In the report accompanying the FY 2019 Labor, Health and Human Services, and Education funding bill, the House Committee on Appropriations requested that MACPAC examine the advantages of a universal definition of therapeutic foster care (TFC). This presentation begins the Commissions’ work on TFC, providing background on Medicaid’s role for children and youth in child welfare and current practices related to TFC. It then raises questions related to a uniform definition and how such a definition might affect state flexibility and the consistency of benefits across states.