Family support services are community-based, face-to-face
interactions with children, youth or adults and their family, available to
managed care members only. Family support services enhance the member family's
strengths, capacities, and resources to promote the member's ability to reach
the recovery and resiliency behavioral health goals they consider most
important. See Subsections A and B of
8.321.2.9
NMAC for MAD general provider requirements.
A.
Eligible providers:
(1) Family support service providers and
staff shall meet standards established by the state of NM and documented in the
New Mexico BH policy and billing manual.
(2) Family support service staff and
supervision by licensed behavioral health practitioners must be in accordance
with their respective licensing board regulations or credentialing standards
for peer support workers or family peer support workers.
(3) Minimum staff qualifications for peer
support workers or family peer support workers includes maintenance of
credentials as a peer support worker or family peer support worker in New
Mexico.
(4) Minimum staff
qualifications for the clinical supervisor:
(a) Must be a licensed independent
practitioner (i.e., psychiatrist, psychologist, LISW, LPCC, LMFT, or
psychiatrically certified nurse practitioner) practicing under the scope of
their NM licensure;
(b) Have four
years' relevant experience in the delivery of case management or comprehensive
community support services or family support services with the target
population;
(c) Have one year
demonstrated supervisory experience; and
(d) Have completed both basic and supervisory
training regarding family support services.
B.
Identified population:
(1) Members with parents, family members,
legal guardians, and other primary caregivers who are living with or closely
linked to the member and engaged in the plan of care for the member.
(2) Members are young persons diagnosed with
a severe emotional disturbance or adults diagnosed with serious mental illness
as defined by the state of New Mexico.
C.
Covered services:
(1) Minimum required family support services
activities:
(a) review of the existing social
history and other relevant information with the member and family;
(b) review of the existing service and
treatment plans;
(c) identification
of the member and family functional strengths and any barriers to
recovery;
(d) participation in
service planning and delivery with the member and family; and
(e) adherence to the applicable code of
ethics.
(2) The specific
services provided are tailored to the individual needs of the member and family
according to the individual's treatment or service plan and include but are not
limited to support needed to:
(a) prevent
members from being placed into more restrictive setting; or
(b) quickly reintegrate the member to their
home and local community; or
(c)
direct the member and family towards recovery, resiliency, restoration,
enhancement and maintenance of the member's functioning; or
(d) increase the family's ability to
effectively interact with the member.
(3) Family support services focus on
psycho-education, problem solving, and skills building for the family to
support the member and may involve support activities such as:
(a) working with teams engaged with the
member;
(b) engaging in service
planning and service delivery for the member;
(c) identifying family strengths and
resiliencies in order to effectively articulate those strengths and prioritize
their needs;
(d) navigating the
community-based systems and services that impact the member's life;
(e) identifying natural and community
supports;
(f) assisting the member
and family to understand, adjust to, and manage behavioral health crises and
other challenges;
(g) facilitating
an understanding of the options for treatment of behavioral health
issues;
(h) facilitating an
understanding of the principles and practices of recovery and resiliency;
and
(i) facilitating effective
access and use of the behavioral health service system to achieve recovery and
resiliency.
(4)
Documentation requirements:
(a) notes related
to all family support service interventions to include how and to what extent
the activity promoted family support in relationship to the member's recovery
and resilience goals and outcomes;
(b) any supporting collateral
documentation.
D.
Non-covered services: This
service may be billed only during the transition phases from these services:
(a) accredited residential treatment center
(ARTC);
(b) adult accredited
residential treatment center (AARTC);
(c) residential treatment center
services;
(d) group home
services;
(e) inpatient
hospitalization;
(f) partial
hospitalization;
(g) treatment
foster care; or
(h) crisis triage
centers.
E.
Reimbursement: To help an eligible MCO member receive medically
necessary services, the centennial care MCOs pay for family support
services.
Notes
N.M. Code R. §
8.321.2.22
Adopted by
New
Mexico Register, Volume XXX, Issue 23, December 17, 2019, eff.
1/1/2020, Adopted by
New
Mexico Register, Volume XXXII, Issue 15, August 10, 2021, eff.
8/10/2021