3431.1 FFT is an evidence-based proprietary therapeutic service for youth and their families to prevent youth who are already involved or at risk of becoming involved in the juvenile justice system from further penetrating the system. FFT is a strength-based model that focuses on the risk and protective factors that impact the adolescent, family and their environment. FFT providers shall ensure that services are provided in accordance with FFT fidelity standards and maintain an acceptable rating on all FFT fidelity audits.

3431.2 The FFT model adopts a phase-based approach, which must include the following phases:

1. (a) Engagement;
2. (b) Motivation;
3. (c) Relational Assessment;
4. (d) Behavioral Change; and
5. (e) Generalization.

3431.3 FFT is available to youth ages eleven (11) years old to eighteen (18), who meet at least one (1) criteria from the first category, and both of the criteria from the second category:

1. (a) First category:
2. (1) Have a documented history of moderate to serious behavioral problems which impair functioning in at least one (1) area (for example school or home);
3. (2) Exhibit significant externalizing behavior which impairs functioning in at least one (1) area (for example school or home); or
4. (3) Be at risk of a disruption in placement; and
5. (b) Second category:
6. (1) Be willing to participate with service providers for the duration of FFT treatment services; and

(2) Be involved with a caregiver who is willing to participate with service providers for the duration of FFT treatment services.

3431.4 To qualify for FFT, youth must be residing with or returning within thirty (30) calendar days to the home of the family/caregiver who is willing to participate in FFT treatment services.

3431.5 FFT is not appropriate for:

1. (a) Children or youth who require the safety of a hospital or other secure setting;
2. (b) Children or youth in congregate living programs; or
3. (c) Children or youth in an emergency or respite placement.

3431.6 Eligible providers of FFT services shall:

1. (a) Be certified as an FFT provider by FFT LLC;
2. (b) Comply with the FFT trainings and site certification requirements specified by the Department;
3. (c) Have the capacity to deliver FFT services to at least ten (10) to twelve (12) consumers for each therapist;
4. (d) Be available to work a flexible schedule based on the needs of the consumer and the family or caregiver; and
5. (e) Develop a crisis intervention plan for after-hours response, which shall include a Mobile Crisis Response Team.

3431.7 Each FFT Team shall include:

1. (a) An FFT-trained supervisor who provides the clinical and administrative supervision of the FFT Team and has the capacity to carry up to five (5) cases; and
2. (b) Three (3) to eight (8) FFT clinicians who have satisfied the FFT requirements for a therapist.

3431.8 The FFT supervisor shall be a Master's level independently licensed qualified practitioner pursuant to § 3431.12 practicing within the scope of their license and

experienced in providing individual, group, marital, or family counseling or psychotherapy. The FFT supervisor shall have a minimum of two (2) years of post-graduate experience working with behaviorally challenged youth and their families in community-based settings and must have satisfied the FFT requirement for a clinical supervisor.

3431.9 FFT clinicians shall be qualified practitioners pursuant to § 3431.12 practicing within the scope of their license and have a minimum of one (1) year of experience working with behaviorally challenged youth and their families in community-based settings. FFT clinicians must satisfy all FFT requirements for FFT therapists.

3431.10 FFT shall be provided in the family home or an outpatient clinic.

3431.11 FFT shall not be billed on the same day as:

(a) CBI;

(b) Community Support;

(c) TF-CBT; or

(d) TST.

3431.12 Qualified practitioners of FFT are:

(a) Psychiatrists;

(b) Psychologists;

(c) LICSWs;

(d) APRNS;

(e) LPCs;

(f) Psychology Associates;

(g) LISWs;

(h) LMFTs;

(i) LGSWs; and

(j) LGPCs.

SOURCE: Final Rulemaking published at 67 DCR 10674 (September 4, 2020); as amended by Final Rulemaking published at 69 DCR 013495 (November 4, 2022); as amended by Final Rulemaking published at 70 DCR 003050 (March 10, 2023); as corrected by Errata Notice published at 71 DCR 004474 (April 19, 2024).