CAMHPRO Peer Certification SB 614 Update & Input Meeting August 11, 2016 870 Market St., Suite 922; San Francisco, Karin Lettau, MS, Director of California CA 94102 ▪ (415) 341-9460 ▪ Please follow us and like us on Face Book Training & Employment, see our new website:http://camhpro.org/ CAMHPRO klettau7@gmail.com https://www.facebook.com/camhpro
CAMHPRO’s Mission • The California Association of Mental Health Peer- Run Organizations (CAMHPRO) non-profit consumer-run statewide organization • Members are consumer-run organizations and programs, and individuals. • Empower, support, and ensure the rights of consumers, eliminate stigma, and advance self- determination and choice. Poll 1-4 2
Senate Bil ill 614, Peer Certification Not moving forw rward at this is tim ime • The County BH Directors Assoc. (CBHDA), sponsor of bill SB 614, will NOT go with the Dept. of Health Care Services (DHCS) technical amendments that would butcher the bill, but CBHDA has not decided yet. • Bill author Senator Leno will let the bill expire. 3
Bottom Line Since Last Month • Since DHCS will NOT support new unique billing for peer support, an integral part of the current bill, DHCS would not be needed in a new bill. • A new State Peer Certification legislative proposal could omit DHCS & omit the new billing to focus on the other key elements of the current bill. • WE WILL NEED ALL OF YOUR SUPPORT & ACTIVE INVOLVEMENT TO GET A LEGISLATIVE PROPOSAL READY BY JAN, 2017, REFLECTING THE 17 RECOMMENDATIONS MADE BY OVER 700 STAKEHOLDERS . 4
Now what? …Peer Support… Then some sugg ggestions • Research alternatives to a unique billing code needed for a State Plan Amendment that could allow for additional CA credentialing and draw more funding for Peer Support Specialist Services • Capitated billing that includes peer services? • Legislative proposals/bills in steps • Create CA Peer Specialist billing code for Medicaid draw down — LATER • State Certification with Certifying body — FIRST with above in mind Torrey Pine named Esperanza 5
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Peer Certification Movement in California • Originally evaluated by California Network (CNMHC) • Working Well Together (WWT) (2008-2014) Training and Technical Assistance Collaborative: CNMHC, then in 2012, CAMHPRO-PEERS - California Association of Mental Health Peer Run Organizations – Peers Envisioning and Engaging in Recovery Services NAMI California - National Alliance on Mental Illness - California UACF - United Advocates for Children and Families CiMH - California Institute for Mental Health 7
CA 58 Counties = 58 Different Peer Standards • Many agencies/colleges offer “certificates” for completion of trainings/courses to become MH peer/family providers • These are NOT state recognized • Most counties employ/contract for peer, parent/family support specialist providers • But Most Counties… • require no training or require no training standardized to the role of peer/family/parent support specialist • if training exists it is mostly provided by clinicians/trainers not familiar with peer practices • have no practice guidelines • have no appropriate supervision requirements • don’t allow peer providers to bill under existing codes (rehab…) 8
Stakeholder Process & In Involvement 165 people attended five regional Used multiple methods of gathering input, including four research reports stakeholder meetings 223 people attended the Statewide Written surveys Summit in May, 2013. Focus groups Vetted the recommendations at this Comment and question sessions meeting utilizing a modified in face-to-face meetings consensus model. Webinars On-going monthly teleconferences 4 Specialized workgroups & Member list has over 700 people monthly teleconferences Resulted in 17 Stakeholder Recommendations for CA Peer/Family Specialist Certification, mostly reflected in SB 614 9
Stakeholder Recommendation — Certifying Body Composition • Establish Certifying Body • NOT Dept. of Health Care Services • Agency plus collaborative cluster of state organizations representing youth, consumer, family of adult, parents of child, etc. • Completely separate from training entities 10
Stakeholder Recommendation: Certifying Body Function For each category of peer support specialist: youth, adult, family of adult, parent of child/youth, Certifying Body develops • Formal Definitions, Scope of Practice, Values & Ethics • Core competencies and standardized training content • Trainer and training entity qualifications • Standards for supervision of peer support specialists • Certification exam • Certifies training entities throughout the state for trainings that meet competencies, to retain cultural & regional diversity • Administers exam 11
Stakeholder Recommendation: Education & Experience • State Certification Training • 80 hours of training by accredited programs with testing • Plus 25 optional hours for specialty emphasis • whole health, forensics, co-occurring, foster care, etc. • Continuing Education for re-certification • Experience • Lived experience with mental health challenges or family • 6 months as full time peer specialist intern, work or volunteer 12
Stakeholder Recommendation--Supervision Policy that outlines key qualifications necessary for the Supervision of Peer Support Specialists • Prefer supervisors have lived experience & expertise in peer support • Define specific qualities and skills required for the supervision of Peer Specialists, that align with the values and philosophy of peer support • Consider federal billing requirements regarding qualified supervision for the future • Research other State Certification supervision requirements to determine what is acceptable 13
Stakeholder Recommendations-Training to County Administrations • Plan for extensive & expansive training to County BH Administrations and Staff on • Values, philosophy and efficacy of peer support services • County and Organizational cultures that welcome peer support specialists fully onto teams • Definitions of the unique service components of peer support, separate & distinct from other disciplines and services 14
Peer Support Guiding Values: • Core belief systems and worldview • People can and do recover from psychiatric difficulties • To help others is to also help one’s self • Choice, empowerment, and responsibility • Acceptance and respect for diversity • Reciprocity, mutuality in relationships • Social action 15
Defi fining Peer Support as a Dis istin inct Practice • A relationship of mutual learning • Peer Providers may also provide any other allowable mental health • Key principles are hope, equality, service to their scope of practice. respect, personal responsibility and • A relationship without the self-determination constraints of the traditional • Therapeutic interactions between expert/patient or expert/family people who have a shared lived member role experience • Peer Support is differentiated from • Key distinctions are: WHO does it and other mental health services such HOW the service is done. as: rehabilitation, targeted case management or collateral. 16
The Case for Certification • Defines the service of peer • Certification is portable to any support. CA county. • Provides a scope of practice that • Provides formal validation of the service recipients can benefit role of peer support. from. • Assures that practitioners • Can be utilized as a basis for the receive standardized training ability to bill Medi-Cal for and demonstrate competency. services provided. • Standardizes the quality of services provided by Peer Support Specialists that employers can rely on. 17
Key CA Peer Specialist Vetted Documents • Four Research & Stakeholder Recommendations Reports, links: • https://camhpro.org/peer-certification-sb614/ • Definitions • Values & Code of Ethics • Informational Brief • Scope of Practice • 17 Recommendations • National Medicaid Peer Specialist Matrix • Consumer, Family Member & Parent or Caregiver Peer Specialist Training Crosswalk • Draft Core Content Areas & Competencies 18
Official National & State Certifications • 42 States & D.C. have State Certified • The International Association of Peer Specialists protocol Peer Specialists (INAPS) develops competencies for international Peer • 4 States in process of developing Certification State protocol for certifying peers • SAMHSA drafted 62 Competencies • 14 States have State Certified Family for Peer Support workers in or Parent Specialists behavioral health (2015) • Billing Medicaid for Peer Services is • CA could be the first state in the the primary impetus nation to adopt certification for • U.S. Veterans Administration peer providers across the life span. Certifies Peer Specialists • Over 30 states have unique peer o Employs over 1,000 Peer support Medicaid billing codes Specialists (5 grades) 19
Peer Specialist Training and Certification 2014
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