Nov 6 2023

WASHINGTON, D.C. – Senators Thom Tillis (R-NC) and Marco Rubio (R-FL) recently introduced the Ensuring Medicaid Continuity for Children in Foster Care Act to remove the federal prohibition on Medicaid funding going to certain facilities that provide foster children with mental and substance use care. 

“Foster care provides a safe and stable environment for children, many of whom are recovering from traumatic events,” said Senator Tillis. “However, children in foster care who require critically important support and services oftentimes face unnecessary barriers in receiving care. This legislation will ensure these children can receive the necessary behavioral and mental health services when they need it and where they need it. Investing in the mental health and well-being of children in foster care will positively impact lives and improve outcomes for the next generation, and I’m glad to work with Senator Rubio to achieve these goals.” 


The Family First Prevention Services Act of 2018 (FFPSA) created a federal category of residential settings calledQualified Residential Treatment Programs (QRTPs). These programs were designed to provide care for children in foster care with assessed emotional or behavioral needs in a residential setting. 

The health care needs of children in foster care are covered by Medicaid. Today, however, QRTPs may not receive Medicaid financing because of the Institutions for Mental Disease (IMD) exclusion, a law that prohibits Medicaid payments to a hospital, nursing facility, or other institution with more than 16 beds that primarily provides care for people with mental health conditions.

The Ensuring Medicaid Continuity for Children in Foster Care Act would provide a narrow exemption from the IMD exclusion to ensure children in foster care receiving care in QRTPs can continue to receive care provided in these settings without losing their federal Medicaid coverage.

Text of the bill is available HERE.