Senators Baldwin and Portman Lead Bipartisan Effort to Improve Family Care Services for America’s Most Vulnerable Youth

The Family-Based Care Services Act increases quality of care for children with major health and mental health challenges

WASHINGTON, D.C. – U.S. Senators Tammy Baldwin (D-WI) and Rob Portman (R-OH) today, introduced bipartisan legislation to improve home-based health and mental health services for thousands of America’s most vulnerable youth. The Family-Based Care Services Act increases access to quality care by clarifying Medicaid policy that directly affects children, including foster children, with special behavioral health needs and/or medical disabilities, as well as vulnerable children living with kinship and biological caregivers.  Original cosponsors included Senators Debbie Stabenow (D-MI) and Roy Blunt (R-MO).

“Our bipartisan legislation will improve health care and mental health services for some of the most vulnerable youths in our country and ensures that effective, community-based options are available to our families who need it most,” said Senator Baldwin. “By strengthening access to supports for families and foster families to care for children’s unique needs, we can help grow strong families and help vulnerable young people find some stability in their home life, often for the very first time.”

“This commonsense bill will allow vulnerable children to have better access to high-quality foster care,” said Senator Portman. “By improving health care and mental health services for kids with unique needs, we will provide a sense of stability for these children and better equip foster parents to care for them.”

Therapeutic Family Care, often referred to as “Treatment /Therapeutic Foster Care” or TFC, is the evidence-informed, trauma-informed, and highly effective placement of children and youth with serious medical, psychological, emotional and social needs. In TFC care, foster parents as well as other parents and caregivers are given special training to address the needs of youths with major mental health challenges and children receive intensive in-home services to sustain them in the community. Kinship and biological families may also receive TFC training to care for their youth to help avoid out-of -home care, to support kinship placements and sustain strong family homes.

TFC provides critical services to approximately 45,000 foster children across the country. The intervention works to keep its particularly vulnerable youth out of costly and often ineffective institutional care. In addition, it provides needed clinical therapy options to youth in lieu of overmedication.

Despite the clear benefits of TFC, current law does not provide for a standard definition of TFC under Medicaid. Though TFC services are provided across the country—and are reimbursed under Medicaid and other child welfare funding streams—the lack of a federal standard definition impairs TFC quality and access. The Family-Based Services Act fixes this problem by establishing a federal Medicaid definition for TFC. This commonsense clarification will promote accountability for states offering TFC, identify financing options, and drive personnel training and standards. 

Senator Baldwin is dedicated to improving access to high-quality foster and family-based care services nationwide because of Wisconsin’s exemplary TFC agencies and quality services provided across the state. In Wisconsin, TFC is called “Treatment Foster Care” and according to the Wisconsin Department of Children and Families, provides quality services across the state to roughly 1,000 children per year. Wisconsin TFC providers, including the Children’s Hospital of Wisconsin, have been recognized for providing quality services to at-risk youth.

“Children’s Hospital of Wisconsin applauds Senator Baldwin for championing this evidence-based, cost effective approach to protecting our most vulnerable children” said Amy Herbst, VP Child Welfare, Community Services Division, Children’s Hospital of Wisconsin. “As the largest provider of TFC in Wisconsin, we know firsthand that trauma informed, therapeutic family placements are effective in providing for the safety and well-being of children needing a higher-level of care.”

“Anu Family Services is proud to support Senator Baldwin’s and her efforts to establish the Family-Based Care Services Act and create a standard definition of TFC under Medicaid,” said Mechele Pitt, CEO, of Anu Family Services, MSSW, LICSW, LCSW. “Senator Baldwin’s commitment to the standardization of TFC services across the country and her commitment to children in our foster care system is commended and appreciated.  We believe that the Family-Based Care Services Act is an important step towards providing foster youth with the quality services that they need to heal from past traumas.  

“We are very happy to support the Family-Based Care Services Act. Children in our foster care system are among the most vulnerable Americans,” said Ken Taylor, Executive Director of WI Council on Children & Families. “The maltreatment they have experienced is traumatizing, as is their removal from their family. Research shows that this trauma has long term negative consequences for their physical and mental health and their ability to form relationships. Caregivers who are properly trained and supported to address the particular challenges of traumatized children are essential to those children’s current and future well-being. Having a standard definition of Treatment Foster Care under Medicaid will promote a stronger, stable funding base for this very important and cost effective treatment for these vulnerable children.” 

Ohio has long offered a treatment foster care model for vulnerable foster youth who have been impacted by complex trauma, intensive mental health needs, and medically fragile conditions. Pressley Ridge, located in Cincinnati, works with children and foster care to provide a haven for safety, renewal, and return. Pressley Ridge works with foster parents, therapists, and caseworkers to provide services that help children thrive with intensive, individualized treatment within a safe, supportive, and nurturing home environment. This kind of evidence-based practice ensures that children and youth receive the services and support they need to enhance their overall quality of life.

The legislation is endorsed by a significant number of national children’s and mental health organizations, including: The Foster Family-based Treatment Association, the Children’s Defense Fund, Generations United, Child Welfare League of America, National Foster Care Coalition, First Focus Campaign for Children, KidsPeace, the Bair Foundation, the Alliance for Strong Families and Communities, the Children’s Leadership Council, National Council for Behavioral Health, and Voice for Adoption.

Senators Baldwin and Portman introduced a similar bill, the Family-Based Foster Care Services Act, during the last Congress in 2015. Bipartisan companion legislation has been introduced in the House of Representatives (H.R. 2290) by Representatives Rosa DeLauro (D-CT), Tom Cole (R-OK), Markwayne Mullin (R-OK) and Diana DeGette (D-CO).

More information about the Family-Based Care Services Act can be found here.

A copy of the bill text is available here.