Between SCDMH and the Community Mental Health Centers
For Supplemental Funding to Hire Peer Support Specialists

September 2, 2003

Dear Center Executive Directors:

I am happy to hear that you are planning to hire peer support specialists at your center this fall.  The attached Memorandum of Agreement and supporting documents will hopefully make the process go more smoothly for you and your staff. 

This document makes available up to $10,000 to each mental health center in FY04.

Please read the introduction materials carefully. This Memorandum of Agreement requires a written response back to me by September 30.  A form is provided for this purpose (see page 10).

To simplify this process, I have provided a time line on the following page.

Please know that I welcome the opportunity to meet with your management team members about this exciting opportunity at their convenience over the next three months.

Thank you for your efforts in furthering consumer involvement in our recovery-based system of care.  I look forward to hearing from you.



Vicki Cousins
SCDMH Office of Consumer Affairs

cc:        Center Quality Assurance Staff
            Center Human Resource Services Staff
            Center Consumer Affairs Coordinators


 Between SCDMH and the Community Mental Health Centers
For Supplemental Funding to Hire Peer Support Specialists



By September 30, the centers respond back in writing and agree to participate, committing to hire peer support specialist candidates in FY04. 

October and November

Throughout October and November, centers advertise, prospect for candidates, and conduct interviews.  They make offers.  They hire. They reserve places for their candidates at the upcoming certification training by calling (803) 898-8621 or by emailing


On December 8, 2003, the Peer Support Specialist certification training begins at White Oak at 8:30 a.m.  Candidates are expected to arrive Sunday evening the night before and dine there at 5 p.m. The training concludes by the end of the day on Friday, December 12, 2003.


On January 12, 2004, candidates are interviewed and tested in Columbia. Some candidates traveling long distances may need to make overnight arrangements for the night before the exam. 


On February 2-6, 2004, another round of certification training begins at White Oak at 8:30 a.m. for people who missed the first training.  Candidates are expected to arrive Sunday evening the night before and dine there at 5 p.m. The training concludes by the end of the day on Friday, February 6, 2004.


On March 1, 2004, candidates from the second PSS certification training are interviewed and tested in Columbia. Some candidates traveling long distances may need to make overnight arrangements for the night before the exam.


Centers are reviewed for compliance with the Memorandum of Agreement.  If not in compliance, centers are required to give back their funding.


 Between SCDMH and the Mental Health Centers
For Supplemental Funding to Hire Peer Support Specialists


Cover Letter

Time Line


Requirements of the Memorandum of Agreement                                 

Signature Page


(I)        Medicaid Regulation on Peer Support Services

(II)       Outcomes of Peer Support Services

(III)      Position Description (Level I)

(IV)      Position Description (Level II)

(V)       PSS Certification Training on December 8-12, 2003

(VI)      Testing (oral and written) on January 12, 2004

(VII)    Certification Training February 2-6, 2004

(VIII)   Testing (oral and written) on March 1, 2004

(IX)      First Person Account by a Peer Support Specialist


 Between SCDMH and the Mental Health Centers
For Supplemental Funding to Hire Peer Support Specialists


It is the expectation of South Carolina Department of Mental Health that the community mental health centers will hire, train and certify 34 peer support specialists by the end of FY04.

Every mental health center will participate in this system-wide effort by hiring at least two peer support specialists. 

Candidates for these positions will be well qualified and capable of  providing Medicaid-billable peer support services (see Appendix I).  They must be able to execute documentation properly for clinical and billing purposes.  They must have the potential to become respected and valued colleagues within the culture of the individual mental health centers.

Funding Incentive

$170,000 in one-time funding is available this fiscal year to the mental health centers to encourage the hiring of peer support specialists. 

This funding will be distributed to the mental health centers based on a per candidate basis in the amount $5,000.  Up to $10,000 may be distributed to each center. The funding can be applied to either full-time or part-time candidates.

How the Funding Can Be Used

This supplemental funding is to be used to support and sustain peer support specialists hired in FY04 only.  This funding will help defray training/travel costs related to the certification process and the candidateís on-going continuing education expenses in their first year. 

Complying with the Memorandum of Agreement (MOA)

The candidates must meet all aspects of the position descriptions developed by the SCDMH Office of Human Resource Services (see Appendix II and Appendix III).

Two positions have been created for certified peer support specialists.  The Level I position requires a Bachelors degree and has additional regional training and support responsibilities of other regional peer support specialists. 

All peer support specialists must be hired by the mental health center and then sent to the certification training in December or February.  They must successfully complete the Departmentís 40-hour certification training and oral/written examination before they begin to provide and bill for Medicaid Peer Support Services.

Peer Support Specialists Bill Peer Support Services, Plus Other Services

The impact of peer support services on actual practice within the centers and on client outcomes (see Appendix IV) will be closely monitored.  It is important that the peer support specialists perform and bill specifically for peer support services described in the new Chapter 200 regulations and that the service of peer support is indicated on the clientís treatment plan.  The Centers must be able to track clients and staff who have either received or delivered this service.  This way, SCDMH can produce significant outcome information on this new service. Centers also have additional opportunities to engage peer support specialists in the delivery of services beyond peer support services, such as case management.

Training and Testing of Peer Support Candidates

Following a 40-hour certification training during the week of December 8-12, 2003 (see Appendix V) and successful completion of an oral and written examination on January 12, 2004 (see Appendix VI), newly certified peer support specialists will begin to provide billable Medicaid services to eligible center clients. 

Peer Support Specialists who completed the peer support specialist certification process on June 12, 2003 may begin to provide Medicaid-billable peer support services in October 2003 or when the new Chapter 200 regulations are finally approved for use.

A second peer support certification training will be held at White Oak the week of February 2-6, 2004 (see Appendix VII).  Testing for these candidates will be held on March 1, 2004 (see Appendix VIII).

Finding Good Candidates

Candidates for this position must provide services appropriately; execute documentation properly; and bill for Medicaid services under the approved peer support service category found in the Chapter 200 regulations. It is important that centers carefully select qualified and capable candidates for this position.   The ability to communicate effectively and to document clearly is of critical importance. 

Supervising the Peer Support Specialist

The Medicaid agency requires that certified Peer Support Specialists be supervised by a MHP (Mental Health Professional), although the MHP does not have to be on-site while peer support services are rendered.

All Peer Support Specialists are required by the SCDMH Office of Consumer Affairs to have a planning stage EPMS conducted annually, regardless of their weekly time or permanency status.

Reasonable accommodations under the Americans with Disability Act need to be made for qualified individuals who are capable of performing the essential elements of this position.

Continuing Education for Peer Support Specialists

One of the intended uses of this funding to is to help defray the expense of sending the candidates to the 40-hour, week-long overnight training and certification testing.

Centers need to anticipate the need for certified peer support specialists to take part in on-going professional development and training opportunities.  A plan to provide continuing educational opportunities for certified peer support specialists is currently under development by the SCDMH Office of Consumer Affairs.  Approximately every six months, a Certified Peer Support Specialist will be expected to attend a 2-day training, involving 2 hotel nights, per diem, travel within the state, and possible registration fees. 

Other staff from the centers will be encouraged to attend these continuing education trainings with the peer support specialists, even though traditional staff can not bill for Peer Support Services.  It will be important for traditional staff to understand the unique scope of practice of the Peer Support Specialists.  New self-help tools and approaches advocated in the local and national consumer movements and supported by evidence-based research will be shared at these continuing education trainings.  As an example, a March training is being plan in partnership with the SC Independent Living Council and the Columbia-based Disability Action Center on Mary Ellen Copelandís WRAP and techniques to assist clients with setting and achieving goals.

Centers will also be expected to send their certified peer support specialists annually to certification trainings to refresh their skills.

Required Characteristics of Peer Support Specialist Candidates

          All candidates will be current or former consumers of mental health services, defined by having or having had a serious mental illness which meets the Federal definition.

         All candidates must have received treatment for a current or former serious mental illness. 

          All candidatesí treatment experience can be from either a private or public mental health system -- and it can be from either inpatient or outpatient settings.

         All candidates must be willing to self-identify as a current or former consumer of mental health services with the staff they work with and with clients and families.

Required Experience and Abilities

          All candidates must have a high school degree or a GED equivalent.

           All candidates will have at least one year active participation in the local or national mental health consumer movement; or

           All candidates must be able to demonstrate recovery expertise (knows how to support others in recovery) and have the ability to demonstrate own effort at self-directed recovery.

Recommended Approaches

           Give all candidates a literacy examination in the application process because of the documentation required.

            Require that all candidates have a current South Carolina driverís license and will be expected to drive clients in state vehicles.

           Require that no candidate may receive mental health services or treatment from the center where they are employed.

          Require supervisors of either part-time or full-time peer support specialists to conduct an EPMS planning stage with the peer support specialists and review periodically with them.

 Terms and Conditions to Receive the Funding

1.         Centers will agree to the terms and conditions of this funding as described above in the Introduction and below in the Terms and Conditions to Receive the Funding. 

2.         Written acceptance of this Memorandum of Agreement, using the Signature Page Form found on page 9, will be received by the SCDMH Office of Consumer Affairs by September 30, 2003, at 5 p.m.  Please send this form to the SCDMH Administration Building in Columbia to the attention of Vicki Cousins.

3.         Funding will be dispensed as soon as possible to the mental health centers once the signed Signature Page Form has been received by the SCDMH Office of Consumer Affairs.

4.         Centers will interview and hire qualified peer support specialists and will orient them to their new workplace.

5.         Centers will assume responsibility for training Peer Support Specialists in the areas of Consumer Involvement in SCDMH, Documentation and Billing, Consumer Rights, HIPAA, Treatment Planning, and Cultural Competence. If you need assistance from the Central Office in fulfilling this training obligation, please contact Vicki Cousins.

6.         On December 8-12, 2003, all peer support specialist candidates will be sent by their centers to attend and successfully complete the 40-hour Peer Support Certification training. (Only consumer candidates employed by the mental health centers attend PSS certification trainings in FY04). The location of the training will be at White Oak.  Each mental health center will be billed $300.00 per person by SC Share for each employed peer support specialist sent by the center to the certification training.   

7.         Each candidate will be required to take and pass a written and oral certification examination on January 12, 2004, in Columbia, from 10:00 a.m. to 5 p.m., covering the material in the training.  The centers are responsible for any travel expenses incurred by Peer Support Specialists coming to Columbia for the testing. 

8.         If a candidate does not successfully pass the written and oral examinations, he or she may try again.  Another peer support certification training will be held at White Oak the week of February 2-6, 2004.  Testing for these candidates will be held on March 1, 2004. As before, each center will be billed $300.00 per person for a peer support specialist sent to the certification training. 

9.         The one-time supplemental funding will be dispensed on the basis of $5,000 per person hired.  Up to two people may be hired using this funding.  If a center only hires one peer support specialist, the center receives $5,000.  If a center hires two peer support specialists $10,000 will be distributed to that center.  If a center hires three peer support specialists, they will receive no more than $10,000.

10.       This funding may only be used to hire new or additional peer support specialists at the mental health centers or at a contracted agency where mental health center clients receive services. Centers will not receive credit toward the supplemental funding by using an existing peer support specialist as a candidate. Nor will they receive funding for moving an existing Consumer Affairs Coordinator into a peer support position unless the center fills the Consumer Affairs Coordinator position at an equal or greater time level by March 15, 2004.

11.       If at the end of this fiscal year, centers who have not fulfilled their signed Memorandum of Agreement will return their peer support supplemental funding to SCDMH.

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