382 
† HR 1892 EAS2 
codes and units described in this clause, 
with respect to drugs included in payment 
category 2 described in subparagraph 
(C)(i), are one unit of HCPCS code 96369 
plus three units of HCPCS code 96370 (as 
identified as of January 1, 2018, and as 
subsequently modified by the Secretary). 
‘‘(iv) PAYMENT
AMOUNT
FOR
CAT-
EGORY 3.—For purposes of clause (i), the 
codes and units described in this clause, 
with respect to drugs included in payment 
category 3 described in subparagraph 
(C)(i), are one unit of HCPCS code 96413 
plus three units of HCPCS code 96415 (as 
identified as of January 1, 2018, and as 
subsequently modified by the Secretary). 
‘‘(E) CLARIFICATIONS.— 
‘‘(i) INFUSION DRUG ADMINISTRATION 
DAY.—For purposes of this subsection, with 
respect to the furnishing of transitional 
home infusion drugs or home infusion drugs 
to an individual by an eligible home infu-
sion supplier or a qualified home infusion 
therapy supplier, a reference to payment to 
such supplier for an infusion drug adminis-
383 
† HR 1892 EAS2 
tration calendar day in the individual’s 
home shall refer to payment only for the 
date on which professional services (as de-
scribed in section 1861(iii)(2)(A)) were fur-
nished to administer such drugs to such in-
dividual. For purposes of the previous sen-
tence, an infusion drug administration cal-
endar day shall include all such drugs ad-
ministered to such individual on such day. 
‘‘(ii) TREATMENT OF MULTIPLE DRUGS 
ADMINISTERED
ON
SAME
INFUSION
DRUG 
ADMINISTRATION DAY.—In the case that an 
eligible home infusion supplier, with respect 
to an infusion drug administration cal-
endar day in an individual’s home, fur-
nishes to such individual transitional home 
infusion drugs which are not all assigned to 
the same payment category under subpara-
graph (C), payment to such supplier for 
such infusion drug administration calendar 
day in the individual’s home shall be a sin-
gle payment equal to the amount of pay-
ment under this paragraph for the drug, 
among all such drugs so furnished to such 
individual during such calendar day, for
384 
† HR 1892 EAS2 
which the highest payment would be made 
under this paragraph. 
‘‘(F) 
ELIGIBLE
HOME
INFUSION
SUP-
PLIERS.—In this paragraph, the term ‘eligible 
home infusion supplier’ means a supplier that is 
enrolled under this part as a pharmacy that pro-
vides external infusion pumps and external infu-
sion pump supplies and that maintains all 
pharmacy licensure requirements in the State in 
which the applicable infusion drugs are adminis-
tered. 
‘‘(G) 
IMPLEMENTATION.—Notwithstanding 
any other provision of law, the Secretary may 
implement this paragraph by program instruc-
tion or otherwise.’’. 
(b) 
CONFORMING
AMENDMENTS.—(1) 
Section 
1842(b)(6)(I) of the Social Security Act (42 U.S.C. 
1395u(b)(6)(I)) is amended by inserting ‘‘or, in the case 
of items and services described in clause (i) of section 
1834(u)(7)(A) furnished to an individual during the period 
described in clause (ii) of such section, payment shall be 
made to the eligible home infusion therapy supplier’’ after 
‘‘payment shall be made to the qualified home infusion ther-
apy supplier’’.
385 
† HR 1892 EAS2 
(2) Section 5012(d) of the 21st Century Cures Act is 
amended by inserting the following before the period at the 
end: ‘‘, except that the amendments made by paragraphs 
(1) and (2) of subsection (c) shall apply to items and serv-
ices furnished on or after January 1, 2019’’. 
SEC. 50402. ORTHOTIST’S AND PROSTHETIST’S CLINICAL 
NOTES AS PART OF THE PATIENT’S MEDICAL 
RECORD. 
Section 1834(h) of the Social Security Act (42 U.S.C. 
1395m(h)) is amended by adding at the end the following 
new paragraph: 
‘‘(5) DOCUMENTATION CREATED BY ORTHOTISTS 
AND
PROSTHETISTS.—For purposes of determining 
the reasonableness and medical necessity of orthotics 
and 
prosthetics, 
documentation 
created 
by 
an 
orthotist or prosthetist shall be considered part of the 
individual’s medical record to support documentation 
created by eligible professionals described in section 
1848(k)(3)(B).’’. 
SEC. 50403. INDEPENDENT ACCREDITATION FOR DIALYSIS 
FACILITIES AND ASSURANCE OF HIGH QUAL-
ITY SURVEYS. 
(a) ACCREDITATION AND SURVEYS.— 
(1) IN GENERAL.—Section 1865 of the Social Se-
curity Act (42 U.S.C. 1395bb) is amended—
386 
† HR 1892 EAS2 
(A) in subsection (a)— 
(i) in paragraph (1), in the matter 
preceding subparagraph (A), by striking ‘‘or 
the conditions and requirements under sec-
tion 1881(b)’’; and 
(ii) in paragraph (4), by inserting 
‘‘(including a renal dialysis facility)’’ after 
‘‘facility’’; and 
(B) by adding at the end the following new 
subsection: 
‘‘(e) With respect to an accreditation body that has re-
ceived approval from the Secretary under subsection 
(a)(3)(A) for accreditation of provider entities that are re-
quired to meet the conditions and requirements under sec-
tion 1881(b), in addition to review and oversight authori-
ties otherwise applicable under this title, the Secretary shall 
(as the Secretary determines appropriate) conduct, with re-
spect to such accreditation body and provider entities, any 
or all of the following as frequently as is otherwise required 
to be conducted under this title with respect to other accredi-
tation bodies or other provider entities: 
‘‘(1) Validation surveys referred to in subsection 
(d).
387 
† HR 1892 EAS2 
‘‘(2) Accreditation program reviews (as defined 
in section 488.8(c) of title 42 of the Code of Federal 
Regulations, or a successor regulation). 
‘‘(3) Performance reviews (as defined in section 
488.8(a) of title 42 of the Code of Federal Regula-
tions, or a successor regulation).’’. 
(2) TIMING
FOR
ACCEPTANCE
OF
REQUESTS 
FROM
ACCREDITATION
ORGANIZATIONS.—Not later 
than 90 days after the date of enactment of this Act, 
the Secretary of Health and Human Services shall 
begin accepting requests from national accreditation 
bodies 
for 
a 
finding 
described 
in 
section 
1865(a)(3)(A) of the Social Security Act (42 U.S.C. 
1395bb(a)(3)(A)) for purposes of accrediting provider 
entities that are required to meet the conditions and 
requirements under section 1881(b) of such Act (42 
U.S.C. 1395rr(b)). 
(b) REQUIREMENT FOR TIMING OF SURVEYS OF NEW 
DIALYSIS FACILITIES.—Section 1881(b)(1) of the Social Se-
curity Act (42 U.S.C. 1395rr(b)(1)) is amended by adding 
at the end the following new sentence: ‘‘Beginning 180 days 
after the date of the enactment of this sentence, an initial 
survey of a provider of services or a renal dialysis facility 
to determine if the conditions and requirements under this 
paragraph are met shall be initiated not later than 90 days
388 
† HR 1892 EAS2 
after such date on which both the provider enrollment form 
(without regard to whether such form is submitted prior 
to or after such date of enactment) has been determined by 
the Secretary to be complete and the provider’s enrollment 
status indicates approval is pending the results of such sur-
vey.’’. 
SEC. 50404. MODERNIZING THE APPLICATION OF THE 
STARK RULE UNDER MEDICARE. 
(a) CLARIFICATION OF THE WRITING REQUIREMENT 
AND SIGNATURE REQUIREMENT FOR ARRANGEMENTS PUR-
SUANT TO THE STARK RULE.— 
(1) 
WRITING
REQUIREMENT.—Section 
1877(h)(1) of the Social Security Act (42 U.S.C. 
1395nn(h)(1)) is amended by adding at the end the 
following new subparagraph: 
‘‘(D) WRITTEN
REQUIREMENT
CLARIFIED.—In 
the case of any requirement pursuant to this section 
for a compensation arrangement to be in writing, 
such requirement shall be satisfied by such means as 
determined by the Secretary, including by a collection 
of documents, including contemporaneous documents 
evidencing the course of conduct between the parties 
involved.’’. 
(2) 
SIGNATURE
REQUIREMENT.—Section 
1877(h)(1) of the Social Security Act (42 U.S.C.
389 
† HR 1892 EAS2 
1395nn(h)(1)), as amended by paragraph (1), is fur-
ther amended by adding at the end the following new 
subparagraph: 
‘‘(E) SPECIAL RULE FOR SIGNATURE RE-
QUIREMENTS.—In the case of any requirement 
pursuant to this section for a compensation ar-
rangement to be in writing and signed by the 
parties, such signature requirement shall be met 
if— 
‘‘(i) not later than 90 consecutive cal-
endar days immediately following the date 
on which the compensation arrangement be-
came noncompliant, the parties obtain the 
required signatures; and 
‘‘(ii) the compensation arrangement 
otherwise complies with all criteria of the 
applicable exception.’’. 
(b) INDEFINITE HOLDOVER
FOR LEASE ARRANGE-
MENTS AND PERSONAL SERVICES ARRANGEMENTS PURSU-
ANT TO THE STARK RULE.—Section 1877(e) of the Social 
Security Act (42 U.S.C. 1395nn(e)) is amended— 
(1) in paragraph (1), by adding at the end the 
following new subparagraph: 
‘‘(C) HOLDOVER LEASE ARRANGEMENTS.— 
In the case of a holdover lease arrangement for
390 
† HR 1892 EAS2 
the lease of office space or equipment, which im-
mediately follows a lease arrangement described 
in subparagraph (A) for the use of such office 
space or subparagraph (B) for the use of such 
equipment and that expired after a term of at 
least 1 year, payments made by the lessee to the 
lessor pursuant to such holdover lease arrange-
ment, if— 
‘‘(i) the lease arrangement met the con-
ditions of subparagraph (A) for the lease of 
office space or subparagraph (B) for the use 
of equipment when the arrangement ex-
pired; 
‘‘(ii) the holdover lease arrangement is 
on the same terms and conditions as the 
immediately preceding arrangement; and 
‘‘(iii) the holdover arrangement con-
tinues to satisfy the conditions of subpara-
graph (A) for the lease of office space or 
subparagraph (B) for the use of equip-
ment.’’; and 
(2) in paragraph (3), by adding at the end the 
following new subparagraph: 
‘‘(C) HOLDOVER
PERSONAL
SERVICE
AR-
RANGEMENT.—In the case of a holdover personal
391 
† HR 1892 EAS2 
service arrangement, which immediately follows 
an arrangement described in subparagraph (A) 
that expired after a term of at least 1 year, re-
muneration from an entity pursuant to such 
holdover personal service arrangement, if— 
‘‘(i) the personal service arrangement 
met the conditions of subparagraph (A) 
when the arrangement expired; 
‘‘(ii) the holdover personal service ar-
rangement is on the same terms and condi-
tions as the immediately preceding arrange-
ment; and 
‘‘(iii) the holdover arrangement con-
tinues to satisfy the conditions of subpara-
graph (A).’’. 
Subtitle B—Additional Medicare 
Provisions 
SEC. 50411. MAKING PERMANENT THE REMOVAL OF THE 
RENTAL CAP FOR DURABLE MEDICAL EQUIP-
MENT UNDER MEDICARE WITH RESPECT TO 
SPEECH GENERATING DEVICES. 
Section 1834(a)(2)(A)(iv) of the Social Security Act 
(42 U.S.C. 1395m(a)(2)(A)(iv)) is amended by striking 
‘‘and before October 1, 2018,’’.
392 
† HR 1892 EAS2 
SEC. 50412. INCREASED CIVIL AND CRIMINAL PENALTIES 
AND INCREASED SENTENCES FOR FEDERAL 
HEALTH CARE PROGRAM FRAUD AND ABUSE. 
(a) INCREASED CIVIL MONEY PENALTIES AND CRIMI-
NAL FINES.— 
(1) INCREASED CIVIL MONEY PENALTIES.—Sec-
tion 1128A of the Social Security Act (42 U.S.C. 
1320a–7a) is amended— 
(A) in subsection (a), in the matter fol-
lowing paragraph (10)— 
(i) by striking ‘‘$10,000’’ and inserting 
‘‘$20,000’’ each place it appears; 
(ii) by striking ‘‘$15,000’’ and insert-
ing ‘‘$30,000’’; and 
(iii) by striking ‘‘$50,000’’ and insert-
ing ‘‘$100,000’’ each place it appears; and 
(B) in subsection (b)— 
(i) in paragraph (1), in the flush text 
following subparagraph (B), by striking 
‘‘$2,000’’ and inserting ‘‘$5,000’’; 
(ii) in paragraph (2), by striking 
‘‘$2,000’’ and inserting ‘‘$5,000’’; and 
(iii) in paragraph (3)(A)(i), by strik-
ing ‘‘$5,000’’ and inserting ‘‘$10,000’’.
393 
† HR 1892 EAS2 
(2) 
INCREASED
CRIMINAL
FINES.—Section 
1128B of such Act (42 U.S.C. 1320a–7b) is amend-
ed— 
(A) in subsection (a), in the matter fol-
lowing paragraph (6)— 
(i) by striking ‘‘$25,000’’ and inserting 
‘‘$100,000’’; and 
(ii) by striking ‘‘$10,000’’ and insert-
ing ‘‘$20,000’’; 
(B) in subsection (b)— 
(i) in paragraph (1), in the flush text 
following subparagraph (B), by striking 
‘‘$25,000’’ and inserting ‘‘$100,000’’; and 
(ii) in paragraph (2), in the flush text 
following subparagraph (B), by striking 
‘‘$25,000’’ and inserting ‘‘$100,000’’; 
(C) in subsection (c), by striking ‘‘$25,000’’ 
and inserting ‘‘$100,000’’; 
(D) in subsection (d), in the flush text fol-
lowing paragraph (2), by striking ‘‘$25,000’’ and 
inserting ‘‘$100,000’’; and 
(E) in subsection (e), by striking ‘‘$2,000’’ 
and inserting ‘‘$4,000’’. 
(b) INCREASED SENTENCES FOR FELONIES INVOLVING 
FEDERAL HEALTH CARE PROGRAM FRAUD AND ABUSE.—
394 
† HR 1892 EAS2 
(1) FALSE
STATEMENTS
AND
REPRESENTA-
TIONS.—Section 1128B(a) of the Social Security Act 
(42 U.S.C. 1320a–7b(a)) is amended, in the matter 
following paragraph (6), by striking ‘‘not more than 
five years or both, or (ii)’’ and inserting ‘‘not more 
than 10 years or both, or (ii)’’. 
(2) ANTIKICKBACK.—Section 1128B(b) of such 
Act (42 U.S.C. 1320a–7b(b)) is amended— 
(A) in paragraph (1), in the flush text fol-
lowing subparagraph (B), by striking ‘‘not more 
than five years’’ and inserting ‘‘not more than 
10 years’’; and 
(B) in paragraph (2), in the flush text fol-
lowing subparagraph (B), by striking ‘‘not more 
than five years’’ and inserting ‘‘not more than 
10 years’’. 
(3) FALSE
STATEMENT
OR
REPRESENTATION 
WITH RESPECT TO CONDITIONS OR OPERATIONS OF 
FACILITIES.—Section 1128B(c) of such Act (42 U.S.C. 
1320a–7b(c)) is amended by striking ‘‘not more than 
five years’’ and inserting ‘‘not more than 10 years’’. 
(4) EXCESS
CHARGES.—Section 1128B(d) of 
such Act (42 U.S.C. 1320a–7b(d)) is amended, in the 
flush text following paragraph (2), by striking ‘‘not
395 
† HR 1892 EAS2 
more than five years’’ and inserting ‘‘not more than 
10 years’’. 
(c) EFFECTIVE DATE.—The amendments made by this 
section shall apply to acts committed after the date of the 
enactment of this Act. 
SEC. 50413. REDUCING THE VOLUME OF FUTURE EHR-RE-
LATED SIGNIFICANT HARDSHIP REQUESTS. 
Section 1848(o)(2)(A) of the Social Security Act (42 
U.S.C. 1395w–4(o)(2)(A)) and section 1886(n)(3)(A) of 
such Act (42 U.S.C. 1395ww(n)(3)(A)) are each amended 
in the last sentence by striking ‘‘by requiring’’ and all that 
follows through ‘‘this paragraph’’. 
SEC. 50414. STRENGTHENING RULES IN CASE OF COMPETI-
TION FOR DIABETIC TESTING STRIPS. 
(a) SPECIAL RULE IN CASE OF COMPETITION FOR DI-
ABETIC TESTING STRIPS.— 
(1) IN
GENERAL.—Paragraph (10) of section 
1847(b) of the Social Security Act (42 U.S.C. 1395w– 
3(b)) is amended— 
(A) in subparagraph (A), by striking the 
second sentence and inserting the following new 
sentence: ‘‘With respect to bids to furnish such 
types of products on or after January 1, 2019, 
the volume for such types of products shall be de-
termined by the Secretary through the use of
396 
† HR 1892 EAS2 
multiple sources of data (from mail order and 
non-mail order Medicare markets), including 
market-based data measuring sales of diabetic 
testing strip products that are not exclusively 
sold by a single retailer from such markets.’’; 
and 
(B) by adding at the end the following new 
subparagraphs: 
‘‘(C) DEMONSTRATION OF ABILITY TO FUR-
NISH TYPES OF DIABETIC TESTING STRIP PROD-
UCTS.—With respect to bids to furnish diabetic 
testing strip products on or after January 1, 
2019, an entity shall attest to the Secretary that 
the entity has the ability to obtain an inventory 
of the types and quantities of diabetic testing 
strip products that will allow the entity to fur-
nish such products in a manner consistent with 
its bid and— 
‘‘(i) demonstrate to the Secretary, 
through letters of intent with manufactur-
ers, wholesalers, or other suppliers, or other 
evidence as the Secretary may specify, such 
ability; or
397 
† HR 1892 EAS2 
‘‘(ii) demonstrate to the Secretary that 
it made a good faith attempt to obtain such 
a letter of intent or such other evidence. 
‘‘(D) USE OF UNLISTED TYPES IN CALCULA-
TION OF PERCENTAGE.—With respect to bids to 
furnish diabetic testing strip products on or after 
January 1, 2019, in determining under subpara-
graph (A) whether a bid submitted by an entity 
under such subparagraph covers 50 percent (or 
such higher percentage as the Secretary may 
specify) of all types of diabetic testing strip 
products, the Secretary may not attribute a per-
centage to types of diabetic testing strip products 
that the Secretary does not identify by brand, 
model, and market share volume. 
‘‘(E) ADHERENCE TO DEMONSTRATION.— 
‘‘(i) IN GENERAL.—In the case of an 
entity that is furnishing diabetic testing 
strip products on or after January 1, 2019, 
under a contract entered into under the 
competition conducted pursuant to para-
graph (1), the Secretary shall establish a 
process to monitor, on an ongoing basis, the 
extent to which such entity continues to
398 
† HR 1892 EAS2 
cover the product types included in the enti-
ty’s bid. 
‘‘(ii) TERMINATION.—If the Secretary 
determines that an entity described in 
clause (i) fails to maintain in inventory, or 
otherwise maintain ready access to (through 
requirements, contracts, or otherwise) a type 
of product included in the entity’s bid, the 
Secretary may terminate such contract un-
less the Secretary finds that the failure of 
the entity to maintain inventory of, or 
ready access to, the product is the result of 
the discontinuation of the product by the 
product manufacturer, a market-wide short-
age of the product, or the introduction of a 
newer model or version of the product in the 
market involved.’’. 
(b) CODIFYING
AND
EXPANDING
ANTI-SWITCHING 
RULE.—Section 1847(b) of the Social Security Act (42 
U.S.C. 1395w–3(b)), as amended by subsection (a)(1), is 
further amended— 
(1) by redesignating paragraph (11) as para-
graph (12); and 
(2) by inserting after paragraph (10) the fol-
lowing new paragraph:
399 
† HR 1892 EAS2 
‘‘(11) ADDITIONAL SPECIAL RULES IN CASE OF 
COMPETITION FOR DIABETIC TESTING STRIPS.— 
‘‘(A) IN GENERAL.—With respect to an enti-
ty that is furnishing diabetic testing strip prod-
ucts to individuals under a contract entered into 
under the competitive acquisition program estab-
lished under this section, the entity shall furnish 
to each individual a brand of such products that 
is compatible with the home blood glucose mon-
itor selected by the individual. 
‘‘(B) PROHIBITION
ON
INFLUENCING
AND 
INCENTIVIZING.—An entity described in sub-
paragraph (A) may not attempt to influence or 
incentivize an individual to switch the brand of 
glucose monitor or diabetic testing strip product 
selected by the individual, including by— 
‘‘(i) persuading, pressuring, or advis-
ing the individual to switch; or 
‘‘(ii) furnishing information about al-
ternative brands to the individual where the 
individual has not requested such informa-
tion. 
‘‘(C) PROVISION OF INFORMATION.— 
‘‘(i) STANDARDIZED
INFORMATION.— 
Not later than January 1, 2019, the Sec-
400 
† HR 1892 EAS2 
retary shall develop and make available to 
entities described in subparagraph (A) 
standardized information that describes the 
rights of an individual with respect to such 
an entity. The information described in the 
preceding sentence shall include information 
regarding— 
‘‘(I) the requirements established 
under subparagraphs (A) and (B); 
‘‘(II) the right of the individual to 
purchase diabetic testing strip products 
from another mail order supplier of 
such products or a retail pharmacy if 
the entity is not able to furnish the 
brand of such product that is compat-
ible with the home blood glucose mon-
itor selected by the individual; and 
‘‘(III) the right of the individual 
to return diabetic testing strip prod-
ucts furnished to the individual by the 
entity. 
‘‘(ii) REQUIREMENT.—With respect to 
diabetic testing strip products furnished on 
or after the date on which the Secretary de-
velops the standardized information under
401 
† HR 1892 EAS2 
clause (i), an entity described in subpara-
graph (A) may not communicate directly to 
an individual until the entity has verbally 
provided the individual with such standard-
ized information. 
‘‘(D) ORDER REFILLS.—With respect to di-
abetic testing strip products furnished on or 
after January 1, 2019, the Secretary shall re-
quire an entity furnishing diabetic testing strip 
products to an individual to contact and receive 
a request from the individual for such products 
not more than 14 days prior to dispensing a re-
fill of such products to the individual.’’. 
(c) IMPLEMENTATION; NON-APPLICATION OF THE PA-
PERWORK REDUCTION ACT.— 
(1) 
IMPLEMENTATION.—Notwithstanding 
any 
other provision of law, the Secretary of Health and 
Human Services may implement the provisions of, 
and amendments made by, this section by program 
instruction or otherwise. 
(2) NON-APPLICATION OF THE PAPERWORK RE-
DUCTION ACT.—Chapter 35 of title 44, United States 
Code (commonly referred to as the ‘‘Paperwork Re-
duction Act of 1995’’), shall not apply to this section 
or the amendments made by this section.
402 
† HR 1892 EAS2 
TITLE V—OTHER HEALTH 
EXTENDERS 
SEC. 50501. EXTENSION FOR FAMILY-TO-FAMILY HEALTH IN-
FORMATION CENTERS. 
Section 501(c) of the Social Security Act (42 U.S.C. 
701(c)) is amended— 
(1) in paragraph (1)(A)— 
(A) in clause (v), by striking ‘‘and’’ at the 
end; 
(B) in clause (vi), by striking the period at 
the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
clause: 
‘‘(vii) $6,000,000 for each of fiscal years 2018 
and 2019.’’; 
(2) in paragraph (3)(C), by inserting before the 
period the following: ‘‘, and with respect to fiscal 
years 2018 and 2019, such centers shall also be devel-
oped in all territories and at least one such center 
shall be developed for Indian tribes’’; and 
(3) by amending paragraph (5) to read as fol-
lows: 
‘‘(5) For purposes of this subsection—
403 
† HR 1892 EAS2 
‘‘(A) the term ‘Indian tribe’ has the meaning 
given such term in section 4 of the Indian Health 
Care Improvement Act (25 U.S.C. 1603); 
‘‘(B) the term ‘State’ means each of the 50 States 
and the District of Columbia; and 
‘‘(C) the term ‘territory’ means Puerto Rico, 
Guam, American Samoa, the Virgin Islands, and the 
Northern Mariana Islands.’’. 
SEC. 50502. EXTENSION FOR SEXUAL RISK AVOIDANCE EDU-
CATION. 
(a) IN GENERAL.—Section 510 of the Social Security 
Act (42 U.S.C. 710) is amended to read as follows: 
‘‘SEC. 510. SEXUAL RISK AVOIDANCE EDUCATION. 
‘‘(a) IN GENERAL.— 
‘‘(1) ALLOTMENTS TO STATES.—For the purpose 
described in subsection (b), the Secretary shall, for 
each of fiscal years 2018 and 2019, allot to each State 
which has transmitted an application for the fiscal 
year under section 505(a) an amount equal to the 
product of— 
‘‘(A) the amount appropriated pursuant to 
subsection (e)(1) for the fiscal year, minus the 
amount reserved under subsection (e)(2) for the 
fiscal year; and
404 
† HR 1892 EAS2 
‘‘(B) the proportion that the number of low- 
income children in the State bears to the total of 
such numbers of children for all the States. 
‘‘(2) OTHER ALLOTMENTS.— 
‘‘(A) OTHER
ENTITIES.—For the purpose 
described in subsection (b), the Secretary shall, 
for each of fiscal years 2018 and 2019, for any 
State which has not transmitted an application 
for the fiscal year under section 505(a), allot to 
one or more entities in the State the amount that 
would have been allotted to the State under 
paragraph (1) if the State had submitted such 
an application. 
‘‘(B) PROCESS.—The Secretary shall select 
the recipients of allotments under subparagraph 
(A) by means of a competitive grant process 
under which— 
‘‘(i) not later than 30 days after the 
deadline for the State involved to submit an 
application for the fiscal year under section 
505(a), the Secretary publishes a notice so-
liciting grant applications; and 
‘‘(ii) not later than 120 days after such 
deadline, all such applications must be sub-
mitted.
405 
† HR 1892 EAS2 
‘‘(b) PURPOSE.— 
‘‘(1) IN GENERAL.—Except for research under 
paragraph (5) and information collection and report-
ing under paragraph (6), the purpose of an allotment 
under subsection (a) to a State (or to another entity 
in the State pursuant to subsection (a)(2)) is to en-
able the State or other entity to implement education 
exclusively on sexual risk avoidance (meaning volun-
tarily refraining from sexual activity). 
‘‘(2) REQUIRED
COMPONENTS.—Education on 
sexual risk avoidance pursuant to an allotment under 
this section shall— 
‘‘(A) ensure that the unambiguous and pri-
mary emphasis and context for each topic de-
scribed in paragraph (3) is a message to youth 
that normalizes the optimal health behavior of 
avoiding nonmarital sexual activity; 
‘‘(B) be medically accurate and complete; 
‘‘(C) be age-appropriate; 
‘‘(D) be based on adolescent learning and 
developmental theories for the age group receiv-
ing the education; and 
‘‘(E) be culturally appropriate, recognizing 
the experiences of youth from diverse commu-
nities, backgrounds, and experiences.
406 
† HR 1892 EAS2 
‘‘(3) TOPICS.—Education on sexual risk avoid-
ance pursuant to an allotment under this section 
shall address each of the following topics: 
‘‘(A) The holistic individual and societal 
benefits associated with personal responsibility, 
self-regulation, goal setting, healthy decision-
making, and a focus on the future. 
‘‘(B) The advantage of refraining from non-
marital sexual activity in order to improve the 
future prospects and physical and emotional 
health of youth. 
‘‘(C) The increased likelihood of avoiding 
poverty when youth attain self-sufficiency and 
emotional maturity before engaging in sexual ac-
tivity. 
‘‘(D) 
The 
foundational 
components 
of 
healthy relationships and their impact on the 
formation of healthy marriages and safe and sta-
ble families. 
‘‘(E) How other youth risk behaviors, such 
as drug and alcohol usage, increase the risk for 
teen sex. 
‘‘(F) How to resist and avoid, and receive 
help regarding, sexual coercion and dating vio-
407 
† HR 1892 EAS2 
lence, recognizing that even with consent teen sex 
remains a youth risk behavior. 
‘‘(4) CONTRACEPTION.—Education on sexual risk 
avoidance pursuant to an allotment under this section 
shall ensure that— 
‘‘(A) any information provided on contra-
ception is medically accurate and complete and 
ensures that students understand that contracep-
tion offers physical risk reduction, but not risk 
elimination; and 
‘‘(B) the education does not include dem-
onstrations, simulations, or distribution of con-
traceptive devices. 
‘‘(5) RESEARCH.— 
‘‘(A) IN GENERAL.—A State or other entity 
receiving an allotment pursuant to subsection (a) 
may use up to 20 percent of such allotment to 
build the evidence base for sexual risk avoidance 
education by conducting or supporting research. 
‘‘(B) REQUIREMENTS.—Any research con-
ducted or supported pursuant to subparagraph 
(A) shall be— 
‘‘(i) rigorous; 
‘‘(ii) evidence-based; and
408 
† HR 1892 EAS2 
‘‘(iii) designed and conducted by inde-
pendent researchers who have experience in 
conducting and publishing research in peer- 
reviewed outlets. 
‘‘(6) INFORMATION
COLLECTION
AND
REPORT-
ING.—A State or other entity receiving an allotment 
pursuant to subsection (a) shall, as specified by the 
Secretary— 
‘‘(A) collect information on the programs 
and activities funded through the allotment; and 
‘‘(B) submit reports to the Secretary on the 
data from such programs and activities. 
‘‘(c) NATIONAL EVALUATION.— 
‘‘(1) IN GENERAL.—The Secretary shall— 
‘‘(A) in consultation with appropriate State 
and local agencies, conduct one or more rigorous 
evaluations of the education funded through this 
section and associated data; and 
‘‘(B) submit a report to the Congress on the 
results of such evaluations, together with a sum-
mary of the information collected pursuant to 
subsection (b)(6). 
‘‘(2) CONSULTATION.—In conducting the evalua-
tions required by paragraph (1), including the estab-
lishment of rigorous evaluation methodologies, the
409 
† HR 1892 EAS2 
Secretary shall consult with relevant stakeholders and 
evaluation experts. 
‘‘(d) APPLICABILITY OF CERTAIN PROVISIONS.— 
‘‘(1) Sections 503, 507, and 508 apply to allot-
ments under subsection (a) to the same extent and in 
the same manner as such sections apply to allotments 
under section 502(c). 
‘‘(2) Sections 505 and 506 apply to allotments 
under subsection (a) to the extent determined by the 
Secretary to be appropriate. 
‘‘(e) DEFINITIONS.—In this section: 
‘‘(1) The term ‘age-appropriate’ means suitable 
(in terms of topics, messages, and teaching methods) 
to the developmental and social maturity of the par-
ticular age or age group of children or adolescents, 
based on developing cognitive, emotional, and behav-
ioral capacity typical for the age or age group. 
‘‘(2) The term ‘medically accurate and complete’ 
means verified or supported by the weight of research 
conducted in compliance with accepted scientific 
methods and— 
‘‘(A) published in peer-reviewed journals, 
where applicable; or 
‘‘(B) comprising information that leading 
professional organizations and agencies with rel-
410 
† HR 1892 EAS2 
evant expertise in the field recognize as accurate, 
objective, and complete. 
‘‘(3) The term ‘rigorous’, with respect to research 
or evaluation, means using— 
‘‘(A) established scientific methods for meas-
uring the impact of an intervention or program 
model in changing behavior (specifically sexual 
activity or other sexual risk behaviors), or reduc-
ing pregnancy, among youth; or 
‘‘(B) other evidence-based methodologies es-
tablished by the Secretary for purposes of this 
section. 
‘‘(4) The term ‘youth’ refers to one or more indi-
viduals who have attained age 10 but not age 20. 
‘‘(f) FUNDING.— 
‘‘(1) IN GENERAL.—To carry out this section, 
there is appropriated, out of any money in the Treas-
ury not otherwise appropriated, $75,000,000 for each 
of fiscal years 2018 and 2019. 
‘‘(2) RESERVATION.—The Secretary shall reserve, 
for each of fiscal years 2018 and 2019, not more than 
20 percent of the amount appropriated pursuant to 
paragraph (1) for administering the program under 
this section, including the conducting of national
411 
† HR 1892 EAS2 
evaluations and the provision of technical assistance 
to the recipients of allotments.’’. 
(b) EFFECTIVE DATE.—The amendment made by this 
section shall take effect as if enacted on October 1, 2017. 
SEC. 50503. EXTENSION FOR PERSONAL RESPONSIBILITY 
EDUCATION. 
(a) IN GENERAL.—Section 513 of the Social Security 
Act (42 U.S.C. 713) is amended— 
(1) in subsection (a)(1)(A), by striking ‘‘2017’’ 
and inserting ‘‘2019’’; and 
(2) in subsection (a)(4)— 
(A) in subparagraph (A), by striking 
‘‘2017’’ each place it appears and inserting 
‘‘2019’’; and 
(B) in subparagraph (B)— 
(i) in the subparagraph heading, by 
striking ‘‘3-YEAR
GRANTS’’ and inserting 
‘‘COMPETITIVE PREP GRANTS’’; and 
(ii) in clause (i), by striking ‘‘solicit 
applications to award 3-year grants in each 
of fiscal years 2012 through 2017’’ and in-
serting ‘‘continue through fiscal year 2019 
grants awarded for any of fiscal years 2015 
through 2017’’;
412 
† HR 1892 EAS2 
(3) in subsection (c)(1), by inserting after ‘‘youth 
with HIV/AIDS,’’ the following: ‘‘victims of human 
trafficking,’’; and 
(4) in subsection (f), by striking ‘‘2017’’ and in-
serting ‘‘2019’’. 
(b) EFFECTIVE DATE.—The amendments made by this 
section shall take effect as if enacted on October 1, 2017. 
TITLE VI—CHILD AND FAMILY 
SERVICES AND SUPPORTS EX-
TENDERS 
Subtitle A—Continuing the Mater-
nal, Infant, and Early Child-
hood Home Visiting Program 
SEC. 50601. CONTINUING EVIDENCE-BASED HOME VISITING 
PROGRAM. 
Section 511(j)(1)(H) of the Social Security Act (42 
U.S.C. 711(j)(1)(H)) is amended by striking ‘‘fiscal year 
2017’’ and inserting ‘‘each of fiscal years 2017 through 
2022’’. 
SEC. 50602. CONTINUING TO DEMONSTRATE RESULTS TO 
HELP FAMILIES. 
(a) REQUIRE SERVICE DELIVERY MODELS TO DEM-
ONSTRATE IMPROVEMENT
IN APPLICABLE BENCHMARK 
AREAS.—Section 511 of the Social Security Act (42 U.S.C.
413 
† HR 1892 EAS2 
711) is amended in each of subsections (d)(1)(A) and 
(h)(4)(A) by striking ‘‘each of’’. 
(b) DEMONSTRATION OF IMPROVEMENTS IN SUBSE-
QUENT YEARS.—Section 511(d)(1) of such Act (42 U.S.C. 
711(d)(1)) is amended by adding at the end the following: 
‘‘(D) DEMONSTRATION
OF
IMPROVEMENTS 
IN SUBSEQUENT YEARS.— 
‘‘(i) CONTINUED MEASUREMENT OF IM-
PROVEMENT
IN
APPLICABLE
BENCHMARK 
AREAS.—The eligible entity, after dem-
onstrating improvements for eligible fami-
lies as specified in subparagraphs (A) and 
(B), shall continue to track and report, not 
later than 30 days after the end of fiscal 
year 2020 and every 3 years thereafter, in-
formation demonstrating that the program 
results in improvements for the eligible fam-
ilies participating in the program in at 
least 4 of the areas specified in subpara-
graph (A) that the service delivery model or 
models selected by the entity are intended to 
improve. 
‘‘(ii) CORRECTIVE
ACTION
PLAN.—If 
the eligible entity fails to demonstrate im-
provement in at least 4 of the areas speci-
414 
† HR 1892 EAS2 
fied in subparagraph (A), as compared to 
eligible families who do not receive services 
under an early childhood home visitation 
program, the entity shall develop and im-
plement a plan to improve outcomes in each 
of the areas specified in subparagraph (A) 
that the service delivery model or models se-
lected by the entity are intended to improve, 
subject to approval by the Secretary. The 
plan shall include provisions for the Sec-
retary to monitor implementation of the 
plan and conduct continued oversight of the 
program, including through submission by 
the entity of regular reports to the Sec-
retary. 
‘‘(iii) TECHNICAL
ASSISTANCE.—The 
Secretary shall provide an eligible entity re-
quired to develop and implement an im-
provement plan under clause (ii) with tech-
nical assistance to develop and implement 
the plan. The Secretary may provide the 
technical assistance directly or through 
grants, contracts, or cooperative agreements. 
‘‘(iv) NO
IMPROVEMENT
OR
FAILURE 
TO SUBMIT REPORT.—If the Secretary de-
415 
† HR 1892 EAS2 
termines after a period of time specified by 
the Secretary that an eligible entity imple-
menting an improvement plan under clause 
(ii) has failed to demonstrate any improve-
ment in at least 4 of the areas specified in 
subparagraph (A), or if the Secretary deter-
mines that an eligible entity has failed to 
submit the report required by clause (i), the 
Secretary shall terminate the grant made to 
the entity under this section and may in-
clude any unexpended grant funds in grants 
made to nonprofit organizations under sub-
section (h)(2)(B).’’. 
(c) INCLUDING INFORMATION ON APPLICABLE BENCH-
MARKS IN APPLICATION.—Section 511(e)(5) of such Act (42 
U.S.C. 711(e)(5)) is amended by inserting ‘‘that the service 
delivery model or models selected by the entity are intended 
to improve’’ before the period at the end. 
SEC. 50603. REVIEWING STATEWIDE NEEDS TO TARGET RE-
SOURCES. 
Section 511(b)(1) of the Social Security Act (42 U.S.C. 
711(b)(1)) is amended by striking ‘‘Not later than’’ and all 
that follows through ‘‘section 505(a))’’ and inserting ‘‘Each 
State shall, as a condition of receiving payments from an 
allotment for the State under section 502, conduct a state-
416 
† HR 1892 EAS2 
wide needs assessment (which may be separate from but in 
coordination with the statewide needs assessment required 
under section 505(a) and which shall be reviewed and up-
dated by the State not later than October 1, 2020)’’. 
SEC. 50604. IMPROVING THE LIKELIHOOD OF SUCCESS IN 
HIGH-RISK COMMUNITIES. 
Section 511(d)(4)(A) of the Social Security Act (42 
U.S.C. 711(d)(4)(A)) is amended by inserting ‘‘, taking into 
account the staffing, community resource, and other re-
quirements to operate at least one approved model of home 
visiting and demonstrate improvements for eligible fami-
lies’’ before the period. 
SEC. 50605. OPTION TO FUND EVIDENCE-BASED HOME VIS-
ITING ON A PAY FOR OUTCOME BASIS. 
(a) IN GENERAL.—Section 511(c) of the Social Secu-
rity Act (42 U.S.C. 711(c)) is amended by redesignating 
paragraphs (3) and (4) as paragraphs (4) and (5), respec-
tively, and by inserting after paragraph (2) the following: 
‘‘(3) AUTHORITY TO USE GRANT FOR A PAY FOR 
OUTCOMES INITIATIVE.—An eligible entity to which a 
grant is made under paragraph (1) may use up to 25 
percent of the grant for outcomes or success payments 
related to a pay for outcomes initiative that will not 
result in a reduction of funding for services delivered 
by the entity under a childhood home visitation pro-
417 
† HR 1892 EAS2 
gram under this section while the eligible entity devel-
ops or operates such an initiative.’’. 
(b) DEFINITION OF PAY FOR OUTCOMES INITIATIVE.— 
Section 511(k) of such Act (42 U.S.C. 711(k)) is amended 
by adding at the end the following: 
‘‘(4) PAY FOR OUTCOMES INITIATIVE.—The term 
‘pay for outcomes initiative’ means a performance- 
based grant, contract, cooperative agreement, or other 
agreement awarded by a public entity in which a 
commitment is made to pay for improved outcomes 
achieved as a result of the intervention that result in 
social benefit and direct cost savings or cost avoidance 
to the public sector. Such an initiative shall in-
clude— 
‘‘(A) a feasibility study that describes how 
the proposed intervention is based on evidence of 
effectiveness; 
‘‘(B) a rigorous, third-party evaluation that 
uses experimental or quasi-experimental design 
or other research methodologies that allow for the 
strongest possible causal inferences to determine 
whether the initiative has met its proposed out-
comes as a result of the intervention; 
‘‘(C) an annual, publicly available report 
on the progress of the initiative; and
418 
† HR 1892 EAS2 
‘‘(D) a requirement that payments are 
made to the recipient of a grant, contract, or co-
operative agreement only when agreed upon out-
comes are achieved, except that this requirement 
shall not apply with respect to payments to a 
third party conducting the evaluation described 
in subparagraph (B).’’. 
(c) EXTENDED AVAILABILITY
OF FUNDS.—Section 
511(j)(3) of such Act (42 U.S.C. 711(j)(3)) is amended— 
(1) by striking ‘‘(3) AVAILABILITY.—Funds’’ and 
inserting the following: 
‘‘(3) AVAILABILITY.— 
‘‘(A) IN GENERAL.—Except as provided in 
subparagraph (B), funds’’; and 
(2) by adding at the end the following: 
‘‘(B) FUNDS FOR PAY FOR OUTCOMES INI-
TIATIVES.—Funds made available to an eligible 
entity under this section for a fiscal year (or 
portion of a fiscal year) for a pay for outcomes 
initiative shall remain available for expenditure 
by the eligible entity for not more than 10 years 
after the funds are so made available.’’.
419 
† HR 1892 EAS2 
SEC. 50606. DATA EXCHANGE STANDARDS FOR IMPROVED 
INTEROPERABILITY. 
(a) IN GENERAL.—Section 511(h) of the Social Secu-
rity Act (42 U.S.C. 711(h)) is amended by adding at the 
end the following: 
‘‘(5) DATA
EXCHANGE
STANDARDS
FOR
IM-
PROVED INTEROPERABILITY.— 
‘‘(A) DESIGNATION AND USE OF DATA EX-
CHANGE STANDARDS.— 
‘‘(i) DESIGNATION.—The head of the 
department or agency responsible for ad-
ministering a program funded under this 
section shall, in consultation with an inter-
agency work group established by the Office 
of Management and Budget and considering 
State government perspectives, designate 
data exchange standards for necessary cat-
egories of information that a State agency 
operating the program is required to elec-
tronically exchange with another State 
agency under applicable Federal law. 
‘‘(ii) DATA
EXCHANGE
STANDARDS 
MUST
BE
NONPROPRIETARY
AND
INTER-
OPERABLE.—The data exchange standards 
designated under clause (i) shall, to the ex-
420 
† HR 1892 EAS2 
tent practicable, be nonproprietary and 
interoperable. 
‘‘(iii) 
OTHER
REQUIREMENTS.—In 
designating data exchange standards under 
this paragraph, the Secretary shall, to the 
extent practicable, incorporate— 
‘‘(I) interoperable standards devel-
oped and maintained by an inter-
national voluntary consensus stand-
ards body, as defined by the Office of 
Management and Budget; 
‘‘(II) interoperable standards de-
veloped and maintained by intergov-
ernmental partnerships, such as the 
National Information Exchange Model; 
and 
‘‘(III) interoperable standards de-
veloped and maintained by Federal en-
tities with authority over contracting 
and financial assistance. 
‘‘(B) DATA
EXCHANGE
STANDARDS
FOR 
FEDERAL REPORTING.— 
‘‘(i) DESIGNATION.—The head of the 
department or agency responsible for ad-
ministering a program referred to in this
421 
† HR 1892 EAS2 
section shall, in consultation with an inter-
agency work group established by the Office 
of Management and Budget, and consid-
ering State government perspectives, des-
ignate data exchange standards to govern 
Federal reporting and exchange require-
ments under applicable Federal law. 
‘‘(ii) REQUIREMENTS.—The data ex-
change reporting standards required by 
clause (i) shall, to the extent practicable— 
‘‘(I) incorporate a widely accept-
ed, nonproprietary, searchable, com-
puter-readable format; 
‘‘(II) be consistent with and im-
plement applicable accounting prin-
ciples; 
‘‘(III) be implemented in a man-
ner that is cost-effective and improves 
program efficiency and effectiveness; 
and 
‘‘(IV) be capable of being contin-
ually upgraded as necessary. 
‘‘(iii) INCORPORATION OF NONPROPRI-
ETARY
STANDARDS.—In designating data 
exchange standards under this paragraph,
422 
† HR 1892 EAS2 
the Secretary shall, to the extent practicable, 
incorporate existing nonproprietary stand-
ards, such as the eXtensible Mark up Lan-
guage. 
‘‘(iv) RULE OF CONSTRUCTION.—Noth-
ing in this paragraph shall be construed to 
require a change to existing data exchange 
standards for Federal reporting about a 
program referred to in this section, if the 
head of the department or agency respon-
sible for administering the program finds 
the standards to be effective and efficient.’’. 
(b) EFFECTIVE DATE.—The amendment made by sub-
section (a) shall take effect on the date that is 2 years after 
the date of enactment of this Act. 
SEC. 50607. ALLOCATION OF FUNDS. 
Section 511(j) of the Social Security Act (42 U.S.C. 
711(j)) is amended by adding at the end the following: 
‘‘(4) ALLOCATION OF FUNDS.—To the extent that 
the grant amount awarded under this section to an 
eligible entity is determined on the basis of relative 
population or poverty considerations, the Secretary 
shall make the determination using the most accurate 
Federal data available for the eligible entity.’’.
423 
† HR 1892 EAS2 
Subtitle 
B—Extension 
of 
Health 
Professions 
Workforce 
Dem-
onstration Projects 
SEC. 50611. EXTENSION OF HEALTH WORKFORCE DEM-
ONSTRATION PROJECTS FOR LOW-INCOME 
INDIVIDUALS. 
Section 2008(c)(1) of the Social Security Act (42 
U.S.C. 1397g(c)(1)) is amended by striking ‘‘2017’’ and in-
serting ‘‘2019’’. 
TITLE VII—FAMILY FIRST 
PREVENTION SERVICES ACT 
Subtitle A—Investing in Prevention 
and Supporting Families 
SEC. 50701. SHORT TITLE. 
This subtitle may be cited as the ‘‘Bipartisan Budget 
Act of 2018’’. 
SEC. 50702. PURPOSE. 
The purpose of this subtitle is to enable States to use 
Federal funds available under parts B and E of title IV 
of the Social Security Act to provide enhanced support to 
children and families and prevent foster care placements 
through the provision of mental health and substance abuse 
prevention and treatment services, in-home parent skill- 
based programs, and kinship navigator services.
424 
† HR 1892 EAS2 
PART I—PREVENTION ACTIVITIES UNDER TITLE 
IV–E 
SEC. 50711. FOSTER CARE PREVENTION SERVICES AND 
PROGRAMS. 
(a) STATE OPTION.—Section 471 of the Social Secu-
rity Act (42 U.S.C. 671) is amended— 
(1) in subsection (a)(1), by striking ‘‘and’’ and 
all that follows through the semicolon and inserting ‘‘, 
adoption assistance in accordance with section 473, 
and, at the option of the State, services or programs 
specified in subsection (e)(1) of this section for chil-
dren who are candidates for foster care or who are 
pregnant or parenting foster youth and the parents or 
kin caregivers of the children, in accordance with the 
requirements of that subsection;’’; and 
(2) by adding at the end the following: 
‘‘(e) PREVENTION AND FAMILY SERVICES AND PRO-
GRAMS.— 
‘‘(1) IN
GENERAL.—Subject to the succeeding 
provisions of this subsection, the Secretary may make 
a payment to a State for providing the following serv-
ices or programs for a child described in paragraph 
(2) and the parents or kin caregivers of the child 
when the need of the child, such a parent, or such a 
caregiver for the services or programs are directly re-
lated to the safety, permanence, or well-being of the
425 
† HR 1892 EAS2 
child or to preventing the child from entering foster 
care: 
‘‘(A) MENTAL
HEALTH
AND
SUBSTANCE 
ABUSE
PREVENTION
AND
TREATMENT
SERV-
ICES.—Mental health and substance abuse pre-
vention and treatment services provided by a 
qualified clinician for not more than a 12-month 
period that begins on any date described in 
paragraph (3) with respect to the child. 
‘‘(B) IN-HOME PARENT SKILL-BASED PRO-
GRAMS.—In-home parent skill-based programs 
for not more than a 12-month period that begins 
on any date described in paragraph (3) with re-
spect to the child and that include parenting 
skills training, parent education, and individual 
and family counseling. 
‘‘(2) CHILD DESCRIBED.—For purposes of para-
graph (1), a child described in this paragraph is the 
following: 
‘‘(A) A child who is a candidate for foster 
care (as defined in section 475(13)) but can re-
main safely at home or in a kinship placement 
with receipt of services or programs specified in 
paragraph (1).
426 
† HR 1892 EAS2 
‘‘(B) A child in foster care who is a preg-
nant or parenting foster youth. 
‘‘(3) DATE DESCRIBED.—For purposes of para-
graph (1), the dates described in this paragraph are 
the following: 
‘‘(A) The date on which a child is identified 
in a prevention plan maintained under para-
graph (4) as a child who is a candidate for foster 
care (as defined in section 475(13)). 
‘‘(B) The date on which a child is identified 
in a prevention plan maintained under para-
graph (4) as a pregnant or parenting foster 
youth in need of services or programs specified 
in paragraph (1). 
‘‘(4) REQUIREMENTS
RELATED
TO
PROVIDING 
SERVICES AND PROGRAMS.—Services and programs 
specified in paragraph (1) may be provided under 
this subsection only if specified in advance in the 
child’s prevention plan described in subparagraph (A) 
and the requirements in subparagraphs (B) through 
(E) are met: 
‘‘(A) PREVENTION PLAN.—The State main-
tains a written prevention plan for the child that 
meets the following requirements (as applicable):
427 
† HR 1892 EAS2 
‘‘(i) CANDIDATES.—In the case of a 
child who is a candidate for foster care de-
scribed in paragraph (2)(A), the prevention 
plan shall— 
‘‘(I) identify the foster care pre-
vention strategy for the child so that 
the child may remain safely at home, 
live temporarily with a kin caregiver 
until 
reunification 
can 
be 
safely 
achieved, or live permanently with a 
kin caregiver; 
‘‘(II) list the services or programs 
to be provided to or on behalf of the 
child to ensure the success of that pre-
vention strategy; and 
‘‘(III) comply with such other re-
quirements as the Secretary shall es-
tablish. 
‘‘(ii) PREGNANT OR PARENTING FOS-
TER YOUTH.—In the case of a child who is 
a pregnant or parenting foster youth de-
scribed in paragraph (2)(B), the prevention 
plan shall— 
‘‘(I) be included in the child’s case 
plan required under section 475(1);
428 
† HR 1892 EAS2 
‘‘(II) list the services or programs 
to be provided to or on behalf of the 
youth to ensure that the youth is pre-
pared (in the case of a pregnant foster 
youth) or able (in the case of a par-
enting foster youth) to be a parent; 
‘‘(III) describe the foster care pre-
vention strategy for any child born to 
the youth; and 
‘‘(IV) comply with such other re-
quirements as the Secretary shall es-
tablish. 
‘‘(B) TRAUMA-INFORMED.—The services or 
programs to be provided to or on behalf of a 
child are provided under an organizational 
structure and treatment framework that involves 
understanding, recognizing, and responding to 
the effects of all types of trauma and in accord-
ance with recognized principles of a trauma-in-
formed approach and trauma-specific interven-
tions to address trauma’s consequences and fa-
cilitate healing. 
‘‘(C) ONLY SERVICES AND PROGRAMS PRO-
VIDED IN ACCORDANCE WITH PROMISING, SUP-
429 
† HR 1892 EAS2 
PORTED, OR WELL-SUPPORTED PRACTICES PER-
MITTED.— 
‘‘(i) IN GENERAL.—Only State expend-
itures for services or programs specified in 
subparagraph (A) or (B) of paragraph (1) 
that are provided in accordance with prac-
tices that meet the requirements specified in 
clause (ii) of this subparagraph and that 
meet the requirements specified in clause 
(iii), (iv), or (v), respectively, for being a 
promising, supported, or well-supported 
practice, shall be eligible for a Federal 
matching 
payment 
under 
section 
474(a)(6)(A). 
‘‘(ii) GENERAL
PRACTICE
REQUIRE-
MENTS.—The general practice requirements 
specified in this clause are the following: 
‘‘(I) The practice has a book, 
manual, or other available writings 
that specify the components of the 
practice protocol and describe how to 
administer the practice. 
‘‘(II) There is no empirical basis 
suggesting that, compared to its likely
430 
† HR 1892 EAS2 
benefits, the practice constitutes a risk 
of harm to those receiving it. 
‘‘(III) If multiple outcome studies 
have been conducted, the overall weight 
of evidence supports the benefits of the 
practice. 
‘‘(IV) Outcome measures are reli-
able and valid, and are administrated 
consistently and accurately across all 
those receiving the practice. 
‘‘(V) There is no case data sug-
gesting a risk of harm that was prob-
ably caused by the treatment and that 
was severe or frequent. 
‘‘(iii) PROMISING PRACTICE.—A prac-
tice shall be considered to be a ‘promising 
practice’ if the practice is superior to an 
appropriate comparison practice using con-
ventional standards of statistical signifi-
cance (in terms of demonstrated meaningful 
improvements in validated measures of im-
portant child and parent outcomes, such as 
mental health, substance abuse, and child 
safety and well-being), as established by the
431 
† HR 1892 EAS2 
results or outcomes of at least one study 
that— 
‘‘(I) was rated by an independent 
systematic review for the quality of the 
study design and execution and deter-
mined to be well-designed and well-exe-
cuted; and 
‘‘(II) utilized some form of control 
(such as an untreated group, a placebo 
group, or a wait list study). 
‘‘(iv) SUPPORTED PRACTICE.—A prac-
tice shall be considered to be a ‘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 one study 
that—
432 
† HR 1892 EAS2 
‘‘(aa) was 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) was a rigorous ran-
dom-controlled trial (or, if not 
available, a study using a rig-
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
433 
† HR 1892 EAS2 
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— 
‘‘(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.
434 
† HR 1892 EAS2 
‘‘(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 
(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):
435 
† HR 1892 EAS2 
‘‘(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 
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
436 
† HR 1892 EAS2 
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-
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
437 
† HR 1892 EAS2 
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 
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.
438 
† HR 1892 EAS2 
‘‘(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 
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
439 
† HR 1892 EAS2 
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 
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.
440 
† HR 1892 EAS2 
‘‘(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 
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
441 
† HR 1892 EAS2 
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-
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.
442 
† HR 1892 EAS2 
‘‘(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— 
‘‘(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.
443 
† HR 1892 EAS2 
‘‘(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)). 
‘‘(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-
444 
† HR 1892 EAS2 
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 
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-
445 
† HR 1892 EAS2 
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 United States Census Bureau). 
‘‘(8) PROHIBITION AGAINST USE OF STATE FOS-
TER CARE PREVENTION EXPENDITURES AND FEDERAL 
IV–E PREVENTION FUNDS FOR MATCHING OR EXPEND-
ITURE REQUIREMENT.—A State that elects to provide 
services and programs specified in paragraph (1) 
shall not use any State foster care prevention expend-
itures for a fiscal year for the State share of expendi-
tures under section 474(a)(6) for a fiscal year. 
‘‘(9) ADMINISTRATIVE COSTS.—Expenditures de-
scribed in section 474(a)(6)(B)— 
‘‘(A) shall not be eligible for payment under 
subparagraph (A), (B), or (E) of section 
474(a)(3); and 
‘‘(B) shall be eligible for payment under sec-
tion 474(a)(6)(B) without regard to whether the 
expenditures are incurred on behalf of a child 
who is, or is potentially, eligible for foster care 
maintenance payments under this part.
446 
† HR 1892 EAS2 
‘‘(10) APPLICATION.— 
‘‘(A) IN GENERAL.—The provision of serv-
ices or programs under this subsection to or on 
behalf of a child described in paragraph (2) shall 
not be considered to be receipt of aid or assist-
ance under the State plan under this part for 
purposes of eligibility for any other program es-
tablished under this Act. 
‘‘(B) CANDIDATES
IN
KINSHIP
CARE.—A 
child described in paragraph (2) for whom such 
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-
447 
† HR 1892 EAS2 
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 
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
448 
† HR 1892 EAS2 
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-
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
449 
† HR 1892 EAS2 
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 
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
450 
† HR 1892 EAS2 
‘‘(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 
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-
451 
† HR 1892 EAS2 
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.’’. 
(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-
452 
† HR 1892 EAS2 
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-
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
453 
† HR 1892 EAS2 
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.— 
‘‘(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 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.’’.
454 
† HR 1892 EAS2 
(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; 
(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.—
455 
† HR 1892 EAS2 
‘‘(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 
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)
456 
† HR 1892 EAS2 
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 
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. 50712. 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
457 
† HR 1892 EAS2 
(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 
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
458 
† HR 1892 EAS2 
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 
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. 50713. 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 50711(c), 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:
459 
† HR 1892 EAS2 
‘‘(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-
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.’’. 
PART II—ENHANCED SUPPORT UNDER TITLE IV– 
B 
SEC. 50721. 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)—
460 
† HR 1892 EAS2 
(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 
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.
461 
† HR 1892 EAS2 
SEC. 50722. REDUCING BUREAUCRACY AND UNNECESSARY 
DELAYS WHEN PLACING CHILDREN IN HOMES 
ACROSS STATE LINES. 
(a) STATE PLAN REQUIREMENT.—Section 471(a)(25) 
of the Social Security Act (42 U.S.C. 671(a)(25)) is amend-
ed— 
(1) by striking ‘‘provide’’ and inserting ‘‘pro-
vides’’; and 
(2) by inserting ‘‘, which, in the case of a State 
other than the Commonwealth of Puerto Rico, the 
United States Virgin Islands, Guam, or American 
Samoa, not later than October 1, 2027, shall include 
the use of an electronic interstate case-processing sys-
tem’’ before the first semicolon. 
(b) 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
462 
† HR 1892 EAS2 
tribal consortium that elects to operate a program 
under this part.’’. 
(c) 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 
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: 
‘‘(A) A description of the goals and out-
comes to be achieved, which goals and outcomes 
must result in—
463 
† HR 1892 EAS2 
‘‘(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 
‘‘(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
464 
† HR 1892 EAS2 
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). 
‘‘(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.
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† HR 1892 EAS2 
‘‘(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. 
‘‘(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);
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† HR 1892 EAS2 
‘‘(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 
child abuse and neglect registries as required by 
section 471(a)(20)(B).’’. 
(d) 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. 50723. 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—
467 
† HR 1892 EAS2 
(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’’; 
(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.
468 
† HR 1892 EAS2 
‘‘(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 
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.
469 
† HR 1892 EAS2 
‘‘(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. 
‘‘(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)—
470 
† HR 1892 EAS2 
(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)— 
(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:
471 
† HR 1892 EAS2 
‘‘(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 
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:
472 
† HR 1892 EAS2 
‘‘(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’’; 
(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.’’;
473 
† HR 1892 EAS2 
(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 
(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
474 
† HR 1892 EAS2 
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-
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
475 
† HR 1892 EAS2 
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-
cluded in the evaluation of the regional 
partnership.’’; and 
(9) in paragraph (10), by striking ‘‘2012 
through 2016’’ and inserting ‘‘2017 through 2021’’. 
PART III—MISCELLANEOUS 
SEC. 
50731. 
REVIEWING 
AND 
IMPROVING 
LICENSING 
STANDARDS FOR PLACEMENT IN A RELATIVE 
FOSTER 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;
476 
† HR 1892 EAS2 
(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— 
‘‘(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
477 
† HR 1892 EAS2 
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 
‘‘(D) a description of the steps the State is 
taking to improve caseworker training or the 
process, if any; and’’. 
SEC. 50732. 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
478 
† HR 1892 EAS2 
‘‘(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 
agency partners, including those in public 
health, law enforcement, and the courts.’’. 
SEC. 50733. 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. 50734. EFFECTIVE DATES. 
(a) EFFECTIVE DATES.—
479 
† HR 1892 EAS2 
(1) IN GENERAL.—Except as provided in para-
graph (2), subject to subsection (b), the amendments 
made by parts I through III of this subtitle shall take 
effect on October 1, 2018. 
(2) EXCEPTIONS.—The amendments made by 
sections 50711(d), 50731, and 50733 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 parts I through III of this sub-
title, the State plan shall not be regarded as failing 
to comply with the requirements of such part solely 
on the basis of the failure of the plan to meet such 
additional requirements before the first day of the 
first calendar quarter beginning after the close of the 
first regular session of the State legislature that be-
gins after the date of enactment of this Act. For pur-
poses of the previous sentence, in the case of a State 
that has a 2-year legislative session, each year of the
480 
† HR 1892 EAS2 
session shall be deemed to be a separate regular ses-
sion of the State legislature. 
(2) APPLICATION TO PROGRAMS OPERATED BY 
INDIAN TRIBAL ORGANIZATIONS.—In the case of an 
Indian tribe, tribal organization, or tribal consortium 
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 parts I through III of this 
subtitle (whether the tribe, organization, or tribal con-
sortium has a plan under section 479B of the Social 
Security Act or a cooperative agreement or contract 
entered into with a State), the Secretary shall provide 
the tribe, organization, or tribal consortium with such 
additional time as the Secretary determines is nec-
essary for the tribe, organization, or tribal consortium 
to take the action to comply with the additional re-
quirements before being regarded as failing to comply 
with the requirements.
481 
† HR 1892 EAS2 
PART 
IV—ENSURING 
THE 
NECESSITY 
OF 
A 
PLACEMENT THAT IS NOT IN A FOSTER FAM-
ILY HOME 
SEC. 50741. LIMITATION ON FEDERAL FINANCIAL PARTICI-
PATION 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 
50712(a), is amended— 
(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
482 
† HR 1892 EAS2 
(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. 
‘‘(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).
483 
† HR 1892 EAS2 
‘‘(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 
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
484 
† HR 1892 EAS2 
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-
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);
485 
† HR 1892 EAS2 
‘‘(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 according to the treat-
ment model referred to in subparagraph 
(A); and 
‘‘(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;
486 
† HR 1892 EAS2 
‘‘(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). 
‘‘(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
531 
† HR 1892 EAS2 
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. 
‘‘(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.