CurrentOptumPolicy N/A

Family Support and Training (FST) service performance specifications

Defines operational, staffing, service, documentation, quality, and delivery requirements for Family Support and Training (FST) provided to parents/caregivers/guardians of youth under age 21 for MassHealth enrollees under Optum. Governs eligibility linkage to existing behavioral health treatment plans/ICPs, service locations (home/community/telehealth), staffing qualifications, training, documentation, outreach/timeliness, supervision, discharge, and quality reporting.

Policy Summary

PayerOptum

PolicyFamily Support and Training (FST) service performance specifications

Policy CodePolicy N/A

Change TypeNo material change

Effective DateN/A

Next Review DateN/A

Key ActionCreate a written individual action plan signed by the Family Partner, parents/caregivers/guardians, and FST supervisor within 30 days of service start and update at least every 90 days; document contacts and outreach in the FST record.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes — brief indicates has_material_change=false and no changes provided.

9Core service/component sections

14Required training topics (a–r)

5Time thresholds (days)

Coverage Summary

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Coverage is mixed. Family Support and Training (FST) is for parents/caregivers/guardians of youth under age 21 and is covered when it directly supports goals in an existing behavioral health treatment plan or Individual Care Plan (ICP) for Outpatient therapy, In‑Home Therapy (IHT), or Intensive Care Coordination (ICC). FST may also continue after discharge only if it is necessary to achieve goals identified in the youth's discharge plan and progress is documented and shared with ongoing behavioral health providers.

Services are delivered by qualified paraprofessional Family Partners under the supervision of a licensed clinician and may be provided in the youth's home, other community settings, or via a HIPAA‑compliant telehealth platform when clinically appropriate and requested by the family (the reason for telehealth use must be documented).

Provision is governed by staffing, training, supervision, outreach/timeliness, individual action plan, documentation, and quality management requirements (e.g., outreach within 5 calendar days of referral; initial individual action plan due within 30 days; action plan updates at least every 90 days; weekly Family Partner contacts and required supervision and training).

Key time thresholds and quick requirements

Outreach initiationWithin 5 calendar days of referral (including self-referral)

Timely initiation standardMedicaid standard: within 14 calendar days of outreach (measured from family contact after referral; 42 CFR 441.56(e))

Initial action plan dueInitial individual action plan due within 30 days of Family Partner services initiating

Action plan update frequencyUpdated every 90 days at minimum (and as needed)

Discharge plan deliveryDischarge plan given to parent/caregiver and referring providers within 5 business days of last date of service

Provider Actions and Operational Requirements

Prior Authorization

Referral communication

Referring provider must communicate the reason for referral and the initial goals to the FST provider prior to initiation of services.

Documentation Required

Individual Action Plan creation and maintenance

Create a written individual action plan signed by the Family Partner, parents/caregivers/guardians, and the FST supervisor within 30 days of service initiation. The plan must identify tasks, timeframes, modality, and location, and must be updated at least every 90 days.

Documentation Required

Contact documentation

Document each contact in a progress report in the FST provider's record. Maintain records of outreach and waitlist procedures, document reasons for discharge and any follow-up plans, and record efforts to reengage if termination occurs without notice.

Denial Risk

Timeliness and waitlist management

Outreach to parents/caregivers/guardians must occur within five (5) calendar days of referral. The Medicaid timely initiation standard is within 14 calendar days of outreach (42 CFR 441.56(e)); if services cannot be initiated within 14 days, providers must maintain a waitlist and contact the family and referral source about waitlist procedures. Failure to meet these timeliness and waitlist requirements may pose contract or performance risk.

Documentation Required

Telehealth documentation

If services are delivered via telehealth, document the reason telehealth was used, use a HIPAA-compliant platform, and follow current MassHealth and MCE telehealth guidelines and applicable standards of care.

Billing Rule

Make clinical outcomes available

Clinical outcomes data must be made available to Optum upon request and must be consistent with the performance specifications for this service.

Documentation Required

Training records availability

Documentation of the provider's training curriculum must be made available upon request.

Background and Definitions

Family Support and Training (FST) is a paraprofessional‑delivered, strength‑based, one‑to‑one service in which a Family Partner supports parents/caregivers/guardians of a youth under 21 to improve the youth's functioning by helping caregivers meet treatment plan goals and navigate child‑serving systems.

Services focus on education, coaching, system navigation, empowerment/linkages to supports, and identifying community resources, and are delivered by culturally and linguistically appropriate paraprofessionals under licensed clinician supervision.

Term	Definition
Family Support and Training (FST)
A structured, one-to-one, strength-based relationship between a Family Partner and a parent/caregiver/guardian to support the youth's behavioral health goals identified in treatment plans or Individual Care Plans (ICPs); paraprofessional-delivered services to parents/caregivers designed to improve youth functioning by supporting caregivers to meet treatment plan goals, navigate child-serving systems, and link to community resources.
Family Partner
Qualified paraprofessional who delivers FST services under the supervision of a licensed clinician, meeting specified education/experience pathways (e.g., bachelor's degree + 1 year; associate's degree + 1 year; or high school diploma/HiSET + minimum 2 years experience) and experience as a caregiver of a youth with special needs, with required trainings and supervision.
ICP
Individual Care Plan for youth enrolled in Intensive Care Coordination (ICC), used to identify goals and guide Family Support and Training services for youth in ICC.

Policy Summary

PayerOptum

PolicyFamily Support and Training (FST) service performance specifications

Policy CodePolicy N/A

Change TypeNo material change

Effective DateN/A

Next Review DateN/A

SourceLink

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Family Support and Training (FST) service performance specifications

Coverage Summary

Medically Necessary / Covered Conditions and Service Criteria

Provider Actions and Operational Requirements

Coding

Background and Definitions

Revision History