tained age 21, and who, as a result of mental illness, 
other emotional or behavioral disorders, medically 
fragile conditions, or developmental disabilities, need 
the level of care provided in a psychiatric residential 
treatment or congregate care facility the cost of 
which could be reimbursed under the State Medicaid 
program or the title IV–E program but who can re-
ceive services in a family-based setting. 
(b) GUIDANCE ON TREATMENT FAMILY CARE SERV-
ICES.— 
(1) IN
GENERAL.—Not later than 180 days 
after the date of enactment of this Act, the Sec-
retary, in consultation with the Administrator of the 
Centers for Medicare & Medicaid Services and the 
Assistant Secretary of the Administration for Chil-
dren and Families, shall develop and issue guidance 
to States and Indian tribes identifying opportunities 
to fund treatment family care services. 
(2) ADDITIONAL
REQUIREMENTS.—The guid-
ance required under paragraph (1) shall include de-
scriptions of the following: 
(A) Existing opportunities and flexibilities 
under the Medicaid program, including under 
waivers authorized under section 1115 or 1915 
of the Social Security Act (42 U.S.C. 1315, 
VerDate Sep 11 2014 
21:35 Jul 16, 2019
Jkt 089200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H3649.IH
H3649
pamtmann on DSKBFK8HB2PROD with BILLS
1396n), for States to receive Federal funding 
under that program for the provision of treat-
ment family care services, including services ad-
dressing the development, improvement, moni-
toring, and reinforcing of age-appropriate so-
cial, communication and behavioral skills, trau-
ma-informed and gender-responsive services, 
crisis intervention and crisis support services, 
medication monitoring, counseling, and case 
management, and other intensive community 
services identified by the Secretary. 
(B) Funding opportunities and flexibilities 
under the title IV–E program, including for 
specialized training and consultation for biologi-
cal parents, relative and kinship caregivers, 
adoptive parents, and foster parents, adminis-
trative costs related to in-home prevention serv-
ices to candidates for foster care and their par-
ents or kin caregivers, and reunification services 
for youth returning from foster care, as well as 
other services identified by the Secretary. 
(C) How States can employ and coordinate 
funding provided under the Medicaid program, 
the title IV–E program, and other programs ad-
VerDate Sep 11 2014 
21:35 Jul 16, 2019
Jkt 089200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H3649.IH
H3649
pamtmann on DSKBFK8HB2PROD with BILLS
ministered by the Secretary to support the pro-
vision of treatment family care services. 
(c) BEST PRACTICES FOR ESTABLISHING PROGRAMS 
TO PROVIDE TREATMENT FAMILY CARE SERVICES.— 
(1) IN GENERAL.—Not later than 2 years after 
the date of enactment of this Act, the Secretary, in 
consultation with the Administrator of the Centers 
for Medicare & Medicaid Services and the Assistant 
Secretary of the Administration for Children and 
Families, shall develop and issue guidance to States 
identifying best practices for establishing programs 
to provide treatment family care services. 
(2) 
COLLABORATION
REQUIRED.—Before 
issuing guidance on best practices, the Secretary 
shall solicit input from representatives of States and 
Indian tribes, health care providers with expertise in 
child trauma and child development, children with 
mental illness, or other emotional or behavioral dis-
orders, recipients of treatment family care services, 
foster and kinship care families, and other relevant 
experts and stakeholders. 
(3) ADDITIONAL
REQUIREMENTS.—The guid-
ance required under paragraph (1) shall include the 
following: 
VerDate Sep 11 2014 
01:35 Jul 17, 2019
Jkt 089200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H3649.IH
H3649
pamtmann on DSKBFK8HB2PROD with BILLS
(A) Best practices for the organization and 
provision of treatment family care services and 
supports. 
(B) Identification of services and supports 
included in successful programs that treatment 
family care services. 
(C) Descriptions of State standards for li-
censing and accrediting programs that provide 
treatment family care services to ensure pro-
viders are appropriately licensed and trained to 
provide high-quality treatment family care serv-
ices, including best practices concerning State 
requirements for such licensure and accredita-
tion by recognized national independent, not- 
for-profit entities that accredit health care orga-
nizations or by any other independent, not-for- 
profit accrediting organizations approved by the 
State. 
(d) GAO STUDY AND REPORT.—Not later than 1 
year after the date of enactment of this Act, the Comp-
troller General of the United States shall conduct a study 
and submit a report to Congress evaluating State efforts 
to ensure foster parents and other caregivers who are eligi-
ble for training for which Federal payments are available 
under the title IV–E program are provided with necessary 
VerDate Sep 11 2014 
21:35 Jul 16, 2019
Jkt 089200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H3649.IH
H3649
pamtmann on DSKBFK8HB2PROD with BILLS
and appropriate training to meet the individual needs of 
foster children placed in their care, consistent with the re-
quirements of sections 471(a)(24) and 477(b)(3)(D) of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
671(a)(24), 
677(b)(3)(D)), including an analysis of, and recommenda-
tions to improve, State review, approval and oversight of 
all such training (whether provided directly by the State 
or under contract with a public or private agency respon-
sible for finding, placing, or monitoring the placement of 
children in foster family homes). 
Æ 
VerDate Sep 11 2014 
21:35 Jul 16, 2019
Jkt 089200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6301
E:\BILLS\H3649.IH
H3649
pamtmann on DSKBFK8HB2PROD with BILLS