SB 803 (Beall): Mental health services: Peer Support Specialist Certification – SUPPORT

February 19, 2020
The Honorable Jim Beall
California State Senator
California State Capitol, Room 2082
Sacramento, CA 95814

RE: SB 803 (Beall): Mental health services: peer support specialist certification – SUPPORT

Dear Senator Beall: The California Association of Mental Health Peer Run Organizations (CAMHPRO) supports Senate Bill 806, which would establish a statewide certification program for peer support specialists and would provide the structure needed to maximize the federal match for peer services under Medi-Cal. CAMHPRO is proud to be a co-sponsor of SB 803.

CAMHPRO promotes the work and missions of peer-run organizations devoted to advocacy and empowerment for mental health consumers. CAMHPRO’s mission is to transform communities and the behavioral health care system throughout California to empower, support, and ensure the rights of consumers; eliminate stigma, and advance self-determination for all those affected by mental health issues.

In supporting a Peer Support Specialist Certification Program in California, CAMHPRO joins the formidable array of California organizations, counties and individuals advocating for growth in high quality peer/family support services and peer specialist career development. Through support of SB 803, we look to finally bring peer support specialist certification to California.

Programmatically, peer certification makes sense
Numerous research studies support the efficacy and cost effectiveness of peer specialist services. Peer services, as opposed to traditional services alone, lead to less inpatient services, decreased symptoms, increased coping skills and life satisfaction, reduced overall ongoing need for mental health services, and decreased substance use.

Across California, peers are already providing peer support services. However, there is no statewide scope of practice, standardized curriculum, training standards, supervision standards, or certification protocol. Few counties that provide peer support services require training prior to hire. The benefits of Peer Certification for peer support are obvious.

Peer certification:
  • Defines the service of peer support;
  • Provides a standardized scope of practice, values and ethics, and competencies;
  • Assures that practitioners receive standardized training and demonstrate competency;
  • Ensures that service recipients will receive the same quality of services regardless of where in California they live;
  • Provides a basis for the ability to bill Medi-Cal for services provided; and
  • Allows for portability of Certification between counties.
Peer Certification also makes good fiscal sense, and California is one of only two states in the nation without it.

In 2007, the US Centers for Medicare and Medicaid Services (CMS) sent a guidance letter to all State Medicaid Directors emphasizing, “peer support services are an evidence-based mental health model of care which consists of a qualified peer support provider who assists individuals with their recovery from mental illness and substance use disorders.” CMS encouraged states to establish a state certification process for training, credentialing, supervision and care coordination. (CMS, SMDL #07-011). This enables the use of federal Medicaid (Medi-Cal in California) financial participation with a 50% match. Currently, 48 states, plus the District of Columbia and the US Department of Veteran’s Affairs, have implemented protocols to certify peer specialists, enabling them to leverage Medicaid funds. However, California has not acted and Californians deserve better!

Initially funded by Department of Mental Health and then Office of Statewide Health Planning and Development (OSHPD), California began an in-depth and focused look at peer certification in 2011.Substantial grassroots work has been done toward peer certification since 2012 and substantial government funds have already been invested into developing peer certification in California.

SB 803 makes sense from both a policy and fiscal perspective and will provide more comprehensive assistance to people in need. CAMHPRO is proud to be part of a statewide movement to bring California up to speed with the rest of the nation in recovery and resiliency services through a state protocol for Medi-CAL billing and certification of peer support specialists.

Sincerely,
Sally Zinman
Executive Director
CAMHPRO
sallyzinman@gmail.com

United States Department of Health & Human Services, Centers for Medicare & Medicaid Services, Guidance Letter to State Medicaid Directors, SMDL #07-011, August 15, 2007.

Click to access SMD081507A.pdf

SB 10 Peer Certification VETOED – again

Governor Newsom Takes Final Action of 2019 Legislative Season
Published: 

LINK TO ALL FINAL ACTIONS

OFFICAL SB 10 VETO MESSAGE

*From the website*
Joint accomplishments include urgently addressing California’s affordability crisis by passing the Nation’s strongest statewide rent protections, expanding health care coverage and passing legislation to lower prescription drug prices

Focused on effective government by fortifying state against natural disasters and economic downturns – passing historic wildfire safety legislation and creating largest rainy day fund Ensuring justice for all Californians by passing historic clean drinking water legislation and taking on powerful institutions on behalf of everyday Californians

“Together, we have accomplished a great deal this year to help California families get ahead and made historic progress on some of the state’s most intractable challenges.”

SACRAMENTO — Governor Gavin Newsom took his final actions of the 2019 legislative season today and thanked the Legislature for their work and accomplishment on enacting 870 bills in the following statement:

“I want to take a moment to congratulate the Legislature on their work this year and to thank Senate President pro Tempore Toni Atkins and Speaker of the Assembly Anthony Rendon for their leadership. Together, we have accomplished a great deal this year – through the budget and legislation – that helps California families get ahead and tackles some of the state’s most intractable problems.

“This year, California passed the nation’s strongest renter protection package. Our state made record housing and homeless investments paired with big new tools for housing production. We moved California closer to universal health care coverage by expanding coverage, increasing Covered California subsidies for middle-income Californians and taking on rising prescription drug prices. 

“California, faced with catastrophic wildfires, invested $1 billion to prevent, mitigate and recover from wildfires, disasters and emergencies. And in July, our state enacted something that few people thought could be done – wildfire legislation that moved California closer to a safer, reliable and affordable energy future.

“Our state is doing more now than at any point in our history to help California families tackle the challenges of affordability and provide opportunity to all Californians – more than doubling tax cuts for working families, expanding paid family leave, increasing access to early childhood education, and taking on payday lenders. 

“On education, California brought disparate sides in the education community together and forged a historic agreement on changes to charter school law that was years in the making. We invested more in K-14 education than at any point in our history, and put on next year’s ballot the chance to make long-overdue investments in school infrastructure and safety. California made two years of community college tuition-free, increased financial aid for parents pursuing a college degree and kept tuition from rising in our UC and CSU systems.

“We have helped defend our state from Trump’s attacks – blocking the Administration from using state lands to open up drilling on protected federal lands. We took on the long-standing challenge of clean drinking water systems, became the first ever to require SMOG tests for semi trucks and convinced four major auto-makers to stand up for higher emission standards and oppose the Trump administration.

“California is once again striking out against injustice and leading the nation by example. We passed one of the country’s strongest police use-of-force laws, and outlawed private, for-profit prisons. California became the first state in the nation to stand up to the NCAA’s long-standing profiteering from student athletes. California took first-in-the-nation steps to strengthen our gun safety laws, protect workers and defend reproductive health care rights. We continued to make progress reforming our criminal justice system – eliminating a major mandatory minimum sentence and establishing a system to seal arrest and conviction records for low-level offenses.

“We are proving that our state is successful not despite our diversity, but because of it. California isn’t just defending our vibrant immigrant communities. We are affording all Californians – regardless of immigration status – the chance to serve their communities and give back.

“In California, we are putting in place new reforms of agencies that don’t serve the public as well as they should – pushing the DMV to join the 21st century, giving new authority to the California Public Utilities Commission (CPUC) to enforce wildfire safety standards, and recasting the priorities of our state’s agency that regulates oil and gas extraction.

“California did all of this while living within our means: creating the largest rainy day fund in California history, paying down pension liabilities and eliminating our state’s wall of debt.  

“In my inaugural, I spoke of the California Dream as a house – one that must be built on a strong fiscal foundation. For that reason, I am returning a number of bills to the Legislature without my signature that would significantly increase costs outside of the state’s regular budget process. 

“We have clearly achieved a great deal together, and I commend the Legislature for their hard work. I look forward to our continued partnership as we head into the new year and continue to tackle challenges of affordability and work to expand opportunity to all Californians.”

In his final action of the 2019 legislative season, the Governor today vetoed a number of bills that would significantly increase costs outside of the state’s regular budget process. In total, Governor Newsom vetoed bills this year costing $1.2 billion, increasing to $3 billion ​annually at full implementation. He also took action on a number of other bills.

#CAPeerRespites, Peer2Peer Support

Collaborating with Pool of Consumer Champions (POCC) and Mental Health Services Oversight & Accountability Commission (MHSOAC), we would like to send a very special thank you for everyone who joined us in celebrating Peer2Peer Support

#CAPeerRespites

Peer Respites: Expanding Peer2Peer Support
May 15, 2019

Peer2Peer Program of the day
Second Story Peer Respite Home (Santa Cruz County)
Share! Recovery House (Los Angeles County)
Blackbird House (Santa Clara County)
Sally’s Place (Alameda County)

Photos of the day:

 

Ideas from Breakout Groups

Peer Respites:
Expanding Peer2Peer Support


During the event 5/15/19, participates were asked how we could continue to network and grow peer respites throughout California. The responses below, categorized by themes, were the outcomes of the ongoing discussions throughout the day. This is the community voice.

To Build Support for Peer Respites: Advocacy

  • Educate the community, politicians, churches, schools, community service centers and other service providers, etc.
  • Provide exceptional services at existing respites, will lead to word of mouth
  • Create a tax incentive (or other financial incentive) to rent or sell a house for peer respite
  • Good data to communicate successes
  • Tax on Big Pharma to fund peer respite
  • Social media campaign using #CAPeerRespites
  • Connecting with faith-based organizations that have supportive mindset about mental health treatment/care/peer support
  • Utilize connections like news outlets to do local public interest stories spotlighting local peer respites (human kindness, compassion)
  • Create a “Peer Respite Day” during mental health month
  • Approach legislators to create bills
  • Determining messages and resources
  • Multimedia, TV, social media, radio, advertisements

Building a Network to Expand & Strengthen Peer Respite

  • Create a long-term strategic plan with existing peer respites to create a movement for peer respites in all counties
  • Peer respite working group to plan for Medi-Cal billing if SB 10 passes
  • Bimonthly meetings among existing peer respites for collaboration, sharing, learning, advising
  • Identify a “welcomer,” a point of contact to welcome others (new peer respites?)
  • Visit other peer sites
  • Build fellowship within peer community (ex: cookout)
  • Knowing people who will donate supplies or a house
  • Understanding and leveraging funding: seeking donations from corporations
  • Create info sheet about using MHSA money to fund peer respites
  • Potential statewide respite coalition partners: existing peer respites, county allies, other peer-run organizations, CAMHPRO, MHSOAC, established recover-focused nonprofits, provider organizations

To Improve Peer Respite

  • Child care for parents who need peer respite, link to child-care providers (and funds)
  • Pet care at peer respites
  • Community gardens
  • Emotional support animals at peer respites
  • Lift restrictions requiring diagnosis and/or taking medications (for those that have those requirements)
  • Consistent, consumer-produced statewide quality guidelines for peer respites
  • Make peer respite more accessible to people who don’t have housing
  • Gather community input on needs
  • Creating activities that engage understanding: yoga, exercise, music, art

Toward Peer Respite in Contra Costa County

  • Public comment, presentation, plant seeds CPAW: monthly meeting for MHSA, 1st Thursday, 3-5PM in Concord
  • Apply to be on MHC (1st Wednesday, 4:30-6:30 South, West, Central) and CPAW
  • BOS meetings
  • Community forums and outreach
  • Contra Costa Mental Health/Behavioral Health Services
  • POCC/Friends of Adeline
  • Peer programs
  • Contra Costa College & Spirit Program, Spirit Alumni Group
  • Social Inclusion meeting
  • RI: lost advocacy
  • Diversity
  • Surveys of community

Other Ideas

  • Build every tier of needed resources – peer respite is just one part; use available empty housing, explore co-housing and kibbutz model

SB 906 Peer Cert. VETOED! Persistence is key!

From Sally Zinman, Executive Director, CAMHPRO

Governor Brown has Vetoed SB 906. The consumer and larger mental health stakeholder community will pursue California state certification and, by all accounts, will have a better chance with a new Governor.

Persistence is the key to success, and essential to advocacy. Persistence and hope. We will have peer certification in California!

See the Governor’s veto message (below), which in my opinion, is not knowledgeable of the purpose or content of the bill.

~Sally~

 VETO MESSAGE

Senator Beall's Response to SB 906 Veto.JPG

Macro Advocacy Project – Los Angeles

Los Angeles peers, sponsored by Project Return, Peer Support Network,  and CAMHPRO advocating at the Capitol. One picture is of a group of us after we visited Senator Jim Beall’s office, author of SB 906, the peer certification bill. 
 
The Los Angeles novice advocates participated in a Macro Advocacy Project that trained peers on advocacy skills. CAMHPRO consulted on this project. The project culminated in the group coming to Sacramento and advocating for the bills they selected to support.
The intention of the Macro Advocacy Project was to train individuals on the state legislative process and how to effectively promote and advocate for legislation.

Photos curtesy of Sally Zinman May 2018