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Peer Support Services (PSS)

OPTUM IDAHO LEVEL OF CARE GUIDELINES: PEER SUPPORT SERVICES– IDAHO MEDICAID
BH803IDPSS_012017 Page 2 of 5 Level of Care Guidelines: Peer Support Services – Optum Idaho Effective July 2017 Proprietary Information of Optum. Copyright 2017 Optum, Inc

Peer Support Services: Peer Services are recovery support services in which a Certified Peer Support Specialist utilizes his/her training, lived experience and experiential knowledge to mentor, guide and coach the member as he/she works to achieve self-identified recovery and resiliency goals. These services are designed to promote empowerment, foster self-determination and choice, and inspire hope as the member progresses through the recovery process.

Peer support services are typically delivered to a person with a serious mental illness or co-occurring mental health and substance use disorder who is actively involved in their own recovery process. This specialized support is intended to complement an array of therapeutic services and may be offered before, during, or after mental health treatment has begun to facilitate long-term recovery in the community. The relationship between the Peer Support Specialist and member receiving services is highly supportive, rather than directive. The duration of the relationship between the two depends on a number of factors such as how much recovery time the member has, how much other support the member is receiving, or how quickly the member’s most pressing problems can be addressed.

Components of Peer Support Services may include:

  • Assistance with setting recovery goals, developing a recovery action plan, a relapse plan, solving problems and addressing barriers related to recovery;
  • Encouraging self-determination, hope, insight, and the development of new skills;
  • Connecting members with professional and non-professional recovery resources in the community and helping members navigate the service system in accessing resources independently;
  • Facilitating activation so that the member may effectively manage his/her own mental illness or co-occurring conditions by empowering the member to engage in their own treatment, healthcare and recovery;
  • Helping the member decrease isolation and build a community supportive of the member establishing and maintaining recovery.

These criteria should be used in conjunction with the criteria for the admission and continuing service criteria to manage initial and ongoing services.