New National Standards for Peer Support Workers
“States recognize the value that the peer workforce brings to behavioral healthcare and are exploring ways to support and advance these critical services” — SAMHSA spokesperson
SAMHSA recently released national model standards for certifying peer support workers. The primary goal of improving standards and certification processes for peer support specialists is accelerating the universal adoption, recognition, and integration of the peer mental health workforce across domains of the healthcare system. SAMHSA collaborated with federal, state, tribal, territorial, and local partners, including peer specialists, to develop national standards inclusive of substance use, mental health, and family peer certifications. These standards aim to mitigate the behavioral health workforce shortage by improving quality and access to a natural, humanistic, and effective form of care that is currently underutilized.
In March of 2022, President Biden announced his administration’s strategy to address our nation’s mental health crisis. This national mental health strategy seeks to strengthen system capacity, connect more Americans to care, and create a continuum of support — transforming our health and social services infrastructure to address mental health holistically and equitably. A major goal within this systemic strategy is facilitating the adoption and implementation of a broader and versatile peer support workforce across the spectrum of healthcare sectors.
Peer support services have gained recognition over the past several decades as a vital component of mental and behavioral health services. Peer support workers use their lived experience of recovery, combined with professional training and supervision, to assist people in initiating and maintaining recovery. Through shared understanding and mutual empowerment, peer support workers can fill the gaps in support that clinical care cannot reach. A robust body of empirical evidence support peer specialists’ effectiveness in a myriad of positive outcomes including increased treatment retention, improved access to social supports and other social determinants of health, as well as reduced misuse recurrence, criminal justice involvement, and recidivism to hospitalizations and residential treatment (see our prior post for references). These benefits would not only improve care and health outcomes but also significantly lower the overall cost of behavioral healthcare.
The need for standardized national standards arises from the growing demand for consistency, competence, and accountability in this evolving field. These standards act as a benchmark — ensuring that individuals seeking peer support receive the highest quality of care, regardless of their location. Additionally, issues including reimbursement and state license requirements have set up barriers that organizations face when attempting to employ the peer workforce. While the new standards do not substitute for any state certification, their goal is to hasten universal adoption, recognition, and integration of the peer mental health workforce across the country.
There are over 30,000 people who have overcome addiction and struggles with mental health that want to assist those who are currently struggling, Samir Malik, CEO of firsthand, told Behavioral Health Business. These national standards are a formative guide in the efforts to fulfill workforce gaps — and the growing need for peer support specialists to use their lived experience and versatile skillset to help individuals navigate their lives and stay on track with their self-directed goals and values. The model standards aim to standardize certification across the different forms of peer support — mental health, substance use, and family support — while recognizing the commonality and differences between them. SAMHSA outlines the education, hours of training, work experience, and examination requirements for peer support workers
The introduction of these new national standards on peer support certifications marks a significant milestone in the field of behavioral health services. These standards have the potential to elevate the quality, accessibility, reach, flexibility, and acceptability of peer support services — ensuring that individuals receive consistent, competent, and ethical care. As peer support continues to gain recognition and impact lives in its natural, humanistic form — the peer workforce will further solidify its position as an invaluable resource on the path to recovery and well-being.
Reach out to Manifesto directly at info@manifestohealth.com to learn more about how we can enhance your patients, members, or employees health and wellness for the long run.
Dr. Mullen's Dissertation Study: Mental Health Professionals’ Perception of Medications for Opioid Use Disorder
The DEA appears to have filed for a temporary extension of telehealth flexibilities for medications for opioid use disorder (MOUD) beyond the public health emergency.
Our Chief Clinical Officer & Cofounder, Dr. Patrick Mullen's study—recently published online in Philadelphia College of Osteopathic Medicine’s Digital Commons—may shed some light on why reinstating restrictions on MOUD is something we should reconsider:
- Medications for opioid use disorder work. The evidence is unequivocal: MOUD keep people alive and significantly improve treatment outcomes (with or without adjunctive therapy) *
- Currently, MOUD is markedly underutilized in opioid use disorder (OUD) treatment. Merely one-third of substance use disorder treatment centers offer any form of MOUD and only 30% of individuals with OUD (the small portion that are diagnosed and treated) receive any form of MOUD. *
- In this survey of OUD professionals (clinicians or researchers that work directly with individuals with OUD) aimed to examine characteristics of groups (clinicians vs. researchers, years of experience in the OUD field, and direct exposure to MOUD) in relation to their utility ratings of MOUD (how “helpful” they rated the use of MOUD in treating OUD)
- Statistically significant differences between groups were found. Researchers rated MOUD significantly more favorably than clinicians. Professionals with more than 10 years in the field rated MOUD more favorably than professionals with less than 10 years of experience.
- What do this study's results indicate? Researchers and longer-tenured professionals have more access, exposure, and contribution to the scientific literature as well as real-world experiences with the OUD population and are therefore more aware and supportive of the effectiveness of MOUD.
- The study’s results suggest that the perception of MOUD could be enhanced by an increase in training and education.
- Here are some suggestions: (a) Targeted training that emphasizes the efficacy of medications, portrays OUD as a treatable condition, and illuminates personal narratives of people who are effectively treated with MOUD; (b) Academic detailing that involves visits to health care providers by trained professionals who can provide tailored training and technical assistance specifically designed for MOUD education and; (c) Improvements in continued education requirements for SUD professionals and nonclinical support staff.
- While it is encouraging to see behavioral health startups (e.g., Workit Health, Eleanor Health, Quit Genius) aiming to improve access to MOUD, recent barriers demonstrate that the misguided stigma associated with OUD in general, and MOUD in particular, persist.
Find the full publication here: Dr. Mullen's Dissertation Transcript
Why Does Recovery Capital Matter Now More Than Ever?
Recovery Capital (RC) are the resources that people in recovery rely on to sustain and enhance their lives—internal resources such as coping skills, resiliency, and perseverance as well as external assets such as supportive relationships, peer support, and meaningful work/employment.
Although the term was coined over 20 years ago (Granfield & Cloud, 1999), RC’s utility is only recently getting the attention it deserves. RC can be categorized in the following domains: (a) personal capital (qualities such as resiliency); (b) social capital (networks and supports that the individual can draw from) and (c) community capital (resources from the individual’s local community such as affordable housing and training/employment opportunities; Best & Laudet, 2010).
Why does Recovery Capital matter now more than ever? RC transcends traditional health screening and offers a more comprehensive picture of how an individual is doing on their recovery journey—identifying both strengths and areas for growth. In other words, RC is a currency of recovery—a measure of how much recovery an individual possesses at a moment in time.
RC enables a more meaningful and comprehensive assessment of recovery—insights into indicators and predictors such as global health and wellness, nutrition, social connectivity, employment satisfaction, socioeconomic status, relationship health, educational interests, and skill-building.
For example, RC enables an individual in recovery and their care team (e.g., a Manifesto peer recovery coach) to gain well-rounded insights into their strengths and potential risk areas while tracking useful outcomes and informing targeted and timely interventions. At Manifesto Health, we use RC as our barometer for progress—enabling a higher level of personalization for our nonclinical support services (in stark contrast to the one-size-fits-all addiction treatment approach).
Moreover, RC provides other stakeholders in the measurement and outcomes of treatment (e.g., providers, payers) a valid, reliable and standardized tool. This holistic measure of recovery transcends the limited and reductive measures of old—such as only tracking substance use recurrence or treatment recidivism.
RC gets us closer to an empirically testable science of recovery—one that upends traditional addiction science that emphasizes pathology over strengths and capabilities. Capturing and measuring recovery pathways and trajectories is a work in progress in addiction research. RC offers an empirically-driven and culturally-appropriate method that can accelerate addiction science and identify the elusive indicators and predictors of recovery.
As the evolution of value-based care in behavioral health continues to emerge, measurement and outcome tracking will take on a new level of necessity—and for good reason! We cannot manage (i.e., change/improve/modify/test) what we don’t measure—and Recovery Capital measures what matters.
Behavioral Healthcare Industry Outlook Panel
Join us on May 19th for the first of our live webinar series, Behavioral Healthcare Industry Outlook, featuring leading voices in the behavioral health industry.
With an estimated one in four adults having a diagnosable mental health condition and over 60 million people using substances, the need for person-centered, culturally appropriate, high quality behavioral health treatment has become a top priority in the United States. These disturbing statistics have led to a nationwide push to enforce parity laws, prioritize health equity, and integrate physical and behavioral health. In addition to expanding access and proving the care being offered is effective, stakeholders in the behavioral health field are calling for a corresponding change to the reimbursement model, one where incentives are based on value instead of volume. The result has been an accelerated push towards Value-based Care (VBC) contracts.
Hear from the expert panelists:
Tony Rocchino, Former Health Insurance Executive
Serenna MacLachlan MS, MAC, CADC-III, QMHP, CEO, SLO Recovery Center
Stu Segal, Owner & Consultant, @Strategic Solutions in Health
Eric J. Gremminger, ICADC, SAP Gremminger, Co-Founder & CEO, ERPHealth
Mike Lifshotz, Chief Executive Officer, Hatch Compliance
Gregory Keilin, Co-Founder / Chief Strategy and Growth Officer, Prosperity Behavioral Health
Nick Jaworski, Chief Executive Officer, Circle Social Inc.
Ben Dittman, Senior Vice President, Partnerships - Kipu Health
Dan Hilferty Jr., Co-Founder & CEO, Manifesto Health
Moderated by Cori E. McMahon, Psy.D., NCCE, Chief Clinical Officer at ERPHealth
Sign up today: https://lnkd.in/g86_dCTi
Collegiate Recovery Program (CRP) Resource Fair at Holy Family
Can't wait to support the Collegiate Recovery Program at Holy Family University led by our friend and fellow advocate, Dr. Patrick McElwaine!
Join us and many other recovery resources on Saturday, May 6th for this FREE community event that promises to be fun & impactful!
The Evolution of Value-Based Care Publication
We are excited to present the new value-based care provider resource, the Value-Based Care Roadmap. This roadmap is designed to be an industry-leading guide for addiction treatment and mental health providers as the industry shifts from fee-for-service to value-based care.
Access it for free here: The Evolution of Value-Based Care
In this publication, you will find articles and interviews from nearly a dozen leading experts in the behavioral health field. They share best practices and recommendations for how providers can thrive in value-based arrangements.
Tapping into decades of experience and perspectives from multiple stakeholders, the Value-Based Care Roadmap offers a comprehensive understanding of value-based care and is a resource that providers will be able to visit again and again to navigate the rapidly changing reimbursement landscape.
Be sure to check out Chapter 7 titled, “Peer Support Workers in VBC” where our cofounders Pat and Dan delineate the role of peer support as an innovative solution—along the continuum of care—in the transition to VBC arrangements.
A big thanks to our partners at ERPHealth for masterfully producing this roadmap.
Peer Support Workers are an Underutilized Solution the Behavioral Health Industry Needs
The research is clear—peer support works. If you’re looking to check out the robust empirical support for the effectiveness of peer coaching, check out our prior blog post: The Impact of Peer Recovery Coaching.
At Manifesto Health, our peer recovery coaches extend care into real-world scenarios where it’s needed most—such as returning home after treatment, going back to work, and reaching the crucial one-year mark in recovery.
Our peer support workers use their lived experience of recovery, combined with our extensive and continuous training/supervision, to assist people in initiating and maintaining recovery. Through shared understanding and mutual empowerment, peer support workers can fill the gaps in support that clinical care cannot reach.
We want to be deliberately clear here: our peer-led support is not a replacement for clinical services such as psychotherapy and medications—but it can enhance and reinforce them. Moreover, individuals in different stages of their recovery may not elect to use clinical services (or may not have access to them), but could benefit from accessible and affordable peer support.
There’s an estimate of over 20 million individuals in recovery living in the US. While not everyone in recovery will choose to be a peer support worker, even a small portion of the recovery population that elect to become peer support workers can fill the problematic shortages of behavioral health professionals.
Currently, the shortage of behavioral health providers is posing a major barrier to effective care—and people in need are paying the price. Furthermore, if the client is willing to tolerate the long wait-lists and limited access, outpatient psychotherapy is expensive and many behavioral health providers do not take insurance because of poor reimbursement rates by insurers.
Peer support services create much greater access to care-delivery by providing localized, affordable, and effective services that keep people connected to care for longer durations. While peer support services are not a replacement for clinical care, they are an underutilized resource that should be implemented in more outpatient settings along the continuum of care.
In Pennsylvania, approximately 55% of SUD treatment centers offer peer services of some kind. However, most of these services are limited to a few peer staff that support inpatient clients. Employing peer support workers in greater numbers in outpatient settings is the key to facilitating long-term engagement and connection to the continuum of care. A commitment to long-term recovery is no easy feat—and should come with a longer-term support plan than clinical treatment typically offers.
Simply put, addiction is a behavioral condition that requires long-term engagement for the best likelihood of sustained behavior change. At Manifesto Health, our peer recovery coaches offer accessible and affordable support with understanding and empathy that only a peer can offer.
Behavioral Health Business VALUE Conference
Behavioral Health Business presents VALUE, a conference for industry executives focused on the future of value-based care in behavioral health.
C-suite executives and thought-leaders look to define the conversation around this and future payment models in behavioral health care.
Who You Can Expect to Meet at VALUE:
- Behavioral health owners and operators
- Payers, insurers and health systems
- Investors and capital providers
- Technology providers
How can peer support workers help to accelerate value-based care arrangements?
We will be answering that question and more alongside industry leaders in Outcome Tracking (ERPHealth) and EMR (Kipu Health) at next week's VALUE conference!
What is the Cost of SUDs for Employers, Employees, and their Health Insurance Payers?
A recently-published JAMA study titled, Medical Costs of Substance Use Disorders in the US Employer-Sponsored Insurance Population, examined the research question: What is the medical cost of substance use disorders (SUDs) for US employers, employees, and their health insurance payers?
The answer: of the 162 million non–Medicare eligible enrollees with employer-sponsored health insurance (ESI) in 2018, 2.3 million had an SUD diagnosis. The annual attributable medical expenditure was $15,640 per affected enrollee and $35.3 billion in the population.
The authors said it best, so we’ll highlight their words:
- “The cost of strategies to support employees and their health insurance dependents to prevent and treat SUDs can be considered in terms of potentially offsetting the existing high medical cost of SUDs.”
- "Not all people with SUDs have a diagnosis, and costs related to absenteeism, presenteeism, job retention, and mortality are not addressed.”
- “In this study, 1% of the ESI population had an SUD diagnosis compared with 11% of workers who self-report SUD, suggesting the medical cost that employers and their health insurance payers face is likely far higher than reported here. Employers can take action by developing workplace-supported prevention, treatment, and recovery programs.”
Is your workplace Recovery-Ready? Manifesto Health will co-create your workplace-supported recovery program. Let us help you lead the way!
Creating Recovery-Ready Workplaces
In April, the Biden administration released its National Drug Control Strategy as a comprehensive outline to address the current opioid crisis. In response to the harrowing number of overdose deaths in 2021 (≈106,000 lives), the 127-page document prioritizes actions that will save lives and get people the care they need.
The Strategy defines the four major dimensions of recovery as home, health, purpose, and community. Thus, recovery is measured by recovery capital—the resources that individuals develop and rely on to sustain and enhance their lives in recovery. Examples of recovery capital include internal resources such as coping skills, resilience, and perseverance as well as external assets such as family, a supportive community, and employment or meaningful work.
A major focus of the Strategy is creating Recovery-Ready Workplaces, characterized by effective policies and procedures that:
- Expand employment opportunities for people in or seeking recovery
- Encourage and facilitate help-seeking among employees with substance use disorder - Streamline access to essential services including treatment and recovery support - Inform employees in recovery about their rights to reasonable accommodations and other protections to help keep their jobs
Recovery-ready workplaces can be instrumental to employers, employees, and the broader public in reducing turnover, enhancing productivity, reducing health care costs, expanding the workforce, and promoting overall well-being and recovery.
Employers can be at the forefront of combating stigma and misunderstanding by fostering a conscientious and compassionate culture that recognizes SUD as a health condition and welcomes and supports individuals in or seeking recovery.
Is your workplace Recovery-Ready? Lead the way!
