CAMHPRO State Peer Certification SB 614 Update & Input Meeting November 10, 2016 California Funded by the U.S. Substance Abuse & Mental Health Services Administration (SAMHSA) State Consumer Network Grant 870 Market St., Suite 922; San Francisco, Karin Lettau, MS, Director of 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
Webinar Format — How to Participate 1. Polling Questions In-webinar , click box to choose best answer. We will show results. 2. Questions box--type in question or comment, send to all. One of us will try to answer the question during the web, or read it during question/contribution at the end. 3. Speak up during question/contribution at the end, raise your virtual hand to be unmuted to ask a question or make comment. If you have no microphone or if you are self- muted this won’t work— you could switch to using a telephone — on control panel under audio, click telephone and dial in, enter code and audio pin provided in order to be heard. You may download all handouts from the control panel 2
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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 1-3 4
Agenda • Bottom Line • Regroup & Refocus • Identify options • Workforce Education & Training (WET) $8 million • Honor Stakeholders’ 17 Recommendations 5
Peer ‘Certificate’ vs. State Certification • Formal State Program that typically designates the State Department of Mental Health or another agency to establish certification components including: • Lived experience required; work experience • Responsibilities and practice guidelines • Curriculum and core competencies • Training and continuing education requirements • Code of ethics • Certification revocation process • Billing status • Supervision 6
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. 7
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 8
Bottom Line • Known as California State Peer, Transition Age, Parent & Family Support Certification Program, Senate Bill 614 (Leno-D) is now dead. • The shell, 'SB 614', was used for a new bill that has nothing to do with what we worked for. • Gratefully, Senator Leno and bill sponsor, the County Behavioral Health Directors Association (CBHDA) refused to move the bill forward with the California Department of Health Care Services (DHCS) 'technical amendments' that undermined the intent of the bill and the essence of genuine peer support services. 9
Now what? Regroup • Collectively craft new proposal for the next legislative session in Jan. 2017. • Identify options when choosing the agencies to implement State Certification. • 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 California stakeholders. • What else? What are more options? 10
How Can We Gain Formal State Validation and Billing for Peer Specialist Services? We have to ask ourselves the right questions to bring forth creative answers. 11
What Leverage Do We Have? • DHCS is applying for Section 223 Demonstration Project • Updated 2016 Peer Specialist Training & Certification Programs: National Overview • What funding leverage do we have? 12
Background: US Section 223 Demo Project Requires Peer Support US Congress passed H.R. 4302 “Protecting Access to Medicare Act (PAMA) of 2014” and President signed into law April, 2014. • Included Section 223 — a two-year Demonstration Project: Improving Community Behavioral Health Services (also known as 223 Demo Project) • Established criteria that states use to certify CCBHCs (SAMHSA): • Certified BH Community Clinics (CCBH) include required Peer Support Services. • Provided guidance on the development of a Prospective Payment System (CMS) increases federal share of cost to 65% for 2 years • In Oct. 2015, awarded grants to 24 states to plan and apply for the Demonstration program (SAMHSA), included California 13
Section 223 Demonstration Project • Submit an application by Oct.30 Requirements of Planning Grant Phase Oct, 2015-Oct 30, 2016 2016 to be reviewed to be part of Demonstration • Certify Behavioral Health • 8 States to be selected to be part Clinics of the project by Dec. 31, 2016. • Establish PPS (prospective • Demonstration runs Jan. 2017 to payment system) • Robust process to solicit input Jan. 2019 from consumers, providers and • Evaluate-Final report to stakeholders required Congress Dec. 2021 14
223 Scope of Services Outpatient Services are Primary Care provided by CCBHCs Screening & directly and through Crisis Monitoring formal relationships Services*** DCO with DCOs CCBHCs directly provide services in green*** Screening, Assessment, Treatment Additional required services are Diagnosis & Planning Risk provided directly or through Assessment formal relationships with Community- Designated Collaborating Psychiatric Based Organizations (DCOs) Rehab Outpatient Mental Services Mental Health Care Health & DCO Referrals (R) are to providers for Veterans Substance Peer, outside the CCBHC and DCOs DCO Use Services Targeted Family Case Support & *** “unless there is an existing state -sanctioned, Counselor certified, or licensed system or network for the Management provision of crisis behavioral health services that Services dictates otherwise.” DCO DCO R Slide 15
Section 223 Demonstration Project • 24 States received grant (Oct. 2015) • 8 States to be selected to be part of to develop a plan the project by Dec. 31, 2016. • CA is one of the 24 states awarded a • Demonstration runs Jan. 2017 to planning grant Jan. 2019: • Federal Medicaid Matching $ to • Planning Grant Phase Oct, 2015-Oct, States to Medicaid (Medi-CAL) 2016 enrollees equivalent to the Federally • Certify clinics Qualified Health Centers (FQHC) • Establish PPS (prospective payment system) rates. • Solicit input from consumers, • Evaluate-Final report to Congress providers and stakeholders Dec. 2021 • Heidi has just recently gotten on a CCBH stakeholder group • Submit an application by Oct. 2016 to be part of Demonstration 16
State Peer Certification — National Context • Over 40 States have State Certified • The International Association of Peer Specialists protocols Peer Specialists (INAPS) developed competencies for • 2 States in process of developing international Peer Certification State protocol for certifying peers • SAMHSA drafted 62 • Billing Medicaid for Peer Services is Competencies for Peer Support the primary impetus workers in behavioral health (2015) • U.S. Veterans Administration • Over 30 states have unique peer Certifies Peer Specialists support Medicaid billing codes o Employs over 1,000 Peer • We may have a national Specialists (5 grades, career ladder) certification before we have a CA protocol 17
2016 Updated Report on National Peer Specialist Certification • Peer Specialist Training & Certification Programs: National Overview 2016 • Kaufman, L., Kuhn, W., & Stevens Manser, S. 2016. Peer Specialist Training and Certification Programs: A National Overview. Texas Institute for Excellence in Mental Health, School of Social Work, University of Texas at Austin. • https://camphro.files.wordpress.com/2016/07/peer-specialist-training-and-certification-programs- national-overview-2016-update.pdf • Also a handout • Identify from other states • their certifying bodies • other mechanisms to allow for billing 18
Report & Map of Peer Specialist Training and Certification Programs by State https://camphro.files.wordpress.com/20 • As of July 2016, 41 16/07/peer-specialist-training-and- certification-programs-national- states and the District overview-2016-update.pdf of Columbia have established programs to train and certify peer specialists and 2 states are in the CA is the only State process of developing without a State and/or implementing Certification Program a program. [New Mexico also has a applying for the 223 Certification Program] Demonstration Project 19
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