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Peer Specialist Programs

Peer specialist programs are non-clinical services and supports provided by peers who have received training on recovery issues and have also had personal experience with substance use disorders. Peer specialists provide services throughout the entire continuum of care by providing emotional support and mentoring, linking patients to information, and helping with practical tasks such as completing paperwork and assisting with transportation. Peer specialists, often in recovery themselves, play a key role in establishing and maintaining social connections in a supportive and understanding environment.

With training, some peers may serve in a more formal role as community health workers (CHWs). CHWs serve as a bridge between the target population and a variety of treatment services organizations. When addressing substance use disorders and the implementation of successful care models, CHWs have the capacity to assist individuals with staying committed to receiving needed healthcare and mental health services. The Affiliated Service Providers of Indiana Network provides a three-day training to certify CHWs, with an optional two additional days of training to obtain a Community Recovery Specialist (CRS) designation. The CRS must attend the total five days of training, be in recovery themselves (either from a mental health issue or substance use disorder), and pass an online examination in order to obtain the CRS certification.

Peer specialists can provide a critical role in rural communities, where there are often few treatment resources and few healthcare providers. The Centers for Medicare & Medicaid Services recognizes peer support services as an evidence-based mental health model and has provided guidelines to states regarding reimbursement for peer-provided services; however, reimbursement rates often vary by setting. An analysis by the Washington State Institute for Public Policy found a $1.20 return on investment for every dollar spent on peer specialists.

Examples of Peer Specialist Programs

  • The Alaska Peer Support Consortium conducts trainings in Peer Support and uses Peer Leads to establish and maintain support and advocacy groups.
  • The Affiliated Service Providers of Indiana Network provides Certified Recovery Specialist trainings to qualifying Indiana-based community health workers and assists with placement in clinics and organizations throughout the state.
  • The Armstrong-Indiana-Clarion Drug and Alcohol Commission's Nurse Navigator and Recovery Specialist Outreach Program in Shelocta, Pennsylvania, has used the CHW model to provide case management services by pairing peer recovery specialists and registered nurses to help patients navigate substance use disorder services.
  • The Marquette Peer Recovery Drop-In Center provides peer recovery support services including peer mentoring and coaching, resource connecting, facilitating recovery groups, and building a safe community for members. The drop-in center is located in Marquette, Michigan, but serves multiple counties in Michigan's Upper Peninsula.

Considerations for Implementation

One major challenge to implementing peer specialist programs in rural communities is convincing healthcare providers that peer specialists offer a valuable service for their practice. And while peer specialist services are reimbursable, the rate of reimbursement can be low.

One way of addressing these concerns has been to establish standardized certification programs for peer specialists. The International Association of Peer Supporters maintains a list of various national training curricula and standards on its website. Certification typically involves coursework, fees, testing, and renewal fees.

CHWs and peer specialists are often members of the communities in which they work and are well positioned to provide culturally sensitive services to the population. Their understanding of their community allows them to develop close relationships with the people they serve, improving quality of care. RHIhub's Community Health Workers Toolkit provides in-depth information on implementing CHW programs in rural settings.

Program Clearinghouse Examples

Resources to Learn More

Community Health Worker (CHW) Toolkit
A toolkit with tools and resources including evidence-based research on the effectiveness of CHWs.
Organization(s): Centers for Disease Control and Prevention

DIMENSIONS: Peer Support Program Toolkit
A toolkit providing an overview and definition of peer specialists and peer support programs as well as information on program planning, education and training, and sustainability of peer support programs.
Author(s): Morris, C., Banning, L., Mumby, S., and Morris, C.
Organization(s): University of Colorado Anschutz Medical Campus, School of Medicine, Behavioral Health and Wellness Program
Date: 6/2015