMENT AWARD.—Not later than 
30 days after entering into an agreement under this section
462 
the Secretary shall publish a notice in the Federal Register 
that includes, with regard to the agreement, the following: 
‘‘(1) The outcome goals of the social impact part-
nership project. 
‘‘(2) A description of each intervention in the 
project. 
‘‘(3) The target population that will be served by 
the project. 
‘‘(4) The expected social benefits to participants 
who receive the intervention and others who may be 
impacted. 
‘‘(5) The detailed roles, responsibilities, and pur-
poses of each Federal, State, or local government enti-
ty, intermediary, service provider, independent eval-
uator, investor, or other stakeholder. 
‘‘(6) The payment terms, the methodology used to 
calculate outcome payments, the payment schedule, 
and performance thresholds. 
‘‘(7) The project budget. 
‘‘(8) The project timeline. 
‘‘(9) The project eligibility criteria. 
‘‘(10) The evaluation design. 
‘‘(11) The metrics that will be used in the eval-
uation to determine whether the outcomes have been
463 
achieved as a result of each intervention and how 
these metrics will be measured. 
‘‘(12) The estimate of the savings to the Federal, 
State, and local government, on a program-by-pro-
gram basis and in the aggregate, if the agreement is 
entered into and implemented and the outcomes are 
achieved as a result of each intervention. 
‘‘(e) AUTHORITY TO TRANSFER ADMINISTRATION OF 
AGREEMENT.—The Secretary may transfer to the head of 
another Federal agency the authority to administer (includ-
ing making payments under) an agreement entered into 
under subsection (c), and any funds necessary to do so. 
‘‘(f) REQUIREMENT ON FUNDING USED TO BENEFIT 
CHILDREN.—Not less than 50 percent of all Federal pay-
ments made to carry out agreements under this section shall 
be used for initiatives that directly benefit children. 
‘‘FEASIBILITY STUDY FUNDING 
‘‘SEC. 2054. (a) REQUESTS FOR FUNDING FOR FEASI-
BILITY STUDIES.—The Secretary shall reserve a portion of 
the amount made available to carry out this subtitle to as-
sist States or local governments in developing feasibility 
studies to apply for social impact partnership funding 
under section 2052. To be eligible to receive funding to as-
sist with completing a feasibility study, a State or local 
government shall submit an application for feasibility 
study funding addressing the following:
464 
‘‘(1) A description of the outcome goals of the so-
cial impact partnership project. 
‘‘(2) A description of the intervention, including 
anticipated program design, target population, an es-
timate regarding the number of individuals to be 
served, and setting for the intervention. 
‘‘(3) Evidence to support the likelihood that the 
intervention will produce the desired outcomes. 
‘‘(4) A description of the potential metrics to be 
used. 
‘‘(5) The expected social benefits to participants 
who receive the intervention and others who may be 
impacted. 
‘‘(6) Estimated costs to conduct the project. 
‘‘(7) Estimates of Federal, State, and local gov-
ernment savings and other savings if the project is 
implemented and the outcomes are achieved as a re-
sult of each intervention. 
‘‘(8) An estimated timeline for implementation 
and completion of the project, which shall not exceed 
10 years. 
‘‘(9) With respect to a project for which the State 
or local government selects an intermediary to operate 
the project, any partnerships needed to successfully
465 
execute the project and the ability of the intermediary 
to foster the partnerships. 
‘‘(10) The expected resources needed to complete 
the feasibility study for the State or local government 
to apply for social impact partnership funding under 
section 2052. 
‘‘(b) FEDERAL SELECTION OF APPLICATIONS FOR FEA-
SIBILITY STUDY.—Not later than 6 months after receiving 
an application for feasibility study funding under sub-
section (a), the Secretary, in consultation with the Federal 
Interagency Council on Social Impact Partnerships and the 
head of any Federal agency administering a similar inter-
vention or serving a population similar to that served by 
the project, shall select State or local government feasibility 
study proposals for funding based on the following: 
‘‘(1) The recommendations made by the Commis-
sion on Social Impact Partnerships. 
‘‘(2) The likelihood that the proposal will achieve 
the desired outcomes. 
‘‘(3) The value of the outcomes expected to be 
achieved as a result of each intervention. 
‘‘(4) The potential savings to the Federal Gov-
ernment if the social impact partnership project is 
successful.
466 
‘‘(5) The potential savings to the State and local 
governments if the project is successful. 
‘‘(c) PUBLIC DISCLOSURE.—Not later than 30 days 
after selecting a State or local government for feasibility 
study funding under this section, the Secretary shall cause 
to be published on the website of the Federal Interagency 
Council on Social Impact Partnerships information ex-
plaining why a State or local government was granted fea-
sibility study funding. 
‘‘(d) FUNDING RESTRICTION.— 
‘‘(1) FEASIBILITY
STUDY
RESTRICTION.—The 
Secretary may not provide feasibility study funding 
under this section for more than 50 percent of the es-
timated total cost of the feasibility study reported in 
the State or local government application submitted 
under subsection (a). 
‘‘(2) AGGREGATE
RESTRICTION.—Of the total 
amount made available to carry out this subtitle, the 
Secretary may not use more than $10,000,000 to pro-
vide feasibility study funding to States or local gov-
ernments under this section. 
‘‘(3) NO
GUARANTEE
OF
FUNDING.—The Sec-
retary shall have the option to award no funding 
under this section.
467 
‘‘(e) SUBMISSION
OF
FEASIBILITY
STUDY
RE-
QUIRED.—Not later than 9 months after the receipt of feasi-
bility study funding under this section, a State or local gov-
ernment receiving the funding shall complete the feasibility 
study and submit the study to the Federal Interagency 
Council on Social Impact Partnerships. 
‘‘(f) DELEGATION
OF AUTHORITY.—The Secretary 
may transfer to the head of another Federal agency the au-
thorities provided in this section and any funds necessary 
to exercise the authorities. 
‘‘EVALUATIONS 
‘‘SEC. 2055. (a) AUTHORITY TO ENTER INTO AGREE-
MENTS.—For each State or local government awarded a so-
cial impact partnership project approved by the Secretary 
under this subtitle, the head of the relevant agency, as rec-
ommended by the Federal Interagency Council on Social 
Impact Partnerships and determined by the Secretary, shall 
enter into an agreement with the State or local government 
to pay for all or part of the independent evaluation to deter-
mine whether the State or local government project has 
achieved a specific outcome as a result of the intervention 
in order for the State or local government to receive outcome 
payments under this subtitle. 
‘‘(b) EVALUATOR QUALIFICATIONS.—The head of the 
relevant agency may not enter into an agreement with a 
State or local government unless the head determines that
468 
the evaluator is independent of the other parties to the 
agreement and has demonstrated substantial experience in 
conducting rigorous evaluations of program effectiveness in-
cluding, where available and appropriate, well-imple-
mented randomized controlled trials on the intervention or 
similar interventions. 
‘‘(c) METHODOLOGIES TO BE USED.—The evaluation 
used to determine whether a State or local government will 
receive outcome payments under this subtitle shall use ex-
perimental designs using random assignment or other reli-
able, evidence-based research methodologies, as certified by 
the Federal Interagency Council on Social Impact Partner-
ships, that allow for the strongest possible causal inferences 
when random assignment is not feasible. 
‘‘(d) PROGRESS REPORT.— 
‘‘(1) SUBMISSION OF REPORT.—The independent 
evaluator shall— 
‘‘(A) not later than 2 years after a project 
has been approved by the Secretary and bian-
nually thereafter until the project is concluded, 
submit to the head of the relevant agency and the 
Federal Interagency Council on Social Impact 
Partnerships a written report summarizing the 
progress that has been made in achieving each 
outcome specified in the agreement; and
469 
‘‘(B) before the scheduled time of the first 
outcome payment and before the scheduled time 
of each subsequent payment, submit to the head 
of the relevant agency and the Federal Inter-
agency Council on Social Impact Partnerships a 
written report that includes the results of the 
evaluation conducted to determine whether an 
outcome payment should be made along with in-
formation on the unique factors that contributed 
to achieving or failing to achieve the outcome, 
the challenges faced in attempting to achieve the 
outcome, and information on the improved fu-
ture delivery of this or similar interventions. 
‘‘(2) SUBMISSION TO THE SECRETARY AND CON-
GRESS.—Not later than 30 days after receipt of the 
written report pursuant to paragraph (1)(B), the 
Federal Interagency Council on Social Impact Part-
nerships shall submit the report to the Secretary and 
each committee of jurisdiction in the House of Rep-
resentatives and the Senate. 
‘‘(e) FINAL REPORT.— 
‘‘(1) SUBMISSION OF REPORT.—Within 6 months 
after the social impact partnership project is com-
pleted, the independent evaluator shall—
470 
‘‘(A) evaluate the effects of the activities un-
dertaken pursuant to the agreement with regard 
to each outcome specified in the agreement; and 
‘‘(B) submit to the head of the relevant 
agency and the Federal Interagency Council on 
Social Impact Partnerships a written report that 
includes the results of the evaluation and the 
conclusion of the evaluator as to whether the 
State or local government has fulfilled each obli-
gation of the agreement, along with information 
on the unique factors that contributed to the suc-
cess or failure of the project, the challenges faced 
in attempting to achieve the outcome, and infor-
mation on the improved future delivery of this or 
similar interventions. 
‘‘(2) SUBMISSION TO THE SECRETARY AND CON-
GRESS.—Not later than 30 days after receipt of the 
written report pursuant to paragraph (1)(B), the 
Federal Interagency Council on Social Impact Part-
nerships shall submit the report to the Secretary and 
each committee of jurisdiction in the House of Rep-
resentatives and the Senate. 
‘‘(f) LIMITATION ON COST OF EVALUATIONS.—Of the 
amount made available under this subtitle for social impact 
partnership projects, the Secretary may not obligate more
471 
than 15 percent to evaluate the implementation and out-
comes of the projects. 
‘‘(g) DELEGATION
OF AUTHORITY.—The Secretary 
may transfer to the head of another Federal agency the au-
thorities provided in this section and any funds necessary 
to exercise the authorities. 
‘‘FEDERAL INTERAGENCY COUNCIL ON SOCIAL IMPACT 
PARTNERSHIPS 
‘‘SEC. 2056. (a) ESTABLISHMENT.—There is estab-
lished the Federal Interagency Council on Social Impact 
Partnerships (in this section referred to as the ‘Council’) 
to— 
‘‘(1) coordinate with the Secretary on the efforts 
of social impact partnership projects funded under 
this subtitle; 
‘‘(2) advise and assist the Secretary in the devel-
opment and implementation of the projects; 
‘‘(3) advise the Secretary on specific pro-
grammatic and policy matter related to the projects; 
‘‘(4) provide subject-matter expertise to the Sec-
retary with regard to the projects; 
‘‘(5) certify to the Secretary that each State or 
local government that has entered into an agreement 
with the Secretary for a social impact partnership 
project under this subtitle and each evaluator selected 
by the head of the relevant agency under section 2055
472 
has access to Federal administrative data to assist the 
State or local government and the evaluator in evalu-
ating the performance and outcomes of the project; 
‘‘(6) address issues that will influence the future 
of social impact partnership projects in the United 
States; 
‘‘(7) provide guidance to the executive branch on 
the future of social impact partnership projects in the 
United States; 
‘‘(8) prior to approval by the Secretary, certify 
that each State and local government application for 
a social impact partnership contains rigorous, inde-
pendent data and reliable, evidence-based research 
methodologies to support the conclusion that the 
project will yield savings to the State or local govern-
ment or the Federal Government if the project out-
comes are achieved; 
‘‘(9) certify to the Secretary, in the case of each 
approved social impact partnership that is expected 
to yield savings to the Federal Government, that the 
project will yield a projected savings to the Federal 
Government if the project outcomes are achieved, and 
coordinate with the relevant Federal agency to 
produce an after-action accounting once the project is 
complete to determine the actual Federal savings real-
473 
ized, and the extent to which actual savings aligned 
with projected savings; and 
‘‘(10) provide periodic reports to the Secretary 
and make available reports periodically to Congress 
and the public on the implementation of this subtitle. 
‘‘(b) COMPOSITION OF COUNCIL.—The Council shall 
have 11 members, as follows: 
‘‘(1) CHAIR.—The Chair of the Council shall be 
the Director of the Office of Management and Budget. 
‘‘(2) OTHER MEMBERS.—The head of each of the 
following entities shall designate one officer or em-
ployee of the entity to be a Council member: 
‘‘(A) The Department of Labor. 
‘‘(B) The Department of Health and 
Human Services. 
‘‘(C) The Social Security Administration. 
‘‘(D) The Department of Agriculture. 
‘‘(E) The Department of Justice. 
‘‘(F) The Department of Housing and 
Urban Development. 
‘‘(G) The Department of Education. 
‘‘(H) The Department of Veterans Affairs. 
‘‘(I) The Department of the Treasury. 
‘‘(J) The Corporation for National and 
Community Service.
474 
‘‘COMMISSION ON SOCIAL IMPACT PARTNERSHIPS 
‘‘SEC. 2057. (a) ESTABLISHMENT.—There is estab-
lished the Commission on Social Impact Partnerships (in 
this section referred to as the ‘Commission’). 
‘‘(b) DUTIES.—The duties of the Commission shall be 
to— 
‘‘(1) assist the Secretary and the Federal Inter-
agency Council on Social Impact Partnerships in re-
viewing applications for funding under this subtitle; 
‘‘(2) make recommendations to the Secretary and 
the Federal Interagency Council on Social Impact 
Partnerships regarding the funding of social impact 
partnership agreements and feasibility studies; and 
‘‘(3) provide other assistance and information as 
requested by the Secretary or the Federal Interagency 
Council on Social Impact Partnerships. 
‘‘(c) COMPOSITION.—The Commission shall be com-
posed of nine members, of whom— 
‘‘(1) one shall be appointed by the President, 
who will serve as the Chair of the Commission; 
‘‘(2) one shall be appointed by the Majority 
Leader of the Senate; 
‘‘(3) one shall be appointed by the Minority 
Leader of the Senate;
475 
‘‘(4) one shall be appointed by the Speaker of the 
House of Representatives; 
‘‘(5) one shall be appointed by the Minority 
Leader of the House of Representatives; 
‘‘(6) one shall be appointed by the Chairman of 
the Committee on Finance of the Senate; 
‘‘(7) one shall be appointed by the ranking mem-
ber of the Committee on Finance of the Senate; 
‘‘(8) one member shall be appointed by the 
Chairman of the Committee on Ways and Means of 
the House of Representatives; and 
‘‘(9) one shall be appointed by the ranking mem-
ber of the Committee on Ways and Means of the 
House of Representatives. 
‘‘(d) QUALIFICATIONS OF COMMISSION MEMBERS.— 
The members of the Commission shall— 
‘‘(1) be experienced in finance, economics, pay 
for performance, or program evaluation; 
‘‘(2) have relevant professional or personal expe-
rience in a field related to one or more of the out-
comes listed in this subtitle; or 
‘‘(3) be qualified to review applications for social 
impact partnership projects to determine whether the 
proposed metrics and evaluation methodologies are
476 
appropriately rigorous and reliant upon independent 
data and evidence-based research. 
‘‘(e) TIMING OF APPOINTMENTS.—The appointments of 
the members of the Commission shall be made not later than 
120 days after the date of the enactment of this subtitle, 
or, in the event of a vacancy, not later than 90 days after 
the date the vacancy arises. If a member of Congress fails 
to appoint a member by that date, the President may select 
a member of the President’s choice on behalf of the member 
of Congress. Notwithstanding the preceding sentence, if not 
all appointments have been made to the Commission as of 
that date, the Commission may operate with no fewer than 
five members until all appointments have been made. 
‘‘(f) TERM OF APPOINTMENTS.— 
‘‘(1) IN
GENERAL.—The members appointed 
under subsection (c) shall serve as follows: 
‘‘(A) Three members shall serve for 2 years. 
‘‘(B) Three members shall serve for 3 years. 
‘‘(C) Three members (one of which shall be 
Chair of the Commission appointed by the Presi-
dent) shall serve for 4 years. 
‘‘(2) ASSIGNMENT OF TERMS.—The Commission 
shall designate the term length that each member ap-
pointed under subsection (c) shall serve by unanimous 
agreement. In the event that unanimous agreement
477 
cannot be reached, term lengths shall be assigned to 
the members by a random process. 
‘‘(g) VACANCIES.—Subject to subsection (e), in the 
event of a vacancy in the Commission, whether due to the 
resignation of a member, the expiration of a member’s term, 
or any other reason, the vacancy shall be filled in the man-
ner in which the original appointment was made and shall 
not affect the powers of the Commission. 
‘‘(h) APPOINTMENT POWER.—Members of the Commis-
sion appointed under subsection (c) shall not be subject to 
confirmation by the Senate. 
‘‘LIMITATION ON USE OF FUNDS 
‘‘SEC. 2058. Of the amounts made available to carry 
out this subtitle, the Secretary may not use more than 
$2,000,000 in any fiscal year to support the review, ap-
proval, and oversight of social impact partnership projects, 
including activities conducted by— 
‘‘(1) the Federal Interagency Council on Social 
Impact Partnerships; and 
‘‘(2) any other agency consulted by the Secretary 
before approving a social impact partnership project 
or a feasibility study under section 2054. 
‘‘NO FEDERAL FUNDING FOR CREDIT ENHANCEMENTS 
‘‘SEC. 2059. No amount made available to carry out 
this subtitle may be used to provide any insurance, guar-
antee, or other credit enhancement to a State or local gov-
478 
ernment under which a Federal payment would be made 
to a State or local government as the result of a State or 
local government failing to achieve an outcome specified in 
an agreement. 
‘‘AVAILABILITY OF FUNDS 
‘‘SEC. 2060. Amounts made available to carry out this 
subtitle shall remain available until 10 years after the date 
of the enactment of this subtitle. 
‘‘WEBSITE 
‘‘SEC. 2061. The Federal Interagency Council on So-
cial Impact Partnerships shall establish and maintain a 
public website that shall display the following: 
‘‘(1) A copy of, or method of accessing, each no-
tice published regarding a social impact partnership 
project pursuant to this subtitle. 
‘‘(2) A copy of each feasibility study funded 
under this subtitle. 
‘‘(3) For each State or local government that has 
entered into an agreement with the Secretary for a so-
cial impact partnership project, the website shall con-
tain the following information: 
‘‘(A) The outcome goals of the project. 
‘‘(B) A description of each intervention in 
the project. 
‘‘(C) The target population that will be 
served by the project.
479 
‘‘(D) The expected social benefits to partici-
pants who receive the intervention and others 
who may be impacted. 
‘‘(E) The detailed roles, responsibilities, and 
purposes of each Federal, State, or local govern-
ment entity, intermediary, service provider, 
independent evaluator, investor, or other stake-
holder. 
‘‘(F) The payment terms, methodology used 
to calculate outcome payments, the payment 
schedule, and performance thresholds. 
‘‘(G) The project budget. 
‘‘(H) The project timeline. 
‘‘(I) The project eligibility criteria. 
‘‘(J) The evaluation design. 
‘‘(K) The metrics used to determine whether 
the proposed outcomes have been achieved and 
how these metrics are measured. 
‘‘(4) A copy of the progress reports and the final 
reports relating to each social impact partnership 
project. 
‘‘(5) An estimate of the savings to the Federal, 
State, and local government, on a program-by-pro-
gram basis and in the aggregate, resulting from the
480 
successful completion of the social impact partnership 
project. 
‘‘REGULATIONS 
‘‘SEC. 2062. The Secretary, in consultation with the 
Federal Interagency Council on Social Impact Partner-
ships, may issue regulations as necessary to carry out this 
subtitle. 
‘‘DEFINITIONS 
‘‘SEC. 2063. In this subtitle: 
‘‘(1) AGENCY.—The term ‘agency’ has the mean-
ing given that term in section 551 of title 5, United 
States Code. 
‘‘(2) INTERVENTION.—The term ‘intervention’ 
means a specific service delivered to achieve an im-
pact through a social impact partnership project. 
‘‘(3) SECRETARY.—The term ‘Secretary’ means 
the Secretary of the Treasury. 
‘‘(4) SOCIAL IMPACT PARTNERSHIP PROJECT.— 
The term ‘social impact partnership project’ means a 
project that finances social services using a social im-
pact partnership model. 
‘‘(5) SOCIAL IMPACT PARTNERSHIP MODEL.—The 
term ‘social impact partnership model’ means a 
method of financing social services in which— 
‘‘(A) Federal funds are awarded to a State 
or local government only if a State or local gov-
481 
ernment achieves certain outcomes agreed on by 
the State or local government and the Secretary; 
and 
‘‘(B) the State or local government coordi-
nates with service providers, investors (if appli-
cable to the project), and (if necessary) an inter-
mediary to identify— 
‘‘(i) 
an 
intervention 
expected 
to 
produce the outcome; 
‘‘(ii) a service provider to deliver the 
intervention to the target population; and 
‘‘(iii) investors to fund the delivery of 
the intervention. 
‘‘(6) STATE.—The term ‘State’ means each State 
of the United States, the District of Columbia, each 
commonwealth, territory or possession of the United 
States, and each federally recognized Indian tribe. 
‘‘FUNDING 
‘‘SEC. 2064. Out of any money in the Treasury of the 
United States not otherwise appropriated, there is hereby 
appropriated $92,000,000 for fiscal year 2018 to carry out 
this subtitle.’’.
482 
Subtitle C—Modernizing Child 
Support Enforcement Fees 
SEC. 2691. MODERNIZING CHILD SUPPORT ENFORCEMENT 
FEES. 
(a) IN GENERAL.— Section 454(6)(B)(ii) of the Social 
Security Act (42 U.S.C. 654(6)(B)(ii)) is amended— 
(1) by striking ‘‘$25’’ and inserting ‘‘$35’’; and 
(2) by striking ‘‘$500’’ each place it appears and 
inserting ‘‘$550’’. 
(b) EFFECTIVE DATE.— 
(1) IN GENERAL.—The amendment made by sub-
section (a) shall take effect on the 1st day of the 1st 
fiscal year that begins on or after the date of the en-
actment of this Act, and shall apply to payments 
under part D of title IV of the Social Security Act 
for calendar quarters beginning on or after such 1st 
day. 
(2) DELAY PERMITTED IF STATE LEGISLATION 
REQUIRED.—If the Secretary of Health and Human 
Services determines that State legislation (other than 
legislation appropriating funds) is required in order 
for a State plan developed pursuant to part D of title 
IV of the Social Security Act to meet the requirement 
imposed by the amendment made by subsection (a), 
the plan shall not be regarded as failing to meet the
483 
requirement before the 1st day of the 1st calendar 
quarter beginning after the first regular session of the 
State legislature that begins after the date of the en-
actment of this Act. For purposes of the preceding 
sentence, if the State has a 2-year legislative session, 
each year of the session is deemed to be a separate 
regular session of the State legislature. 
Subtitle D—Increasing Efficiency of 
Prison Data Reporting 
SEC. 2699. INCREASING EFFICIENCY OF PRISON DATA RE-
PORTING. 
(a) IN GENERAL.—Section 1611(e)(1)(I)(i)(II) of the 
Social Security Act (42 U.S.C. 1382(e)(1)(I)(i)(II)) is 
amended by striking ‘‘30 days’’ each place it appears and 
inserting ‘‘15 days’’. 
(b) EFFECTIVE DATE.—The amendments made by sub-
section (a) shall apply with respect to any payment made 
by the Commissioner of Social Security pursuant to section 
1611(e)(1)(I)(i)(II) of the Social Security Act (as amended 
by such subsection) on or after the date that is 6 months 
after the date of enactment of this Act.
484 
TITLE VII—OFFSETS 
SEC. 2701. PAYMENT FOR EARLY DISCHARGES TO HOSPICE 
CARE. 
(a) IN GENERAL.—Section 1886(d)(5)(J) of the Social 
Security Act (42 U.S.C. 1395ww(d)(5)(J)) is amended— 
(1) in clause (ii)— 
(A) in subclause (III), by striking ‘‘or’’ at 
the end; 
(B) by redesignating subclause (IV) as sub-
clause (V); and 
(C) by inserting after subclause (III) the 
following new subclause: 
‘‘(IV) for discharges occurring on 
or after October 1, 2022, is provided 
hospice care by a hospice program; or’’; 
and 
(2) in clause (iv)— 
(A) by inserting after the first sentence the 
following new sentence: ‘‘The Secretary shall in-
clude in the proposed rule published for fiscal 
year 2023, a description of the effect of clause 
(ii)(IV).’’; and 
(B) in subclause (I), by striking ‘‘and 
(III)’’ and inserting ‘‘(III), and, in the case of
485 
proposed and final rules for fiscal year 2023 and 
subsequent fiscal years, (IV)’’. 
(b) MEDPAC EVALUATION AND REPORT ON HOSPITAL 
TO HOSPICE TRANSFERS.— 
(1) EVALUATION.—The Medicare Payment Advi-
sory Commission (in this subsection referred to as the 
‘‘Commission’’) shall conduct an evaluation of the ef-
fects of the amendments made by subsection (a), in-
cluding the effects on— 
(A) the numbers of discharges of patients 
from an inpatient hospital setting to a hospice 
program; 
(B) the lengths of stays of patients in an in-
patient hospital setting who are discharged to a 
hospice program; 
(C) spending under the Medicare program 
under title XVIII of the Social Security Act; and 
(D) other areas determined appropriate by 
the Commission. 
(2) CONSIDERATION.—In conducting the evalua-
tion under paragraph (1), the Commission shall con-
sider factors such as whether the timely access to hos-
pice care by patients admitted to a hospital has been 
affected through changes to hospital policies or behav-
iors made as a result of such amendments.
486 
(3) PRELIMINARY
RESULTS.—Not later than 
March 15, 2024, the Commission shall provide Con-
gress with preliminary results on the evaluation being 
conducted under paragraph (1). 
(4) REPORT.—Not later than March 15, 2025, 
the Commission shall submit to Congress a report on 
the evaluation conducted under paragraph (1). 
SEC. 2702. HOME HEALTH MARKET BASKET REDUCTION. 
Section 1895(b)(3)(B) of the Social Security Act (42 
U.S.C. 1395fff(b)(3)(B)) is amended— 
(1) in clause (iii), in the last sentence, by insert-
ing before the period at the end the following: ‘‘and 
for 2020 shall be 1.5 percent’’; and 
(2) in clause (vi), by inserting ‘‘and 2020’’ after 
‘‘except 2018’’. 
SEC. 2703. REDUCTION FOR NON-EMERGENCY ESRD AMBU-
LANCE TRANSPORTS. 
Section 1834(l)(15) of the Social Security Act (42. 
U.S.C. 1395m(l)(15)) is amended by striking ‘‘on or after 
October 1, 2013’’ and inserting ‘‘during the period begin-
ning on October 1, 2013, and ending on September 30, 
2018, and by 23 percent for such services furnished on or 
after October 1, 2018’’.
487 
SEC. 2704. EXTENSION OF TARGET FOR RELATIVE VALUE 
ADJUSTMENTS FOR MISVALUED SERVICES 
AND TRANSITIONAL PAYMENT RULES FOR 
CERTAIN 
RADIATION 
THERAPY 
SERVICES 
UNDER THE PHYSICIAN FEE SCHEDULE. 
Section 1848 of the Social Security Act (42 U.S.C. 
1395w–4) is amended— 
(1) in subsection (b)(11), by striking ‘‘2017 and 
2018’’ and inserting ‘‘2017, 2018, and 2019’’; and 
(2) in subsection (c)(2)— 
(A) in subparagraph (K)(iv), by striking 
‘‘2017 and 2018’’ and inserting ‘‘2017, 2018, 
and 2019’’; and 
(B) in subparagraph (O), by striking 
‘‘2018’’ and inserting ‘‘2019’’. 
SEC. 2705. DELAY IN AUTHORITY TO TERMINATE CON-
TRACTS FOR MEDICARE ADVANTAGE PLANS 
FAILING TO ACHIEVE MINIMUM QUALITY RAT-
INGS. 
Section 1857(h)(3) of the Social Security Act (42 
U.S.C. 1395w–27(h)(3)) is amended by striking ‘‘2018’’ and 
inserting ‘‘2027’’. 
SEC. 2706. MEDICARE IMPROVEMENT FUND. 
Section 1898(b)(1) of the Social Security Act (42 
U.S.C. 1395iii(b)(1)) is amended by striking ‘‘during and 
after fiscal year 2021’’ and all that follows through the pe-
488 
riod at the end and inserting ‘‘during and after fiscal year 
2021, $0.’’. 
SEC. 2707. PAYMENT FOR OUTPATIENT PHYSICAL THERAPY 
SERVICES AND OUTPATIENT OCCUPATIONAL 
THERAPY SERVICES FURNISHED BY A THER-
APY ASSISTANT. 
Section 1834 of the Social Security Act (42 U.S.C. 
1395m), as amended by sections 2204 and 2414, is further 
amended by adding at the end the following new subsection: 
‘‘(x) PAYMENT FOR OUTPATIENT PHYSICAL THERAPY 
SERVICES
AND
OUTPATIENT
OCCUPATIONAL
THERAPY 
SERVICES FURNISHED BY A THERAPY ASSISTANT.— 
‘‘(1) IN GENERAL.—In the case of an outpatient 
physical therapy service or outpatient occupational 
therapy service furnished on or after January 1, 
2022, for which payment is made under section 1848 
or subsection (k), that is furnished in whole or in 
part by a therapy assistant (as defined by the Sec-
retary), the amount of payment for such service shall 
be an amount equal to 85 percent of the amount of 
payment otherwise applicable for the service under 
this part. Nothing in the preceding sentence shall be 
construed to change applicable requirements with re-
spect to such services. 
‘‘(2) USE OF MODIFIER.—
489 
‘‘(A) ESTABLISHMENT.—Not later than 
January 1, 2019, the Secretary shall establish a 
modifier to indicate (in a form and manner 
specified by the Secretary), in the case of an out-
patient physical therapy service or outpatient 
occupational therapy service furnished in whole 
or in part by a therapy assistant (as so defined), 
that the service was furnished by a therapy as-
sistant. 
‘‘(B) REQUIRED
USE.—Each request for 
payment, or bill submitted, for an outpatient 
physical therapy service or outpatient occupa-
tional therapy service furnished in whole or in 
part by a therapy assistant (as so defined) on or 
after January 1, 2020, shall include the modifier 
established under subparagraph (A) for each 
such service. 
‘‘(3) IMPLEMENTATION.—The Secretary shall im-
plement this subsection through notice and comment 
rulemaking.’’. 
SEC. 2708. CHANGES TO LONG-TERM CARE HOSPITAL PAY-
MENTS. 
(a) EXTENSION.—Section 1886(m)(6)(B)(i) of the So-
cial Security Act (42 U.S.C. 1395ww(m)(6)(B)(i)) is 
amended—
490 
(1) in subclause (I), by striking ‘‘fiscal year 
2016 or fiscal year 2017’’ and inserting ‘‘fiscal years 
2016 through 2019’’; and 
(2) in subclause (II), by striking ‘‘2018’’ and in-
serting ‘‘2020’’. 
(b) TEMPORARY ADJUSTMENT TO SITE NEUTRAL PAY-
MENT RATES.—Section 1886(m)(6)(B) of the Social Secu-
rity Act (42 U.S.C. 1395ww(m)(6)(B)) is amended— 
(1) in clause (ii), in the matter preceding sub-
clause (I), by striking ‘‘In this paragraph’’ and in-
serting ‘‘Subject to clause (iv), in this paragraph’’; 
and 
(2) by adding at the end the following new 
clause: 
‘‘(iv) ADJUSTMENT.—For each of fiscal 
years 2018 through 2026, the amount that 
would otherwise apply under clause (ii)(I) 
for the year (determined without regard to 
this clause) shall be reduced by 4.6 per-
cent.’’. 
SEC. 2709. NON-BUDGET NEUTRAL TRANSITIONAL PASS- 
THROUGH PAYMENT CHANGE FOR CERTAIN 
PRODUCTS. 
(a) IN GENERAL.—Subsection 1833(t)(6)(A)(iv) of the 
Social Security Act (42 U.S.C. 1395l(t)(6)(A)(iv)) is
491 
amended by inserting ‘‘(except, beginning as of April 1, 
2018, a biosimilar biological product (as defined under sec-
tion 1847A(c)(6)(H)))’’ after ‘‘biological’’. 
(b) APPLICATION.—The amendment made by sub-
section (a) shall apply with respect to biosimilar biological 
products beginning on April 1, 2018, regardless of whether 
such products were receiving pass-through status for an ad-
ditional payment under section 1833(t)(6) of the Social Se-
curity Act (42 U.S.C. 1395l(t)(6)) before such date. In the 
case of a product that was receiving such an additional 
payment pursuant to clause (iv) of subparagraph (A) of 
such section as of the day before such date and after appli-
cation of the amendment under subsection (a) is not eligible 
for such an additional payment as of such date, such prod-
uct may not be eligible for such an additional payment pur-
suant to any other clause of such subparagraph (A). 
SEC. 2710. THIRD PARTY LIABILITY IN MEDICAID AND CHIP. 
(a) MODIFICATION OF THIRD PARTY LIABILITY RULES 
RELATED TO SPECIAL TREATMENT OF CERTAIN TYPES OF 
CARE AND PAYMENTS.— 
(1) IN GENERAL.—Section 1902(a)(25)(E) of the 
Social Security Act (42 U.S.C. 1396a(a)(25)(E)) is 
amended, in the matter preceding clause (i), by strik-
ing ‘‘prenatal or’’.
492 
(2) EFFECTIVE DATE.—The amendment made by 
paragraph (1) shall take effect on the date of enact-
ment of this Act. 
(b) DELAY IN EFFECTIVE DATE AND REPEAL OF CER-
TAIN BIPARTISAN BUDGET ACT OF 2013 AMENDMENTS.— 
(1) REPEAL.—Effective as of September 30, 
2017, subsection (b) of section 202 of the Bipartisan 
Budget Act of 2013 (Public Law 113–67; 127 Stat. 
1177; 42 U.S.C. 1396a note) (including any amend-
ments made by such subsection) is repealed and the 
provisions amended by such subsection shall be ap-
plied and administered as if such amendments had 
never been enacted. 
(2) DELAY IN EFFECTIVE DATE.—Subsection (c) 
of section 202 of the Bipartisan Budget Act of 2013 
(Public Law 113–67; 127 Stat. 1177; 42 U.S.C. 
1396a note) is amended to read as follows: 
‘‘(c) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall take effect on October 1, 2019.’’. 
(3) EFFECTIVE DATE; TREATMENT.—The repeal 
and amendment made by this subsection shall take ef-
fect as if enacted on September 30, 2017, and shall 
apply with respect to any open claims, including 
claims pending, generated, or filed, after such date. 
The amendments made by subsections (a) and (b) of
493 
section 202 of the Bipartisan Budget Act of 2013 
(Public Law 113–67; 127 Stat. 1177; 42 U.S.C. 
1396a note) that took effect on October 1, 2017, are 
null and void and section 1902(a)(25) of the Social 
Security Act (42 U.S.C. 1396a(a)(25)) shall be ap-
plied and administered as if such amendments had 
not taken effect on such date. 
(c) GAO STUDY AND REPORT.—Not later than 18 
months after the date of enactment of this Act, the Comp-
troller General of the United States shall submit a report 
to the Committee on Energy and Commerce of the House 
of Representatives and the Committee on Finance of the 
Senate on the impacts of the amendments made by sub-
sections (a)(1) and (b)(2), including— 
(1) the impact, or potential effect, of such 
amendments on access to prenatal and preventive pe-
diatric care (including early and periodic screening, 
diagnostic, and treatment services) covered under 
State plans under such title (or waivers of such 
plans); 
(2) the impact, or potential effect, of such 
amendments on access to services covered under such 
plans or waivers for individuals on whose behalf child 
support enforcement is being carried out by a State 
agency under part D of title IV of such Act; and
494 
(3) the impact, or potential effect, on providers 
of services under such plans or waivers of delays in 
payment or related issues that result from such 
amendments. 
(d) APPLICATION TO CHIP.— 
(1) IN GENERAL.—Section 2107(e)(1) of the So-
cial Security Act (42 U.S.C. 1397gg(e)(1)) is amend-
ed— 
(A) by redesignating subparagraphs (B) 
through (R) as subparagraphs (C) through (S), 
respectively; and 
(B) by inserting after subparagraph (A) the 
following new subparagraph: 
‘‘(B) Section 1902(a)(25) (relating to third 
party liability).’’. 
(2) 
MANDATORY
REPORTING.—Section 
1902(a)(25)(I)(i) of the Social Security Act (42 
U.S.C. 1396a(a)(25)(I)(i)) is amended— 
(A) by striking ‘‘medical assistance under 
the State plan’’ and inserting ‘‘medical assist-
ance under a State plan (or under a waiver of 
the plan)’’; 
(B) by striking ‘‘(and, at State option, 
child’’ and inserting ‘‘and child’’; and
495 
(C) by striking ‘‘title XXI)’’ and inserting 
‘‘title XXI’’. 
SEC. 2711. TREATMENT OF LOTTERY WINNINGS AND OTHER 
LUMP-SUM INCOME FOR PURPOSES OF IN-
COME ELIGIBILITY UNDER MEDICAID. 
(a) IN GENERAL.—Section 1902 of the Social Security 
Act (42 U.S.C. 1396a) is amended— 
(1) in subsection (a)(17), by striking ‘‘(e)(14), 
(e)(14)’’ and inserting ‘‘(e)(14), (e)(15)’’; and 
(2) in subsection (e)(14), by adding at the end 
the following new subparagraph: 
‘‘(K) TREATMENT
OF
CERTAIN
LOTTERY 
WINNINGS AND INCOME RECEIVED AS A LUMP 
SUM.— 
‘‘(i) IN GENERAL.—In the case of an 
individual who is the recipient of qualified 
lottery winnings (pursuant to lotteries oc-
curring on or after January 1, 2018) or 
qualified lump sum income (received on or 
after such date) and whose eligibility for 
medical assistance is determined based on 
the application of modified adjusted gross 
income under subparagraph (A), a State 
shall, in determining such eligibility, in-
496 
clude such winnings or income (as applica-
ble) as income received— 
‘‘(I) in the month in which such 
winnings or income (as applicable) is 
received 
if 
the 
amount 
of 
such 
winnings or income is less than 
$80,000; 
‘‘(II) over a period of 2 months if 
the amount of such winnings or income 
(as applicable) is greater than or equal 
to $80,000 but less than $90,000; 
‘‘(III) over a period of 3 months 
if the amount of such winnings or in-
come (as applicable) is greater than or 
equal 
to 
$90,000 
but 
less 
than 
$100,000; and 
‘‘(IV) over a period of 3 months 
plus 1 additional month for each incre-
ment of $10,000 of such winnings or 
income (as applicable) received, not to 
exceed a period of 120 months (for 
winnings or income of $1,260,000 or 
more), if the amount of such winnings 
or income is greater than or equal to 
$100,000.
497 
‘‘(ii) COUNTING
IN
EQUAL
INSTALL-
MENTS.—For purposes of subclauses (II), 
(III), and (IV) of clause (i), winnings or 
income to which such subclause applies 
shall be counted in equal monthly install-
ments over the period of months specified 
under such subclause. 
‘‘(iii) HARDSHIP EXEMPTION.—An in-
dividual whose income, by application of 
clause (i), exceeds the applicable eligibility 
threshold established by the State, shall con-
tinue to be eligible for medical assistance to 
the extent that the State determines, under 
procedures established by the State (in ac-
cordance with standards specified by the 
Secretary), that the denial of eligibility of 
the individual would cause an undue med-
ical or financial hardship as determined on 
the basis of criteria established by the Sec-
retary. 
‘‘(iv) NOTIFICATIONS AND ASSISTANCE 
REQUIRED
IN
CASE
OF
LOSS
OF
ELIGI-
BILITY.—A State shall, with respect to an 
individual who loses eligibility for medical
498 
assistance under the State plan (or a waiv-
er of such plan) by reason of clause (i)— 
‘‘(I) before the date on which the 
individual loses such eligibility, inform 
the individual— 
‘‘(aa) of the individual’s op-
portunity to enroll in a qualified 
health plan offered through an 
Exchange established under title I 
of the Patient Protection and Af-
fordable Care Act during the spe-
cial enrollment period specified in 
section 9801(f)(3) of the Internal 
Revenue Code of 1986 (relating to 
loss of Medicaid or CHIP cov-
erage); and 
‘‘(bb) of the date on which 
the individual would no longer be 
considered ineligible by reason of 
clause (i) to receive medical as-
sistance under the State plan or 
under any waiver of such plan 
and be eligible to reapply to re-
ceive such medical assistance; and
499 
‘‘(II) provide technical assistance 
to the individual seeking to enroll in 
such a qualified health plan. 
‘‘(v) QUALIFIED
LOTTERY
WINNINGS 
DEFINED.—In this subparagraph, the term 
‘qualified lottery winnings’ means winnings 
from a sweepstakes, lottery, or pool de-
scribed in paragraph (3) of section 4402 of 
the Internal Revenue Code of 1986 or a lot-
tery operated by a multistate or multijuris-
dictional 
lottery 
association, 
including 
amounts awarded as a lump sum payment. 
‘‘(vi) QUALIFIED
LUMP
SUM
INCOME 
DEFINED.—In this subparagraph, the term 
‘qualified lump sum income’ means income 
that is received as a lump sum from mone-
tary winnings from gambling (as defined by 
the Secretary and including gambling ac-
tivities described in section 1955(b)(4) of 
title 18, United States Code).’’. 
(b) RULES OF CONSTRUCTION.— 
(1) INTERCEPTION OF LOTTERY WINNINGS AL-
LOWED.—Nothing in the amendment made by sub-
section (a)(2) shall be construed as preventing a State 
from intercepting the State lottery winnings awarded
500 
to an individual in the State to recover amounts paid 
by the State under the State Medicaid plan under 
title XIX of the Social Security Act (42 U.S.C. 1396 
et seq.) for medical assistance furnished to the indi-
vidual. 
(2) APPLICABILITY LIMITED TO ELIGIBILITY OF 
RECIPIENT OF LOTTERY WINNINGS OR LUMP SUM IN-
COME.—Nothing in the amendment made by sub-
section (a)(2) shall be construed, with respect to a de-
termination of household income for purposes of a de-
termination of eligibility for medical assistance under 
the State plan under title XIX of the Social Security 
Act (42 U.S.C. 1396 et seq.) (or a waiver of such 
plan) made by applying modified adjusted gross in-
come under subparagraph (A) of section 1902(e)(14) 
of such Act (42 U.S.C. 1396a(e)(14)), as limiting the 
eligibility for such medical assistance of any indi-
vidual that is a member of the household other than 
the individual who received qualified lottery winnings 
or qualified lump-sum income (as defined in subpara-
graph (K) of such section 1902(e)(14), as added by 
subsection (a)(2) of this section).
501 
SEC. 2712. MODIFYING REDUCTIONS IN MEDICAID DSH AL-
LOTMENTS. 
Section 1923(f)(7)(A) of the Social Security Act (42 
U.S.C. 1396r–4(f)(7)(A)) is amended— 
(1) in clause (i), in the matter preceding sub-
clause (I), by striking ‘‘2018’’ and inserting ‘‘2020’’; 
and 
(2) in clause (ii), by striking subclauses (I) 
through (VIII) and inserting the following: 
‘‘(I) $4,000,000,000 for fiscal year 
2020; and 
‘‘(II) $8,000,000,000 for each of 
fiscal years 2021 through 2025.’’. 
SEC. 2713. MEDICAID IMPROVEMENT FUND RESCISSION. 
Section 1941(b) of the Social Security Act (42 U.S.C 
1396w–1(b)) is amended— 
(1) in paragraph (1), by striking ‘‘$5,000,000’’ 
and inserting ‘‘$0’’; and 
(2) in paragraph (3)(A) (as added by section 
3006(2)(B) of the Helping Ensure Access for Little 
Ones, Toddlers, and Hopeful Youth by Keeping Insur-
ance Delivery Stable Act (Public Law 115–120)), by 
striking ‘‘$980,000,000’’ and inserting ‘‘$0’’.
502 
SEC. 2714. SUNSETTING EXCLUSION OF BIOSIMILARS FROM 
MEDICARE PART D COVERAGE GAP DISCOUNT 
PROGRAM. 
Section 1860D–14A(g)(2)(A) of the Social Security 
Act (42 U.S.C. 1395w–114a(g)(2)(A)) is amended by insert-
ing ‘‘, with respect to a plan year before 2019,’’ after ‘‘other 
than’’. 
SEC. 2715. PREVENTION AND PUBLIC HEALTH FUND. 
Section 4002(b) of the Patient Protection and Afford-
able Care Act (42 U.S.C. 300u–11(b)) is amended by strik-
ing paragraphs (1) through (9) and inserting the following 
new paragraphs: 
‘‘(1) for each of fiscal years 2018 and 2019, 
$900,000,000; 
‘‘(2) for each of fiscal years 2020 and 2021, 
$1,000,000,000; 
‘‘(3) for each of fiscal years 2022 through 2027, 
$1,100,000,000; and 
‘‘(4) for fiscal year 2028 and each subsequent fis-
cal year, $2,000,000,000.’’. 
DIVISION G—BUDGETARY 
EFFECTS 
SEC. 3001. BUDGETARY EFFECTS. 
(a) IN GENERAL.—The budgetary effects of division D 
and each succeeding division shall not be entered on either
503 
PAYGO scorecard maintained pursuant to section 4(d) of 
the Statutory Pay-As-You-Go Act of 2010. 
(b) SENATE PAYGO SCORECARDS.—The budgetary ef-
fects of division D and each succeeding division shall not 
be entered on any PAYGO scorecard maintained for pur-
poses of section 4106 of H. Con. Res. 71 (115th Congress). 
(c) CLASSIFICATION OF BUDGETARY EFFECTS.—Not-
withstanding Rule 3 of the Budget Scorekeeping Guidelines 
set forth in the joint explanatory statement of the committee 
of conference accompanying Conference Report 105–217 
and section 250(c)(8) of the Balanced Budget and Emer-
gency Deficit Control Act of 1985, the budgetary effects of 
division D and each succeeding division shall not be esti-
mated— 
(1) for purposes of section 251 of such Act; and 
(2) for purposes of paragraph (4)(C) of section 
3 of the Statutory Pay-As-You-Go Act of 2010 as 
being included in an appropriation Act. 
Attest: 
Clerk.
115TH CONGRESS 
2D SESSION 
H.R. 1892 
HOUSE AMENDMENT TO 
SENATE AMENDMENT