Amended in Senate April 6, 2015

Senate BillNo. 614


Introduced by Senator Leno

February 27, 2015


An act to add Article 1.4 (commencing with Section 14045.10) to Chapter 7 of Part 3 of Division 9 of, the Welfare and Institutions Code, relating to Medi-Cal.

LEGISLATIVE COUNSEL’S DIGEST

SB 614, as amended, Leno. Medi-Cal: mental health services: peer and family support specialist certification.

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services and under which qualified low-income persons receive health care benefits. The Medi-Cal program is, in part, governed and funded by federal Medicaid provisions. Existing law provides for a schedule of benefits under the Medi-Cal program and provides for various services, including various behavioral and mental health services.

Existing law, the Mental Health Services Actbegin insert (MHSA)end insert, an initiative measure enacted by the voters as Proposition 63 at the November 2, 2004, statewide general election, establishes the continuously appropriated Mental Health Services Fund to fund various county mental health programs. The act also requires funds to be reserved for the costs for the State Department of Health Care Services, the California Mental Health Planning Council, the Office of Statewide Health Planning and Development (OSHPD), the Mental Health Services Oversight and Accountability Commission, the State Department of Public Health, and any other state agency to implement all duties pursuant to certain programs provided for by the act, subject to appropriation in the annual Budget Act. The act provides that it may be amended by the Legislature by a 23 vote of each house as long as the amendment is consistent with and furthers the intent of the act, and that the Legislature may also clarify procedures and terms ofbegin delete heend deletebegin insert theend insert act by majority vote.

This bill would require the State Department of Health Care Services to establish, by July 1, 2016, a statewide peer and family support specialist certification program, as a part of the state’s comprehensive mental health delivery systembegin insert and the Medi-Cal programend insert. The bill would include 3 certification categories: adult peer support specialists, family peer support specialists, and parent peer support specialists. The certification program’s components would include, among others, defining responsibilities and practice guidelines, determining curriculum and core competencies, specifying training and continuing education requirements, and establishing a code of ethics and certification revocation processes.

This bill would require the department to collaborate with OSHPD and interested stakeholders in developing the certification program, and to obtain technical assistance pursuant to a specified joint state-county decisionmaking process. The bill would authorize the department to use funding provided through the MHSA and designated funds administered by OSHPD, to develop and administer the program.

This bill would require the department to amend the Medicaid state plan to include a certified peer and family support specialist as a provider type for purposes of the Medi-Cal program, but would implement this provision only if and to the extent that federal financial participation is available and the department obtains all necessary federal approvals.begin insert The bill would authorize the department to enter into exclusive or nonexclusive contracts on a bid or nonbid basis, as specified, on a statewide or more limited geographic basis. This bill also would authorize the department to implement, interpret, or make specific its provisions by various informational documents until regulations are adopted.end insert

This bill would declare that it clarifies terms and procedures under the Mental Health Services Act.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.

The people of the State of California do enact as follows:

P3    1

SECTION 1.  

Article 1.4 (commencing with Section 14045.10)
2is added to Chapter 7 of Part 3 of Division 9 of the Welfare and
3Institutions Code
, to read:

4 

5Article 1.4.  Peer and Family Support Specialist Certification
6

 

7

14045.10.  

This article shall be known, and may be cited, as
8the Peer and Family Support Specialist Certification Program Act
9of 2015.

10

14045.11.  

The Legislature finds and declares all of the
11following:

12(a) With the enactment of the Mental Health Services Act in
132004, support to include peer providers identified as consumers,
14parents, and family members for the provision of services has been
15on the rise.

16(b) There are over 6,000 peer support specialists in California
17who provide individualized support, coaching, facilitation, and
18education to clients with mental health care needs, in a variety of
19settings, yet no statewide scope of practice, standardized
20curriculum, training standards, supervision standards, or
21certification protocol is available.

22(c) The United States Department of Veterans Affairs and over
2330 states utilize standardized curricula and certification protocols
24for peer provider services.

25(d) The federal Centers for Medicare and Medicaid Services
26(CMS) recognizes peer support services as an evidence-based
27mental health model of care and notes it is an important component
28in a state’s delivery of effective treatment. The CMS encourages
29states to offer peer support services as a component of a
30comprehensive mental health delivery system and federal financial
31participation is available for this purpose.

32(e) A substantial number of research studies demonstrate that
33peer providers improve client functioning, increase client
34satisfaction, reduce family burden, alleviate depression and other
35symptoms, reduce hospitalizations and hospital days, increase
36client activation, and enhance client self-advocacy.

37(f) Certification at the state level can incentivize the public
38mental health systembegin insert and the Medi-Cal program,end insert to increase the
P4    1number, diversity, and availability of peer providers and
2peer-driven services.

3

14045.12.  

It is the intent of the Legislature that the peer and
4family support specialist certification program, established under
5this article, achieve all of the following:

6(a) Establish the ongoing provision of peer support services for
7beneficiaries with mental health care needs by certified peer support
8specialists, including adults 18 years of age or older.

9(b) Provide increased family support, building on the strengths
10of families and helping them achieve desired outcomes.

11(c) Provide a part of a wraparound continuum of services, in
12conjunction with other community mental health services.

13(d) Collaborate with others providing care or support to the
14beneficiary or family.

15(e) Assist parents, when applicable, in developing coping
16mechanisms and problem-solving skills.

17(f) Provide an individualized focus on the beneficiary, the
18family, or both, as needed.

19(g) Promote socialization, recovery, self-sufficiency,
20self-advocacy, development of natural supports, and maintenance
21of skills learned in other support services.

22

14045.13.  

No later than July 1, 2016, the department shall
23establish a certified peer and family support specialistbegin delete program,
24whichend delete
begin insert program that,end insert at a minimum, shall do all of the following:

begin insert

25(a) Establish a certifying body to provide for the certification
26of peer and family support specialists.

end insert
begin delete

27(a)

end delete

28begin insert(b)end insert Provide for a statewide certification for each of the following
29begin delete categories:end deletebegin insert categories of peer support specialist providers, as
30contained in federal guidance issued by the Centers for Medicare
31and Medicaid Services, State Medical Director Letter (SMDL)
32#07-011:end insert

33(1) Adult peer support specialists, 18 years of age or older.

34(2) Family peer support specialists.

35(3) Parent peer support specialists.

begin delete

36(b)

end delete

37begin insert(c)end insert Define the range of responsibilities and practice guidelines
38for peer support specialists.

begin delete

39(c)

end delete

P5    1begin insert(d)end insert Determine curriculum and core competencies, including
2areas of specialization, such as veterans, family support, and
3forensics.

begin delete

4(d)

end delete

5begin insert(e)end insert Specifybegin delete required training and continuing education
6requirements for certification.end delete
begin insert training requirements, allowing for
7multiple qualified training entities, and requiring training to
8include individuals with practical experience as consumers of peer
9support services, or their family members.end insert

begin insert

10(f) Specify required continuing education requirements for
11certification.

end insert
begin delete

12(e)

end delete

13begin insert(g)end insert Determine clinical supervision requirements for personnel
14certified under this section.

begin delete

15(f)

end delete

16begin insert(h)end insert Establish a code of ethics and processes for revocation of
17certification.

begin delete

18(g)

end delete

19begin insert(i)end insert Determine the process for certification renewal.

begin insert

20(j) Determine a process for allowing existing personnel
21employed in the peer support field to obtain certification under
22this article, at their option.

end insert
23

14045.14.  

The department shall closely collaborate with the
24Office of Statewide Health Planning and Development (OSHPD)
25and its associated workforce collaborative, and regularly consult
26with interested stakeholders, including peer support and family
27organizations, mental health providers and organizations, the
28County Behavioral Health Directorsbegin delete Association,end deletebegin insert Association of
29California, health plans participating in the Medi-Cal managed
30care program,end insert
the California Mental Health Planning Council, and
31other interested parties, as deemed appropriate by the department,
32in developing, implementing, and administering the peer and family
33support specialist certification program.

34

14045.15.  

The department may contract to obtain technical
35assistance for the development of the peer and family support
36specialist certification program, as provided in Section 4061.

37

14045.16.  

(a) The department shall amend its Medicaid state
38plan tobegin delete include a peer and family support specialist pursuant to
39this article as a provider type for purposes of this chapter.end delete
begin insert do both
40of the following:end insert

begin insert

P6    1(1) Include a peer and family support specialist certified
2pursuant to this article as a provider type for purposes of this
3chapter.

end insert
begin insert

4(2) Include peer support specialist services as a distinct service
5type for purposes of this chapter.

end insert

6(b) The department may seek any federal waivers or other state
7plan amendments as necessary to implement the certification
8program provided for under this article.

9(c) This article shall be implemented only if and to the extent
10that federal financial participation under Title XIX of the federal
11Social Security Act (42 U.S.C. Sec. 1396 et seq.) is available and
12all necessary federal approvals have been obtained.

13

14045.17.  

It is not the intent of the Legislature in enacting this
14article to modify the Medicaid state plan in any manner that would
15otherwise change or nullify the requirements, billing, or
16reimbursement of the “other qualified provider” provider type, as
17currently authorized by the Medicaid state plan.

18

14045.18.  

The department may utilize Mental Health Services
19Act funds, as authorized in subdivision (d) of Section 5892, and
20any designated Workforce Education and Training Program
21resources, including funding, as administered by OSHPD pursuant
22to Section 5820, to develop and administer the peer and family
23support specialist certification program.

begin insert
24

begin insert14045.19.end insert  

For the purposes of implementing this article, the
25department may enter into exclusive or nonexclusive contracts on
26a bid or negotiated basis, including contracts for the purpose of
27obtaining subject matter expertise or other technical assistance.
28Contracts may be statewide or on a more limited geographic basis.

end insert
begin insert
29

begin insert14045.20.end insert  

Notwithstanding Chapter 3.5 (commencing with
30Section 11340) of Part 1 of Division 3 of Title 2 of the Government
31Code, the department may implement, interpret, or make specific
32this article by means of plan letters, plan or provider bulletins, or
33similar instructions, without taking regulatory action, until the
34time regulations are adopted. The department shall adopt
35regulations by July 1, 2018, in accordance with the requirements
36of Chapter 3.5 (commencing with Section 11340) of Part 1 of
37Division 3 of Title 2 of the Government Code. Notwithstanding
38Section 10231.5 of the Government Code, beginning six months
39after the effective date of this article, the department shall provide
40semiannual status reports to the Legislature, in compliance with
P7    1Section 9795 of the Government Code, until regulations have been
2 adopted.

end insert
3

SEC. 2.  

The Legislature finds and declares that this act clarifies
4procedures and terms of the Mental Health Services Act within
5the meaning of Section 18 of the Mental Health Services Act.



O

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