Peer Certification SB 906

SB 906: Peer Certification
introduced by
Senator Beall and Senator Anderson

CAMHPRO and California stakeholders
look forward to working with both Senators, co authors Hertzberg and Pan, and the bill’s sponsor, the Steinberg Institute, to bring long awaited peer certification to California.

SB 906 The Bill

Peer Provider Certification Fact Sheet

Sen. Beall Proposes State Certification of Peer Providers

January 17, 2018

SACRAMENTO – A proposal allowing qualified peer providers – people who have lived experience as clients, family members, or caretakers of individuals recovering from mental illness or addiction – to be certified by the state to deliver services to patients with such disorders was introduced today by Sen. Jim Beall, D-San Jose.

“Because of their life experience, peer providers who have personally dealt with mental disorders possess a level of expertise that professional training cannot replicate,’’ Beall said. “This legislation allows the Department of Health Care Services to establish a new category of trained and qualified providers who can connect people in need to services.

“Peer providers can be especially effective because they personally understand the fears that people grappling with alcoholism or mental illness are going through. They’ve been there.’’

Research studies show peer support can reduce hospitalizations, improve client functioning and client satisfaction, and alleviate depression and other symptoms. One study found the effect of peer providers to be transformative, helping mental health clients “move beyond the patient role into one of empowerment.’’

Senate Bill 906 requires the Department of Health Care Services to establish a certification program that includes guidelines, a code of ethics, defining the range of a peer provider’s responsibilities, the required training, continuing education, clinical supervision, and a process to revoke certification.

Secondly, the bill authorizes the department to amend the state’s Medicaid program by adding the peer support providers as a reimbursable category. It also directs the department to seek any federal waivers to offset costs. The federal Centers for Medicare and Medicaid have established guidelines for certification for states to set up programs and have offered a 50 percent match in federal funding.

Approximately 40 states have instituted peer provider support programs and services.

Jessica Cruz, NAMI California Executive Director, said peer providers can augment available treatment to increase healthy outcomes.

“Peer certification is essential to the behavioral health care continuum,’’ Cruz said.  “Peer providers can enhance the level of treatment provided by medical professionals, and in most cases the rate of reduced hospitalization is reduced ten-fold.

“Because families and individuals are experts out of their own experience, they are able to leverage their knowledge and expertise to help others through their journey.  NAMI California stands in strong support of California becoming the 41st state  accepting peers as certified professionals. We need to catch up with the rest of the country.’’

Beall’s proposal arrives at a time when the state anticipates that there will be substantial demand for peer support specialists, although there are no statewide standards, training or supervision processes in place.

SB 906 has drawn bipartisan support. Senator Joel Anderson, R-Alpine, is a joint author. Senators Robert Hertzberg, D-Van Nuys and Dr. Richard Pan D-Sacramento, are co-authors.

“We look forward to working on this important issue with these legislative champions,’’ said Maggie Merritt, Executive Director of the Steinberg Institute, which is sponsoring the bill.  “Peer certification has been shown to be hugely beneficial in mental health care. It’s time peers are certified and are recognized for the role they play in the course of someone’s healing.”

California Stakeholders

Working Well Together (WWT), a former collaboration of the National Alliance for the Mentally Ill (NAMI), United Advocates for Children and Families (UACF), the California Association of Mental Health Peer Run Organizations (CAMHPRO) and the California Institute for Behavioral Health Services (CIBHS), worked on this issue from 2011 to June, 2014 to investigate, research and develop certification standards. This process has included an extensive stakeholder process (over 500 stakeholders) across the state that developed a consensus set of seventeen (17) recommendations on Peer Support Certification.

Research reports:

Peer Specialist Training and Certification Programs: A National Overview

The certified peer specialist workforce is relatively new in the behavioral health field, with state recognized certification programs first emerging in 2001. Within this short timeframe, states have recognized the potential of peer specialists to improve individual outcomes by promoting recovery. A nearly universal definition of a peer specialist is: an individual with lived experience who has initiated his/her own recovery journey and assists others who are in earlier stages of the recovery process. As of July 2016, 41 states and the District of Columbia have established programs to train and certify peer specialists and 2 states are in the process of developing and/or implementing a program.


Peer Certification Report July 2014:
Following the extensive stakeholder process and the development of three reports on Peer Support Certification, Working Well Together was tasked with reaching out of state level agencies to gather feedback and input on the recommendations regarding certification. Working Well Together met with the Department of Health Care Services, the Department of REhabilitation, and the California Mental Health Directors Association, as well as the California Mental Health Planning Council. These meetings provided the agencies with background information on certification and sought feedback for the purposes of informing and refining the recommendations in order to achieve a consensus.

Peer Certification Report 2013:
WWT has engaged stakeholders in ongoing teleconferences, webinars, and work groups and five regional stakeholder meetings to provide feedback and recommendations that will support the requirements as laid out by the U.S. Centers for Medicaid and Medicare Services (CMS) letter dated August 15, 2007, regarding inclusion of Peer Support as a part of 4 services provided under Specialty Mental Health. This resulted in several recommendations in support of the development of a statewide certification for Peer Support Specialists. In May of 2013, a final statewide Stakeholder Summit was convened to provide further vetting with the goal of finalizing recommendations for the inclusion of Peer Support into the State Plan Amendment and the development of a statewide Certification for Peer Support Specialists. By and large, the vast majority of stakeholders support the original recommendations; however, where appropriate, adjustments have been made to more closely align with stakeholder feedback and provide clarity. The 17 recommendations are listed beginning on page nine of this report.

Peer Certification Report June 2012:
Peer support is a long established and increasingly used practice that offers hope, inspires positive growth and promotes recovery and resiliency for individuals and their family members, parents and caregivers who are living with the challenges of a mental health issue. In California, the Mental Health Services Act (MHSA), passed by voters in 2004, stipulates that individuals receiving services for a mental health diagnosis, as well as their family members, must be actively involved in the development and provision of services to ensure system transformation toward a recovery and resiliency orientation. A significant strategy for system transformation is peer support. The MHSA has created increased demand and opportunities for individuals to receive and provide peer support services.

Peer Certification Report 2012:
This report is intended to provide stakeholders with background information on efforts in other states to include peer services into their systems of care. Additionally, the report will review existing hiring and training practices of peer providers in California. The report will also identify varying mechanisms and types of certification and discuss special considerations such as health care reform and the needs of small and/or rural counties. The report will conclude with recommendations and next steps toward certification. It is the intention of WWT that the report will precede and inform five regional stakeholder meetings in 2011-2012 to allow stakeholders the opportunity to utilize the information in the report to make recommendations to the state.

Informational Documents:

History and Status April 2016:
A PDF with up-to-date information regarding the history and current status of SB614.

Southern Region Forum February 2016:
A PDF/PowerPoint presentation. Keynote panel: Karin Lettau of CAMHPRO, Sally Zinman of CAMHPRO, Mario Lopez, of Riverside University Health System Behavioral Health. , and Lisa St. George of RI International.

Medi-CAL Billing and the State Plan Q & A:
A PDF of information about frequently asked questions in regards to Medi-CAL Billing. Informational purposes.

Peer Support Specialists County Behavioral Health Systems:
A PDF/PowerPoint for informational purposes.

The Big Picture:
A PDF/PowerPoint of the larger picture regarding SB614. For informational purposes. A document with resources. A presentation by Heidi Strunk of CAMHPRO, February 2016.

Public Policy Committee:
A PDF/PowerPoint regarding SB614 September 2015. For informational purposes.

SB-614 FAQ:
A PDF with frequently asked questions regarding the purpose of SB614.

What was SB 614

~~Don’t Be Confused~~

SB 614 is now being used for a different bill. Senate Bill 614 was “gutted and amended” into a totally different bill. Senate Bill 614 is no longer the Peer Certification bill. The bill is now titled, “Criminal Procedure: Legal Assistance: ability to pay.”

SB614 is NOT moving forward at this time. For more details, visit UPDATE ALERT: August 9, 2016. Work on peer certification will continue in the fall of 2016 for the new legislative session. Please note that the CAMHPRO SB614 webinars (registration link below) are still scheduled as before; they’ll going to be more focused on upcoming changes and updates regarding the new legislative session in the fall of 2016.

SB 614 Memo to DHCS_81716_Final: This document will provide the detailed report on the “collective decision not to move Senate Bill 614 (Leno) forward this year.”

Stay up to date and REGISTER FOR UPCOMING WEBINARS. After registering once, you will receive a confirmation email containing information about joining the webinar each month. Visit the previous recordings of SB614 webinars facilitated by CAMHPRO. Download the SB614 Support Letter.


California Senate Bill 614 (SB 614) Learn the status of California State Peer, Transition Age, Parent & Family Support Certification Program Senate Bill 614 (Leno-D) and provide input to advance peer certification.

CA SB 614 PASSED the CA Senate, was due for the last vote in the Assembly in last year’s legislative session when the bill was stalled and ordered into the ‘inactive file’. The Department of Health Care Services (DHCS) would be the agency implementing the bill and is still negotiating with the bill sponsor, the County Behavioral Health Directors Association (CBHDA) to make it mutually agreeable. DHCS refuses to open the State Plan for Amendments to allow for unique peer support specialists/services billing codes and has recommended ‘technical amendments’, not open to the public that could undermine the intent of the bill and the essence of genuine peer support services. No legislative progress has been made since August of last year. The voice of CA stakeholders has resonated loudly for many years in support of this bill with specific recommendations reflected in the bill as of 8/31/15. What happens next is in part up to us. What can you do to help CA emerge from the Dark Ages as one of four remaining US states without a state-approved plan for peer certification in mental health?

A State Peer Specialist Certification is a 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, testing and continuing education requirements
  • Code of ethics
  • Supervision
  • Billing as unique peer provider & service