Medi-Cal Peer Support Specialist Certification Program
The federal Centers for Medicare and Medicaid Services (CMS) recognizes the value of a peer support specialist’s experience as part of an evidence-based model of care and the importance in the state’s delivery of mental health and substance use disorder treatment. Through the passage of Senate Bill 803, (SB 803) Beall, a certified Medi-Cal Peer Support Specialist is recognized as a new provider type that provides a distinct service type under the Medi-Cal programs for Specialty Mental Health Services (SMHS) and the Drug Medi-Cal Organized Delivery System (DMC-ODS) in California. In alignment with SB 803, the California Department of Health Care Services (DHCS), through community stakeholder input, set statewide standards for the Medi-Cal Peer Support Specialist Certification in California. Standards are set forth in the Behavioral Health Information Notice 21-041 (BHIN 21-041).
California Mental Health Services Authority (CalMHSA) is proud to have been selected by County behavioral health plans to implement a single, standardized Medi-Cal Peer Support Specialist certification program. This was done in recognition of the need for a uniform process across the state — one that does not require peers to obtain multiple certifications in multiple counties, supports quality and application of standards, creates efficiency for counties, and adds credibility to the peer profession in California.
Program Roles and Responsibilities
A partnership exists between the Department of Health Care Services, CalMHSA, and County behavioral health services to ensure the California Medi-Cal Peer Support Specialist Program operates properly and efficiently. Functions and duties vary within each entity, from setting standards and scope of practice, implementing and enforcing those standards to hiring and billing, there are many functions, and we hope the below information will assist in differentiating the roles and responsibilities of the program,
STANDARDS, SCOPE OF PRACTICE, MEDI-CAL
Responsible: Department of Health Care Services
- Sets core competency requirements for certification
- Sets standards for county peer support services and supervisor requirements
- Establishes Code of Ethics for certified peer specialists
- Sets scope of practice for certified peer specialists
- Sets Medi-Cal claim rates
- Contracts with county behavioral health programs
IMPLEMENTATION, CERTIFICATION, ENFORCEMENT
Responsible: Certifying Entity (CalMHSA)
- Processes applications for certification
- Approves training providers who meet curriculum standard
- Administers exam
- Issues certifications and recertifications to individuals
- Ensures certification requirements are equally applied
- Enforces professional standards
- Investigates consumer complaints
- Imposes disciplinary actions for violations of the state-approved Code of Ethics
- Receives appeals
- Collects data and keeps records; submits annual state-level reports
- Sets core curriculum, based on best practices, in the four areas of peer specialization:
- Parent, caregiver, family member
- Working with persons who are unhoused
- Working with persons who are in crisis
- Working with persons who are involved in justice system
- Maintains public-facing searchable certification database
- Maintains a dedicated website for certification
HIRING, SUPERVISION, BILLING
Responsible: County Behavioral Health Programs
- Enters into contract with Department of Health Care Services
- Prepares behavioral health delivery system to claim new peer support services
- Updates electronic health record for claiming
- Hires certified Medi-Cal Peer Support Specialists
