Y E S T E R DAY , T O DAY , T O M O R R O W

JDTR PEER SPECIALISTS

CRPS-V

Certified Recovery Peer Specialist – Veteran

The Peer Support Policy issued in the August 15, 2007 State Medicaid Director Letter : Per SMDL #07-011, “as States develop behavioral health models of care under the Medicaid program, they have the option to offer Peer Support services as a component of a comprehensive mental health and substance use service delivery system.” Peer Support services can be offered for mental illnesses and/or substance use disorders.

FLORIDA DEPARTMENT OF CHILDREN AND FAMILY SERVICES

ANDFLORIDA CERTIFICATION BOARD

Created the first (veteran specific) certified credential for peers hired by the Hillsborough County JDTR OEF/OIF Grant Project.Individuals holding the CRPS-V credential are veterans who are competent and certified to provide recovery support to other veterans facing mental illness, substance abuse, or trauma issues. 

EVIDENCE BASED PRACTICE

• For hundreds of years, peer support has been a recovery strategy for people wrestling with alcoholism or post-traumatic stress — Native Americans were utilizing it as far back as the 18th century. But the U.S. health system didn’t fully embrace peer support for people suffering from mental illness until less than a decade ago, when multiple state-run Medicaid programs began to pay for it. (See Stateline map)

• In 1999, Georgia became the first state to get federal approval to pay for peer services through Medicaid. The program was such a success that by 2007, the federal Centers for Medicare and Medicaid Services (CMS) urged other states to follow Georgia’s lead. Since then, at least 30 states and the District of Columbia have launched peer programs. Several others are seeking federal approval.

FILLING THE GAPS

• Beyond Medicaid, at least as many states are spending scarce mental health dollars to train and certify peer specialists to work in a variety of public and private settings. One such program, called peer mentoring, assigns a peer specialist to an individual who is discharged after a long-term stay in a state mental hospital. By helping discharged patients find housing, employment and social support, peer specialists have succeeded in lowering readmissions. 

• Private insurers and other public programs such as the Veterans Administration are also ramping up their use of peers, in part to fill a widening gap in the number of clinically trained mental health workers.

ORGANIZATIONAL SUPPORT

• “Peer support is absolutely part of a national strategy to get more boots on the ground quickly,” says Sita Diehl, who heads state policy for the National Alliance on Mental Illness. “Because of their life experience and their relatively low cost, they can provide more face time for people with serious mental illness.”

TEAM SUPPORT

• Diehl cautions that peers should not be placed into volatile situations without being backed up by medical professionals. But she says the concern is only theoretical so far: CMS rules require peers to work under the supervision of mental health professionals.

COST EFFECTIVE

• In Georgia, a 2003 study compared patients diagnosed with schizophrenia, bipolar disorder and major depression whose treatment had included peer support, with patients who received traditional day treatment services without peers.  The patients who had peer support had better health outcomes—and at a lower cost. The average annual cost of day treatment services is $6,400 per person, while support services cost about $1,000.

IMPACT OF THE ACA

The federal health law will require Medicaid and all other health plans to cover mental health services on par with insurance coverage of physical illnesses. It also will add an estimated 8 million people to the Medicaid rolls in the first year, many of whom will have untreated mental illnesses. Another 7 million people are expected to get federal tax subsidies to purchase health insurance, many for the first time.

• That surge in demand, combined with an already severe shortage of mental health workers, has many worried there won’t be enough providers to serve everyone in need. States have deployed a variety of strategies to alleviate the longstanding shortage of mental health professionals. But experts agree peer specialists are the most successful.

MORE POSITIVE EVALUATIONS

• Research shows that by using peer specialists, states can save mental health money by reducing hospitalizations and other emergency interventions. And people with mental illness who are helped by peers tend to experience more thorough and longer-lasting recoveries.

“They are a terribly important new addition to the workforce,” says Bob Glover, director of the National Association of State Mental Health Program Directors. “When peers are involved, outcomes are dramatically better across the board,” he says.

VA PEER SPECIALISTS

• In April of 2013 The Department of Veterans Affairs (VA) started hiring more than 800 Peer Specialists and Peer Support Apprentices to help their fellow Veterans walk a mile in the shoes that lead to better lives and peace of mind. Peer Specialists and Peer Support Apprentices are Veterans and transitioning military personnel who have been successfully and actively engaged in their own mental health recovery for a minimum of one year. Peer Specialists are trained and certified, while Peer Support Apprentices will be expected to go through training for their certification once hired.

DBSA PEER SPECIALIST TRAINING

Currently the VA has a contract with DBSA to provide CRPS-V training. Non VA employees may also acquire training from DBSA which can be used to obtain certification and/or employment outside of the VA.

JDTR COHORTS

• Colorado Mental Health Division, Denver, CO• Connecticut State Department of Mental

Health and Addiction Services, Hartford, CT • Georgia State Department of Human

Resources, Atlanta, GA• Illinois State Department of Human

Services, Chicago, IL• Massachusetts State Department of Mental

Health, Boston, MA• Vermont State Department of Health,

Burlington, VT

• Florida State Department of Children and Families, Tallahassee, FL

• New Mexico State Human Services Department, Santa Fe, NM

• North Carolina State Department of Health and Human Services, Raleigh, NC

• Ohio State Department of Mental Health, Columbus, OH

• Pennsylvania Office of Mental Health and Substance Abuse, Harrisburg, PA

• Rhode Island State Department of Mental Health, Retardation and Hospitals, Cranston, RI

• Texas Department of State Health Services, Austin, TX

TOOLS

• The GAINS Center website: http://gainscenter.samhsa.gov

• The GAINS Center Virtual Learning Community:http://gainscenter.samhsa.gov/forms/join_virtual_learning.asp

• PeerShare on the GAINS Center VLC:http://gainscenter.samhsa.gov/peer_resources/peershare.asp

The Roles of Peer Specialists

Our roles in crisis support

Our roles in development of community roles/natural supports

Our roles in Individual Advocacy

Our roles in Self-Help /Self-improvement

Roles in wellness/recovery

Roles in social networking

How we can help them remain out of jail

NATIONAL VETERANS PEER COALITION

The National Veterans Peer Coalition with PRA and SAMHSA’s GAINS Center has recently formed out of the JDTR OEF/OIF Project. The coalition’s purpose is to highlight the growing demand and facilitate an information resource for Certified and non-certified Veteran Peer Specialists across the nation.

THE VALUE OF PEER INVOLVEMENT

• View project and services through different lenses

• Ability to identify what core project components • have the most significant impact in such areas as • recovery, wellness and recidivism

• Best evidence

LEVERAGING PEER INVOLVEMENT

• Videotape stories and include testimonials in • grant applications and updates to stakeholders

• Members of teams that engage public officials and

• potential funders

FUNDING PEER SUPPORT COMPONENTS OF PROJECTS

• Block Grants

• SAMHSA Peer Support Grants

• VA

• State Department of Veteran Affairs

• Medicaid

• MCO’s

JUSTICE AND TREATMENT PROFESSIONALS, PEER SPECIALISTS AND VOLUNTEER MENTORS

December 2-5, 2013 in Washington, DC. Vet Court Con is the first gathering of Veterans Treatment Court personnel ever assembled. With an expected attendance of 1,000 justice and treatment professionals, volunteer mentors and nationally recognized experts, Vet Court Con will host over 75 training sessions, including more than 150 hours of education and the first class of the Justice For Vets Veterans Mentor Corps Bootcamp.  For more information and to register, visit Vet Court Con Registration at Justice For Vets.

THE FUTUREWhole HealthThe next step is to train peer specialists to help people in recovery improve and maintain their physical health. On average, people with serious mental illness die 25 years earlier than the general population, largely due to preventable conditions such as diabetes and cardiovascular disease, according to a 2006 study by medical directors in state Medicaid programs.“I’ve never seen anything like it,” says consultant Larry Fricks, who is credited with starting the peer program in Georgia.  The peer program caught on pretty quickly, he says, “but this is where the workforce is really going to take off.” Last June, Georgia got federal approval to bill Medicaid for peer support specialists who provide health coaching. Since then, Fricks and his colleagues have been travelling across the country training peers on what is known as Whole Health Action Management or WHAM.

Resources

SAMHSA GAINS Center for Behavioral Health Justice Transformation

gainscenter.samhsa.gov

PRESENTED BY

Kevin EdwardsStatewide Veterans Advisory CouncilVeteran Representative