Teacher P2P Model Jennifer Padron Ver 1.0.pdf

US TEACHER P2P
| 2019 1.0
A US Certified Peer Specialist Endorsement
ABSTRACT
The Teacher Peer to Peer (Teacher P2P)
Model is a Certified Peer Specialist
Endorsement which works hand in hand with
the Transition Age Youth and Recovery
Coach Endorsements. The Teacher P2P is
specifically designed to be used by Educators
in any environment conducive to supporting a
Zero Tolerance Bullying regimen. It is
Trauma Informed and written in mind for
Suicide Education & Prevention (The
Language of Pain) to support all Teachers in
their Classrooms and in Schools everywhere.
JENNIFER M. PADRON, CPS,
ACPS, CHW, M.ED
Padron & Associates © 2019. All Rights Reserved.

Padron & Associates © 2019. All Rights Reserved. (706) 391-3864 | jennifermpadron@gmail.com
US TEACHER P2P | 2019 1.0
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Table of Contents
Introduction................................................................................................................................. 3
Guiding Principles of Recovery (SAMHSA/CMHS, 2019)........................................................... 3
TO REVIEW................................................................................................................................... 4
Organizational Culture Challenges................................................................................................. 5
Why Youth with Shared Life Experience? ..................................................................................... 8
Goals & Objectives of the US Teacher P2P ................................................................................... 9
Future Options for Teacher P2P CPS TAY RC............................................................................ 10
Teachers are the Providers of Choice for Early Intervention, Prevention & Education to practiced
Zero Tolerance Bullying (Student/Student, Student/Teacher, Teacher/Teacher)......................... 11
Eventual Teacher P2P Center for Medicaid Billing Teacher/Student Deliverables in a practiced
Trauma Informed Secondary School Environment ...................................................................... 14
The Purpose of the US Teacher P2P | CPS Endorsement............................................................. 14
Backstory ...................................................................................................................................... 15
Bullying Zero Tolerance Practice ................................................................................................. 16
...................................................................................... 16
The range of detrimental effects bullying has on students, including impacts on student
learning, school safety, student engagement, and the school environment............................... 16
Statement of Scope.................................................................................................................... 17

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Specification of Prohibited Conduct ......................................................................................... 17
Enumeration of Specific Characteristics................................................................................... 18
Georgia Anti-Bullying Laws & Policies https://www.stopbullying.gov/laws/georgia.html ........ 19
What terms are used in Georgia anti-bullying laws and regulations? ................................... 19
Do these laws cover cyberbullying?...................................................................................... 19
What groups are listed under Georgia anti-bullying laws and regulations?.......................... 19
Is there a state model policy I can use to create anti-bullying policies for my school or
district? .................................................................................................................................. 19
Which of the key components can be found in Georgia anti-bullying laws, regulations, and
model policies? What are the Georgia laws and regulations that cover bullying?................ 19
The Teacher P2P | Suicide Education & Prevention and LGBTQ TAY ...................................... 20
Trauma Informed Care and the Teacher P2P................................................................................ 24
Outcome and Impacts on Behavioral Health Utilization [Participantsin New York Peer
Program (NYAPRS) OptumHealth, n=54]................................................................................ 26
Impact on Behavioral Health Utilization [Participants inWisconsin Peer Program (GEP),
OptumHealth, N=130]............................................................................................................... 27
The Teacher P2P Certified Peer Specialist Endorsement Within the Context of Zero Tolerance
Bullying, Suicide Education & Prevention that is also Trauma Informed for Educators and Youth
....................................................................................................................................................... 28
Benefits to Utilizing Peer Services | Supports via the CPS Teacher P2P are: .......................... 29
Core Competencies for the Teacher P2P CPS Endorsement........................................................ 29
SAMHSA / CMHS CPS Core Competencies, Principles and Values.......................................... 30
Projected CMS Revenue FY 2020, 2021, 2022 Public/Private Secondary Education Teacher P2P
at National Average of CMS Reimbursement x 3-5 FTE CPS TAY RC..................................... 31
Direct Applications ....................................................................................................................... 33
The Teacher P2P Training ............................................................................................................ 33
References..................................................................................................................................... 34

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Introduction
There is a growing body of evidence suggesting that peer-provided, recovery-oriented mental
health services produce outcomes as good as and, in some cases superior to, services from non-
peer professionals.1
Growing evidence includes reduced hospitalizations, reduced use of crisis
services, improved symptoms, larger social support networks, and improved quality of life, as
well as strengthening the recovery of the people providing the peer services.2
Research also
demonstrates that peer providers can increase empowerment, decrease substance use, reduce
days in the hospital, and increase use of outpatient services, at least as long as the peer support
continues.3
“The unique role of trusted peers connecting with each other to foster hope and build
on strengths is emerging as a key transformational factor in mental health services.4
This Teacher P2P Certified Peer Specialist Endorsement is a driven educator subject matter
expertise model of design specializing in day to practice for a Zero Tolerance in Bullying,
Suicide Education & Prevention, Trauma Informed training where related training regionally and
nationally in the following di rigeur areas for a true Youth Engaged and Recovery based
application in real-time.
The Georgia Model for Secondary School Education Certified Peer Specialist Transition Age
Youth Recovery Coach initiative is a companion piece to the Teacher P2P | 2019 1.0.
Guiding Principles of Recovery (SAMHSA/CMHS, 2019)
1
Klein, Padron & Associates Maryland, 2016
2
3
4

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TO REVIEW

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Organizational Culture Challenges

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Why Youth with Shared Life Experience?

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Goals & Objectives of the US Teacher P2P
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5
Klein, Padron & Associates 2016

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Future Options for Teacher P2P CPS TAY RC

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Teachers are the Providers of Choice for Early Intervention, Prevention
& Education to practiced Zero Tolerance Bullying (Student/Student,
Student/Teacher, Teacher/Teacher)

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Eventual Teacher P2P Center for Medicaid Billing Teacher/Student
Deliverables in a practiced Trauma Informed Secondary School
Environment
The Purpose of the US Teacher P2P | CPS Endorsement
The purpose of this Teacher P2P scope of work is capable of immediately rolling out a 2019
scale for the benefit of having a developed program(s) by which establishing a fully functional
CPS Teacher P2P Endorsement of peer services | supports, peer led, for the provision of
embedding Teacher P2P’s that are inherently TAY Certified Peer Specialist (CPS) into not only
a behavioral health care public community mental health setting(s) but to ultimately function in
co-located Behavioral and Primary Care environment across care environments in the US.
One goal is to improve the physical health status of adults with serious mental illnesses
(SPMI)6
and those with co-occurring substance use disorders who have or are at risk for co-
6 Adults with a serious mental illness (SMI) are defined by SAMHSA as persons age 18 and over, who currently or at any time during the past year,
have had a diagnosable mental, behavioral, oremotional disorder of sufficient duration to meet diagnostic criteria specified within the [DSM-IV],
resultingin functional impairment which substantially interferes with or limits one or more major lifeactivities. SAMHSA will defer to state definitions
of SMI.

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morbid primary careconditions and chronic diseases. The program’s objective is to support the
Substance Abuse and Mental Health Services Agency’s triple aim of improving the health of
individuals with SMI; enhancing the consumer experience of care (including quality, access,
and reliability); and reducing/controlling the per capitacost of care.
Padron & Associates does inherently support the SAMHSA Recovery definition, where
recovery is defined as “a process of change through which individuals improve their health and
wellness, live a self-directed life, and strive to reach their full potential.” Recovery has four
major dimensionsthat support a life in recovery:
1. Health: overcoming or managing one’s disease(s) or symptoms—for example,
abstaining from use of alcohol, illicit drugs, and non-prescribed medications if one has
an addiction problem—and for everyone in recovery, making informed, healthy
choices that support physical and emotional wellbeing.
2. Home: a stable and safe place to live;
3. Purpose: meaningful daily activities, such as a job, school, volunteerism, family
caretaking,or creative endeavors, and the independence, income and resources to
participate in society;and
4. Community: relationships and social networks that provide support, friendship, love,
and hope.
Backstory
SPMI and physical health problems are a major issue among individuals living with a
psychiatric label. Physical comorbidities are a leading reason why people with serious
persistent mental illness SPMI are dying 25 years earlier than the general population who is not
accessing nor receiving community public mental health services (Fricks, 2012; Mental Health
America, 2010; National Alliance on Mental Illness, 2011). Nearly half (45%) of all individuals
living with any mental disorder have two or more physical disorders, leading to a significantly
high rate of comorbid physical issues (Harvard Mental Health Letter, 2003; NASMHPD, 2006;
Parks, Svendsen, Singer, & Foti, 2006).
According to the DSM-V (2015), serious persistent mental illness is defined as a medical
clinical psychiatric diagnosis of schizophrenia, bipolar disorder, major depression, obsessive
compulsive disorder (OCD), panic disorder, post-traumatic stress disorder (PTSD) and
borderline personality disorder. Common clinical diagnosis of SMI affects more than 4% of
adults in the United States (National Alliance onMental Illness, 2014). People living with an
SPMI often carry the added burden of physical ill-healthissues. Youth numbers are relational.

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Compared with adults without mental illness, people with SPMI have higher rates of chronic
disease, such as hypertension, diabetes, and obesity, and are more than twice as likely to die
prematurelyfrom these conditions, due in part, because they experience significant barriers to
accessing primaryand preventative medical care (Garrison, 2014). After heart disease, mental
illness is the most common cause of premature death (Garrison, 2014). Psychotropic
medications are often barriers to physical health due to multiple symptomatic features (e.g.,
higher sugar levels, weight gain, and the propensityto participate in tobacco smoking)
(Whitaker, 2012).
Excess morbidity and mortality in persons with SPMI is a public health crisis (SAMHSA,
2014). Compared with people without mental illness, individuals with SMI also experience
higher rates of chronic medical conditions, including hypertension, diabetes, obesity,
cardiovascular disease, and HIV/AIDS. A higher frequency of multiple general medical
conditions exist; the result is often morethan twice the rate of premature death (Kelly, Boggs,
and Conley, 2007; Laursen, et al., 2013; Mauer,2006; Parks et al., 2006; SAMHSA, 2014;
Saha, Chant, McGrath, 2007; Sokal et al., 2004).
Bullying Zero Tolerance Practice
The range of detrimental effects bullying has on students, including impacts on student learning,
school safety, student engagement, and the school environment.
• Declares that any form, type, or level of bullying is unacceptable, and that every incident
needs to be taken seriously by school administrators, school staff (including teachers),
students, and students’ families.

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Oklahoma: Okla. Stat. Ann. Tit. 70, § 24-100.3 (2009): "The Legislature finds that bullying has
a negative effect on the social environment of schools, creates a climate of fear among students,
inhibits their ability to learn, and leads to other antisocial behavior. Bullying behavior has been
linked to other forms of antisocial behavior, such as vandalism, shoplifting, skipping and
dropping out of school, fighting, and the use of drugs and alcohol... Successful programs to
recognize, prevent, and effectively intervene in bullying behavior have been developed and
replicated in schools across the country. These schools send the message that bullying behavior
is not tolerated and, as a result, have improved safety and created a more inclusive learning
environment."
For additional examples of purpose statements, see: 105 Ill. Comp. Stat. Ann. 5/27-23.7.a
(2010); Iowa Code § 280.28.1 (2008); Md. Code Ann., Educ. § 7-424 (2010); Nev. Rev. Stat.
Ann. § 388.132 (2009); N.J. Stat. Ann. § 18A:37.13 (2010); Or. Rev. Stat. § 339.353 (2009);
Tenn. Code Ann. § 49-6-1014 (2010); W. Va. Code Ann. § 18-2C-1 (2009).
Statement of Scope7
Covers conduct that occurs on the school campus, at school-sponsored activities or events
(regardless of the location), on school-provided transportation, or through school-owned
technology or that otherwise creates a significant disruption to the school environment.
Specification of Prohibited Conduct8
• Provides a specific definition of bullying that includes a clear definition of
cyberbullying. The definition of bullying includes a non-exclusive list of specific
behaviors that constitute bullying, and specifies that bullying includes intentional
efforts to harm one or more individuals, may be direct or indirect, is not limited to
behaviors that cause physical harm, and may be verbal (including oral and written
language) or non-verbal. The definition of bullying can be easily understood and
interpreted by school boards, policymakers, school administrators, school staff,
students, students’ families, and the community.
• Is consistent with other federal, state and local laws. (For guidance on school
districts’ obligations to address bullying and harassment under federal civil rights
laws, see the Dear Colleague Letter: Harassment and Bullying[PDF - 295 KB], issued
by the Department’s Office for Civil Rights on October 26, 2010.
Prohibited Conduct also includes:
7
Ibid.
8
Ibid.

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• Retaliation for asserting or alleging an act of bullying.
• Perpetuating bullying or harassing conduct by spreading hurtful or
demeaning material even if the material was created by another person
(e.g., forwarding offensive e-mails or text messages).
Examples for the Specification of Prohibited Conduct
Florida: Fla. Stat. Ann. 1006.147(3) (2010): "(a) ‘Bullying’ means systematically and
chronically inflicting physical hurt or psychological distress on one or more students and may
involve: (1) Teasing; (2) Social exclusion; (3) Threat; (4) Intimidation; (5) Stalking; (6) Physical
violence; (7) Theft; (8) Sexual, religious, or racial harassment; (9) Public humiliation; or (10)
Destruction of property. . . . (d) The definitions of ‘bullying’ and ‘harassment’ include: (1)
Retaliation against a student or school employee by another student or school employee for
asserting or alleging an act of bullying or harassment...[and] (2) Perpetuation of [bullying or
harassing] conduct ... by an individual or group with intent to demean, dehumanize, embarrass,
or cause physical harm to a student..."
Kansas: Kan. Stat. Ann. § 72-8256.C.2 (2009): "‘Cyberbullying’ means bullying by use of any
electronic communication device through means including, but not limited to, e-mail, instant
messaging, text messages, blogs, mobile phones, pagers, online games and websites."
For additional examples of bullying definitions, see: Del. Code Ann. Tit. 14, § 4112D.a
(2010); Kan. Stat. Ann. § 72-8256 (2009); 105 Ill. Comp. Stat. Ann. 5/27-23.7(b) (2010).
For additional examples of cyberbullying definitions, see: Iowa Code § 280.28.2 (a) (2008);
Md. Code Ann., Educ. § 7-424.3 (2010); 2010 Mass. Adv. Legis. Serv. Ch. No. 92-2010 (Lexis
Nexis 2010); N.J. Stat. Ann. § 18A 37.14.2 (2010); Okla. Stat. Ann. Tit. 70, § 24-100.3 (2009).
Enumeration of Specific Characteristics9
• Explains that bullying may include, but is not limited to, acts based on actual or
perceived characteristics of students who have historically been targets of bullying,
and provides examples of such characteristics.
• Makes clear that bullying does not have to be based on any particular characteristic.
Examples Enumeration of Specific Characteristics
North Carolina: N.C. Gen. Stat. § 115C-407.15(a) (2010): "Bullying or harassing behavior
includes, but is not limited to, acts reasonably perceived as being motivated by any actual or
perceived differentiating characteristic, such as race, color, religion, ancestry, national origin,
gender, socioeconomic status, academic status, gender identity, physical appearance, sexual
9
Ibid.

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orientation, or mental, physical, developmental, or sensory disability, or by association with a
person who has or is perceived to have one or more of these characteristics."
Washington: Wash. Rev. Code Ann. § 28A.300.285.2 (2010): "Nothing in this section requires
the affected student to actually possess a characteristic that is a basis for the...bullying."
For additional examples of characteristic enumeration, see: 105 Ill. Comp. Stat. Ann. 5/27-
23.7.a (2010); Iowa Code § 280.28 (2008); Or. Rev. Stat. § § 339.351.3(2009).
Georgia Anti-Bullying Laws & Policies https://www.stopbullying.gov/laws/georgia.html
What terms are used in Georgia anti-bullying laws and regulations?
Bullying.
Do these laws cover cyberbullying?
Yes.
What groups are listed under Georgia anti-bullying laws and regulations?
There are no specific groups listed under Georgia anti-bullying laws and regulations.
Schools that receive federal funding are required by federal law to address discrimination on a
number of different personal characteristics. Find out when bullying may be a civil rights
violation.
Is there a state model policy I can use to create anti-bullying policies for my school or district?
The Georgia state model policy Site exit disclaimer is available on the Georgia Department of
Education website Site exit disclaimer.
Which of the key components can be found in Georgia anti-bullying laws, regulations, and
model policies? What are the Georgia laws and regulations that cover bullying?
Georgia Code Annotated §16-5-61. Hazing Site exit disclaimer
Georgia Code Annotated §20-2-145. Character education
Georgia Code Annotated §20-2-751.4. Policies prohibiting bullying; assignment to alternative
school;
Georgia Code Annotated §20-2-751.5. Student codes of conduct; safety rules on school buses;
distribution
Georgia Code Annotated §20-2-751.6. Disciplinary policy for students committing acts of
physical violence against teacher, school bus driver, or other school official or employee
Georgia Code Annotated §20-2-1181. Disrupting operations of public school, school bus, or
school bus stop; penalty; progressive discipline
Georgia State Board of Education Administrative Rule No. 160-4-8-.15. Student Discipline

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The key component framework used in the analysis of state laws is based on the review of
legislation presented in the “Analysis of State Bullying Laws and Policies – December 2011”
(U.S. Department of Education).
[Content last updated on June 21, 2017]
The Teacher P2P | Suicide Education & Prevention and LGBTQ TAY
Racial and ethnic composition of youth who identify as Transgender is typically characterized
and summed two ways: the percentage of transgender youth who identify with each racial or
ethnic group and the percentage out of each racial or ethnic group that identifies as transgender.
Within these populations of focus are subpopulations where it may be found to have disparate
access to, use of, or outcomes from provided services. These disparities also may be found to be
due to the result of differences in language, beliefs, norms, values, and/or socioeconomic factors
specific to that subpopulation.
Social stigma for diagnosis and living with an SPMI increases triggers and stressors to an
already vulnerable, disenfranchised, marginalized and impoverished population of citizens living
with perceived mental illness and physical comorbidity. LGBQT individuals are 2 or more times
more likely than heterosexual individuals to live with a mental health diagnosis. 11% of trans
individuals reported being denied care by mental health clinics due to bias or discrimination.
Lesbian, gay, bisexual, gender queer, trans and questioning transition aged youth are 2 to 3 times
more likely to attempt suicide than heterosexual youth. Mental illness and the disease model
rarely takes into consideration cultural bias, white privilege, trauma, re-traumatization, hate of
the Other and Queer catalytic self-hate marked - magnetized by extensive experiential loss, harm
and hardship. We categorized the racial and ethnic groups to be consistent across the data
sources utilized in this report (i.e., BRFSS and the American Community Survey).
The National Transgender Discrimination Survey, for example, which surveyed the largest 3
sample of transgender individuals in the U.S., prior to the 2015 U.S. Trans Survey, found that
83% of respondents identified as White, a much larger percentage than in the U.S. general
population. Other non-representative samples have found that transgender respondents were
more likely to identify as people of color than the U.S. general population. One of the few 4
studies to have drawn on representative, state-level data, found that in Massachusetts (for
example) adults who identify as transgender are significantly less likely to identify as White and
more likely to identify as Latino or Hispanic than the non-transgender adult population.5
In this report, we utilize data from the CDC’s Behavioral Risk Factor Surveillance System
(BRFSS), a national, state-administered survey, which collected data on transgender identity
among adults in 19 states for the first time since 2014. Considering the racial and ethnic
composition of the transgender population in another way, it is found that there are differences in
the percentage of adults who identify as transgender depending on their race/ethnicity. We 6
estimate that >73% of White adults identify as transgender, as do >7% of African-American or

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Black adults, >13% of Latino or Hispanic adults, and >8 % of adults of other races and
ethnicities. The estimates are based on a modelling strategy and are comparable to weighted and
unadjusted estimates.
https://williamsinstitute.law.ucla.edu/wp-content/uploads/Race-and-Ethnicity-of-Transgender-Identified-Adults-in-t
he-US.pdf
Ibid.
Reback, C. J. & Lombardi, E. L. (2001). HIV Risk Behaviors of Male-to-Female Transgenders in a Community-
based Harm Reduction Program. In W. Bockting, & S. Kirk (Eds.), Transgender and HIV: Risks, Prevention and
Care (pp. 59–68). Binghamton, NY: Haworth Press, Inc.
Conron, K. J., Scott, G., Stowell, G. S., & Landers, S. J. (2012). Transgender Health in Massachusetts: Results from
a Household Probability Sample of Adults. American Journal of Public Health, 102(1), 118-122. 6
https://williamsinstitute.law.ucla.edu/wp-content/uploads/Race-and-Ethnicity-of-Transgender-Identified-Adults-in-
the-US.pdf (2016).
Rate of LGBQT suicide attempts (%) (Trevor Foundation and Williams Institute 2016)
• According to surveys, 4.6 percent of the overall U.S. population has self-reported a
suicide attempt, with that number climbing to between 10 and 20 percent for lesbian, gay
or bisexual respondents. By comparison, 41 percent of trans or gender non-conforming
people surveyed have attempted suicide.
• The most recent, comprehensive data on suicide attempts was gathered by The Williams
Institute, in collaboration with the American Foundation for Suicide Prevention. Its
report, Suicide Attempts Among Transgender and Gender Non-Conforming Adults,
analyzed responses from 6,456 self-identified transgender and gender non-conforming
adults (18+) who took part in the U.S. National Transgender Discrimination Survey.
• Beyond the overall number of suicide attempts, the rates are consistently high from
respondents ages 18 to 65, when they begin to recede. Trans men are the most impacted,
with 46 percent reporting an attempt in their lifetime. Trans women are close behind at 42
percent, and female-assigned cross-dressers report rates of 44 percent.
• Rates of transgender and gender non-confirming suicide attempts by age (%) (Source
2016).
• Rates of transgender and gender non-confirming suicide attempts by gender identity (%)
(Source 2016).
• Race and ethnicity also play a role. More than half of all American Indian, Alaska
Natives and mixed-race/ethnicity respondents have attempted to take their own lives, and
the figures aren’t much better for the black (45 percent) and Latino (44 percent) trans
communities. Even those with the lowest rates—Asian or Pacific Islander and white
respondents—are still almost nine times higher than the national average.
Queer adolescents are more likely to be involuntarily committed to a long term mental health
facility where they are subjected to being forcibly medicated with powerful psychotropic drugs,
and archaic treatments such as aversion therapy, sensory deprivation, rotational therapy, ECT,
restraint isolation and other inhumane practices. Homosexuality was removed from the DSM in
1973 but we are still persecuted, tortured and psychically damaged in our community’s youth.

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SAMHSA’s efforts and initiative to increase the numbers of “saved” lives from suicide is telling.
People are killing themselves out of presumably apparent poverty, experienced trauma, loss,
grief, hate crimes, living shelterlessly, living disenfranchised and marginalized, from battling in
combat and seeing it full front and center or from being out and out and exhaustively beaten to a
pulp by our mental health system.
In SAMHSA’s and the Alliance for Suicide Prevention (2012) paper and study, “National
Strategy for Suicide Prevention: How You Can Play a Role in Preventing Suicide,” they
comprehensively detail the following facts:
• Suicide is the 10th leading cause of death in the United States, claiming more than twice
as many lives each year as homicides. i
• On average, more than 33,000 Americans died each year between 2001 and 2009 as a
result of suicide—more than 1 person every 12.5 minutes. ii
• More than 8 million adults reported having serious suicidal thoughts in the past year, 2.5
million people reported making a suicide plan in the past year, and 1.1 million reported a
suicide attempt in the past year. iii
• Nearly 16 percent of students in grades 9 to 12 report having seriously considered
suicide, and
• 8 percent report having attempted suicide once or more in the past 12 months. iv
Although suicide can affect anyone, the following populations are known to have an increased
risk for “suicidal” behaviors:
• Individuals with mental and/or substance use disorders;
• Individuals bereaved by suicide;
• Individuals in justice and child welfare settings;
• Individuals who engage in non-suicidal self-injury;
• Individuals who have attempted suicide;
• Individuals with medical conditions;
• Individuals who are lesbian, gay, bisexual, or transgender (LGBT);
• American Indians/Alaska Natives;
• Members of the Armed Forces and veterans;
• Males in midlife; and
• Older
Further, in SAMSHA’s Leading Change 2.0: Advancing the Behavioral Health of the Nation
2015-2018. (HHS Publication No. (PEP) 14-LEADCHANGE2. Rockville, MD: Substance
Abuse and Mental Health Services Administration, 2014.) they speak to creating, “… a
framework and process for identifying, developing, and implementing strategies to yield specific
outcomes and ultimately influence system change” (p. 6). SAMHSA’s Strategic Initiative (SI #3,
pp. 19-22) describes Disparities fall-out:

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“Trauma, violence, and involvement with the criminal justice
system disproportionately affect individuals, families, and
communities of color, including indigenous and native populations.
Racial, ethnic, sexual, and gender minority individuals experience
trauma not just as individuals, but often also in the context of
historical, intergenerational, or community trauma, which further
compounds the effects of specific traumatic events. Mass trauma,
such as natural disasters, often leave these communities
underserved, unserved, or cut off from recovery resources. These
communities are overrepresented in the justice system, are provided
less opportunities for diversion from the system, and often move
deeper into a system that itself is traumatizing and not geared
toward recovery for people with mental or substance use disorders.
For some people in these communities, the justice system becomes
the de facto behavioral health system.”
For hundreds upon thousands of individuals living within the spiritual and emotional day to day
anguish compounds and builds traumatizing distress. For individuals living with dual diagnosis
and/or co-occurring physical health issues, how does recovery and hope really save us from the
very “medicinal” prescriptive medications which are killing us slowly, bit by bit, day after day?
They will not and they won’t help. We have accepted that we are dying a fast death
biochemically due to extraneous debilitating side effects from 45 years of combined clinically
invasive medication with concurrent treatment adherence at the hands of psychiatric staff
nationwide. Our vital body organs are damaged, disease inflicted. We show premature damaged
sugared blood coursing our veins blurring vision. Increasing terrible physical pain, aching and
tenderness with effected cognition and comprehensibility is affected. We are already dying and
we welcome relief.
One argument rests in the very simple understanding that there is no difference between physical
or psychiatric illness. That the body inherently breaks down and dies is tantamount to one’s
humanity towards longevity of eternal life of one’s mind, heart and spirit. The daily poisoning of
one’s body daily with antipsychotics, antidepressants, mood stabilizers from big pharma (e.g.,
Eli Lilly, Astrazeneca, Bristol Myers Squibb) weighs heavily on increasing opportunity for
physical structural breaking down due to consistent poisonous or negligible medication dosing.
Symptoms to many of these very prescriptive psychiatric solutions is increased suicidal ideation
which may or may not lead to death of the body. Given the presumptive mutual agreement
between provider and acknowledging non-revocability to remaining truly self-informed, then
contractually, we retain a right to die a physical death.
Centers for Disease Control and Prevention. Fatal Injury Data, 2009. Web-based Injury Statistics
Query and Reporting System. Available
at http://www.cdc.gov/injury/wisqars/fatal.html. Accessed January 12, 2017.

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• Centers for Disease Control and Prevention. Fatal Injury Data, 2009. Web-based Injury
Statistics Query and Reporting System. Available
at http://www.cdc.gov/injury/wisqars/fatal.html. Accessed January 12,
• Substance Abuse and Mental Health Services Administration. Utilization of mental
health services by adults with suicidal thoughts and behavior. (National Survey on Drug
Use and The NSDUH Report.) Rockville, MD: Author; 2011.
• Centers for Disease Control and Youth risk behavior surveillance—United States,
2011. MMWR. 2012;61(4) 1-162
Trauma Informed Care and the Teacher P2P
Numerousfactors contribute to the excess burden of general medical conditions among persons
with SPMI, including low levels of self-care, medication side effects, substance abuse
comorbidity, unhealthy lifestyles, and socioeconomic disadvantage (Burnam & Watkins, 2006;
CDC, 2012; Druss, 2002, 2010, 2011). The organizational and financial separation of the
behavioral and general health care sectors contributes to disparities in access to and the quality
of general medical care for people with SMI (Alakeson, Frank, and Katz, 2010; Bao, Casalino,
and Pincus, 2013; Druss, 2002, 2010, 2011; Horvitz-Lennon,Kilbourne, and Pincus, 2006).
People living with serious mental illness in the United States die, on average, twenty-five years
earlier than those without a serious mental illness, largely due to preventable medical
conditions andsuboptimal medical care (Brekke, Siantz, Pahwa, Kelly, Tallen, L. and Fulginiti,
2013). Studies are finding higher incidences of certain physical disorders and comorbid
addiction disorders, among people with serious mental illnesses including:
• Diabetes
• Obesity
• High Cholesterol or Dyslipidemia
• Metabolic syndromes
• Cardiovascular and Respiratory
• Cancer
• HIV / AIDS/STI/HCV, TB, Infectious Disease
When combined with a serious mental illness, physical illness can lead to other health
conditions and toa quality of life lower than that of both the general population and individuals
with mental illnesses alone. These negative health consequences affect other recovery goals
such as housing, vocationaltraining, and education (Brekke, Siantz, Pahwa, Kelly, Tallen, and
Fulginiti, 2013).
Peer providers bring their own experiences of living with mental illnesses, addictions and/or
community health problems to light the path to recovery for others. Creating a recovery based
peer driven and delivered workforce creates training and employment opportunities providing
peers with a stronger role and voice in integrated care plus the opportunity to break the cycle of
poverty with employment inthis emerging new healthcare field.

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25
The Affordable Care Act (ACA) and its implementing regulations, building on the Mental
Health Parity and Addiction Equity Act of 2008, expands coverage of mental health and
substance use disorder benefits and federal parity protections in three distinct ways:
• By including mental health and substance use disorder benefits in the Essential Health
Benefits;
• By applying federal parity protections to mental health and substance use disorder
benefits inthe individual and small group markets; and
• By providing more Americans with access to quality health care that includes coverage
formental health and substance use disorder services (Stateline, C., 2013).
CMS is developing new programs and tools as a result of the Affordable Care Act. The ACA is
basedon a wellness model rather than a fee for service model, changing the landscape of health
care.
This new landscape is paving roads for peer provided services. OptumHealth, an innovative
MCO, implemented a Peer Services project in New York and Wisconsin both of which are
producing remarkable outcomes. The Peer Services preliminary program evaluation results
(July 2013) show members who received Peer Services:
• Have a Significant Decrease in the number of behavioral health hospital admissions
• Have a Significant Decrease in the number of behavioral health inpatient days
• Have a Significant Increase in outpatient behavioral health visits
• Have Significantly Decreased total behavioral health care costs.
The Teacher P2P clinical EBD methodology is referred or self-selected and implemented
among the following evidence-based and promising (EBPs) interventions as per SAMHSA
(2019) Guidelines. In addition, EBPs can be found at SAMHSA’s National Registry of
Evidence Based Programs and Practices (NREPP) at http//:www.nrepp.samsha.gov.
a. Achieving Healthy Lifestyles in Psychiatric Rehabilitation (ACHIEVE)
2. Chronic Disease Self-Management
3. Community Integration & Social Inclusion
4. Crisis Intervention De-Escalation Model
a. Diabetes Awareness and Rehabilitation Training (DART)
b. Double Trouble In Recovery (Group Supports for Dual Diagnosis)
c. Emotional CPR [National Empowerment Center]
d. Employment, Work, Volunteerism
e. Home is Where the Heart Is
f. Learning About Healthy Living
g. Nutrition and Exercise for Wellness and Recovery (NEW-R)
5. Nutrition/Exercise
a. Peer-to-Peer Tobacco Dependence Recovery Program
b. Physical Fitness & Training
c. Real Solutions for Wellness

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26
6. Recovery (CPS, RC) and MH/SUD (FPS, TAY CPS RC)
7. Self-Advocacy: Shared Decision Making, Project iSDM™ “My Choice, My Health”
2015 [Padron & Associates and The Campbell Center, Washington, DC]
a. Social Circling Supports & Visioning
b. Sustainable A Healthy Lifestyle
8. Tobacco Cessation
9. Trauma Informed Peer Support: Social Change and Trauma Healing
10. Wellness Recovery Action Plan (WRAP) ® with additional trainings in:
a. Whole Health Action Management (WHAM) ®
b. Yoga, Meditation, Physical Movement & Energy Therapies | Atlanta Healing
Arts (Georgia)
c. Mental Health First Aid ®
d. Emotional CPR ®
e. Intentional Peer Support ®
Outcome and Impacts on Behavioral Health Utilization [Participantsin New York Peer
Program (NYAPRS) OptumHealth, n=54]
10
Enrolled (N =
54)
6 month Pre-
Period 6 month Post-Period Sig. of Pre-Post Difference
% of Members
Who Used
Inpatient Services 92.6% 48.2% p<.001
Inpatient Cost $9,212.05 $3,858.21 p<.001
Inpatient Days 11.2 4.4 p<.001
% of Members
Who Used
Intermediate
Services 5.6% 11.1% ns
Intermediate Cost $102.84 $314.76 ns
10 *Among subsample referred to NY Peer Program 09/01/09 - 07/31/12, agreed to participate, had a closed case
at the time of analysis, had continuous eligibility 6 months pre and post referral, and atleast one behavioral
health claim during that period, OptumHealth

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27
Outpatient Cost $693.79 $1,118.62 p<.01
% of Members
Who Used
Outpatient
Outpatient Visits 8.5 11.8 p<.05
Total BH Cost $9,998.69 $5,291.59 p<.01
Impact on Behavioral Health Utilization [Participants inWisconsin Peer Program (GEP),
OptumHealth, N=130]
11
Enrolled
(N = 130)
Pre-
Period
Post-
Period
Sig. of Pre-Post
Difference
% of Members
Who Used
Inpatient Services 71.5% 43.9% p<.001
Inpatient Cost $6,247.48 $3,881.54 p<.01
Inpatient Days 6.4 4.5 p<.05
% of Members
Who Used
Intermediate
Intermediate Cost $308.70 $411.88 ns
11 Among subsample referred to the WI program between 12/09/09 – 12/31/11, agreed to participate, had a
closed case at the time of analysis, had continuous eligibility 6 months pre and post referral, and at least one
behavioral health claim during that period, OptumHealth

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28
% of Members
Who Used
Outpatient
Outpatient Cost $999.32 $1,422.88 p<.05
Outpatient Visits 9.1 11.8 p<.01
Total BH Cost $7,555.49 $5,716.31 p<.05
The Teacher P2P Certified Peer Specialist Endorsement Within the
Context of Zero Tolerance Bullying, Suicide Education & Prevention
that is also Trauma Informed for Educators and Youth
In general, the US Certified Peer Specialists (CPS), is an essential tool for implementing
ACA driven physical andbehavioral integrated systems of care (Hardin & Padron, 2014;
Manderscheid, 2016). Increasingly, peer services are being embedded in healthcare delivery,
helping to inform and transform those systems through an emphasis on whole health,
wellness, social inclusion, cultural competency and the professionalizing of a peer-led and
peer driven workforce.
A key goal of a Teacher P2P CPS Endorsement (US CPS peer workforce) creation in an
integrated health care environment is to prevent co-optation and the diminution of critical US
peer support values and practices.
Health activated people represent a new approach to healthcare focusing on prevention and
wellbeing instead of the medical model of diseasetreatment.
These people are able to implement their own recovery and wellness so effectively that they
learn and hone specific skills that increase their subsequent resiliency (Manderscheid, 2014).
This proposalfocuses on leadership development for the future of a truly integrated approach
to recovery and rebirth for millions of Americans trapped in this cycle of poverty. Evidence
based practices with CPS all demonstrate improved health outcomes when interventions are
delivered by individuals with shared lifeexperience.
Peer roles in mental health, substance abuse and community health are evolving, as people
with lived experience offer a potent resource to help other peers who are facing these health
concernsthrough education, support, and coaching. Peer roles are evolving within the
context of emerging “recovery- oriented” integrated health systems (Tucker, Tiegreen,
Toole, Banathy, Mulloy,and Swarbrick, 2013).
A great deal of important work has been done toward integrating mental health and

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29
substanceabuse peer support services. The next phase of integration is to include physical
health concernsincluding preventative services and wellness planning.
The ACA requires Medicaid and all other health plans to cover behavioral health care on par
withhealth care for physical services. It also will add an estimated 8 million people to the
Medicaid rolls in the first year, many of whom will have untreated mental illnesses. Another 7
million people are expected toget federal tax subsidies to purchase health insurance, many for
the first time. This surge in demand, combined with an already severe shortage of mental and
community health workers not only supportsbut demands the need to expand the peer
workforce.
Benefits to Utilizing Peer Services | Supports via the CPS Teacher P2P are:
1. Immediate Screening & Engagement Care Assessment
2. Goal setting (Healthcare, Wellness/Lifestyle)
3. Preparing for the Medical Appointment
4. Coaching and Navigating the Medical Based Environments
5. Coaching and Maintaining Appointments
6. Continuum of Care and Whole Health & Wellness Plans
Core Competencies for the Teacher P2P CPS Endorsement
US Teacher P2P CPS
Endorsement
SAMHSA/CMHS 2015 CPS
Peer Core Competencies
Voluntary support Recovery Oriented
Facilitate change Person Centered
Strengths-focused Non-Coercive
Person-driven Relationship Focused
Shared power Trauma Informed Care
Mutuality
Education
Youth & Community

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30
CJ Intersection
Maryland Options to Foster
Care Provision
*Adapted from National Practice
Guidelines for Peer Supporters
SAMHSA / CMHS CPS Core Competencies, Principles and Values
In addition to identifying the core competencies for any/all US peer professionals, the set
includes a list ofprinciples or values that guide the way in which these competencies are to be
performed by peer workers.All competencies are to be performed in a manner that aligns with
the principles of recovery- orientation, person-centered, non-coercive, trauma-informed and
relationship-focused. These principles of peer support are a synthesis or summary of principles
and values that havebeen described in various documents about peer support.
Recovery-oriented: Peer support provides a hopeful framework for the person to envision
a meaningful and purposeful life, recognizing that there are multiple pathways torecovery.
Person-centered: Peer support is directed by the person participating in peer support
service. Peer support is personalized to meet the specific hopes, needs and goals of an
individual.
Non-coercive: Peer support never involves force and participation in peer support is always
voluntary.
Relationship-focused: Peer support centers on the affiliation between peers.
Characteristics of the relationship are: respectful, empathetic, and mutual.
Trauma-Informed Care Peer to Peer Services: Peer support utilizes a strengths-based
framework that emphasizes physical, psychological, and emotional safety and creates
opportunities for survivors to rebuilda sense of control and empowerment.
Experts agree that peer providers are the most successful new component for services that
canimprove outcomes for people recovering from mental illness and addiction and/or
breaking the cycle ofpoverty. “They are a terribly important new addition to the
workforce,” says Bob Glover, director of the National Association of State Mental Health
Program Directors. “When peers are involved, outcomes are dramatically better across the
board,” he says.
Peer providers are health activated individuals who have developed a strong sense of personal
wellbeing and of personal quality of life by learning and applying the principles of recovery
and resiliency in daily life. Peer providers are role models supporting their peers to become
health activated by removing some of the dependencies promoted by the medical model and

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31
promoting a high level of personal responsibility and resiliency.
The delivery and payment for health care services are rapidly evolving:
1. Health services are increasingly being delivered in integrated systems of care
(ACOs) andteam based provider systems (e.g., PCMH, FQHC, other).
2. Treatment for behavioral health conditions are increasingly being coordinated or
integratedwith primary care.
3. Medicaid and Medicare are expanding the use of managed care vehicles to improve
qualityand control costs.
4. Over time – Commercial insurance, State Exchanges, and Medicaid and Medicare
plans willhave greater similarity in form and operations.
5. Models of reimbursement are shifting to population based outcomes and risk.
6. Peer Support Services (intentional and professionally delivered) are fundamentally
health services, and there is a distinct and emerging role for self-care/self-management
advocates in the engagement, activation, and ongoing care for those with chronic
illnesses.
Currently, there is limited coordination between roles and responsibilities for the different
type(s) of nationalpeer provider(s) roles, responsibilities, job duties or performance
expectations.
Essential competency requirements are different between types of peer providersalthough
many competencies are the same for all types of peer providers. A structured approach is
neededto integrate the strengths of each type of peer provider.
Standardization of a Teacher P2P provider CPS Endorsement is notout of scope for a US
initiative in Public/Private Education. Padron & Associates seeks to gather the data
necessary to discover the overlapping competencies among peer providers. Adhering to
mental health rehabilitation standards with the CMS, in the current 47 approved US States
and 3 Territories practicing the CPS and Endorsements (2019)12
. Supervision must currently
provided by a Medicaid provider for the Certified Peer Recovery Specialist is performed by a
MD, RN, LPC, LCSW, PhD, CPRP – all of whom are affiliated with a local mental health
provider group or Managed Care Organization.
Projected CMS Revenue FY 2020, 2021, 2022 Public/Private Secondary
Education Teacher P2P at National Average of CMS Reimbursement x 3-
5 FTE CPS TAY RC
12
Padron & Associates (2019)

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32
Base Project RevenueForecast 3-5 Teacher P2P FY2019/20 FY2020/21 FY2021/22
Revenue
Crisis Intervention (Adult, age 21 - 999)
$14,166 $162,906 $155,823
Crisis Intervention (Child - Youth, age
3-20) $2,402 $14,412 $12,010
Skills Training & Development (Adult,
age 21-999) $28,022 $168,134 $154,123
Skills Training & Development
(HQ=Group) $1,001 $6,505 $8,257
Skills Training & Development (HA, HQ,
age 3-20) $1,001 $6,505 $8,257
Skills Training & Development (HA = 1:1;
age 3-20) $1,224 $2,448 $2,244
Medication Training & Support (Adult, age
21-999) $3,031 $18,184 $16,669
Medication Training & Support (Child -
Youth, age 3-20) $3,897 $4,546 $0
Psychosocial Rehabilitation Service
(ET; age 18-999) $12,065 $72,388 $66,356
(HQ, TD; age 18-999) $6,032 $36,194 $33,178
(TD; age 18-999) $0 $0 $0
Adult Day Program for Acute Needs (age
18-999) $5,448 $32,686 $27,238
Case Management &
Rehabilitation Services (0-20) $170 $1,020 $935
90792 Case Management &
Rehabilitation Services (21+) $0 $0 $0
Total Revenue $78,459 $525,928 $485,090
Direct Cost, 3-5 Teacher P2P
Crisis Intervention (Adult, age 21 - 999)
$1,632 $18,768 $17,952
Crisis Intervention (Child - Youth, age
3-20) $408 $2,448 $2,040
Skills Training & Development (Adult,
age 21-999) $4,760 $28,560 $26,180
Skills Training & Development
(HQ=Group) $160 $1,040 $1,320
Skills Training & Development (HA, HQ,
age 3-20) $170 $1,105 $1,403

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33
Expense Outlay (3-5 TAY CPRS)
Medication Training & Support (Child -
Youth, age 3-20) $1,224 $1,428 $0
Psychosocial Rehabilitation Service (ET;
age 18-999) $1,904 $11,424 $10,472
Psychosocial Rehabilitation Service (HQ,
TD; age 18-999) $952 $5,712 $5,236
Psychosocial Rehabilitation Service (TD;
age 18-999) $0 $0 $0
Adult Day Program for Acute Needs (age
18-999) $952 $5,712 $4,760
Case Management & Rehabilitation
Services (0-20) $4,793 $28,757 $26,360
Case Management & Rehabilitation
Services (21+) $0 $0 $0
Total Direct Cost $19,131 $113,114 $103,203
Gross Margin $59,328 $412,814 $381,887
Gross Margin % 76% 78% 79%
Direct Applications
1) Teacher P2P Triaging in application utilizing the Georgia Model13;
2) Teacher P2P | TAY CPS RC | Crisis Investment supporting all/any applications
(2019).
The Teacher P2P Training
A Two Day Training held on-site with Teachers in schools designed for specific MH, SUD,
Crisis Investment Services (Zero Tolerance Bullying, Suicide/Homicide Prevention, Education,
Outreach and Community Engagement).
13
Charles R. Drew High School Secondary School CPS TAY RC Model (2018), Padron & Associates.

Page
34
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For More Information
Jennifer M. Padron, CPS, ACPS, CHW, M.Ed
2114 Pinehurst Drive
Atlanta, GA 30344
(706) 391-3864 text/voice/video
jennifermpadron@gmail.com
Padron & Associates © 2019
All Rights Reserved.

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