Report Summary and Next Step

The Pillars of Peer Support Initiative has completed two phases.  The initial phase constructed a series of twenty-five “Pillars” or fundamental principles that support and enhance peer support services.  These were developed in a forum of participants from states that are currently billing Medicaid for peer support services.  Based upon the overwhelming positive response from the field, a second phase was conducted to bring together those states that were not yet billing Medicaid for peer support services.  In many of these states, there is already significant peer work being done throughout the state system.  However, these states lack formal programs and are not yet able to bill services to Medicaid.  

The goal for the second summit was to present key background material that would help the participating states better understand issues and challenges for implementing Medicaid reimbursable peer support services.  The background materials included presentations from subject matter experts in peer support services implementation, the research base for peer support, and survey information on state level implementation of peer support services.  States that participated in the Summit had a variety of representatives, including State Mental Health Commissioners, Medicaid representatives, peer leaders, and other State administrators. 

The Pillars 2 Summit was a success in assembling background materials and convening key stakeholders.  At the state level, processes were generated for how to approach the development  and implementation of Medicaid reimbursement for peer support services.  Barriers and challenges were also identified.  Another valuable outcome was that the Summit helped States to identify areas where they might benefit from technical assistance in their efforts to develop and implement Medicaid-billable peer support services. 

The key next step for the Pillars of Peer Support initiative is the recognition of the many aspects of technical assistance that were identified by Summit participants.  It will be important to foster the development of these resources and to help secure the necessary financial support to make  them available to the states.  This could be accomplished by the development of a technical assistance center that is tasked to help foster the development of and reimbursement for peer support services at the state level.   Another approach would be to establish an ongoing learning  collaborative that brings together key stakeholders, to address ongoing challenges that states experience in developing Medicaid-billable peer support services.  Any such efforts would likely need to be funded at the Federal level.  States are financially strapped, and although there is a clear intent, they are limited by scarce resources. 

There is a unique opportunity for the development of peer support services in state behavioral health care systems.  Medicaid is a viable funding source; however the development and implementation barriers are substantial.  It will be incumbent on the leaders of the Pillars of Peer Support Services initiative, the funders and supporters of that initiative, participants of the two Summits, and other key stakeholders to continue to push the goal of having high quality peer support services available in all states.  Peer support is a fundamental component of recovery and  resiliency, and the development of such services should be a high priority for all funders, providers, and stakeholders in state behavioral health care systems. 

http://www.pillarsofpeersupport.org/POPS2010.pdf