BILL NUMBER: SB 614 AMENDED
BILL TEXT
AMENDED IN SENATE APRIL 6, 2015
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 Act (MHSA) ,
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 2/3 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 of he the 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 system and the Medi-Cal
program . 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. 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.
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:
SECTION 1. Article 1.4 (commencing with Section 14045.10) is added
to Chapter 7 of Part 3 of Division 9 of the Welfare and Institutions
Code, to read:
Article 1.4. Peer and Family Support Specialist Certification
14045.10. This article shall be known, and may be cited, as the
Peer and Family Support Specialist Certification Program Act of 2015.
14045.11. The Legislature finds and declares all of the
following:
(a) With the enactment of the Mental Health Services Act in 2004,
support to include peer providers identified as consumers, parents,
and family members for the provision of services has been on the
rise.
(b) There are over 6,000 peer support specialists in California
who provide individualized support, coaching, facilitation, and
education to clients with mental health care needs, in a variety of
settings, yet no statewide scope of practice, standardized
curriculum, training standards, supervision standards, or
certification protocol is available.
(c) The United States Department of Veterans Affairs and over 30
states utilize standardized curricula and certification protocols for
peer provider services.
(d) The federal Centers for Medicare and Medicaid Services (CMS)
recognizes peer support services as an evidence-based mental health
model of care and notes it is an important component in a state's
delivery of effective treatment. The CMS encourages states to offer
peer support services as a component of a comprehensive mental health
delivery system and federal financial participation is available for
this purpose.
(e) A substantial number of research studies demonstrate that peer
providers improve client functioning, increase client satisfaction,
reduce family burden, alleviate depression and other symptoms, reduce
hospitalizations and hospital days, increase client activation, and
enhance client self-advocacy.
(f) Certification at the state level can incentivize the public
mental health system and the Medi-Cal program, to increase
the number, diversity, and availability of peer providers and
peer-driven services.
14045.12. It is the intent of the Legislature that the peer and
family support specialist certification program, established under
this article, achieve all of the following:
(a) Establish the ongoing provision of peer support services for
beneficiaries with mental health care needs by certified peer support
specialists, including adults 18 years of age or older.
(b) Provide increased family support, building on the strengths of
families and helping them achieve desired outcomes.
(c) Provide a part of a wraparound continuum of services, in
conjunction with other community mental health services.
(d) Collaborate with others providing care or support to the
beneficiary or family.
(e) Assist parents, when applicable, in developing coping
mechanisms and problem-solving skills.
(f) Provide an individualized focus on the beneficiary, the
family, or both, as needed.
(g) Promote socialization, recovery, self-sufficiency,
self-advocacy, development of natural supports, and maintenance of
skills learned in other support services.
14045.13. No later than July 1, 2016, the department shall
establish a certified peer and family support specialist
program, which program that, at a minimum, shall
do all of the following:
(a) Establish a certifying body to provide for the certification
of peer and family support specialists.
(a)
(b) Provide for a statewide certification for each of
the following categories: categories of peer
support specialist providers, as contained in federal guidance issued
by the Centers for Medicare and Medicaid Services, State Medical
Director Letter (SMDL) #07-011:
(1) Adult peer support specialists, 18 years of age or older.
(2) Family peer support specialists.
(3) Parent peer support specialists.
(b)
(c) Define the range of responsibilities and practice
guidelines for peer support specialists.
(c)
(d) Determine curriculum and core competencies,
including areas of specialization, such as veterans, family support,
and forensics.
(d)
(e) Specify required training and continuing
education requirements for certification. training
requirements, allowing for multiple qualified training entities, and
requiring training to include individuals with practical experience
as consumers of peer support services, or their family members.
(f) Specify required continuing education requirements for
certification.
(e)
(g) Determine clinical supervision requirements for
personnel certified under this section.
(f)
(h) Establish a code of ethics and processes for
revocation of certification.
(g)
(i) Determine the process for certification renewal.
(j) Determine a process for allowing existing personnel employed
in the peer support field to obtain certification under this article,
at their option.
14045.14. The department shall closely collaborate with the
Office of Statewide Health Planning and Development (OSHPD) and its
associated workforce collaborative, and regularly consult with
interested stakeholders, including peer support and family
organizations, mental health providers and organizations, the County
Behavioral Health Directors Association,
Association of California, health plans participating in the Medi-Cal
managed care program, the California Mental Health Planning
Council, and other interested parties, as deemed appropriate by the
department, in developing, implementing, and administering the peer
and family support specialist certification program.
14045.15. The department may contract to obtain technical
assistance for the development of the peer and family support
specialist certification program, as provided in Section 4061.
14045.16. (a) The department shall amend its Medicaid state plan
to include a peer and family support specialist pursuant to
this article as a provider type for purposes of this chapter.
do both of the following:
(1) Include a peer and family support specialist certified
pursuant to this article as a provider type for purposes of this
chapter.
(2) Include peer support specialist services as a distinct service
type for purposes of this chapter.
(b) The department may seek any federal waivers or other state
plan amendments as necessary to implement the certification program
provided for under this article.
(c) This article shall be implemented only if and to the extent
that federal financial participation under Title XIX of the federal
Social Security Act (42 U.S.C. Sec. 1396 et seq.) is available and
all necessary federal approvals have been obtained.
14045.17. It is not the intent of the Legislature in enacting
this article to modify the Medicaid state plan in any manner that
would otherwise change or nullify the requirements, billing, or
reimbursement of the "other qualified provider" provider type, as
currently authorized by the Medicaid state plan.
14045.18. The department may utilize Mental Health Services Act
funds, as authorized in subdivision (d) of Section 5892, and any
designated Workforce Education and Training Program resources,
including funding, as administered by OSHPD pursuant to Section 5820,
to develop and administer the peer and family support specialist
certification program.
14045.19. For the purposes of implementing this article, the
department may enter into exclusive or nonexclusive contracts on a
bid or negotiated basis, including contracts for the purpose of
obtaining subject matter expertise or other technical assistance.
Contracts may be statewide or on a more limited geographic basis.
14045.20. Notwithstanding Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code, the
department may implement, interpret, or make specific this article
by means of plan letters, plan or provider bulletins, or similar
instructions, without taking regulatory action, until the time
regulations are adopted. The department shall adopt regulations by
July 1, 2018, in accordance with the requirements of Chapter 3.5
(commencing with Section 11340) of Part 1 of Division 3 of Title 2 of
the Government Code. Notwithstanding Section 10231.5 of the
Government Code, beginning six months after the effective date of
this article, the department shall provide semiannual status reports
to the Legislature, in compliance with Section 9795 of the Government
Code, until regulations have been adopted.
SEC. 2. The Legislature finds and declares that this act clarifies
procedures and terms of the Mental Health Services Act within the
meaning of Section 18 of the Mental Health Services Act.