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SB-906 Mental health services and substance use disorder treatment: peer support specialist certification.(2017-2018)

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Date Published: 09/08/2018 04:00 AM
SB906:v95#DOCUMENT

Enrolled  September 07, 2018
Passed  IN  Senate  August 31, 2018
Passed  IN  Assembly  August 31, 2018
Amended  IN  Assembly  August 21, 2018
Amended  IN  Senate  May 25, 2018
Amended  IN  Senate  April 19, 2018

CALIFORNIA LEGISLATURE— 2017–2018 REGULAR SESSION

Senate Bill No. 906


Introduced by Senators Beall and Anderson
(Coauthors: Senators Hertzberg and Pan)

January 17, 2018


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 mental health.


LEGISLATIVE COUNSEL'S DIGEST


SB 906, Beall. Mental health services and substance use disorder treatment: peer 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 program 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 the act by majority vote.
This bill would require the State Department of Health Care Services to establish, no later than July 1, 2020, a peer support specialist certification to support the ongoing provision of services to individuals experiencing mental health care needs, substance use disorder needs, or both by certified peer support specialists. The certification components would include, among others, curriculum and core competencies, training and continuing education requirements, a code of ethics, and a process for the investigation of complaints and corrective action. The bill would require an applicant for the certification as a peer support specialist to meet specified requirements, including successful completion of the curriculum and training requirements.
This bill would require, among other things, the department to collaborate with OSHPD and interested stakeholders in implementing the certification. The bill would authorize the department to use funding provided through the MHSA to fund state administrative costs related to this article, subject to an express appropriation in the annual Budget Act, and to the extent authorized under the Mental Health Services Act. The bill would permit the department to claim federal financial participation under the Medicaid program, as specified.
This bill would authorize the department to establish a certification fee schedule and to require remittance of fees as contained in the schedule, for the purpose of supporting activities associated with the ongoing administration of the peer support specialist certification. The bill would declare the intent of the Legislature that the certification fees charged by the department reasonably reflect the expenditures directly applicable to the ongoing administration of the certification.
This bill would authorize the department to enter into exclusive or nonexclusive contracts on a bid or negotiated basis, as specified. This bill also would authorize the department to implement, interpret, or make specific its provisions by means of informational notices, plan letters, plan or provider bulletins, or similar instructions, without taking regulatory action, until regulations are adopted. The bill would require the department to adopt regulations by July 1, 2022, and, commencing July 1, 2019, would require the department to provide semiannual status reports to the Legislature until regulations have been adopted. The bill would provide that the department’s implementation of the peer support specialist certification, with respect to Medi-Cal specialty mental health services and Drug Medi-Cal services, is contingent upon federal approval and federal matching funds.
This bill would declare that it clarifies terms and procedures under the Mental Health Services Act.
Vote: MAJORITY   Appropriation: NO   Fiscal Committee: YES   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 Support Specialist Certification Act of 2018

14045.10.
 This article shall be known, and may be cited, as the Peer Support Specialist Certification Act of 2018.

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 providers in California who provide individualized support, coaching, facilitation, and education to clients with mental health care needs and substance use disorder, 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 support services.
(d) The federal Centers for Medicare and Medicaid Services (CMS) recognizes that the experiences of peer support specialists, as part of an evidence-based model of care, can be an important component in a state’s delivery of effective mental health and substance use disorder treatment. The CMS encourages states to offer comprehensive programs.
(e) A substantial number of research studies demonstrate that peer supports 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 can encourage an increase in the number, diversity, and availability of peer support specialists.

14045.12.
 It is the intent of the Legislature that the Peer Support Specialist Certification Act of 2018, established under this article, achieve all of the following:
(a) Support the ongoing provision of services for beneficiaries experiencing mental health care needs, substance use disorder needs, or both by certified peer support specialists.
(b) Support coaching, linkage, and skill building of beneficiaries with mental health needs, substance use disorder needs, or both, and to families or significant support persons.
(c) Increase family support by building on the strengths of families and assisting them in achieving a better understanding of mental illness in order to help beneficiaries achieve desired outcomes.
(d) Provide part of a continuum of services, in conjunction with other community mental health services and other substance use disorder treatment.
(e) Collaborate with others providing care or support to the beneficiaries or families.
(f) Assist parents, families, and beneficiaries in developing coping mechanisms and problem-solving skills in order to help beneficiaries achieve desired outcomes.
(g) Promote skill building for beneficiaries in the areas of socialization, recovery, self-sufficiency, self-advocacy, development of natural supports, and maintenance of skills learned in other support services.
(h) Encourage employment under the peer support specialist certification to reflect the culture, ethnicity, sexual orientation, gender identity, mental health service experiences, and substance use disorder experiences of the people whom they serve.

14045.13.
 For purposes of this article, the following definitions shall apply:
(a) “Certification” means the activities of the certifying body related to the verification that an individual has met all requirements under this article and that the individual may provide mental health services and substance use disorder treatment pursuant to this article.
(b) “Code of ethics” means the standards to which a peer support specialist is required to adhere.
(c) “Core competencies” are the foundational and essential knowledge, skills, and abilities required for peer specialists.
(d) “Cultural competence” means a set of congruent behaviors, attitudes, and policies that come together in a system or agency that enables that system or agency to work effectively in cross-cultural situations. A culturally competent system of care acknowledges and incorporates, at all levels, the importance of language and culture, intersecting identities, assessment of cross-cultural relations, knowledge and acceptance of dynamics of cultural differences, expansion of cultural knowledge, and adaptation of services to meet culturally unique needs to provide services in a culturally competent manner.
(e) “Department” means the State Department of Health Care Services.
(f) “Peer support specialist” means a person who is 18 years of age or older and who is a person who has self-identified as having lived experience with the process of recovery from mental illness, substance use disorder, or both, either as a consumer of these services, or as the parent or family member of the consumer.
(g) “Recovery” means a process of change through which an individual improves his or her health and wellness, lives a self-directed life, and strives to reach his or her full potential. This process of change recognizes cultural diversity and inclusion, and honors the different routes to resilience and recovery based on the individual and his or her cultural community.

14045.14.
 No later than July 1, 2020, the department shall do all of the following:
(a) Establish a certifying body, through either contract or an interagency agreement, to perform certification of activities as described in this article.
(b) Define the range of responsibilities and practice guidelines for peer support specialists by utilizing best practice materials published by the federal Substance Abuse and Mental Health Services Administration, the federal Department of Veterans Affairs, and related notable experts in the field as a basis for development.
(c) Determine curriculum and core competencies required for certification of an individual as a peer support specialist, including curriculum that may be offered in the following areas of specialization: transition-age youth, veterans, gender identity, sexual orientation, and any other areas of specialization identified by the department. Core competencies-based curriculum shall include, at a minimum, training related to the following elements:
(1) The concepts of hope, recovery, and wellness.
(2) The role of advocacy.
(3) The role of consumers and family members.
(4) Psychiatric rehabilitation skills and service delivery, and addiction recovery principles, including defined practices.
(5) Cultural competence training.
(6) Trauma-informed care.
(7) Group facilitation skills.
(8) Self-awareness and self-care.
(9) Cooccurring disorders of mental health and substance use.
(10) Conflict resolution.
(11) Professional boundaries and ethics.
(12) Safety and crisis planning.
(13) Navigation of, and referral to, other services.
(14) Documentation skills and standards.
(15) Study and test-taking skills.
(16) Confidentiality.
(d) Specify training requirements, including core-competencies-based training and specialized training necessary to become certified under this article, allowing for multiple qualified training entities, and requiring training to include people with lived experience as consumers and family members.
(e) Establish a code of ethics.
(f) Determine continuing education requirements for biennial certification renewal.
(g) Determine the process for biennial certification renewal.
(h) Determine a process for investigation of complaints and corrective action, which may include suspension and revocation of certification.
(i) Determine a process for an individual employed as a peer support specialist on the date that this act becomes operative to obtain certification under this article.

14045.15.
 (a) An applicant for certification under this article shall meet all of the following requirements:
(1) Be at least 18 years of age.
(2) Possess a high school diploma or equivalent degree.
(3) Be self-identified as having experience with the process of recovery from mental illness or substance use disorder treatment either as a consumer of these services, or the parent or family member of the consumer.
(4) Be willing to share his or her experience.
(5) Demonstrate leadership and advocacy skills.
(6) Have a strong dedication to recovery.
(7) Agree, in writing, to adhere to a code of ethics.
(8) Successfully complete the curriculum and training requirements for a peer support specialist.
(9) Pass a certification examination approved by the department for a peer support specialist.
(b) To maintain certification under this article, a peer support specialist shall:
(1) Adhere to the code of ethics and biennially sign an affirmation.
(2) Complete any required continuing education, training, and recertification requirements.

14045.16.
 (a) This article shall not be construed to imply that a person who is certified pursuant to this article is qualified to, or to authorize that person to, diagnose an illness, prescribe medication, or provide clinical services.
(b) This article does not alter the scope of practice for any health care professional or authorize the delivery of health care services in a setting or manner that is not authorized under any provision of the Business and Professions Code or the Health and Safety Code.

14045.17.
 The department shall consult with the Office of Statewide Health Planning and Development, peer support and family organizations, mental health services and substance use disorder treatment providers and organizations, the County Behavioral Health Directors Association of California, and the California Behavioral Health Planning Council in implementing this article. This consultation shall initially include, at a minimum, quarterly stakeholder meetings. The department may additionally conduct technical workgroups upon the request of stakeholders.

14045.18.
 To facilitate early intervention for mental health services, community health workers may partner with peer support specialists to improve linkage to services for the beneficiary.

14045.19.
 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.

14045.20.
 The department may utilize Mental Health Services Act moneys to fund state administrative costs related to developing and administering this article subject to an express appropriation in the annual Budget Act for these purposes, and to the extent authorized under the Mental Health Services Act. These funds shall be available for purposes of claiming federal financial participation under Title XIX of the federal Social Security Act (42 U.S.C. Sec. 1396) contingent upon federal approval.

14045.21.
 For Medi-Cal specialty mental health services and Drug Medi-Cal services, this article shall be implemented only to the extent that both of the following occur:
(a) The department obtains any federal approvals necessary to implement this section.
(b) The department obtains federal matching funds to the extent permitted by federal law.

14045.22.
 The department may establish a certification fee schedule and may require remittance as contained in the certification fee schedule for the purpose of supporting the activities associated with the ongoing administration of the Peer Support Specialist Certification Act of 2018. It is the intent of the Legislature that any certification fees charged by the department reasonably reflect the expenditures directly applicable to the ongoing administration of the peer, parent, transition-age, and family support specialists.

14045.23.
 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.

14045.24.
 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 informational notices, 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, 2022, 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. Commencing July 1, 2019, 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.