Certified peer specialists and recovery specialists are an essential part of the mental health workforce. The “lived experience” of peer specialists has a value typically not offered by other mental health providers. Peer support services can include services to promote hope, socialization, recovery, self-advocacy, development of natural supports and maintenance of community living skills. The inclusion of peer support services in the service array increases the likelihood of recovery which reduces the high costs associated with people cycling through emergency rooms, county and city jails and state mental health facilities.[i] In addition, the inclusion of peer support services reduces the stigma of mental illness by demonstrating recovery is not only possible—it is expected.
Texas has undergone a thoughtful and thorough process to develop certification requirements for mental health peer specialists and substance use recovery specialists. Via Hope is the organization authorized by the Department of State Health Services (DSHS) to certify peer specialists and is jointly funded by DSHS and the Hogg Foundation for Mental Health. Substance use recovery specialist certification is provided by Texas Certification Board of Addiction Professionals. There are currently more than 450 certified mental health peer specialists and over 300 certified recovery specialists in Texas.
There are many settings in which peer support services could help reduce costs and achieve better outcomes for individuals. Under current rules, Medicaid reimbursement for these services is only available when services are provided through the local mental health authorities. Expanding the option to receive support from certified peer specialists in other settings would increase opportunities for recovery. Prime settings for these services include hospital emergency rooms, integrated health care settings, community health clinics, intake units, criminal/juvenile justice settings, and more.
Recommendations:
- DSHS and HHSC should jointly develop a distinct Medicaid state plan service for peer support services, designating certified peer specialists and certified recovery specialists as approved providers.
- Direct HHSC to develop rules defining peer support services, certified peer specialists and certified recovery specialists. The rules should also specify requirements for peer certification and supervision and any other relevant issues identified by the executive commissioner as necessary to promote health and safety in peer specialist/recovery specialist services. Development of the rules should include input from certified peer specialists, certified recovery specialists and other relevant stakeholders.
[i] U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Division. (2012). With peer support, recovery is possible. SAMHSA News, Vol. 20, No. 3. Retrieved at http://www.samhsa.gove/samhsanewsletter/Volume_20_Number_3/peer_support.aspx