The Office of Mental Health and Substance Abuse Services (OMHSAS) and the Office of Medical Assistance Services (OMAP) have issued a Medical Assistance (MA) bulletin entitled Peer Support Services. The issue date is May 22 while the effective date is November 1, 2006. The bulletin is applicable to both Fee-for-Service and HealthChoices providers.
Peer Support Services are person-centered, self-directed, and recovery-focused and include such services as individual advocacy, education, development of natural supports, support of work or other meaningful activity, crisis management support, skills training, effective utilization of the service delivery system, and coordination of and linkage to other service providers. Services are provided in accordance with a recovery-focused Individual Service Plan developed with the individual’s input, provided by a self-identified peer who has completed a peer specialist certification training program approved by the Department of Public Welfare.
Peer Support Services can be provided by an agency that provides only those services or by a psychiatric outpatient clinic, partial hospitalization program, crisis intervention provider, resource coordination provider, intensive case management provider, or psychiatric rehabilitation provider. All providers must be licensed, enrolled in MA, and receive a letter of approval from OMHSAS to provide the service. Services can be delivered through a subcontract arrangement with an agency that is not enrolled in the MA program with OMHSAS approval; however, the enrolled provider is responsible for all aspects of service delivery. A supplemental provider agreement and an approved service description are required before services can begin.
Peer Support Services can be provided upon recommendation by a practitioner for an individual aged 18 years or older who is a member of the adult priority group as defined in Mental Health Bulletin OMH-94-04 (www.dpw.state.pa.us/General/Bulletins/003673169.aspx) and has a moderate to severe functional impairment that interferes with or limits performance in at least one domain (educational, social, vocational, and self-maintenance). Requests for services for individuals who are not part of the priority group defined in this bulletin can be made through the Program Exception Process.
Information about Peer Support Services including the complete bulletin, MA Handbook pages, and the Supplemental Provider Agreement for the Delivery of Peer Support Services is available on the Department of Public Welfare web site (www.dpw.state.pa.us/General/Bulletins/003673169.aspx?BulletinDetailId=4071). Please contact Betty Simmonds with questions about this bulletin.
