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Rural Health Information Hub

Peer Specialist Programs

Peer specialist programs offer non-clinical services and supports provided by peers who have received training on recovery issues and have also had personal experience with substance use disorder (SUD). 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. Peer specialists can provide a critical role in rural communities, where there are often fewer treatment resources and fewer healthcare providers.

With training, some peers may serve in a more formal role like a certified peer recovery support specialist. Certification to become a specialist varies by state. Community health workers (CHWs) may also serve as a bridge between the target population and a variety of treatment services organizations. CHWs have the capacity to help individuals stay committed to receiving needed healthcare and mental health services. CHWs can receive additional training to provide support for peers recovering from SUDs. For example, 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.

Examples of Rural Peer Specialist Programs

  • The Montana Warm Line is a toll-free peer support hotline designed to reach people in rural settings with limited access to recovery supports by linking consumers with trained peer support specialists.
  • 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 SUDs.
  • The Marquette County Peer Recovery Services 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. Proponents of peer support models have addressed this barrier by establishing standardized certification programs for peer specialists. The National 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.

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. Learn more about the benefits and costs of the peer specialist program.

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

DIMENSIONS: Peer Support Program Toolkit
An overview of peer specialists and peer support programs with a focus on behavioral health to be used by hospitals, healthcare organizations and community agencies. Offers information on program planning, education and training, and sustainability.
Author(s): Morris, C., Banning, L., Mumby, S., & Morris, C.
Organization(s): Behavioral Health and Wellness Program, University of Colorado Anschutz Medical Campus School of Medicine,
Date: 6/2015