Certified Peer Support Services

Background

“Peer support is a natural human response to the alienation and adversity associated with being given a psychiatric diagnosis. Wherein the diagnosis marks us as ‘different’ and separates us from the community, peer support creates common ground and the opportunity for inclusion.”
Patricia Deegan, Ph.D

Mental health peer support has existed for decades, both formally and informally in clubhouses, drop-in centers, and consumer/run organizations. Since the 1990’s, increased attention has been paid to the importance and potential of expanding mental health staffing patterns to include “consumers as providers” within mental health service settings.

In 2001, Georgia and Arizona were among the first states to be approved for Medicaid coverage of Certified Peer Specialists. Several states quickly followed and in 2007 the Minnesota Legislature passed Minnesota Statute 256B.0615 directing the Commissioner of the Department of Human Services to establish the Medicaid-covered Certified Peer Specialist role. Minnesota joins 26 states that have a covered peer support service. The Center for Medicare and Medicaid Services (CMS) now recognizes peer support providers as a distinct provider type for the delivery of support services and considers it an evidence-based mental health model of care.

The role of Certified Peer Specialists, as mental health professionals is continuing to develop as states create certification programs and incorporate formally trained Certified Peer Specialists into traditional service settings. The Certified Peer Specialist does not replace other mental health professionals, but rather it is a complement to an array of mental health support services.

Certified Peer Specialist (CPS) Qualifications

Individuals that meet the following requirements are eligible for employment with mental health rehabilitative service providers that have been approved by the Department. A qualified individual may be hired at an entry level as a Certified Peer Specialist Level I or at an advanced level as a Certified Peer Specialist Level II. The primary purpose of these tiered levels is to promote retention and career advancement in the field.

To be employed as a Certified Peer Specialist (CPS) Level I, an individual must meet all of the following criteria:

  • • Must be at least 21 years old.
  • • Have a high school diploma or equivalent.
  • • Have or have had a primary diagnosis of mental illness.
  • • Have received or is currently receiving mental health services.
  • • Be willing to share their experience of recovery.
  • • Successfully complete the Department approved Certified Peer Specialist training and certification exam.
  • To be employed as a Certified Peer Specialist (CPS) Level II, an individual must meet all of the qualifications of a Certified Peer Specialist Level I and meet one or more of the following:

  • • Be qualified at the Mental Health Practitioner level as defined by Minnesota Statute 245.462, subdivision 17.
  • • Have at least 6,000 hours of supervised experience in the delivery of peer services to persons with mental illness
  • • Have at least 4000 hours of supervised experience in the delivery of services to persons with mental illness and an additional 2000 hours of supervised experience in the delivery of peer services to persons with mental illness.
  • Certified Peer Specialists often assist people in completing their own Wellness Recovery Action Plan (WRAP), therefore Certified Peer Specialists will eventually be required to complete a personal WRAP plan and participate in a WRAP facilitator training.

    Certification will remain valid for two years from the time of attaining certification. To retain certification, every two years, Peer Specialists must complete and provide documentation of 30 hours to DHS of continuing education in areas of mental health recovery, mental health rehabilitative services, and peer support.

    Employers/Agencies

    Agencies interested in employing Certified Peer Specialists under the Medicaid rehabilitation services option must submit a Certified Peer Specialist Agency Request for Technical Assistance and an Implementation Plan.

    Medicaid Rehabilitation Services include:

  • • Adult Rehabilitative Mental Health Services (ARMHS) certified by DHS
  • • Assertive Community Treatment (ACT) teams approved by DHS
  • • Crisis Response -Stabilization providers certified by DHS
  • • Intensive Residential Treatment Services (IRTS) providers licensed by DHS
  • Certified Peer Specialists may be employed as part-time or full-time staff depending on agency capacity and the needs of the community. Agencies are encouraged to employ more than one Certified Peer Specialist within an agency and to consider capacity building of the Certified Peer Specialist role across agency services. In order to provide culturally relevant services, agencies are encouraged to employ individuals who reflect the culture, ethnicity, and mental health service experiences of the people with whom they will work.

    Technical assistance for employers will be provided by the Minnesota Department of Human Services (DHS) Adult Mental Health Division staff. Staff will assist agencies in understanding the requirements that are needed to incorporate these services within their existing program areas. Billing and reporting systems will differ for each service type. For more information, please contact Shelley White at shelley.white@state.mn.us or 651-431-2518.

    Individuals

    Individuals interested in the training required for employment as a Certified Peer Specialist must complete the training application found on the department’s website. or on the Mental Health/Consumer Survivor Network’s website. In addition to the application, a letter of recommendation is required.

    The completed application and a letter of recommendation must mailed or faxed (651-431-7566) to DHS They applicant will be contacted by the Program Consultant responsible for this program.

    The mailing address:

    Shelley White
    MN Department of Human Services
    Adult Mental Health Division
    P.O. Box 64981
    St. Paul, MN 55155

    Training and Certification

    Individuals Seeking Certification

    The core curriculum is Recovery Innovations’ Peer Employment Training (PET) program. The 80 hour course includes a mid-term and final exam. Sessions are designed to provide a “hands-on” experience translating concepts and skills into practice. Passing the final exam demonstrates mastery of the concepts and methods learned in the course and readiness to become a Certified Peer Specialist. Certified Peer Specialists working on crisis stabilization teams are required to complete an additional thirty hours of training in the provision of crisis services.

    Supervisor and Agency Staff Training

    Incorporating the work of the Certified Peer Specialist into existing services requires change and transformation for all staff. Supervisors, staff, and agency directors are encouraged to attend a two-day Leading and Coaching training to prepare staff and agencies to support Certified Peer Specialists and the implementation of these services. The curriculum examines leadership and supervisory practices in a recovery organization, identifies opportunities for recovery transformation within the organization and demonstrates recovery coaching techniques.

    Administrative Standards for Medicaid Coverage of the Certified Peer Specialist

    In an August 15, 2007 letter to State Medicaid Directors the Centers for Medicare and Medicaid Services (CMS) encourages states to incorporate peer support services under the Medicaid program. CMS guidance instructs, consistent with all services billed under the Medicaid program, states utilizing peer support services must comply with all federal Medicaid regulations and policy. CMS provides minimum requirements that must be addressed for care coordination, supervision and training when states elect to provide peer support services.

    Care-Coordination
    As a Medicaid-billable service, Certified Peer Specialists provide non- clinical, person-centered recovery focused support while helping to ensure the treatment plan reflects the needs and preferences of the person being served to achieve their measurable and individualized goals. The level of services provided must be determined on an individual basis taking into account the intensity of the situation for the person receiving services, the experience of the Certified Peer Specialist and the acuity of the beneficiary’s condition.

    Supervision
    For the purpose of Medicaid billing, clinical supervision must meet the following requirements. Certified Peer Specialists at Level I and Level II must:

  • • Receive documented monthly individual clinical supervision by a mental health professional during the first 2000 hours of work.
  • • Have 18 hours of documented field supervision by a mental health professional or mental health practitioner during the first 160 hours of contact work with recipients and at least six hours of field supervision quarterly during the following year.
  • • Have review and co-signature of charting of recipient contacts during field supervision by a mental health professional or mental health practitioner.
  • • Complete continuing education training of at least 30 hours every two years in areas of mental health recovery, mental health rehabilitative services and peer support.
  • Amount, Duration and Scope of Service

    Certified Peer Specialist services will have the same threshold as other mental health rehabilitative services. The current threshold is 300 hours of service per year per service recipient.

    Billing CPS Services

    MHCP Billing Codes

    Procedure Code

    Procedure Code Description

    Rate

    H0038

    Self-Help/Peer Services

    The lower of the submitted charge or $11.38 per 15-minute unit

    H0038-Modifier=U5

    Self Help/Peer Services Specialist Level II

    The lower of the submitted charge or $13.01 per 15-minute unit

    H0038-Modifier=HQ

    Self Help/Peer Services in a Group Setting

    In a group setting, the lower of the submitted charge or $5.72 per 15-minute unit

    BRASS Code for County Billing

    A BRASS code for Peer Support Services has been created and should be used as appropriate, depending on agency reporting requirements. The BRASS code is listed as follows:

    420X: Peer Support Services Non-clinical, recovery-focused activities encouraging empowerment, self-determination, and decision-making provided by a Certified Peer Specialist.

    Resources for providers

    Agency request for technical assistance related to certified peer specialist (DOC 1 page)

    CPS Service Implementation Application (PDF 1 page)

    Additional resources

    The following references and resources are provided to assist agencies in the design and incorporation of the certified peer specialist staff within existing mental health rehabilitation services.

    Mental Health Consumer/Survivor Network of Minnesota

    Institute for Recovery & Community Integration

    National Association of Peer Specialists


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