N.M. Admin. Code § 8.321.2.40

Current through Register Vol. 35, No. 23, December 10, 2024

Section 8.321.2.40 - FUNCTIONAL FAMILY THERAPY (FFT)

To help eligible recipients receive behavioral health services to MAD pays for FFT services. FFT is an evidence-based, short term and intensive family-based and manual driven treatment program that has been successful in treating a wide range of problems affecting families in a wide range of multi-ethnic, multicultural, and geographic contexts.

A.Eligible providers: In addition to the requirements of Subsections A and B of 8.321.2.9 NMAC, in order to be eligible to be reimbursed for providing FFT services, an agency must hold a copy of FFT, LLC or FFT partners certification, or any of its approved subsidiaries and meet the state licensure and provider enrollment requirements for each FFT team. Additionally, the agency must complete the application process as described in the BH policy and billing manual. An active FFT team requires FFT certification of a clinical supervisor and at least two FFT certified treatment providers working collaboratively with one another using the FFT services as defined by the State. Providers must be engaged in training, consultation, and oversight by either of the following training entities: FFT LLC or FFT partners.

(1) The FFT program includes an assigned FFT team for each eligible recipient. The FFT team must include at minimum:

(a) master's level independently licensed behavioral health professional clinical supervision; see Subsection H of 8.321.2.9 NMAC;

(b) a licensed master's level behavioral health practitioner that is required to perform all FFT interventions; a bachelor's level behavioral health practitioner is limited to performing functions defined within the scope of their RLD practice board licensure or practice (see Subsection E of 8.321.2.9 NMAC);

(c) bachelor's level staff that has a degree in social work, counseling, psychology, or a related human services field and must have at least three years' experience working with the identified population of children, adolescents and their families. Bachelor's level staff may provide the non-clinical components of treatment including treatment planning, skill-building, and family psychoeducation but not family therapy; and

(d) staffing for FFT services is comprised of no more than one-third bachelor's level staff and, at minimum, two-thirds licensed master's level staff unless an exception is granted by FFT, LLC or FFT partners.

(2) Clinical supervision must include at a minimum:

(a) weekly supervision provided by an independently licensed master's level behavioral health practitioner (see Subsection C of 8.321.2.9 NMAC) who is FFT trained; this supervision, following the FFT supervisory protocol, is provided to team members on topics directly related to the needs of the eligible recipient and their family on an ongoing basis; and

(b) one hour of local group supervision per week and one hour of telephone consultation per week with the FFT systems supervisor, provided to team members on topics directly related to the needs of the eligible recipient and their family on an ongoing basis.

(3) All clinical staff are required to participate in and complete a prescribed five-day FFT introductory training and subsequent quarterly trainings.

B.Identified population:

(1) FFT is provided to an eligible youth meeting medical necessity with serious behavior problems such as conduct disorder, violent acting-out, mental health concerns, truancy, and substance use. FFT is an evidence-based, short term and intensive family-based treatment. FFT program's goals are to: integrate families' voices in all phases of treatment; develop and grow in innovative, collaborative, dynamic and evidence-based practices; practice evidence-based programs in evidence-based ways to maintain model fidelity; evolve the model in a way that is responsive to the needs of families, communities, and agencies; and provide innovative, real-time cloud-based technology and training for predictability and outcomes.

(2) A co-occurring diagnosis of SUD shall not exclude an eligible recipient from the program.

C.Covered services and service limitations: FFT enrolls families with youth meeting medical necessity with serious behavior problems such as conduct disorder, violent acting-out, mental health concerns, truancy, and substance use. FFT services may be provided in both clinic-based and community-based settings. FFT service components include treatment planning; restoration of social skills which is available 24-hours a day, seven days a week; and family therapy and psychoeducation. When services are provided to family or other supports the service must be for the direct benefit of the medicaid recipient.

(1) The following services must be furnished as part of the FFT service to be eligible for reimbursement:

(a) an initial assessment to identify the focus of the FFT intervention;

(b) therapeutic interventions with the eligible recipient and their family; and

(c) case management.

(2) FFT services are conducted by practitioners using the FFT team approach. The FFT team must have the ability to deliver services in various environments both clinic-based and community based.

(3) FFT interventions occur in three primary phases: engagement/motivation, behavior change, and generalization; each with measurable process goals and family skills that are the targets of intervention with the length of treatment covered based on medical necessity. Each phase has specific goals and practitioner skills associated with it. The specificity of the model allows for monitoring of treatment, training, and practitioner model adherence in ways that are not possible with other less specific treatment interventions.

D.Non-covered services: FFT services are subject to the limitations and coverage restrictions that exist for other MAD covered services. See Subsection G of 8.321.2.9 NMAC for general non-covered specialized behavioral health services.

E.Reimbursement: FFT agencies must submit claims for reimbursement on the CMS-1500 claim form or its successor. See Subsection E of 8.321.2.9 NMAC for MAD general reimbursement requirements and 8.302.2 NMAC. Once enrolled, the FFT agency receives instructions on how to access documentation, billing, and claims processing information.

N.M. Admin. Code § 8.321.2.40

Adopted by New Mexico Register, Volume XXXV, Issue 23, December 10, 2024, eff. 12/10/2024