A peer provider is someone who has experiential knowledge of the healing process of recovery from mental health or substance abuse challenges, either from their own experience, or as a parent or family member, and works with clients who have these challenges. Different factors have contributed to the development of paid peer staff—also called Peer Specialists and/or Peer Counselors—in the mental health and substance abuse treatment fields in the United States. As of 2012, 23 to 35 states were providing certification for Peer Support Specialists, and 4 or 5 states providing Family Support Specialist certification, primarily focused on mental health services. State certification titles and requirements vary across states.

For this study, we conducted case studies in 3 states that exemplify best practices in peer provider training, employment, and reimbursement for both Mental Health (MH) and Substance Abuse (SA) peer providers. We examined:

• Which states have implemented CMS-approved billing for peer providers in MH and SA, and what billing approaches they use;
• The models of care in states with successful practices in peer provider employment in MH and SA;
• The skills and training required of peer providers to provide care, and for certification;
• The roles and functions of the peer provider in MH and SA care teams;
• The impact of implementing peer provided services on the roles and responsibilities of other members of the healthcare team;
• How well accepted MH and SA peer providers are by other members of the healthcare team; and
• How the implementation of peer provided services impacts the level of service integration