Medi-Cal Peer Support Services Specialist Program – Frequently Asked Questions
Lub vev xaib no muab cov lus teb rau cov lus nug uas feem ntau hais txog Medi-Cal Peer Support Specialist Program. Thov hu rau County Support inbox los ntawm email rau CountySupport@dhcs.ca.gov yog tias koj nrhiav tsis tau cov lus teb rau koj cov lus nug hauv qab no.
Questions related to California Mental Health Services Authority’s (CalMHSA) role in Medi-Cal Peer Support Specialist certification, including questions about Medi-Cal Peer Support Specialist training, exams, and certification, may be directed to CalMHSA by emailing PeerCertification@calmhsa.org.
Cov FAQ hauv qab no tau muab faib ua pawg hauv qab no:
- Medi-Cal Peer Support Specialist Certification Standards
- Cov cheeb tsam tshwj xeeb
- Medi-Cal Peer Support Specialist saib xyuas
- Medi-Cal Peer Support Specialist Certification Programs
- Xaiv rau Medi-Cal Peer Support Services Benefit
- Muab Medi-Cal Peer Support Services
- Kev them nqi rau Medi-Cal Peer Support Services
- Lwm yam
Medi-Cal Peer Support Specialist Certification Standards
1. Yuav ua li cas tib neeg thiaj li tau ntawv pov thawj los ua Medi-Cal Peer Support Specialists?
Cov ntaub ntawv: BHIN 25-010
Individuals interested in becoming a certified Medi-Cal Peer Support Specialist must apply via an approved certification program. Currently, the only Medi-Cal Peer Support Specialist certification program is available through the California Mental Health Services Authority (CalMHSA). Please visit CalMHSA Peer Certification webpage or contact CalMHSA by emailing PeerCertification@calmhsa.org for information regarding certification.
2. Tus nqi ntawm Medi-Cal Peer Support Specialist daim ntawv pov thawj yog dab tsi?
Cov ntaub ntawv: BHIN 25-010
Fees for individuals applying for Medi-Cal Peer Support Specialist certification are set by counties or county-selected certification programs. Currently, California Mental Health Services Authority (CalMHSA) is the sole certification program for all counties opting in to provide Medi-Cal Peer Support Services in California. CalMHSA’s fees are posted on the CalMHSA website.
3. Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) puas tuaj yeem zam qhov Medi-Cal Peer Support Specialist daim ntawv pov thawj kev kuaj mob thiab/lossis pom zoo ib daim ntawv pov thawj uas tsis tau xeem tiav rau lwm tus neeg thov kev pabcuam?
Siv: BHIN 25-010, W&I Code 14045.15
No. Applicants must pass a certification exam approved by the Department of Health Care Services (DHCS) to receive Medi-Cal Peer Support Specialist certification under the requirements in state law (W&I Code 14045.15).
4. Lub neej lossis kev ua haujlwm puas tuaj yeem hloov pauv rau GED lossis qhov kev xav tau sib npaug?
Siv: BHIN 25-010, W&I Code14045.15(a)
No. Per W&I Code14045.15(a), applicants must have a General Education Development (GED) or equivalent degree to qualify for Medi-Cal Peer Support Specialist certification.
5. Dab tsi yog qhov yuav tsum tau muaj ntawv pov thawj los ntawm cov txheej txheem tawm ntawm lub xeev?
Cov ntaub ntawv: BHIN 25-010
Cov neeg thov tsim nyog yuav tsum muaj:
- Ua tiav 1550 teev ua ib tus neeg ua haujlwm txhawb nqa hauv peb xyoos lossis tsawg dua, nrog 500 teev ua tiav hauv 12 lub hlis dhau los;
- Ua tiav 20 teev ntawm cov chav kawm txuas ntxiv (CEUs), suav nrog rau 6 teev ntawm kev cai lij choj thiab kev coj ncaj ncees;
- CEUs can be in relevant professional competencies obtained via relevant in-state, out-of-state, or national educational forums;
- Has peer support worker certification in good standing issued in a state or territory outside of California;
- Dhau qhov kev xeem ntawv pov thawj;
- Pom zoo ua raws li Txoj Cai ntawm Kev Ncaj Ncees rau Medi-Cal Cov Neeg Pabcuam Pabcuam Peer hauv California;
- Muab cov ntaub ntawv ntawm kev ua tiav tsawg kawg ib qho kev cob qhia ua phooj ywg; thiab
- Muab peb Tsab Ntawv Pom Zoo:
- One from a previous or current supervisor;
- Ib tug los ntawm ib tug npoj yaig / kws tshaj lij; thiab
- Ib qho kev pom zoo rau tus kheej piav qhia txog lawv lub luag haujlwm tam sim no thiab lub luag haujlwm raws li ib tus neeg ua haujlwm txhawb nqa
Tsis muaj hnub kawg ntawm kev ua haujlwm lossis hnub poob rau cov neeg ua haujlwm txhawb nqa nrog cov ntawv pov thawj tawm ntawm lub xeev los thov kev sib raug zoo.
6. Thaum twg yog lub sijhawm kawg kom tsim nyog los ua Medi-Cal Peer Support Specialist uas tau lees paub los ntawm cov txheej txheem niam txiv?
Cov ntaub ntawv: BHIN 25-010
Hnub kawg rau niam tais yawm txiv yog Lub Rau Hli 30, 2023. Txoj kev niam tais yawm txiv tsis muaj lawm.
7. Dab tsi yog cov kev xav tau kev kawm txuas ntxiv rau Medi-Cal Peer Support Specialist?
Cov ntaub ntawv: BHIN 25-010
Medi-Cal Peer Support Specialists must complete 20 hours of continuing education, including six hours of continuing education on law and ethics, every two years. The continuing education must include updates on applicable laws and evidence-based best practices. Information on continuing education requirements is available on CAPeerCertification.org.
8. Puas yog kev cob qhia ua tiav hauv ib cheeb tsam tshwj xeeb suav nrog rau kev kawm txuas ntxiv?
Cov ntaub ntawv: BHIN 25-010
Yog lawm. Cheeb tsam ntawm cov sij hawm kev cob qhia tshwj xeeb ua tiav los ntawm Medi-Cal Cov Neeg Pab Txhawb Kev Pabcuam Tshwj Xeeb hauv ob xyoos ua ntej kev lees paub ob xyoos tuaj yeem suav rau 20 teev ntawm kev kawm txuas ntxiv uas yuav tsum tau ua kom tiav daim ntawv pov thawj biennial.
9. Dab tsi yog txheej txheem rau kev rov ua dua daim ntawv pov thawj lapsed?
Cov ntaub ntawv: BHIN 25-010
Cov xwm txheej thiab cov txheej txheem rau kev rov ua dua tshiab yog raws li hauv qab no:
Lapsed: A certification is considered lapsed if it is not renewed by the renewal due date. The certification will remain lapsed for up to one year after the renewal due date if it is not renewed within this period.
- Txheej txheem nqa daim ntawv pov thawj tam sim no:
- Ua kom tiav 20 teev ntawm kev kawm txuas ntxiv
- Rov lees paub Code of Ethics
- Them tus nqi txuas ntxiv ob xyoos thiab tus nqi lig, yog tias muaj
Expired: A certification is considered expired if it is not renewed within one year of the renewal due date. The certification will remain expired for up to four years after the renewal due date if it is not reinstated within this period.
- Txheej txheem nqa daim ntawv pov thawj tam sim no:
- Ua kom tiav 80-teev cov ntawv pov thawj thawj zaug rov ua dua tshiab lossis xeem dhau daim ntawv pov thawj
- Ua kom tiav 20 teev ntawm kev kawm txuas ntxiv
- Rov lees paub Code of Ethics
- Them tus nqi rov qab thiab tus nqi lig, yog tias muaj
Vacated: A certification is considered vacated if it is not renewed within four years of the renewal due date.
- Txheej txheem nqa daim ntawv pov thawj tam sim no:
- Rov ua ntaub ntawv pov thawj
- Ua kom tiav 80-teev cov ntaub ntawv pov thawj thawj zaug
- Kev xeem ntawv pov thawj
- Them nqi daim ntawv thov, nqi kawm, thiab nqi kuaj
10. Puas muaj hnub nyoog tsawg kawg nkaus kom dhau los ua Medi-Cal Peer Support Specialist?
Siv: BHIN 25-010, W&I Code 14045.15
Yog lawm. Raws li W&I Code 14045.15, Cov neeg thov yuav tsum muaj hnub nyoog tsawg kawg yog 18 xyoo thiaj li tau lees paub tias yog Medi-Cal Peer Support Specialist. Qhov no tsis txwv Medi-Cal Peer Support Specialists los ntawm kev ua haujlwm nrog cov hluas lossis cov hluas uas muaj hnub nyoog hloov pauv.
11. Puas yog ib tug phooj ywg uas tsis ua hauj lwm nrog Medi-Cal cov tswv cuab yuav tsum tau ntawv pov thawj?
Cov ntaub ntawv: BHIN 25-010
No. The Medi-Cal Peer Support Specialist certification is only a specific certification requirement if the Medi-Cal behavioral health delivery system would like to be reimbursed by Medi-Cal for the provision of covered Medi-Cal Peer Support Services to Medi-Cal members.
Cov cheeb tsam tshwj xeeb
12. Medi-Cal Peer Support Specialists puas tuaj yeem ua tiav ntau tshaj ib qho tshwj xeeb?
Cov ntaub ntawv: BHIN 25-010
Yog lawm. Medi-Cal Peer Support Specialists tuaj yeem ua tiav kev cob qhia rau ntau yam tshwj xeeb.
13. Cov neeg raug kaw yav tas los puas tuaj yeem ua tiav qhov kev ua txhaum cai (kev ncaj ncees koom nrog) tshwj xeeb?
Cov ntaub ntawv: BHIN 25-010
Yog lawm. Cov neeg raug kaw yav dhau los tuaj yeem ua tiav qhov kev cai lij choj (kev ncaj ncees koom nrog) tshwj xeeb.
14. Kev cob qhia hauv ib cheeb tsam tshwj xeeb tuaj yeem suav rau 80 teev ntawm kev cob qhia rau kev lees paub thawj zaug?
Cov ntaub ntawv: BHIN 25-010
Tsis yog. Cov cheeb tsam ntawm cov sij hawm kev cob qhia tshwj xeeb tsis suav rau 80 teev ntawm kev cob qhia uas yuav tsum tau ua kom tau txais ntawv pov thawj thawj zaug.
15. Puas yog Medi-Cal Peer Support Specialists yuav tsum ua kom tiav cov kev cob qhia tshwj xeeb kom muaj peev xwm ua hauj lwm hauv qhov tshwj xeeb?
Cov ntaub ntawv: BHIN 25-010
Tsis yog. DHCS tsis xav kom Medi-Cal Peer Support Specialists ua tiav kev cob qhia hauv ib cheeb tsam tshwj xeeb ua ntej muaj peev xwm muab Medi-Cal Peer Support Services rau cov tswv cuab. Kev cob qhia hauv thaj chaw tshwj xeeb yog xaiv tau.
16. Leej twg tsim cov ntaub ntawv kawm rau txhua qhov chaw tshwj xeeb?
Cov ntaub ntawv: BHIN 25-010
Lub Xeev-pom zoo Medi-Cal Cov Kev Pabcuam Ntawv Pov Thawj yog lub luag haujlwm tsim thiab xa lawv cov ntaub ntawv kawm rau txhua qhov chaw tshwj xeeb rau Department of Health Care Services (DHCS) kom pom zoo.
17. Cov Kev Pabcuam Ntawv Pov Thawj puas tuaj yeem muab cov chaw tshwj xeeb ntxiv rau cov kev tshwj xeeb uas yuav tsum tau teev tseg hauv BHIN 25-010?
Cov ntaub ntawv: BHIN 25-010
Counties, or county-selected Certification Programs, may propose supplemental areas of specialization by submitting a draft curriculum to the Department of Health Care Services (DHCS) at CountySupport@dhcs.ca.gov. Additional areas of specialization proposed by Certification Programs are subject to DHCS’ review and approval.
Medi-Cal Peer Support Specialist saib xyuas
18. Cov kws kho mob dab tsi tau tso cai los muab kev taw qhia rau Medi-Cal Peer Support Specialists?
Cov ntaub ntawv: BHIN 25-010
Rau Medi-Cal Cov Kev Pabcuam Peer Kev Pabcuam yog muab raws li Cov Kev Pabcuam Tshwj Xeeb Mental Health (SMHS), cov kws tshaj lij kev noj qab haus huv hauv qab no raug tso cai los muab kev taw qhia rau Medi-Cal Peer Support Specialist: tus kws kho mob; ib tug kws kho mob uas muaj ntawv tso cai los yog zam; ib tug muaj ntawv tso cai, zam los yog sau npe rau social worker; tus neeg muaj ntawv tso cai, zam lossis sau npe sib yuav thiab tus kws kho mob hauv tsev neeg; daim ntawv tso cai, zam lossis sau npe tus kws pab tswv yim kho mob, tus kws saib xyuas neeg mob sau npe (nrog rau tus kws saib xyuas neeg mob tau ntawv pov thawj, lossis tus kws saib xyuas neeg mob), thiab cov kws kho mob muaj ntawv tso cai.
Rau Medi-Cal Cov Kev Pabcuam Peer Kev Pabcuam yog muab los ntawm Kev Pabcuam Kev Noj Qab Haus Huv Medi-Cal (DMC)/Drug Medi-Cal Organized Delivery System (DMC-ODS), cov kws tshaj lij kev noj qab haus huv hauv qab no tau tso cai los qhia rau Medi-Cal Peer Support Specialist: tus kws kho mob; tus kws kho mob; tus neeg saib mob sau npe; tus kws kho mob puas siab puas ntsws muaj ntawv tso cai; ib tus kws kho mob uas muaj ntawv tso cai lossis sau npe ua haujlwm rau social worker; ib daim ntawv tso cai lossis sau npe tus kws pab tswv yim kho mob; ib tug muaj ntawv tso cai los yog sau npe sib yuav thiab tsev neeg kho mob; thiab cov kws kho mob muaj ntawv tso cai.
19. Puas yog Medi-Cal Peer Support Specialist Supervisors yuav tsum yog cov kws tshaj lij kev noj qab haus huv?
Cov ntaub ntawv: BHIN 25-010
Medi-Cal Peer Support Specialist Supervisors are not required to be Behavioral Health Professionals. As stated in BHIN 25-010, Medi-Cal Peer Support Specialist Supervisors must meet at least one of the following qualifications:
· Muaj daim ntawv pov thawj Medi-Cal Peer Support Specialist; ob xyoos ntawm kev paub muab kev pabcuam kev noj qab haus huv ncaj qha rau cov neeg siv khoom; thiab ua tiav Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tau pom zoo Medi-Cal Peer Support Specialist Supervisor cov ntaub ntawv qhia kev cob qhia raws li subdivision (b) ntawm Tshooj 7 ntawm BHIN 25-010.
LOSSIS
- Ua Tus Cwj Pwm Kev Noj Qab Haus Huv Kev Noj Qab Haus Huv raws li subdivision (a)(2) ntawm Tshooj 7 ntawm BHIN 25-010; muaj ob xyoos ntawm kev paub muab kev pabcuam kev noj qab haus huv ncaj qha rau cov neeg siv khoom; thiab ua tiav DHCS pom zoo Medi-Cal Peer Support Specialist Supervisor cov ntaub ntawv qhia kev cob qhia raws li subdivision (b) ntawm Tshooj 7 ntawm BHIN 25-010.
LOSSIS
- Muaj daim ntawv kawm tiav high school lossis GED, plaub xyoos ntawm kev paub muab kev pabcuam kev noj qab haus huv ncaj qha rau cov neeg siv khoom (uas yuav suav nrog kev pabcuam Medi-Cal Peer Support Services), thiab ua tiav DHCS-pom zoo Medi-Cal Peer Support Specialist Supervisor cov kev qhia qhia raws li subdivision (b) ntawm Tshooj 7 ntawm BHIN 25-010.
If a Medi-Cal Peer Support Specialist’s supervisor is not also a Behavioral Health Professional as defined in BHIN 25-010, the Medi-Cal Peer Support Specialist must also provide services under the direction of a Behavioral Health Professional who meets the qualifications described in BHIN 25-010, section 6 subdivision (e).
20. Puas yog Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tau tsim kom muaj cov lus qhia rau cov ntaub ntawv qhia kev saib xyuas?
Cov ntaub ntawv: BHIN 25-010
DHCS qhia txog cov cai rau Medi-Cal Peer Support Specialist Supervisors hauv BHIN 25-010. California Mental Health Services Authority (CalMHSA), raws li txoj haujlwm tam sim no ib lub nroog-xaiv cov ntawv pov thawj, tau tsim ib daim ntawv qhia kev saib xyuas uas tau pom zoo los ntawm DHCS. DHCS txhawb cov nroog kom txhawb nqa Medi-Cal Peer Support Specialists ua tus saib xyuas ntawm lawv cov phooj ywg ua haujlwm.
21. Muaj pes tsawg Medi-Cal Peer Support Specialists muaj peev xwm Medi-Cal Peer Support Specialist Supervisor saib xyuas?
Cov ntaub ntawv: BHIN 25-010
Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tsis tau teeb tsa tus qauv kev ua haujlwm rau Medi-Cal Peer Support Specialist Supervisors thiab Medi-Cal Peer Support Specialists.
Medi-Cal Peer Support Specialist Certification Programs
22. Leej twg yog tus tuav tswj Medi-Cal Peer Support Specialist certification programs?
Cov ntaub ntawv: BHIN 25-010
Lub nroog, lossis ib lub koomhaum sawv cev rau lub nroog, raug tso cai los ntawm Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS), yog lub luag haujlwm tsim, saib xyuas, thiab ua raws li Medi-Cal Peer Support Specialist certification program raws li W&I Code 14045.14 qhov no txhais tau hais tias thaum DHCS yog lub luag haujlwm los teeb tsa cov qauv thoob plaws xeev rau Medi-Cal Cov Kev Pabcuam Tshwj Xeeb, lossis Kev Pabcuam Tshwj Xeeb. sawv cev rau ib lub nroog, yog lub luag haujlwm los tsim ib qho kev pab cuam uas ua raws li cov qauv no thiab xyuas kom nws raug tswj xyuas kom tsim nyog.
23. California Mental Health Services Authority (CalMHSA) ua lub luag haujlwm li cas hauv Medi-Cal Pe er Support Specialist certification process?
Cov ntaub ntawv: BHIN 25-010
Medi-Cal Peer Support Specialist certification programs can be established either by counties or county-selected entities. On behalf of all opt-in counties, the California Behavioral Health Directors’ Association identified CalMHSA as the sole Medi-Cal Peer Support Specialist certification program to support consistency statewide. CalMHSA, on behalf of the counties they represent, must adhere to the state standards set forth in BHIN 25-010.
Xaiv rau Medi-Cal Peer Support Services Benefit
24. Yog hais tias ib lub nroog xaiv los muab Medi-Cal Peer Support Services, nws puas yuav tsum ua rau ob qho tib si xa khoom (Tshwj xeeb Mental Health thiab Tshuaj Medi-Cal/Drug Medi-Cal Organized Delivery System)
Cov ntaub ntawv: BHIN 25-010
Tsis muaj. Raws li DHCS txoj cai tam sim no, cov nroog uas tau xaiv xaiv tuaj yeem ua rau ib lossis ob qho tib si xa khoom. Piv txwv li, ib lub nroog tuaj yeem pib siv cov kev pabcuam hauv Specialty Mental Health Services (SMHS) kev xa khoom, thiab tom qab ntawd xaiv los muab cov txiaj ntsig hauv Drug Medi-Cal (DMC) lossis Drug Medi-Cal Organized Delivery System (DMC-ODS), raws li muaj.
25. Lub nroog pov thawj cov chaw muab Medi-Cal Peer Support Services li cas?
Lub nroog yuav tsum xa cov ntawv ua tiav Tus Muab Kev Pab Cuam Hloov Kho (PFU) cov ntaub ntawv thiab Medi-Cal Certification and Transmittal forms (Transmittal forms) ntxiv Medi-Cal Peer Support Services rau txhua lub koom haum muab kev pab cuam Medi-Cal Peer Support Services. Txog thaum hloov kho tshiab rau hauv daim ntawv Transmittal, cov nroog tuaj yeem sau ntawv txhais tes rau Peer Support Services Hom Kev Pabcuam 15/Service Function 20 ua ke ntawm Transmittal daim ntawv xa.
26. Puas yog lub nroog uas xaiv los muab Medi-Cal Cov Kev Pabcuam Peer hauv Kev Siv Tshuaj Medi-Cal Organized Delivery System (DMC-ODS) yuav tsum muab rau hauv Opioid Treatment Programs (OTPs)?
Cov ntaub ntawv: BHIN 25-010
Tsis tau. Lub nroog tsis tas yuav muab Medi-Cal Kev Pabcuam Peer Kev Pabcuam los ntawm OTPs.
27. Cov koom haum hauv zej zog thiab cov koom haum sib koom ua ke tuaj yeem muab thiab sau nqi rau Medi-Cal Peer Support Services li cas?
Cov ntaub ntawv: BHIN 25-010
Txhua lub nroog xaiv tsa tswj hwm nws tus kheej lub network ntawm Medi-Cal Peer Support Specialists. Cov koom haum xav muab Medi-Cal Peer Support Services yuav tsum hu rau lub nroog lossis lub nroog uas lawv txaus siab muab cov kev pabcuam los tham txog kev cog lus thiab cov cai.
Muab Medi-Cal Peer Support Services
28. Are counties required to provide medically necessary Medi-Cal Peer Support Services to members under age 21 in order to meet the counties’ obligation under the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) mandate?
Cov ntaub ntawv: BHIN 25-010
Yes. As described in BHIN 25-010 in accordance with the EPSDT mandate under Section 1905(r) of the Social Security Act, because Medi-Cal Peer Support Services are coverable under Section 1905(a) of the Social Security Act, all counties, irrespective of their choice to opt-in to providing Medi-Cal Peer Support Services, must ensure that all members under age 21 receive Medi-Cal Peer Support Services to correct or ameliorate discovered health conditions. DHCS’ implementation of Medi-Cal Peer Support Services as a distinct Drug Medi-Cal (DMC), Drug Medi-Cal Organized Delivery System (DMC-ODS), and Specialty Mental Health Services (SMHS) benefit does not limit or modify the scope of the EPSDT mandate.
29. Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DH CS) puas xav tau kev kuaj keeb kwm yav dhau los rau Medi-Cal Peer Support Specialists uas muab Medi-Cal Peer Support Services?
Cov ntaub ntawv: BHIN 25-010
No. DHCS does not require criminal background checks for Medi-Cal Peer Support Specialists because they do not have a Fee-for-Service (FFS) Pathway in DHCS’ provider enrollment system. Counties, or an agency representing the county, may institute background check requirements for Medi-Cal Peer Support Specialists. Medi-Cal Peer Support Specialists shall be subject to applicable requirements regarding suspended and ineligible providers pursuant to 14043.6 and 14123, and to applicable requirements in the Mental Health Plan (MHP) contract.14123, and to applicable requirements in the Mental Health Plan (MHP) contract.
30. Medi-Cal Peer Support Specialists puas tuaj yeem xa cov kev pab cuam hauv xov tooj?
Siv tau: BHIN 23-018, SMHS, DMC, DMC-ODS Phau Ntawv Teev Nqi
Yog lawm. Medi-Cal Cov Kev Pabcuam Peer tuaj yeem muab kev sib ntsib tim ntsej tim muag, hauv xov tooj, lossis hauv xov tooj kev noj qab haus huv nrog tus tswv cuab lossis cov neeg txhawb nqa tseem ceeb thiab tuaj yeem muab rau txhua qhov chaw hauv zej zog. Cov tswv cuab muaj cai thov thiab tau txais kev pabcuam ntawm tus kheej. Yog xav paub ntxiv, mus saib BHIN 23-018 thiab MedCCC Library rau cov ntaub ntawv sau nqi tshiab rau Cov Kev Pabcuam Kev Mob Siab Tshwj Xeeb (SMHS), Tshuaj Medi-Cal (DMC), thiab Tshuaj Medi-Cal-Organized Delivery System (DMC-ODS).
31. Puas yog Medi-Cal Peer Support Specialists muaj peev xwm ua hauj lwm raws li Community Health Workers (CHWs)?
Reference: Community Health Worker Phau Ntawv Qhia
Medi-Cal Peer Support Specialists uas ua tau raws li cov qauv tsim nyog rau Community Health Workers (CHWs) tuaj yeem ua haujlwm li CHWs. Thov mus saib CHW Tus Muab Kev Pab Cuam rau cov ntaub ntawv hais txog qhov tsawg kawg nkaus tsim nyog rau CHWs thiab CHW cov lej them nqi. Cov kev pab cuam muab los ntawm Medi-Cal Peer Support Specialist raws li CHW, yuav tsum siv CHW taxonomy code. CHW cov kev pabcuam tsis suav nrog Medi-Cal Cov Kev Pabcuam Peer Raws li kev pabcuam raws li Kev Pabcuam Kev Noj Qab Haus Huv Medi-Cal, Tshuaj Medi-Cal Organized Delivery System, thiab Cov Kev Pabcuam Tshwj Xeeb Mental Health Services. CHW cov kev pabcuam yog txawv thiab cais los ntawm Medi-Cal Peer Support Services.
32. What is considered an “approved plan of care” for Medi-Cal Peer Support Services?
Siv: BHIN 23-068, CMS State Medicaid Directors Letter 07-011
Per CMS State Medicaid Directors Letter 07-011, Peer Support Services, “must be coordinated within the context of a comprehensive, individualized plan of care that includes specific individualized goals.” A plan of care for Medi-Cal Peer Support Services must include engaging the member to ensure it reflects the needs and preferences of the member.
An approved plan of care must be documented within the member’s clinical record and approved by a treating provider who can render reimbursable Medi-Cal services. Please see BHIN 23-068 (or superseding guidance) for additional details regarding progress note documentation requirements for all Specialty Mental Health (SMH), Drug Medi-Cal (DMC), and Drug Medi-Cal Organized Delivery System (DMC-ODS) services.
33. Cov ntaub ntawv yuav tsum muaj rau Medi-Cal Peer Support Services yog dab tsi?
Reference: BHIN 23-068, W&Code §14045.13
Per W&I Code §14045.13, documentation skills and standards are a required core competency for Medi-Cal Peer Support Specialist certification programs to include in their curriculum. Please refer to BHIN 23-068 (or superseding guidance) for additional information for documentation requirements for Medi-Cal Behavioral Health services, including Medi-Cal Peer Support Services.
34. Puas yog cov kev npaj kho mob rau Targeted Case Management (TCM) thiab Intensive Care Coordination (ICC) puas zoo ib yam li cov kev pab cuam rau Medi-Cal Peer Support Services?
Daim ntawv pov thawj: 42 CFR § 440.169(d)(2)
Medi-Cal Cov Kev Pabcuam Peer yog txawv ntawm Kev Tswj Xyuas Cov Cai thiab Kev Sib Koom Tes Ua Haujlwm hnyav, uas muaj lawv tus kheej cov kev xav tau kev npaj khomob. Yog xav paub ntxiv, saib 42 CFR § 440.169(d)(2).
35. How are “collaterals” defined in the context of Medi-Cal Peer Support Services?
Siv: BHIN 25-010, Ntxiv 3 rau Daim Ntawv Cuam Tshuam 3.1-A ntawm California State Plan
As described in Supplement 3 to Attachment 3.1-A of the California State Plan and BHIN 25-010, Medi-Cal Peer Support Services can include contact with family members or other collaterals (family members or other people supporting the beneficiary). These services are typically directed at aiding significant support person(s) in the member’s life, such as family members or close support networks, to better assist the member in achieving their mental health or substance use recovery goals. Collateral services may include consultations, education, and other forms of engagement that focus on equipping the member’s support system with the knowledge or tools necessary to foster the individual’s recovery and resilience. There may be times when, based on clinical judgment, the member is not present during the delivery of the service, but remains the focus of the service.
Kev them nqi rau Medi-Cal Peer Support Services
36. Cov txheej txheem twg yuav tsum tau siv rau Medi-Cal Peer Support Specialist pab pawg pab pawg thiab dab tsi yog pawg loj?
Siv: BHIN 25-010, SMHS, DMC, DMC-ODS Phau Ntawv Teev Nqi
Per BHIN 25-010, Medi-Cal Peer Support Specialist group services are covered under “Educational Skill Building Groups” and should be claimed under the “Behavioral Health Prevention Education Service” code (H0025). Group size is limited to no less than two and no more than twelve members at the same time. Providers operating in the Specialty Mental Health Services (SMHS), Drug Medi-Cal (DMC), and Drug Medi-Cal Organized Delivery System (DMC-ODS) should refer to the appropriate Medi-Cal billing manual for group claiming methodologies. (See the DHCS MedCCC Library for up-to-date billing manuals for SMHS, DMC, and DMC-ODS.)
37. Nyob rau hauv ib pab pawg uas ob tus kws kho mob tshwj xeeb ntawm Medi-Cal Peer Support Specialist thiab lwm tus kws kho mob tab tom xa cov kev pabcuam, puas yog txhua tus neeg muab kev pabcuam raug tso cai sau nqi rau cov kev pabcuam sib txawv uas lawv tau muab?
Daim ntawv pov thawj: BHIN 25-010, SMHS, DMC, DMC-ODS Billing Manuals
Raws li BHIN 25-010, Cov Kev Pabcuam Peer tuaj yeem xa thiab thov raws li kev pabcuam ib leeg lossis muab nrog rau lwm cov kev pabcuam SMHS, DMC, lossis DMC-ODS. Medi-Cal Peer Support Services yuav tsum tau sib koom ua ke kom tsis txhob muaj cov kev pab cuam sib npaug. Yog li ntawd, thaum ntau tus kws kho mob muab kev pabcuam rau tib tus tswvcuab tib lub sijhawm, txhua tus kws kho mob yuav tsum xa ib daim ntawv thov sib txawv rau cov kev pabcuam sib txawv txhua tus kws kho mob tau lees paub kom tsim nyog rau Medi-Cal cov nyiaj rov qab thaum tsim nyog cov ntaub ntawv thiab sau nqi. Nco ntsoov tias Medi-Cal Peer Support Specialists yog tib hom kws kho mob uas tsim nyog rau cov lej lej H0038 thiab H0025 cov lej, thiab cov kws kho mob tsis raug tso cai hauv DMC thiab DMC-ODS cov khoom xa tuaj.
Kev taw qhia ntsig txog Peer Support Specialist sau nqi rau kev xa ntawm Peer Support Services yog teev nyob rau hauv BHIN 25-010. Kev taw qhia ntxiv rau kev them nqi SMHS, DMC, thiab DMC-ODS cov kev pabcuam tuaj yeem nrhiav tau hauv DHCS MedCCC Library.
38. Medi-Cal Peer Support Specialists puas tuaj yeem thov rau cov kev pabcuam uas tsis yog Medi-Cal Peer Support muab rau cov tswvcuab Medi-Cal siv cov lej pabcuam uas tsis yog H0025, H0038, thiab H0050?
Siv: BHIN 25-010, SMHS, DMC, DMC-ODS Phau Ntawv Teev Nqi
Certified Medi-Cal Peer Support Specialists tsuas yog xa mus rau Short Doyle Medi-Cal (SD/MC) rau Medi-Cal Peer Support Services (H0038 thiab H0025) thiab Contingency Management (H0050) raws li Peer taxonomy. Yog tias Medi-Cal Peer Support Specialist ua tau raws li qhov tsim nyog rau lwm hom kws kho mob (piv txwv li, Lwm Tus Kws Pab Tswv Yim Tsim Nyog), Medi-Cal Peer Support Specialist tuaj yeem xa ib daim ntawv thov cais raws li tus lej se sib txawv rau cov kev pabcuam uas tsis yog Medi-Cal Peer Support Services uas tsis sib npaug ntawm Peer Support Services tau thov. Medi-Cal Peer Support Specialists yuav tsum xa mus rau BHIN 25-010, ntu 11 kom paub meej cov lus qhia txog kev thov kev pab.
39. Puas muaj cov lej sau nqi cais kom paub qhov txawv ntawm Medi-Cal Cov Kev Pabcuam Peer Kev Pabcuam muab rau cov tib neeg thiab Medi-Cal Cov Kev Pabcuam Peer muab rau cov neeg hauv tsev neeg lossis lwm tus neeg saib xyuas?
Siv: BHIN 25-010, SMHS, DMC, DMC-ODS Phau Ntawv Teev Nqi
Tsis muaj. Tsis muaj tus lej txheej txheem sib txawv lossis tus hloov kho kom paub qhov txawv ntawm Medi-Cal Peer Support Specialist cov kev pabcuam muab rau cov tib neeg los ntawm cov kev pabcuam muab rau cov neeg hauv tsev neeg lossis cov neeg saib xyuas.
40. Medi-Cal Cov Kev Pabcuam Peer puas tuaj yeem xa thiab thov thoob plaws tag nrho Cov Tshuaj Medi-Cal Organized Delivery System (DMC-ODS) American Society of Addiction Medicine (ASAM) qib kev saib xyuas?
Siv: BHIN 25-010, SMHS, DMC, DMC-ODS Phau Ntawv Teev Nqi
Yog lawm. Medi-Cal Peer Support Services tej zaum yuav raug xa thiab thov raws li ib qho kev pabcuam ib leeg, lossis ib qho kev pabcuam xa los ua ib feem ntawm ASAM qib kev saib xyuas raws li kev pabcuam DMC-ODS.
41. What are the mode and service function codes for Medi-Cal Peer Support Services (i.e. “Behavioral Health Prevention Education Service” and “Self-Help/Peer Services”)?
Siv: BHIN 25-010, SMHS, DMC, DMC-ODS Phau Ntawv Teev Nqi
Siv Hom 15, Kev Pabcuam Kev Ua Haujlwm 20 thaum qhia txog cov kev pabcuam thiab cov nqi rau Medi-Cal Peer Support Services ntawm Daim Ntawv Qhia Txog Tus Nqi Kho Mob Tshwj Xeeb.
42. Cov Kev Pabcuam Medi-Cal puas tuaj yeem xa thiab thov raws li ib qho kev pabcuam ib leeg lossis muab nrog rau lwm cov Kev Pabcuam Kev Puas Siab Puas Hlwb Tshwj Xeeb (SMHS), Tshuaj Medi-Cal (DMC), lossis Tshuaj Khomob Medi-Cal Organized Delivery System (DMC-ODS) cov kev pabcuam, suav nrog kev pabcuam hauv tsev khomob thiab chaw nyob?
Siv: BHIN 25-010, SMHS, DMC, DMC-ODS Billing Manuals, 42 CFR § 438.208(b)(4)
Medi-Cal Peer Support Services tej zaum yuav raug xa thiab thov raws li ib qho kev pabcuam nyob ib leeg los ntawm Medi-Cal Peer Support Specialist – ib tug tswvcuab yuav tau txais Medi-Cal Peer Support Services txawm tias tam sim no lawv tsis koom nrog lwm cov kev pabcuam sab nraud. Ib tug tswvcuab kuj tuaj yeem tau txais Medi-Cal Cov Kev Pabcuam Peer Kev Pabcuam muab nrog rau lwm cov kev pabcuam SMHS, DMC, lossis DMC-ODS, suav nrog, piv txwv li, Kev Pabcuam Kev Noj Qab Haus Huv - Hauv cov xwm txheej no, Medi-Cal Peer Support Services yuav tsum tau thov ntxiv rau cov kev pabcuam no. Rau cov neeg mob hauv tsev kho mob thiab cov tsev kho mob hauv tsev, Medi-Cal Cov Kev Pabcuam Peer tuaj yeem thov ntxiv rau, lossis ib txhij nrog, cov kev pabcuam hauv tsev lossis cov neeg mob nyob hauv tsev uas tau thov raws li tus nqi tuag, raws li tau piav qhia hauv BHIN 25-010. Raws li tau teev tseg hauv BHIN 25-010, rau kev thov kom raug txiav txim, SMHS counties, DMC counties, thiab/los yog DMC-ODS cov phiaj xwm yuav tsum xa cov ntawv thov uas suav nrog Healthcare Common Procedure Coding System (HCPCS) thiab kev hloov pauv ua ke. Tsuas yog DMC-ODS cov kev npaj yuav tsum qhia txog qib kev saib xyuas hauv kev thov, txawm tias tus tswv cuab xaiv tsis tau txais cov kev pabcuam. Medi-Cal Peer Support Specialist Services tsis raug tso cai ua ntej los ntawm Medi-Cal cov kab kev noj qab haus huv ntawm tus cwj pwm. Raws li SMHS, DMC, thiab DMC-ODS phau ntawv sau nqi, tsis muaj kev kaw tseg rau Medi-Cal Peer Support Services. (Saib DHCS MedCCC Lub Tsev Qiv Ntawv rau cov ntawv teev nqi tshiab rau SMHS, DMC, thiab DMC-ODS.)
Medi-Cal Peer Support Services tej zaum yuav raug xa los ntawm Medi-Cal Peer Support Specialist uas koom tes nrog ib lub koom haum uas tau cog lus nrog Medi-Cal kev coj tus cwj pwm kev noj qab haus huv los muab Medi-Cal Peer Support Services. Raws li tau piav qhia hauv 42 CFR § 438.208(b)(4), Medi-Cal Peer Support Services yuav tsum tau sib koom ua ke kom tsis txhob muaj cov kev pab cuam sib npaug.
43. Medi-Cal Peer Support Specialists puas tuaj yeem muab cov kev kho mob puas siab puas ntsws uas tau piav qhia hauv Xeev Txoj Kev Npaj, suav nrog kev ntsuam xyuas, kev kho puas siab puas ntsws, kev xa mus thiab kev sib txuas, kev kho mob, thiab/lossis kev npaj kho mob?
Siv: BHIN 25-010, SMHS, DMC, DMC-ODS Billing Manuals, Supplement 3 to Attachment 3.1-A of the California State Plan
Cheebtsam ntawm tag nrho cov kev pabcuam hauv qab no yog ua raws li Medi-Cal Peer Support Specialist scope of services: Kev soj ntsuam, kev kho puas siab puas ntsws, kev xa mus thiab kev sib txuas, thiab kev npaj kho mob. Medi-Cal Peer Support Specialists tuaj yeem siv Medi-Cal Peer Support Procedure Codes (H0025 thiab H0038), raws li qhov tsim nyog, los muab cov kev pab cuam nyob rau hauv. Medi-Cal Peer Support Specialists yuav tsum tsis txhob muab cov kev pab cuam dua thiab yuav tsum ua raws li tag nrho cov kev qhia txog kev them nqi thiab cov ntaub ntawv.
Piv txwv li: Nws yog nyob rau hauv lub Scope ntawm Medi-Cal Peer Support Services los muab cov khoom ntawm kev xa mus thiab kev sib txuas cov kev pabcuam, suav nrog kev txheeb xyuas cov peev txheej tsim nyog, teem caij, thiab pab tus neeg txais txiaj ntsig nrog kev sov so kom tau txais cov kev pabcuam txuas mus ntxiv. Medi-Cal Peer Support Specialist yuav them nqi H0025 lossis H0038, raws li qhov tsim nyog, rau kev muab cov kev pabcuam no.
Medi-Cal Peer Support Specialists tsis muaj peev xwm ua SMHS lossis SUD kev soj ntsuam kuaj mob. Txawm li cas los xij, nws nyob hauv thaj tsam ntawm Medi-Cal Peer Support Services los pab txhawb cov ntaub ntawv rau SMHS lossis SUD kev ntsuas. Hauv qhov no, Medi-Cal Peer Support Specialist yuav them nqi H0038, yog tias tsim nyog.
44. Cov Kws Pabcuam Medi-Cal puas tuaj yeem muab cov kev pabcuam tsis zoo rau kev siv tshuaj yeeb tshuaj thiab/lossis cov kev pabcuam teebmeem kev siv yeeb tshuaj uas tau piav qhia hauv Lub Xeev Txoj Haujlwm, suav nrog kev sojntsuam, kev sab laj tus kheej, kev pabcuam pab pawg, kev pabcuam rau tus neeg mob, SUD kev pabcuam teebmeem, kev pabcuam saib xyuas, saib xyuas, thiab/lossis kev pabcuam rov qab los?
Siv: BHIN 25-010, SMHS, DMC, DMC-ODS Billing Manuals, Supplement 3 to Attachment 3.1-A of the California State Plan
Cov ntsiab lus ntawm cov kev pabcuam hauv qab no yog ua raws li Medi-Cal Peer Support Specialist scope of services: Patient Education, SUD kev pab cuam cuam tshuam txog kev kub ntxhov, kev sib koom tes saib xyuas, thiab kev pabcuam rov qab los. Medi-Cal Peer Support Specialists tuaj yeem siv Medi-Cal Peer Support Procedure Codes (H0025 thiab H0038), raws li qhov tsim nyog, los muab cov kev pab cuam nyob rau hauv. Medi-Cal Peer Support Specialists yuav tsum tsis txhob muab cov kev pab cuam dua thiab yuav tsum ua raws li tag nrho cov kev qhia txog kev them nqi thiab cov ntaub ntawv.
Piv txwv li:
- Cov kev pab cuam rov qab los: Cov peev txheej uas twb muaj lawm ntawm Medi-Cal Cov Kev Pabcuam Peer Kev Pabcuam yog zoo ib yam ntawm cov kev pabcuam rov qab los tau piav qhia hauv Xeev Txoj Kev Npaj, suav nrog kev saib xyuas, kev saib xyuas rov qab, thiab kev tiv thaiv rov qab los. Hauv qhov no, Medi-Cal Peer Support Specialist tuaj yeem sau nqi H0025 lossis H0038, raws li qhov tsim nyog.
- Care coordination: Medi-Cal Peer Support Specialists may use engagement services to support connections with practitioner and therapeutic activities to advocate for client’s referrals, consistent with components of care coordination, as defined in the State Plan. In this case, a Medi-Cal Peer Support Specialist may bill H0038, as appropriate.
45. Can providers who billed under “Other Qualified Providers” prior to Medi-Cal Peer Support Services continue billing under service codes available to “Other Qualified Providers”?
Siv: BHIN 25-010, SMHS, DMC, DMC-ODS Phau Ntawv Teev Nqi
The Department of Health Care Services (DHCS) is not removing any existing billing codes, services, or provider types in the Specialty Mental Health Services (SMHS), Drug Medi-Cal (DMC), or Drug Medi-Cal Organized Delivery System (DMC-ODS) programs, including the “Other Qualified Provider” type. “Other Qualified Providers” may continue claiming for tother services using the “Other Qualified Provider” taxonomy code. Medi-Cal Peer Support Specialists may only submit claims to Short Doyle Medi-Cal for Medi-Cal Peer Support Services and Contingency Management (H0038, H0025 and H0050) under the Peer taxonomy.
46. Cov nqi them rau Medi-Cal Peer Support Services nyob qhov twg?
Siv: SMHS, DMC, DMC-ODS phau ntawv qhia txog nqi
Medi-Cal rates claimed by the county behavioral health plan are published on the Department of Health Care Services (DHCS) website, specifically on Medical Behavioral Health Fee Schedules page. The county’s Medi-Cal rates listed are not the rates paid to individual Medi-Cal Peer Support Specialists. Compensation for Medi-Cal Peer Support Specialists is determined by the organization that employs the Medi-Cal Peer Support Specialist.
47. Cov kws kho mob uas muaj ntawv pov thawj Medi-Cal puas tuaj yeem siv Medi-Cal Peer Support Services cov lis dej num (piv txwv li, H0038 & H0025) thaum muab kev pab cuam cuam tshuam rau hauv xov tooj los yog kev tswj xyuas qhov xwm txheej?
Reference: BHIN 25-010, BHIN 23-025, BHIN 24-031
No. Medi-Cal Peer Support Specialists may not use Medi-Cal Peer Support Services billing codes while delivering services under the mobile crisis or contingency management benefits. See BHIN 25-010 for guidance related to Medi-Cal Peer Support Services, BHIN 23-025 for guidance related to Mobile Crisis Services, and BHIN 24-031 for guidance related to Contingency Management Services.
Lwm yam
48. Medi-Cal Pe er Cov Kws Kho Mob puas tuaj yeem muab cov kev pab cuam rov qab los thiab/lossis koom nrog cov kev kho mob txuas mus ntxiv?
Tsis muaj lub xeev txoj cai lij choj hauv txoj cai lij choj, kev tswj hwm, kev zam, lossis Daim Ntawv Pom Zoo Sib Koom Tes uas cov tib neeg ua haujlwm ua Medi-Cal Cov Kws Pabcuam Pabcuam Pabcuam tsis tuaj yeem muab kev pabcuam rau lub sijhawm ntev tomqab rov qab los lossis koom nrog kev pabcuam khomob.
49. How are Medi-Cal Peer Support Specialists’ salaries or hourly rates developed?
Cov ntaub ntawv: BHIN 25-010
Lub Tsev Haujlwm Saib Xyuas Kev Noj Qab Haus Huv (DHCS) tsis raug tso cai raws li txoj cai los tsim kom tau ib qho kev them nyiaj rau Medi-Cal Peer Support Specialists. Lub nroog teeb tsa cov nqi them rau county-ua hauj lwm Medi-Cal Peer Support Specialists. Lub nroog kuj sib tham txog kev them nqi thiab cov nqe lus cog lus nrog cov koom haum hauv zej zog uas ntiav Medi-Cal Cov Neeg Pabcuam Pabcuam Tshwjxeeb thiab cog lus nrog lub nroog los muab Medi-Cal kev pabcuam kev noj qab haus huv. Yog li ntawd, cov nyiaj them rau Medi-Cal Peer Support Specialists yuav txawv ntawm cov nroog thiab lwm lub koom haum uas ntiav cov phooj ywg.
50. Puas muaj txoj hauv kev rau kev nce qib kev tshaj lij rau Medi-Cal Peer Support Specialists?
Cov ntaub ntawv: BHIN 25-010
Medi-Cal Peer Support Specialists tej zaum yuav dhau los ua Medi-Cal Peer Support Specialist Supervisors yog tias lawv ua tau raws li kev tsim nyog thiab kev cob qhia uas tau teev tseg hauv BHIN 25-010 thiab raug xaiv los ntawm lawv qhov chaw ua haujlwm.
Lub nroog thiab cov koom haum sib cog lus muab Medi-Cal Cov Kev Pabcuam Peer tuaj yeem tsim txoj hauv kev ua haujlwm ntxiv, lub luag haujlwm, thiab cov npe rau cov neeg ua haujlwm.