Fillable Printable Bhs Policy 404

Bhs Policy 404

Arizona Departm ent of Health Services Current Effective Date: 2/27/2015

Division of Behavioral Health Services Last Review Date: 12/31/2014

Policy and Procedures Manual

SECTION: 1 CHAPT ER: 400

POLICY: 404, Peer/Recovery Support Training, Certification and Supervision

Requirements

____________________________________________________________________________

1. PURPOSE:

a. The Arizona Department of Health Services/Division of Behavioral Health Services

(ADHS/DBHS) has developed training requirements and certification standards for Peer

/Recovery Support Specialists providing Peer Support Services, as described in the

ADHS/DBHS Cover ed Behavioral Health Ser vices Guide

. Peers serve an important role

as behavioral health providers, and ADHS/DBHS expects consistency and quality in

peer-delivered behavioral health services and support for peer-delivered behavioral

health services statewide.

b. Peer-delivered services are supported on a statewide and national level. The Centers for

Medicare and Medicaid Services (CMS) issued a letter to state Medicaid

directors/agencies, recognizing the importance of peer support services as a viable

component in the treatment of mental health and substance abuse issues. In the letter,

CMS provides guidance to state Medicaid and public health agencies on minimum

requirements for establishing criteria for peer support services, including supervision,

care-coordination and training/credentialing (see SMDL #07-011

for a full copy of the

letter).

2. TERMS:

Definitions for terms are located online at http://www.azdhs.gov/bhs/definitions/index.php

The following t erms are referenced in this section:

Behavioral Health Paraprofessional

Behavioral Health Professional

Behavioral Health Technician

Covered Behavioral Health Services Guide

Individual Service Plan

Peer

Peer-Delivered Services

Peer Support Services

Peer/Recovery Support Specialist

Peer Worker

Recovery

Resilience

3. PROCEDURES:

a. Peer/Recovery Support Specialist Qualifications

i. Individuals seeking certification and employment as Peer/Recovery Support

Specialists must:

(1) Self-identify as a “peer”; and

(2) Meet the requirements to function as a behavioral health paraprofessional,

behavioral health technician, or behavioral health professional.

____________________________________________________________________________

404, Peer/Recovery Support Training,

Certification and Supervision Requirements

Page 1 of 6

Arizona Departm ent of Health Services Current Effective Date: 2/27/2015

Division of Behavioral Health Services Last Review Date: 12/31/2014

Policy and Procedures Manual

SECTION: 1 CHAPT ER: 400

POLICY: 404, Peer/Recovery Support Training, Certification and Supervision

Requirements

____________________________________________________________________________

ii. Individuals meeting the above criteria may be certified as a Peer/Recovery Support

Specialist by completing training and passing a competency test through an

ADHS/DBHS appr oved Peer Support Employment Training Program. ADHS/DBHS

will oversee the approval of all certification materials including curriculum and testing

tools Certification through an ADHS/DBHS approved Peer Support Employment

Training Program is applicable statewide.

iii. Some agencies may wish to employ individuals prior to the completion of certification

through a Peer Support Employment Training Program. However, required trainings

must be completed prior to delivering behavioral health services (see subsection

3.d.). An individual must be certified as a Peer/Recovery Support Specialist or

currently enrolled in a ADHS/DBHS-approved Peer Support Employment Training

Program under the supervision of a qualified individual (see subsection 3.e.) prior to

billing Peer Support Services.

b. Peer Support Employment Training Program Approval Process

i. A Peer Support Employment Training Program must sub mi t th e i r prog ram

curriculum, competency exam, and exam-scoring methodology (including an

explanation of accommodations or alternative formats of program materials available

to individuals who have special needs) to ADHS/DBHS. ADHS/DBHS will issue

feedback or approval of the curriculum, competency exam, and exam-scoring

methodology in accordance with subsection 3.d.

ii. Approval of curriculum is binding for no longer than three years. Three years after

initial approval and thereafter, the program must resubmit their curriculum for review

and re-approval. If a pr ogr am makes substantial changes (meaning change to

content, classroom time, etc.) to their curriculum or if there is an addition to required

elements (see subsection 3.c.) during this three-year period, the program must

submit the updated content to ADHS/DBHS for review and approval.

iii. ADHS/DBHS will base approval of the curriculum, competency exam, and exam-

scoring methodology only on the elements included in this policy. If a Peer Support

Employment Training Program requires regional or culturally specific training

exclusive to a GSA or tribal community, the specific training cannot prevent

employment or transfer of Peer Support Specialist/Recovery Support Specialist

certification based on the additional elements or standards.

c. Competency Exam

i. Individuals seeking certification and employment as a Peer/Recovery Support

Specialist must complete and pass a competency exam with a minimum score of

80% upon completion of re quired training. Each Peer Support Employment Training

Program has the authority to develop a unique competency exam. However, all

exams must include at least one question related to each of the curriculum core

elements liste d in subsection 3.d. Individuals certified in another state may obtain

certification after passing a competency exam. If an individual does not pass the

competency exam, the Peer Support Employment Training Program may require that

____________________________________________________________________________

404, Peer/Recovery Support Training,

Certification and Supervision Requirements

Page 2 of 6

Arizona Departm ent of Health Services Current Effective Date: 2/27/2015

Division of Behavioral Health Services Last Review Date: 12/31/2014

Policy and Procedures Manual

SECTION: 1 CHAPT ER: 400

POLICY: 404, Peer/Recovery Support Training, Certification and Supervision

Requirements

____________________________________________________________________________

the individual repeat or complete additional training prior to taking the competency

exam again.

d. Peer Support Employment Training Curriculum Standards

i. A Peer Support Employment Training Program curriculum must include the following

core elements:

(1) Concepts of Hope and Recovery

(a) Instilling the belief that recovery is real and possible;

(b) The history of the recovery movement and the varied ways that behavioral

health issues have been viewed and treated over time and in the present;

can assist others in many ways;

(d) Mind-Body-Spirit connect ion and holist ic approach to recovery; and

(e) Ove rview of the Individual Service Plan (ISP) and its purpose.

(2) Advocacy and Systems Perspective

(a) Overview of state and national behavioral health system infrastructure and

the history of Arizona’s behavioral health system;

(b) Stigma and effective stigma reduction strategies: countering self-stigma; role

modeling recovery and valuing the lived experience;

and energize one’s agency around recovery, hope, and the value of peer

support;

(d) Creating a sense of community; the role of culture in recovery;

(e) Forms of advocacy and effective strategies – consumer rights and navigating

behavioral health system; and

(f) Introduction to the America n s with Dis a b ilit ie s Ac t (ADA).

(3) Psychiatric Re h ab ilitatio n Sk ills and Service Delivery

(a) Strengths based approach; identifying one’s own strengths and helping

others identify theirs; building resilience;

(b) Distinguishing between sympathy and empathy; emotional intelligenc e;

assist others in overcoming its effects;

(d) Introduction to motivational interviewing; communication skills and active

listening;

(e) Healing relationships – building trust and creating mutual responsibility;

(f) Combating negative self-talk: noticing patterns and replacing negative

statements about one’s self, using mindfulness to gain self-confidence and

relieve stress;

(g) Group facilitation skills; and

____________________________________________________________________________

404, Peer/Recovery Support Training,

Certification and Supervision Requirements

Page 3 of 6

Arizona Departm ent of Health Services Current Effective Date: 2/27/2015

Division of Behavioral Health Services Last Review Date: 12/31/2014

Policy and Procedures Manual

SECTION: 1 CHAPT ER: 400

POLICY: 404, Peer/Recovery Support Training, Certification and Supervision

Requirements

____________________________________________________________________________

(h) Introduction to Culturally & Linguistically Appropriate Services (CLAS)

Standards; creating a safe and supportive environment.

(4) Professional Responsibilities of the Peer Support Employee and Self Care in

the Workplace. Qualified individuals must receive training on the following

elements prior to delivering any covered behavioral health services:

(a) Professional boundaries & ethics- the varied roles of the helping professional;

Collaborative supervision and the unique features of the Peer/Recovery

Support Specialist;

(b) Confidentiality laws and information sharing – understanding the Health

Insurance Portability and Accountability Act (HIPAA);

(d) Understanding common signs and experiences of m ent al i llness, substance

abuse, addiction and trauma; orientation to commonly used medications and

potential side effects;

(e) Guidance on proper service documentation; billing and using recovery

language throughout documentation;

(f) Self-care skills and coping practices for helping professionals; the importance

of ongoing supports for overcoming stress in the workplace; resources to

promote personal resilience; and, understanding burnout and using self-

awareness to prevent compassion fatigue, vicarious trauma and secondary

traumatic stress.

ii. Some curriculum elements include concepts included in required training, as

described in Policy 403, Training Requirements

. Peer support employment training

programs must not duplicate training required of individuals f or employment with a

licensed agency or Community Service Agency (CSA)

. Training elements in this

section must be specific to the Peer/Recovery Support Specialist’s role in the public

behavioral health system and instructional for peer support interactions.

iii. For a list of references to assist in developing a curriculum that addresses the topics

listed in the Curriculum Standards, see

Policy 404.1, Suggested Curriculum

Development References.

iv. T/RBHs must develop and make available policies and procedures as well as

additional resources for development of curriculum, including T/RBHA staff co n ta cts

for questions or assistance.

e. Supervision of Peer Workers Employed as Peer/ Recovery Support Specialists

i. Agencies employing Peer/Recovery Support Specialists must provide supervision by

individuals qualified as Behavioral Health Technicians or Behavioral Health

Professionals. Supervision must be appropriate to the services being delivered and

While peer support employment training programs must not duplicate training required of licensed

agencies or CSAs, it is possible that licensed agencies and/or CSAs may consider training completed as

part of the peer support employment training program as meeting the agencies’ training requirements.

____________________________________________________________________________

404, Peer/Recovery Support Training,

Certification and Supervision Requirements

Page 4 of 6

Arizona Departm ent of Health Services Current Effective Date: 2/27/2015

Division of Behavioral Health Services Last Review Date: 12/31/2014

Policy and Procedures Manual

SECTION: 1 CHAPT ER: 400

POLICY: 404, Peer/Recovery Support Training, Certification and Supervision

Requirements

____________________________________________________________________________

the Peer/Recovery Support Specialist’s qualifications as a Behavioral Health

Technician, Behavioral Health Professional or Behavioral Health Paraprofessional.

Supervision must be documented and inclusive of both clinical and administrative

supervision.

ii. Individuals providing supervision must receive training and guidance to ensure

current knowledge of best practices in providing supervision to Peer/Recovery

Support Specialists. (For more information, see

DBHS Prac tice Protocol, Clinical

Supervision.)

iii. The T/RBHA must develop and make available to the providers policies and

procedures regarding resources available to agencies for establishing supervision

requirements and any expectations for agencies regarding T/RBHA

monitoring/oversight activities for this requirement.

f. Process for Submitting Evidence of Certification

i. Agencies employing Peer Support Specialists/Recovery Support Specialists who are

providing peer support services are responsible for keeping records of required

qualifications and certification. T/RBHAs must ensure that Peer Support

Specialists/Recovery Support Specialists meet qualifications and have certification,

as described in this policy.

ii. T/RBHAs must develop and make available to providers policies and procedures that

describe monitoring and auditing/oversight activities where personnel files of Peer

Support Specialists/Recovery Support Specialists are reviewed.

4. REFERENCES:

A.A.C. R9 -10-101

AHCCCS/ADHS Contrac t

ADHS/RBHA Contrac ts

ADHS/DBHS Covered Behavioral Health Services Guide

Policy 201, Covered Health Services

Policy 403, Training Requirements

Policy 409, Family and Youth Involvement in the Children’s Behavioral Health System

ADHS/DBHS Pr ac tice Protocol: Clinical Sup e r vision

CMS St at e Medicaid Director Letter (SMDL #07-011)

____________________________________________________________________________

404, Peer/Recovery Support Training,

Certification and Supervision Requirements

Page 5 of 6