Innovations in Peer Supports

I first met Larry Fricks, Founder, Appalachia Consulting Group, the first day that I showed up for the DBSA Texas Certified Peer Specialist training in 2007 in Austin, Texas. My father paid for that certification training because I couldn’t afford the $900/training that year. I was promised a job and I needed a job. I ultimately wasn’t hired in MH in Texas anywhere but my higher purpose was in giving back and it led me to where I am today.

The backstory to my procuring and earning my Texas CPS is a basic one. Texas at th time (2007) did not have CPS certification training or program but there were quite a few stunning people who had befriended me and I them. The list is long.

Being resourceful came easy. I had somehow gotten Fricks’ mobile number and telephoned him when I was at Dallas HIV/AIDS training while working with AIDS Services of Austin after 2007. I must have sounded desperate. I asked him how Texas could “get” a CPS training. My reasoning was honest. I wanted to see it in place and my CPS ’07 training had changed my life. He explained how CMS and a Texas Medicaid Director with supports from the MH Recovery Community could strategize and leverage a State of Texas CPS.

In ’08 NAMI Texas and Mental Health America Texas, along with DBSA Texas and the Texas Consumer group collaborated to apply for a SAMHSA Transformation grant. I, of course, excitedly, helped. Texas was awarded a grant in ’09 and the rest is well, history. I was thrilled. I saw the rise of many of my Texan Peers and formation and branding, brilliantly, of via HOPE Texas Mental Health Resource directed by Dennis Bach.

I saw Larry again when via HOPE brought him to Texas to dialogue on Peer supports and CPS Core Competencies with colleagues and co-horts in Central Texas. Appalachia Consulting eventually won the RFA to spearhead the initial CPS certification training.

I liked Larry all at once and respected the work that he and others at the Georgia Mental Health Consumer Network along with the State of Georgia DBHDD Medicaid language guru had developed and changed for those like myself. Larry coined the CPS Medicaid language perhaps near 23-24 years ago now.

Today the CPS exists in nearly 44 states in the United States and luckily in all states where I have worked as a person with shared life experience. What continues to stand in our development is clinical direction resistance to offering Medicaid waivers that could financially sustain a CPS in most states.

In Maryland where I currently reside and work, Adult CMS with support via Medicaid waiver(s) is resisted and I simply wonder at this. Brandee Izquierdo, Director of the State of Maryland Office of Consumer Affairs shines and advocates for thousands in the state. Linda Oney, Director of Training at the University of Maryland, supports and provides oversight for the Maryland Certified Peer Recovery Specialist (CPRS) certification. There are others who work selflessly like On Our Own of Maryland with shining stars Denise Camp, Daphne Klein and for instance, multiple On Our Of Maryland sites (Prince Georges, Montgomery County, Frederick) who subsist in keeping doors open for others like Jen Padron when I was first starting out.

Years later, I eventually made my way from Texas to North Carolina, Georgia, Maryland and Washington, DC to offer my work in MH/SUD as an advocate, activist, program designer and project manager. It’s been quite a ride but I won’t lie and say it isn’t difficult. It is.

Working as a CPS is financially unsustainable for the individual working as a CPS. The pay is miserably low. Unless a person has a sugar daddy or a sugar mama, is married within a 2 income household combined with personal wealth on top of perhaps receiving SSDI means that not many more can afford to do this good work. It worries me. I see poverty. I see hunger not only of the body but for Spirit and of Community.

When a Peer’s  walk and journey finds the CPS it is a marker. It’s a benchmark. It is Spirit led.

Many advanced trainings like WRAP (Copeland 2016), or WHAM (Appalachia Consulting Group and National Council 2016), or Emotional CPR (Fisher 2016) or Intentional Peer Support (Hansen & Mead 2016), and now Mental Health First Aid (National Council 2016) is hungrily devoured by the base CPS community nationally and globally (iNAOPS 2016).

I see the Recovery Coach and Intentional Forensic Peer Support CPS endorsments and certifications seeding and growing nationally. It’s exciting stuff and stuff of legend in my constituency that I walk and work with.

I’m told to be patient. I’m encouraged to be supportive of the growth and in sum, while I am, I urge faster growth. The CPS is brilliantly a tool of Recovery and it is the Peer who literally controls it. The threat of co-optation may undermine mutuality with clinical control over the CPS embedding into Integration. Several years ago, Padron & Associates worked with Cenpatico to develop a peer workforce demonstration pilot project which ultimately was blocked by clinical oppression. It was a stunning end to arduous labor on my part and attempts to see innovation come to fruition. Today, Klein, Padron & Associates continues the struggle.

I see this time and time again in my work. Without full clinical supports, executive and individual US State Director leadership for the CPS to receive CMS Medicaid waiver(s) the CPS is dead in the water, basically. I see it now in Maryland. There must be positive partnership and collaboration. Peers can talk and yell and scream until we’re blue in the face to procure “approval” for state CMS Medicaid waivers and without it, the CPS is not sustainable.

I kindly urge Maryland leadership but not only Maryland’s Director to support an Adult CMS Medicaid waiver for the CPRS because quite simply, it’s the right thing to do. It does not open Pandora’s Box. It supports. It sustains. It offers substantial financial sustainability to an idea that works. I volunteer to show you how.

It remains that people like myself are still dying on average <25 years earlier than those individuals who are not receiving US Public Community Mental Health services and supports (NASHMPD 2006, SAMHSA/CMHS 2016).  Still, the average age of morbidity and mortality rests uncomfortably at 52 years of age.  The work of many others nationally on psychiatric torture, survivorship to trauma induced by psychiatry (e.g., Stop Shock), Recovery as touchy feely as it is, is respected by me and I stand in support as I’ve walked it and continue to.

This Friday, June 24, 2016 the National Council for Behavioral Health and SAMHSA/HRSA led by Larry Fricks is hosting a national webinar at 1-2 PM EST. I have invited colleagues Brandee Izquierdo and Dr. Jessica Wolf to co-present on Peer/CPS disruptive innovations and emergent initiatives regionally, nationally.

I hope you will register for it and sit with us to dialogue. Wolf’s work recently surveying the United States along with others will present on CPS educational attainment strategy and professional growth. Her Toolkit 1.0 encapsulates how the Certified Peer Specialist certification supports such personal occupational growth, establishing strategies instilling not just Hope but basic common sense knowledge. Izquierdo’s recent work developing the State of Maryland CPRS iFPRS (Intentional Forensic Peer Recovery Support) presents on ideas, philosophy and basic tenets to Peer to Peer (CPS) supports and services.

My presentation is meant to show benefits and a roadmap on the how’s, why’s and where the CPS benefits millions of Peers. I came from this. I am a part of it. This is my family and this is my tribe.

Larry Fricks’ work with SAMHSA/HRSA and NatCon presents Innovation Community is designed to engage organizations in acquiring knowledge and skills and applying their learning to implement measureable improvements in a high priority area related to healthcare integration. Lessons learned over the course of the innovation community are compiled and shared with the health care field so other organizations can benefit.

The innovation community is designed to address three key components associated with innovation implementation, including:

Topic-specific foundational information, knowledge, and best practices

Innovation implementation planning

Adoption and sustainability of the innovation

Check out registration information and I hope to dialogue with you this Friday.

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