BILL ANALYSIS Ó
SB 614
Page 1
SENATE THIRD READING
SB
614 (Leno)
As Amended August 31, 2015
Majority vote
SENATE VOTE: 40-0
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|Committee |Votes|Ayes |Noes |
| | | | |
| | | | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Health |18-0 |Bonta, Maienschein, | |
| | |Bonilla, Burke, | |
| | |Chávez, Chiu, Gomez, | |
| | |Gonzalez, Roger | |
| | |Hernández, Lackey, | |
| | |Nazarian, Patterson, | |
| | |Rodriguez, Santiago, | |
| | |Steinorth, Thurmond, | |
| | |Waldron, Wood | |
| | | | |
|----------------+-----+----------------------+--------------------|
|Appropriations |12-0 |Gomez, Bloom, Bonta, | |
| | |Calderon, Nazarian, | |
| | |Eggman, Eduardo | |
| | |Garcia, Holden, | |
| | |Quirk, Rendon, Weber, | |
| | |Wood | |
SB 614
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SUMMARY: Requires the Department of Health Care Services (DHCS)
to establish a program for certifying peer and family support
specialists (PFSS) and to collaborate with interested
stakeholders and allows DHCS to seek any federal waivers or
state plan amendments to implement the certification program.
Specifically, this bill:
1)Requires DHCS to establish a peer, parent, transition-age, and
family support specialist (peer support specialist)
certification program by July 1, 2017, that must do the
following:
a) Establish a certifying body, either within DHCS, through
contract, or through an interagency agreement, to provide
for the certification of peer, parent, and family support
specialists;
b) Provide for a statewide certification for each of the
following categories of peer support specialists, as
contained in federal guidance issued by the Centers for
Medicare and Medicaid Services (CMS):
i) Adult peer support specialists, who may serve
individuals across the lifespan;
ii) Transition-age youth peer support specialists;
iii) Family peer support specialists; and,
iv) Parent peer support specialists.
SB 614
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c) Utilizes 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 of best practices.
d) Determine the range of responsibilities, practice
guidelines, and curriculum and core competencies for each
category of peer support specialist, including curriculum
that may be offered in areas of specialization, such as
older adults, veterans, family support, forensics, whole
health, juvenile justice, youth in foster care, sexual
orientation, gender identity, and any other areas of
specialization identified by DHCS;
e) Specify training requirements and continuing education
requirements for certification;
f) Determine clinical supervision requirements for
certified personnel that require, at a minimum, certified
personnel to work under the direction of a mental health
rehabilitation specialist or substance use disorder
professional;
g) Establish a code of ethics;
h) Determine the process for certification renewal and
revocation; and,
i) Determine a process for allowing existing personnel
employed in the peer support field to obtain certification
under this article, at their option.
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2)Establishes minimum requirements to be certified as an adult
peer support specialists, a transition-age youth peer support
specialist, a family peer support specialist, or a parent peer
support specialist.
3)Specifies that peer support specialists are not qualified or
authorized to diagnose an illness, prescribe medication, or
provide clinical services.
4)Requires full federal financial participation (FFP) and all
necessary federal approvals to be obtained before the
provisions of this bill are enacted.
5)Authorizes DHCS to utilize Mental Health Services Act (MHSA)
funds and any designated Workforce Education and Training
Program resources to develop and administer the peer, parent,
and family support specialist certification program.
6)Authorizes MHSA funding to serve as the state's share of
funding for purposes of claiming FFP.
7)Requires DHCS to adopt regulations by July 1, 2019. Requires,
if regulations have not been adopted, beginning six months
after the effective date of this article, DHCS must provide
semiannual status reports to the Legislature until regulations
have been adopted.
8)Permits DHCS to establish a certification fee schedule and
require remittance of fees for the purpose of supporting DHCS
activities associated with the ongoing state administration of
the peer support specialist's certification program.
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FISCAL EFFECT: According to the Assembly Appropriations
Committee, approximately $1.5 million in administrative staff
costs for the first year of implementation, and conservatively
in the range of $1 million ongoing for DHCS state staff costs
for investigation, discipline, and contract oversight.
Implementation of this bill is contingent on federal approval
and FFP. Fees authorized could potentially support the entire
program if other funding was not made available, or could offset
some of the state costs. Additional costs include contract
costs, likely in the hundreds of thousands of dollars and
uncertain increase in total Medi-Cal spending for peer support
services.
COMMENTS: According to the author this bill provides California
the opportunity to receive new federal Medicaid funds, expand
our behavioral health workforce, and include evidence-based PFSS
services into our comprehensive health and behavioral health
care system. A PFSS is a person who uses lived experience from
mental illness plus skills learned in formal trainings, coupled
with a certification process, to provide guidance in a
behavioral health care setting to promote mind-body recovery and
resiliency. Quantitative, independently assessed research
findings support the efficacy of a PFSS. Peer support services
help people navigate systems of care, remove barriers to
recovery, stay engaged in the recovery process, and live full
lives.
More than 30 states have implemented a certification process
under their Medicaid programs. The author argues that
California would benefit from enactment, for we presently have
no standard definition of training or certification process and
could be obtaining a 50% federal match for services, which are
currently supported by local funds. DHCS has included the PFSS
as a workforce expansion strategy in the recent 1115 Waiver
Renewal "Medi-Cal 2020", which it submitted to CMS on March 27,
2015. The author concludes that this bill can be the vehicle
for this specific purpose.
SB 614
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The sponsor of this bill, the County Behavioral Health Directors
Association (CBHDA), states in support of this bill that peer
providers who use their lived experience with mental illness and
recovery, coupled with skills learned through formal training,
are valuable additions to service delivery in behavioral health
settings. CBHDA states that this bill will offer training and
certification for peers, parents, and family support specialists
and enable California to receive federal funds for this purpose.
Supporters of this bill, including the California Coalition for
Mental Health, Children Now, Disability Rights California, and
Western Center on Law & Poverty, write that the state's
underutilization of the PFSS at a time when the Medi-Cal program
has been expanded and the health care system needs to ensure
that the appropriate workforce meets demand, including
culturally and linguistically appropriate care. Supporters cite
research that the PFSS helps clients hone life functioning
skills, alleviate depression and other symptoms, enhance
clients' advocacy and navigation abilities, reduce
hospitalizations, and improve client satisfaction. Supporters
further cite the lack of statewide training and supervision
standards for the PFSS and state that CMS, the United States
Department of Veteran's Affairs, and more than 30 states have
already recognized the importance and value of PFSS
certification.
The Health Committee notes that multiple letters of concern have
been submitted stating that in order to ensure underserved
communities receive equitable services that are culturally and
linguistically appropriate, language for this bill should be
considered that would simply allow counties to utilize
"Community Health Workers" in lieu of "Peer Support Specialists"
when appropriate to serve racial, ethnic, and cultural
communities.
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The California Consortium of Addiction Professionals (CCAPP)
states in opposition to this bill that the regulatory framework
presented in this bill is not practical and that this bill lacks
standards of education, a code of ethics, a defined scope of
practice, among other things. Additionally, CCAPP states with
concern that DHCS does not currently have licensing
responsibilities.
Analysis Prepared by:
Paula Villescaz / HEALTH / (916) 319-2097 FN:
0001727