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* 1. Name

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* 2. Organizations's name

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* 3. What state does your program operate in?

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* 4. Is your state currently actively certifying family/parent peers?

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* 5. Does your state require certification for family/parent peer support providers?  If yes, what organization/entity provides certification?

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* 6. Does your state offer family/parent peer support as a Medicaid reimbursable service?

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* 7. What types of funding other than Medicaid is available for family/parent peers?

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* 8. Does your state currently accept national certification in lieu of state certification?

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* 9. Is being a parent/caregiver of a child
with behavioral health challenges a
requirement to be a family/parent
support provider?

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* 10. Please send the Core Compentencies used by your state to Mcovington@ffcmh.org or insert link below

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* 11. Please send a copy of the job description you use for Family/Parent    Support Providers to Mcovington@ffcmh.org

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* 12. Who is the designated person for your agency to work with the Federation on
this project?

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