Policy Recommendation: Expanding Mental Health Peer Support Services

Recommendation

HHSC and DSHS will identify and implement changes needed to expand the use of certified peer specialists in the provision of mental health services in Texas. This should include, but not be limited to:

  1. Expanding Medicaid reimbursement opportunities for peer support services
  2. Expanding opportunities for consumer operated service programs
  3. Revising current peer specialist supervision requirements to expand supervision options to allow Medicaid reimbursement for peer support services in a variety of settings.

Rules should be developed relating to peer certification and supervision requirements and other issues identified by the executive commissioner as necessary to promote health and safety in peer specialist services. Development of the rules should include input from certified peer specialists and other stakeholders.

 

Background/Justification:

According to the Centers for Medicare and Medicaid Services (CMS), “peer support services are an evidence-based mental health model of care which consists of a qualified peer support provider who assists individuals with their recovery from mental illness and substance use disorders.” Certified peer specialists are approved providers of mental health rehabilitative services under the Texas Medicaid program. Currently, mental health rehabilitative services are authorized through the LMHAs. Consequently, LMHAs and their subcontractors are the only entities that have access to Medicaid reimbursement for peer support services.

Peer support services are not intended to replace other mental health services, but the frequency of other services can be reduced when an individual is supported by a peer, often resulting in lower costs and better outcomes. When peer support services are included within the continuum of community care, the mental health system expands quantitatively by reaching more people, and qualitatively by helping people become more independent.

 

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