,,ii  #aadth ,,congress  #ast ,session  
,s4 #dbi  ,,in ,,the ,,senate ,,of ,,the
 ,,united ,,states  ,february #aj1      
#bjae,ms4 ,baldwin 7for herself1 ,mr4   
,portman1 ,ms4 ,stabenow1 ,mr4 ,casey1  
and ,mr4 ,brown7 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 ,family-,based ,foster ,care        
,services ,act4  #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 7to the extent allowed and
 as defined in subsection 7ee772 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 the succeeding paragraphs of 
this subsection1 the term therapeutic   
foster care services means 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 a qualified therapeutic foster  
care program described in paragraph     
7#b74  7#b7 ,a qualified therapeutic    
foster care program described in this   
paragraph is a program that-- 7,a7 not  

later than #c years after the date of   
enactment of this subsection1 is        
licensed by the ,state and accredited by
 the ,joint ,commission on              
,accreditation of ,healthcare           
,organizations1 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     
provides structured daily activities1   
including the development1 improvement1 
monitoring1 and reinforcement 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 provides biological 
parents1 kinship caregivers1 and foster 
care parents with specialized training  
and consultation in the management of   

children with mental illness1 other     
emotional or behavioral disorders1      
medically fragile conditions1           
developmental disabilities1 the impact  
of trauma on child and caregiver1 and   
specific additional training on the     
needs of each child provided such       
services4  7#c7 ,in making coverage     
determinations in accordance with       
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#d7 ,for   
purposes of subsection 7a77#bi7 and this
 subsection1 therapeutic foster care    
services shall not include reimbursement
 for any training referred to in        
paragraph 7#b77;,c74  4  7b7 ,effective 
date ,the amendments made by subsection 
7a7 shall apply to medical assistance   
furnished in calendar quarters beginning
 on or after the date of enactment of   
this ,act4