Medicaid regulations significantly limit the ability of peer-run Recovery Community Organizations (RCOs) to access Medicaid reimbursement for peer recovery support and family support partner services. Scientific evidence shows that these services are effective at addressing mental and behavioral health challenges. Much of this evidence comes from research into peer support services provided by non-clinical, peer-run organizations that are the founders and champions of a peer recovery movement dating back almost a century. Unfortunately, regulations were designed to only provide reimbursement to clinical treatment facilities that include peer support services. As a result, RCOs are entirely dependent on grants and donations that are often not sustainable. 

Expanding access to peer support should be a priority for Virginia, particularly the growth and sustainability of peer-run RCOs that are BIPOC-led and LGBTQ-led, as well as located in rural, inner-city and other communities experiencing behavioral health disparities. We recommend that DMAS use available funds to pilot new Medicaid payment mechanisms to fund RCOs directly for peer recovery support and family support partner services. These pilots should not require RCOs to be sub-contractors of clinical treatment facilities or supervised by clinical treatment facilities. They also should streamline the processes or provide technical assistance to help RCOs register with Medicaid and negotiate contracts with managed care organizations.

Strength In Peers is a nonprofit, peer-run Recovery Community Organization. More than half of our Board of Directors and all staff are in active recovery from substance use, mental health and trauma-related challenges. Our mission is to offer hope, support and advocacy for those seeking recovery so that they can build resilience and thrive in their lives and communities. We operate jail and street outreach, needle exchange and other harm reduction services, HIV and Hepatitis C testing, a community recovery and resource center, and comprehensive integrated peer and clinical recovery programs. We serve between 800 and 1,000 individuals per year across our service area that includes the City of Harrisonburg and the Counties of Page, Shenandoah and Rockingham.