,,ii  #aacth ,,congress  #b;d ,session  
,s4 #aiib  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,february #d1  
#bjad,ms4 ,baldwin 7for herself and ,mr4
 ,portman7 introduced the following     
bill2 which was read twice and referred 
to the ,committee on ,finance  ,a ,,bill
  ,to amend title ,,xix of the ,social  
,security ,act to provide a standard    
definition of therapeutic foster care   
services in ,medicaid4  #a4 ,short title
 ,this ,act may be cited as the ,quality
 ,foster ,care ,services ,act of #bjad4 
#b4 ,inclusion of therapeutic foster    
care as medical assistance  7a7 ,in     
general ,section #aije of the ,social   
,security ,act 7#db ,u4,s4,c4 #acif;d7  
is amended-- 7#a7 in subsection 7a7--   
7,a7 in paragraph 7#bh71 by striking and
 at the end2  7,b7 by redesignating     
paragraph 7#bi7 as paragraph 7#cj72 and 
7,c7 by inserting after paragraph 7#bh7 
the following new paragraph3  7#bi7     
therapeutic foster care services        
described in subsection 7ee72 and  2 and

  7#b7 by adding at the end the         
following new subsection3  7ee7 7#a7    
,for purposes of subsection 7a77#bi71   
subject to subparagraph 7,c71           
therapeutic foster care services        
described in this subsection are        
services provided for children who have 
not attained age #ba1 and who1 as a     
result of mental illness1 other         
emotional or behavioral disorders1      
medically fragile conditions1 or        
developmental disabilities1 need the    
level of care provided in an institution
 7including a psychiatric residential   
treatment facility7 or nursing facility 
the cost of which could be reimbursed   
under the ,state plan but who can be    
cared for or maintained in a community  
placement1 through therapeutic foster   
care programs that-- 7,a7 are licensed  
by the ,state and accredited by the     
,joint ,commission1 the ,commission on  
,accreditation of ,rehabilitation       
,facilities1 the ,council on            
,accreditation1 or by another equivalent

 accreditation agency 7or agencies7 as  
the ,secretary may recognize2  7,b7     
provide structured daily activities1    
including the development1 improvement1 
monitoring1 and reinforcing of          
age-appropriate social1 communication   
and behavioral skills1 trauma-informed  
and gender-responsive services1 crisis  
intervention and crisis support         
services1 medication monitoring1        
counseling1 and case management1 and may
 furnish other intensive community      
services2 and  7,c7 provide foster care 
parents with specialized training and   
consultation in the management of       
children with mental illness1 trauma1   
other emotional or behavioral disorders1
 medically fragile conditions1 or       
developmental disabilities1 and specific
 additional training on the needs of    
each child provided such services4  7#b7
 ,in making coverage determinations     
under paragraph 7#a71 a ,state may      
employ medical necessity criteria that  
are similar to the medical necessity    

criteria applied to coverage            
determinations for other services and   
supports under this title4  7#c7 ,the   
services described in this subsection do
 not include the training referred to in
 paragraph 7#a77;,c74  4  7b7 ,effective
 date ,the amendments made by subsection
 7a7 shall apply to calendar quarters   
beginning on or after the date of       
enactment of this ,act4