The Health Care Authority (Authority) certifies peer counselors under its Peer Support Program.? Certification by the Authority is not necessary to provide peer counseling services, however, it is required for reimbursement under Medicaid. ?The services that may be provided by certified peer counselors are specified in Washington's Medicaid State Plan (State Plan). ?The State Plan authorizes them to provide peer support services which are defined as scheduled activities that promote socialization, recovery, self-advocacy, development of natural supports, and maintenance of community living skills.

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In 2023 legislation established peer specialists as a health profession to be certified by the Department of Health beginning July 1, 2025.? Applicants for certification must submit an attestation that they self-identify as:? (1) a person with one or more years of recovery from a mental health condition, substance use disorder, or both; or (2) a parent or legal guardian of a youth who is receiving or has received behavioral health services.? In addition, they must complete an education course offered by the Authority, pass written and oral examinations, and complete a 1,000 hour supervised experience requirement.

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Beginning January 1, 2027, any person who provides peer support services must be certified as a certified peer specialist or a trainee if the person or the person's employer bills a health carrier or medical assistance program for those services.? "Practice of peer support services" means the provision of interventions by either: ?(1) a person in recovery from a mental health condition, substance use disorder, or both; or (2) the parent or legal guardian of a youth who is receiving or has received behavioral health services.? The interventions are provided to a client through the use of shared experiences to assist a client in the acquisition and exercise of shared skills to support the client's recovery.

Naming of Certified Peer Support Specialists.

The profession of certified peer specialists is changed to "certified peer support specialists."

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Endorsements to Peer Support Specialist Certifications.

Certified peer support specialists may receive an endorsement to their certification from the Department of Health (Department). ?The endorsement is available in three different categories: domestic violence peer support services, sexual assault peer support services, and human trafficking peer support services. ?To receive an endorsement the applicant must:? (1) attest to the Department that the applicant self-identifies as a survivor of either domestic violence, sexual assault, or human trafficking; and (2) complete a relevant education course developed by the Office of Crime Victims Advocacy (Office) ?at the Department of Commerce.?

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Obtaining an endorsement is voluntary, unless a victim services agency seeks to bill medical assistance programs for peer support services provided to a client who is a survivor of domestic violence, sexual assault, or human trafficking. ?In this case, the certified peer support specialist providing the services must have an endorsement in the relevant category.

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By July 1, 2026, the Office must develop courses for certified peer support specialists seeking an endorsement in domestic violence, sexual assault, or human trafficking. ?The courses must cover topics relevant to victim advocacy, including:? (1) safety planning; (2) an understanding of domestic violence, sexual assault, or human trafficking; and (3) advocacy in legal, medical, social services, and other systems. ? The courses must be offered on a regular basis at no cost to the certified peer support specialist.

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Expanded Access to Peer Support Services.

The Health Care Authority (Authority) must contract with at least one external entity to expand access to peer support services. ?The contracts begin October 1, 2025, and require the entity to:

• provide technical assistance to support primary clinics, urgent care clinics, and hospitals to integrate certified peer support specialists into their clinical care models and bill health carriers for the services;
• develop proposals to create low barrier and cost-effective opportunities for:? (1) community-based agencies, such as peer-run agencies, to bill health carriers; (2) service providers, such as law enforcement assisted diversion programs and recovery navigators, to bill health carriers for behavioral health services that are currently funded by the state general fund; and (3) community-based victim services agencies, such as agencies that support domestic violence, sexual assault, and trafficking victims, to bill health carriers for peer support services;
• develop a proposal to establish substance use disorder peer-run respite centers and a billing mechanism for them to use; and
• explore options for health carriers to pay for peer support services through capitated payment arrangements rather than a fee-for-service basis.

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The contracted entities must submit a report to the Authority by November 1, 2026. ?The report must describe the technical assistance provided, the proposals developed, the trends in health carriers providing payment for peer support services, and any recommendations to encourage health carriers to reimburse providers for peer support services.

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Peer Support Specialists in Managed Care Organization Networks.

Among the factors that the Authority must give significant weight to when procuring Medicaid managed care services, is the accessibility of peer services. ?The level of accessibility will be demonstrated in the managed care organization's (MCO's) application through a comprehensive analysis of access to peer services in the MCO's network. ?The analysis must evaluate the availability of peer support specialists who are adults in recovery from a mental health condition or a substance use disorder, youth or young adults who are in recovery from a mental health condition, or a substance use disorder, and parents and legal guardians of youth who are receiving behavioral health services.