Policy Impact Analysis - 117/S/3761

Bill Overview

Title: Treatment Family Care Services Act

Description: This bill requires the Department of Health and Human Services (HHS) to issue guidance for states about funding and establishing treatment family care services. Treatment family care services are structured daily services and interventions to address mental and behavioral health disorders, medically fragile conditions, or developmental disabilities that, among other criteria, are provided in a home-based setting to children who are less than 21 years old and enrolled in any Medicaid eligibility group. Specifically, HHS must issue guidance on (1) opportunities for states to fund treatment family care services through Medicaid, federal foster care and related programs, or other HHS programs; and (2) best practices for states to establish treatment family care services programs. The bill also requires the Government Accountability Office to assess and report on certain training provided to foster parents and other caregivers, including recommendations for improving state processes related to approval and oversight of the training.

Sponsors: Sen. Baldwin, Tammy [D-WI]

Target Audience

Population: Children under 21 with mental/behavioral disorders or developmental disabilities

Estimated Size: 2000000

• The bill involves Medicaid services, which primarily impacts low-income individuals and families.
• The target age group for this bill is children under 21 years old.
• It is focused on children with mental and behavioral health disorders, medically fragile conditions, or developmental disabilities.
• The bill ensures these services are delivered in a home-based setting, indicating a focus on children that can benefit from in-home care.
• Medicaid and federal foster care programs are highlighted, which characterize the target population as likely being part of the foster care system.
• Globally, any child under the age of 21 with these conditions in countries with similar support systems could be referenced as having a somewhat similar demographic impact.

Reasoning

• The policy primarily targets children under 21 who are on Medicaid and have mental, behavioral, or developmental challenges. Thus, these children and their families, foster care environments, and other caregivers are the core focus. Given the budget limitations, not all qualifying families may be initially served, particularly those in more populous states.
• The policy aims to deliver services in home-based settings, which implies a shift from institutional to more personalized environments. This may lead to potential improvement in life quality and personal care for the affected children.
• Since the bill also includes an evaluation and improvement of caregiver training, in the long run, caregivers and foster families are anticipated to be better prepared to manage the specific needs of these children, thereby potentially raising their living standards and wellbeing.
• The scope is aimed at reasonably common situations but focuses more intensively on high-need cases within existing federal and state systems.
• Given the US estimate of approximately 2 million affected children, and a budget that allows for only a fraction of this group, equitably scalable solutions will be difficult to implement without additional funding, thus limiting overall impact.

Simulated Interviews

Cost Estimates

Key Considerations

• The degree of state engagement with the guidance issued will significantly affect costs.
• Variations in Medicaid expansion under different state policies could result in diverse financial impacts.
• Coordination with existing state foster care and Medicaid programs is crucial for implementation.