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California Peer Specialist (PS) Career Pathway. State Certified Peer Specialists. Current & Future Need. Current CA Peer Specialist workforce estimate : 6,000 Peer Specialists reflect cultural , ethnic, linguistic, sexual orientation, & socio-economic diversity

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california peer specialist ps career pathway
California Peer Specialist (PS) Career Pathway

State Certified Peer Specialists

current future need
Current & Future Need
  • Current CA Peer Specialist workforce estimate: 6,000
  • Peer Specialists reflect cultural, ethnic, linguistic, sexual orientation, & socio-economic diversity
  • Given anticipated workforce shortages; Peer Specialists can fill this gap while increasing diversity in workforce
  • Depending on service settings, ratios range from 1:10 to 1:50 of Peer Specialists to people served in public mental health

1:25 ratio = need 39,312 Peer Specialists

From DHCS Behavioral Health Services Needs Assessment (Feb. 2012) & Pillars of Peer Support

future need
Future Need
  • Optimal workforce total of 39,312 Certified Peer/Family Specialists
  • To build an optimal cost-effective recovery & resiliency-based workforce in 2013, current needs is:

An increase of 33,312

Certified Peer/Family Specialists

Peer Specialist Pathway



K-12 education

  • TARGET GROUPS: Required to be
  • people with lived experience with
  • mental health challenges, including
  • Consumers, Family Members, Parents.
    • Recipients of Behavioral Health Services
    • People from Diverse Cultural & Linguistic Communities
    • People in Jail & Prison Re-entry Programs
    • Faith-Based Community Members
    • Promotoras & Health Conductors
    • Adult Education Regional Occupational Programs
    • Middle, High School, Community College Students
    • Veterans
    • Career Changers, Previously Employed Workers with Disabilities

Trauma, mental health, & substance use exposure

Career awareness

Financial & logistic feasibility

Training program retention

Academic preparation & entry support

Financing & Support Systems

Access to health professions training program

Retention & Advancement

Hiring & Orientation



Stigma, lack of understanding of value of peer specialist, recovery & resiliency to mental health

Uneven state distribution of and access to training in rural, small programs

No Financial support of individuals in Peer Specialist training programs

Lack of Internships & training for other professionals on how to work with Peer Specialists

No State Plan Amendment or mechanism to bill Medi-Cal SPECIFICALLY for ‘Peer Specialist as a Service Type’or ‘Provider type’

Inappropriate assignments, lack supervision

Lack funding for State certification of Peer Specialists

County policies differ, few counties allow PSS to bill on existing codes

No CA scope of practice, training, supervision standards for Peer Specialists via State certification

Mental health professionals doubt value, abilities of Peer Specialists

Limited awareness of profession; No recognition of profession

Background checks bar employment of Peer Specialists well qualified to serve special populations

Peer Specialists often lack upward mobility, lack applied career ladders & graduate education

Coordination & Support Infrastructure

Health Professions Education

Quality, Diverse, Mental Health Workforce of Trained People with Lived Experience

Cultural Sensitivity and Responsiveness

Adapted from the coordinated health career pathway developed by Jeff Oxendine.

recommendation establish certifying body
Recommendation: Establish Certifying Body
  • To be a Peer-Operated Organization &/or Existing State Organization with certifying capacity (i.e. Statewide Consumer & Family/Parent Collaborative)
  • To honor & vet existing trainings developed by local consumer & family organizations to retain cultural & regional diversity
  • To establish formal Scope of Practice, Values & Ethics, & standards for supervision of Peer Specialists in CA
scope of practice
Scope of Practice

Supervised Sample Duties Include:

  • Provide individualized support to coach wellness, resiliency and recovery
  • Facilitate Wellness Recovery Action Plan (WRAP) & other Health Management groups, ex. Diabetes
  • Model coping skills and self-help strategies
  • Assist in development of Individualized Educational Plan (IEP) & related school-based services
  • Educate, advocate & mentor families & parents in navigating systems & community services
  • Liaison to services for wellness needs, community resources, groups & natural supports
recommendation service settings
Recommendation: Service Settings

Examples of Service Settings:

  • Crisis Respite Houses & Crisis Residential
  • Hospitals & Outpatient Programs
  • Housing & Employment Programs
  • Primary Care Wellness Coaching
  • Wellness Centers
  • Homeless Forensic Programs (AB109)
  • Full Service Partnerships/Integrated Service Teams
  • Peer-Run Programs

State Certification Education & Experience

  • State Certification
    • 80 hours of training by accredited programs with testing
    • Additional 25 hours of training for specialty emphasis in whole health, forensics, co-occurring, foster care, etc.
    • Continuing Education requirements for re-certification
  • Experience
    • Lived experience with mental health challenges or family
    • 6 months of full time peer specialist internship, work or volunteer
  • Training Timelines
    • Average time from starting training program to State Certification would be under 1 year
sample core competency domains
Sample Core Competency Domains
  • Wellness, Recovery, & Resiliency
  • Interpersonal Communication & Collaborative Documentation Practices
  • Professional Role Competencies (Law, Ethics, Boundaries)
  • Integrated & Whole Health Services
  • Trauma Informed & Substance Use Service Competencies
  • Diversity & Cultural Responsiveness
  • Systems Competencies & Navigation
  • Effecting Change: Education & Advocacy
  • Professional Development & Self Care
  • Wellness Coaching, Natural Supports, & Local Resources
peer specialists affordable care act
Peer Specialists & Affordable Care Act
  • USA Today on September 11, 2013:

“Peers May Ease Mental Health Worker Shortage Under Obamacare”

  • “It’s not- like you might think- that you don’t have the money to offer recovery support services, but rather that you don’t have the money NOT to offer them.”
  • Quote from Keith Humphreys, Pillars of Support 2012