MEDI-CAL PEER SUPPORT SPECIALIST | EXAM READY - VERIFIED
QUESTIONS AND ANSWERS - COMPREHENSIVE LATEST VERSION
2026/2027
Q: What is Medi-Cal? ANSWER California’s Medicaid health care program
for low-income individuals and families.
Q: What does CalAIM stand for? ANSWER California Advancing and
Innovating Medi-Cal.
Q: What is the primary goal of CalAIM? ANSWER To transform the Medi-
Cal system to provide more equitable, whole-person care by addressing
social drivers of health (SDOH) and moving away from fee-for-service
models.
Q: Under CalAIM, what is a "Community Supports" service? ANSWER A
new set of covered Medi-Cal benefits that address health-related social
needs, which includes Peer Support Services.
Q: When did Peer Support Services become a billable Medi-Cal benefit in
California? ANSWER Effective January 1, 2023.
Q: Why did California add Peer Support as a Medi-Cal benefit? ANSWER
To improve outcomes for members with complex needs by utilizing the
unique value of lived experience to promote engagement and recovery.
Q: What is a Medi-Cal Peer Support Specialist (PSS)? ANSWER A
professional who uses their own lived experience of mental health and/or
substance use challenges, along with specialized training, to support
others in their recovery journey.
Q: What California legislation formally established the certification of Peer
Support Specialists? ANSWER Senate Bill (SB) 803.
Q: Who oversees the Medi-Cal Peer Support Specialist certification in
California? ANSWER The California Department of Health Care Services
,(DHCS), often in partnership with a designated certifying entity (like the
California Mental Health Services Authority - CalMHSA).
Q: What is "lived experience"? ANSWER Personal knowledge gained from
living through a condition, situation, or system (e.g., experiencing mental
illness, substance use disorder, or homelessness).
Q: Why is lived experience essential to the Peer Support role? ANSWER It
creates an immediate bond of trust, reduces power imbalances, and
provides tangible proof that recovery is possible.
Q: Can Peer Support Specialists provide clinical therapy? ANSWER No, it
is strictly outside their scope of practice.
Q: What is the difference between a Peer Support Specialist and a
clinician? ANSWER Clinicians are licensed to diagnose and treat; PSS use
relational, non-clinical support based on shared experience.
Q: Who is eligible to receive Medi-Cal Peer Support Services? ANSWER
Medi-Cal members who have complex needs, particularly those involved
in Whole Person Care (WPC) pilots, Enhanced Care Management (ECM),
or specific specialty mental health populations.
Q: What is Whole Person Care (WPC) under CalAIM? ANSWER A program
that coordinates physical health, behavioral health, and social services for
high-need Medi-Cal populations.
Q: What is Enhanced Care Management (ECM)? ANSWER A high-level
care management benefit for Medi-Cal members with the most complex
needs, which often includes peer support as a key intervention.
Q: What does "recovery" mean in peer support? ANSWER A process of
change through which individuals improve their health and wellness, live
self-directed lives, and strive to reach their full potential.
Q: What is "recovery capital"? ANSWER The sum of resources available to
a person to start and sustain recovery (e.g., social support, housing,
employment, mental health).
Q: Does a Peer Support Specialist give advice? ANSWER No, they share
their own experiences and explore options, allowing the peer to make
their own choices.
, Q: What is "mutuality" in peer support? ANSWER The understanding that
both the specialist and the peer learn and benefit from the relationship; it
is a two-way street.
Q: Are Peer Support Specialists considered "staff" or "clients"? ANSWER
They are paid professionals (staff) with a specific expertise derived from
their past experience as a consumer/client.
Q: What is the "recovering vs. recovered" debate? ANSWER Peer support
views recovery as an ongoing journey, not a final destination; specialists
are considered "in recovery," not "cured."
Q: Can a Peer Support Specialist work with someone they know
personally from their past (e.g., a former using buddy)? ANSWER
Generally no, due to dual relationships and boundary issues, though
exceptions may be evaluated on a case-by-case basis.
Q: What is "person-centered" care? ANSWER An approach that respects
the peer's autonomy and organizes care around their individual goals,
strengths, and preferences rather than a standardized clinical plan.
Q: What is "strengths-based" language? ANSWER Using words that focus
on abilities and potential (e.g., "person with a substance use disorder")
rather than deficits or labels (e.g., "addict").
Q: What populations does Medi-Cal specifically target for Peer Support
under CalAIM? ANSWER Individuals experiencing homelessness,
transitioning from incarceration, with serious mental illness (SMI), serious
emotional disturbances (SED), or substance use disorders (SUD).
Q: What is "EPSDT"? ANSWER Early and Periodic Screening, Diagnostic,
and Treatment; a Medi-Cal benefit for youth under 21 that can include
peer support services.
Q: Can Peer Support Services be provided via telehealth under Medi-Cal?
ANSWER Yes, CalAIM explicitly allows for the delivery of Community
Supports, including peer support, via telehealth.
Q: What is the primary focus of a Peer Specialist's first few meetings with
a new member? ANSWER Building rapport, establishing trust, and
exploring what the member wants to achieve.
QUESTIONS AND ANSWERS - COMPREHENSIVE LATEST VERSION
2026/2027
Q: What is Medi-Cal? ANSWER California’s Medicaid health care program
for low-income individuals and families.
Q: What does CalAIM stand for? ANSWER California Advancing and
Innovating Medi-Cal.
Q: What is the primary goal of CalAIM? ANSWER To transform the Medi-
Cal system to provide more equitable, whole-person care by addressing
social drivers of health (SDOH) and moving away from fee-for-service
models.
Q: Under CalAIM, what is a "Community Supports" service? ANSWER A
new set of covered Medi-Cal benefits that address health-related social
needs, which includes Peer Support Services.
Q: When did Peer Support Services become a billable Medi-Cal benefit in
California? ANSWER Effective January 1, 2023.
Q: Why did California add Peer Support as a Medi-Cal benefit? ANSWER
To improve outcomes for members with complex needs by utilizing the
unique value of lived experience to promote engagement and recovery.
Q: What is a Medi-Cal Peer Support Specialist (PSS)? ANSWER A
professional who uses their own lived experience of mental health and/or
substance use challenges, along with specialized training, to support
others in their recovery journey.
Q: What California legislation formally established the certification of Peer
Support Specialists? ANSWER Senate Bill (SB) 803.
Q: Who oversees the Medi-Cal Peer Support Specialist certification in
California? ANSWER The California Department of Health Care Services
,(DHCS), often in partnership with a designated certifying entity (like the
California Mental Health Services Authority - CalMHSA).
Q: What is "lived experience"? ANSWER Personal knowledge gained from
living through a condition, situation, or system (e.g., experiencing mental
illness, substance use disorder, or homelessness).
Q: Why is lived experience essential to the Peer Support role? ANSWER It
creates an immediate bond of trust, reduces power imbalances, and
provides tangible proof that recovery is possible.
Q: Can Peer Support Specialists provide clinical therapy? ANSWER No, it
is strictly outside their scope of practice.
Q: What is the difference between a Peer Support Specialist and a
clinician? ANSWER Clinicians are licensed to diagnose and treat; PSS use
relational, non-clinical support based on shared experience.
Q: Who is eligible to receive Medi-Cal Peer Support Services? ANSWER
Medi-Cal members who have complex needs, particularly those involved
in Whole Person Care (WPC) pilots, Enhanced Care Management (ECM),
or specific specialty mental health populations.
Q: What is Whole Person Care (WPC) under CalAIM? ANSWER A program
that coordinates physical health, behavioral health, and social services for
high-need Medi-Cal populations.
Q: What is Enhanced Care Management (ECM)? ANSWER A high-level
care management benefit for Medi-Cal members with the most complex
needs, which often includes peer support as a key intervention.
Q: What does "recovery" mean in peer support? ANSWER A process of
change through which individuals improve their health and wellness, live
self-directed lives, and strive to reach their full potential.
Q: What is "recovery capital"? ANSWER The sum of resources available to
a person to start and sustain recovery (e.g., social support, housing,
employment, mental health).
Q: Does a Peer Support Specialist give advice? ANSWER No, they share
their own experiences and explore options, allowing the peer to make
their own choices.
, Q: What is "mutuality" in peer support? ANSWER The understanding that
both the specialist and the peer learn and benefit from the relationship; it
is a two-way street.
Q: Are Peer Support Specialists considered "staff" or "clients"? ANSWER
They are paid professionals (staff) with a specific expertise derived from
their past experience as a consumer/client.
Q: What is the "recovering vs. recovered" debate? ANSWER Peer support
views recovery as an ongoing journey, not a final destination; specialists
are considered "in recovery," not "cured."
Q: Can a Peer Support Specialist work with someone they know
personally from their past (e.g., a former using buddy)? ANSWER
Generally no, due to dual relationships and boundary issues, though
exceptions may be evaluated on a case-by-case basis.
Q: What is "person-centered" care? ANSWER An approach that respects
the peer's autonomy and organizes care around their individual goals,
strengths, and preferences rather than a standardized clinical plan.
Q: What is "strengths-based" language? ANSWER Using words that focus
on abilities and potential (e.g., "person with a substance use disorder")
rather than deficits or labels (e.g., "addict").
Q: What populations does Medi-Cal specifically target for Peer Support
under CalAIM? ANSWER Individuals experiencing homelessness,
transitioning from incarceration, with serious mental illness (SMI), serious
emotional disturbances (SED), or substance use disorders (SUD).
Q: What is "EPSDT"? ANSWER Early and Periodic Screening, Diagnostic,
and Treatment; a Medi-Cal benefit for youth under 21 that can include
peer support services.
Q: Can Peer Support Services be provided via telehealth under Medi-Cal?
ANSWER Yes, CalAIM explicitly allows for the delivery of Community
Supports, including peer support, via telehealth.
Q: What is the primary focus of a Peer Specialist's first few meetings with
a new member? ANSWER Building rapport, establishing trust, and
exploring what the member wants to achieve.
