DATE: May 19, 2026
TO: Board of Supervisors
SUBMITTED BY: Susan Holt, Director, Department of Behavioral Health
SUBJECT: Amendment No. 2 to Participation Agreement with California Mental Health Services Authority for Medi-Cal Peer Support Specialist Certification Program
RECOMMENDED ACTION(S):
TITLE
Approve and authorize the Chairman to execute Amendment No. 2 to Participation Agreement No. 24-304 with California Mental Health Services Authority, to extend the term of the existing Agreement to manage on behalf of counties the Medi-Cal Peer Support Specialist Certification Program by one year from June 19, 2026 to June 18, 2027 ($0).
REPORT
Approval of the recommended action will allow the Department of Behavioral Health (Department) the ability to continue participating in the California Mental Health Services Authority (CalMHSA) Medi-Cal Peer Support Specialist Certification Program. This will allow CalMHSA to manage the Medi-Cal Peer Support Certification Program for Fresno County and adhere to Welfare and Institutions Code Section 14045.14(a)(3) reporting requirements. As with the original Participation Agreement No. 24-304, the term of this amendment is for one year. This item is countywide.
ALTERNATIVE ACTION(S):
Should your Board not approve the recommended action, the responsibility for managing Medi-Cal Peer Support Specialist certifications would shift to the Department. The Department would need to redirect resources or add positions to develop and manage the Med-Cal Peer Support Specialist Program. The Department would be required to submit a plan for Department of Health Care Services (DHCS) approval that explains how the certification program will meet all the Federal and State requirements for the certification and oversight of peer support specialists (Welfare and Institutions Code Section14045.14 (a)(3)). The plan would need to include Initial Certification Policies and Procedures, Certification Exam, Biennial Certification Renewal Policies and Procedures, Training Curriculum for: Peer Support Specialist, Parent, Caregiver and Family Member Peers, and Peer Supervisors, Certification Fee Schedule, Reciprocity Process, Complaints/Corrective Actions Process, and Reporting Process. Furthermore, additional resources would be needed to report on the required data elements of this program set forth in Behavioral Health Information Notice 21-041. Without the ability to utilize CalMHSA’s Peer Support Specialist Certification Program immediately, the County may be unable to certify additional Peer Support Specialists, which would impact the Department and its contracted providers’ ability to increase the number of Medi-Cal Peer Support Specialists (MPSS) in the network, provide peer support services to Fresno County persons served, and generate revenue by claiming for PSS services rendered.
FISCAL IMPACT:
There is no increase in Net County Cost associated with the recommended action.
DISCUSSION:
On September 14, 2010, the Board approved Agreement No. 10-489 with CalMHSA, authorizing the Department to join the CalMHSA Joint Powers Authority (JPA), to develop, implement, administer and provide fiscal oversight of Mental Health Services Act projects.
On June 18, 2013, the Board approved Amendment No. 10-489-1 with CalMHSA, broadening the stated purpose for the JPA to allow CalMHSA to perform additional services for behavioral health departments acting alone or in collaboration with other departments, which includes but is not limited to data management, research and development.
On September 25, 2020, legislation SB-803 Peer Support Specialist Certification Act was signed into law. This legislation required DHCS to establish statewide requirements for counties or their representatives to use in developing certification programs for the certification of peer support specialists, who are individuals who self-identify as having lived experience with the process of recovery from mental illness, substance use disorder, or both. The established Peer Support Specialist Certification program allowed California to join 48 other states and the United States Department of Veterans Affairs in using standardized curricula and certification protocols for billing peer support services to the State for the work provided.
On March 22, 2022, the Board approved Agreement No. 22-095 with CalMHSA, authorizing the Department to participate in the initial implementation of the Peer Support Specialist Certification program.
On June 18, 2024, the Board approved Agreement No. 24-304 allowing the Department to continue to participate in the certification program developed by CalMHSA and therefore continue to allow more Peer Support Specialists to become certified and be able to bill the State for Medi-Cal services provided to County persons served. This agreement updated the previous agreement to include data reporting to DHCS on behalf of counties in adherence with Welfare and Institutions Code Section14045.14 (a)(3); and data sharing with participating counties regarding candidates seeking certification based on county of residence. For Fiscal Year 2023-24, CalMHSA reported there were 41 MPSS certified in Fresno County. It is essential to clarify that the data is organized based on the county of residence for certified Medi-Cal Peer Support Specialists, rather than their county of employment.
On May 20, 2025, the Board approved Amendment No. 1 to Participation Agreement No. 24-304 (25-195) with CalMHSA extending the term for one additional year to manage the Medi-Cal Peer Support Specialist Certification Program and adhere to State reporting requirements. CalMHSA prefers to extend the term for one year at a time as they may need to modify the data collection requests depending on the State requests. For Fiscal Year 2024-25, CalMHSA reported there were a total of 63 certified MPSS in Fresno County.
The Amendment varies from standard County template as it was drafted by CalMHSA. The template is utilized by CalMHSA to execute amendments to Participation Agreements with different counties and is consistent statewide.
OTHER REVIEWING AGENCIES:
The Behavioral Health Board was notified of this agreement at the May 2026 meeting.
REFERENCE MATERIAL:
BAI #38, May 20, 2025
BAI #43, June 18, 2024
BAI #40, March 22, 2022
BAI #57, June 13, 2013
BAI #39, September 14, 2010
ATTACHMENTS INCLUDED AND/OR ON FILE:
On file with Clerk - Amendment No. 2 to Participation Agreement 24-304 with CalMHSA
CAO ANALYST:
Ronald Alexander