Opportunities for Peer Services in Healthcare Reform

October 17, 2012
Written by Sharon Kuehn

Healthcare Reform is no longer looming large on the horizon. It has arrived! Changes are underway here in Alameda County and in many other counties and states across the nation. Early preparations are finished, and the Healthcare Home will soon be as familiar to us as our local drop-in centers (I'll go more into details about Healthcare Homes later).

Harvey Rosenthal of NYASPRS, Amy Colesante of the Mental Health Empowerment Project and Sarah Goodman of Baltic Street (the largest peer-run agency in NYC), led an excellent workshop on the opportunities for peer services in Healthcare Reform.  We learned about ensuring the involvement and integrity of peer support services in new, federally funded and integrated healthcare services. Their stories of leading the process as peer support champions in New York State gave me hope. We must make our case with clarity, conviction and solid data that peers can most effectively carry out specific aspects of community healthcare. Our skills in outreach and engagement are unparalleled. Our ability to provide compassionate, heart connections and tried-and-true recommendations on resources, are the result of our lived experience with skills honed by quality peer- training programs.  We can provide outreach, engagement, peer support, coaching, bridging and systems navigation most effectively. As peers, we play a critical role in creating new networks of care that serve people’s whole health needs. We are an essential part of the solution in creating high quality healthcare. Our work helps cut costs by reducing the need for expensive (and often traumatizing) medical interventions such as hospitalizations and emergency room services.

Rosenthal said that a major goal in healthcare reform is to provide “upstream” services that will prevent unnecessary visits to the hospital or emergency room. Peer support is particularly effective in assisting people with their wellness self-management, and helping them work on underlying needs and issues before they require high-end services. Here in California, we are uniquely challenged to address this critical statewide advocacy need without the benefit of a fully funded, statewide, consumer organization.  All hands on deck! Local consumer organizations will need to step up to the plate so that we have strong peer representation on the California Coalition for Whole Health and other formative workgroups for California Healthcare Policy as Mental Health funding shifts toward blending with Substance Abuse and Primary Healthcare funds.

One of the major changes under Healthcare Reform is the formation of Health Homes. These are hubs or networks of services that include such "upstream services" as social services and on the ground support for people who are considered to have high needs and high health costs. Health Homes provide care management for all related needs in one plan. The needs are communicated to all providers through electronic health record. They function like an HMO in that they are paid a monthly rate per person per month. Health Homes can use funds to buy Peer Services. Peer provider organizations need to advocate at the state level for this move and market our services. We can do this by using data and providing clear, convincing information about why peer services are a great buy. The goal is to have statewide policy that mandates peer services as an essential aspect of all Health Homes. This would be based on the recognition that we can help people the most by providing high quality services for the least dollars, and keep people out of hospital and emergency room.

The PEERS collaborative program with John George Medical Pavilion is a powerful example here in Alameda County.  Participants who have been hospitalized are paired with a peer mentor. Our data shows a 68% decrease in mentees being re-hospitalized. We know our value. Let’s use all of our skills to measure and market our services to ensure that peer support is not only available, but continues to grow and expand. Let's stay true to our root values as we face the future with unity and strength.

1. Organize Peer Support Organizations and groups
2. Unite on values, services, integrity and how to measure and market these
3. Get to the table on Healthcare Reform
4. Peer Run Agencies to Subcontract with HMOs for Health Homes
5. Do it now! Time sensitive!