,,ii  #aaeth ,,congress  #ast ,session  
,s4 #aceg  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,june #ad1     
#bjag,ms4 ,baldwin 7for herself1 ,mr4   
,portman1 ,ms4 ,stabenow1 and ,mr4      
,blunt7 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 family care   
services in ,medicaid4  #a4 ,short title
 ,this ,act may be cited as the         
,family-,based ,care ,services ,act4    
#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 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 family 
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 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 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 relative and kinship           
caregivers1 adoptive parents1 foster    
parents and1 as appropriate1 other      

members of such parents or caregivers   
homes 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       
including trauma from substance abuse by
 a child or 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 family 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  7c7 ,,gao study and report  
,not later than #a year after the date  
of enactment of this ,act1 the          
,comptroller ,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 eligible for   
training described in paragraph         
7#b77;,c7 of section #aije7;ee7 of the  
,social ,security ,act 7#db ,u4,s4,c4   
#acif;d7ee77 7as added by subsection    
7a77#b77 through a qualified therapeutic
 family care program described in such  
section and for which ,federal payments 
are available under part ,e of title    
,,iv of the ,social ,security ,act 7#db 
,u4,s4,c4 #fgj et seq47 are provided    
with such training as is necessary and  
appropriate to meet the individual needs
 of children placed in their care1      
consistent with the requirements of     

sections #dga7;a77#bd7 and              
#dgg7;b77#c77;,d7 of the ,social        
,security ,act 7#db ,u4,s4,c4           
#fga7;a77#bd71 #fgg7;b77#c77;,d774 ,the 
report shall include an analysis of1 and
 recommendations to improve1 ,state     
review1 approval and oversight of all   
such training 7whether provided directly
 by the ,state or under contract with a 
public or private agency responsible for
 finding1 placing1 or monitoring the    
placement of children in foster family  
homes74