,i  #aaeth ,,congress  #ast ,session    
,h4 ,r4 #bbij  ,,in ,,the ,,house ,,of  
,,representatives  ,may #b1 #bjag,ms4   
,de,lauro 7for herself1 ,mr4 ,cole1 ,mr4
 ,mullin1 and ,ms4 ,de,gette7 introduced
 the following bill2 which was referred 
to the ,committee on ,energy and        
,commerce  ,a ,,bill  ,to amend title   
,,xix of the ,social ,security ,act to  
provide a standard definition of        
therapeutic family care services in     
,medicaid4  #a4 ,short title ,this ,act 
may be cited as the ,family-,based ,care
 ,services ,act of #bjag4  #b4          
,inclusion of therapeutic family 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 family 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 family 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 may be reimbursed     
under the ,state plan but who can be    
cared for or maintained in a community  
placement1 through a qualified          
therapeutic family care program         
described in paragraph 7#b74  7#b7 ,a   
qualified therapeutic family 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 any   
other independent1 not-for-profit       
accrediting organization approved by the
 ,secretary2  7,b7 provides 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 provides biological 
parents1 relative and kinship           
caregivers1 adoptive parents1 and foster
 family homes 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 the impact  
of trauma on child and caregiver1 and   
specific additional training on the     
needs of each child provided such       
services1 including needs related to    
substance abuse by the child or         
caregiver4  7#c7 ,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#d7 ,the   
services described in this subsection do
 not include the training referred to in
 paragraph 7#b77;,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