Cal Voices discusses Medi Cal certification challenges for peer support specialists

The California Mental Health Services Oversight and Accountability Commission convened on April 24, 2025, to address critical challenges facing the state's behavioral health system, particularly regarding the integration of peer support specialists into Medi-Cal billing processes. A significant focus of the meeting was on the complexities and barriers organizations encounter when transitioning from cash-financed services to a Medi-Cal certified model.

Key discussions highlighted the difficulties faced by wellness and recovery centers, which have historically operated outside the insurance framework. These organizations are now seeking to become Medi-Cal billable but are confronted with the daunting task of site certification and understanding the reimbursement landscape. Many providers lack the necessary credentials to bill Medi-Cal, complicating their ability to secure funding for essential services.

Commissioners emphasized the need for clearer guidelines and support for smaller, consumer-operated organizations that have relied on simpler funding models. The conversation also touched on the importance of dual credentialing for peer support specialists, allowing them to leverage their lived experience in both peer support and community health worker roles. This dual certification could enhance their ability to bill for services, thereby expanding access to care for individuals with mental health and substance use disorders.

The meeting underscored the evolving role of peer support specialists within California's mental health system, particularly as the state adapts its training programs to better serve individuals with substance use disorders. As the commission continues to explore these issues, the focus remains on creating a more integrated and accessible behavioral health system that meets the diverse needs of the community.

Looking ahead, the commission's discussions signal a commitment to addressing these systemic challenges, with the potential for significant improvements in service delivery and funding mechanisms for mental health support in California.