The role peer support specialists play is somewhat similar to that of 12-step group sponsors, with some differences. The Substance Abuse and Mental Health Services Administration (SAMSHA) defines PSS as specialized assistance that is delivered by a person in recovery from a serious mental illnesses, substance use, or co-occurring mental and substance use condition, before, during, and after treatment, to facilitate a recipient’s long-term recovery in the community Adults receiving addiction treatment who also participated in peer support groups reported that the peer support helped them develop behaviors that increased the likelihood of long-term recovery. These behaviors included reductions in substance use, improved treatment engagement, reduced craving, and increased self-efficacy. Further, those who received peer support also reported reduced HIV/HCV risk behaviors. Medicaid is the main payer for peer support services, although many state departments of behavioral health offer grant funding for these services. Currently, 39 state Medicaid programs cover peer support services for either individuals with mental illness, individuals with addiction disorders, or both groups, according to the website OpenMinds.com. But few states are using their Medicaid programs to fund peer services for addiction recovery, at least not through Medicaid. Back in 2007, the Centers for Medicare & Medicaid services encouraged states to start funding peer support as a part of both mental health services and substance abuse treatment. While more than 30 states have started paying for mental health peers, only a handful pay for peers to help with addiction recovery.
If a state Medicaid program covers peer support under the fee-for-service benefit, the health plans providing coverage in that state are also required to cover those services. Some states have special provisions that allow them to only cover peer supports for limited groups of individuals, such as those enrolled in managed care. Some states also allow peer support specialists to act as qualified health care professionals for certain types of behavioral health services, but do not allow for the specific reimbursement of peer support services. According to Open Minds.com, a comparison of Medicaid fee-for-service reimbursement rates for selected states found a wide variation in reimbursement. Group rates for a 15-minute period ranged from less than $2.00, to over $5.00 and individual rates ranged from $6.50 to $24.36 per 15 minutes. Comparatively, average peer specialist compensation was $15.42 in 2015 (see National Survey of Compensation Among Peer Support Specialists). According to the International Association of Peer Supporters, the peer support specialist workforce has been growing and expanding since Medicaid established funding for these services in 2007. A majority of states have developed training and certification standards, and research has continued to expand and support the evidence base for these services. One of the traits that makes peer support specialists different from sponsors is that
they are trained, certified and paid professionals.
Made with FlippingBook - Online Brochure Maker