Indiana Certified Recovery Specialist
CRS
 A “new” designation of Community Health Worker
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(CHW)
Not clinicians, “I Am The Evidence”- adding
experiential knowledge to the array of services
Not to lighten work load of others, specific role to fill
Not inexpensive way to provide care, beware of coopting, can be a career ladder
Peer Support is Peer Support- that’s what it is
Behavioral Health Peer Support in Rural Indiana
for Employers
 Workforce development continues to be a critical issue
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in rural areas
Limited availability of trainings, trainees, expense
Economic limitations, reimbursement for services
Workforce development, centralized data collection,
utilization of outcome measures, updating materials.
Integration into continuum, array of services
Development and support- insuring everyone who
chooses to has access to peer support
Behavioral Health Peer Support in Rural Indiana
for CHW/CRS
 Transportation to trainings, and for work
 Availability of trainings/costs of trainings
 Reimbursement rates limit employment opportunities
for peers
 Accommodating peers who have limitations regarding
a choice of supporters
 Access to work improvement trainings
Meeting the Challenge
 3 day training Indiana State Certified Community Health
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Worker. Open to the public, based on availability
2 additional days for the Indiana State Certified Recovery
Specialist designation for those who qualify
Follow-up opportunities for qualified persons in Substance
Abuse, Gambling Addiction, other Specialties
Ongoing availability of free CEUs (21 hours available, 14 hours
required)
Monthly conference calls, archived webinars, conferences and
workshops
Continued work with employers, promotion of peer support as a
value added service, beginning to gather data, “keeping an ear to
the ground” to stay abreast of changing challenges and
opportunities
Meeting the Challenge
 Education for employers on Peer Recovery Services as
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defined by Indiana’s MRO program
Assisting in understanding reimbursement rates
Understanding workforce development
Periodic trainings, archived webinars
Work place preparation, supervision, integration
Participation
in Recovery Oriented Systems of Care
 Mechanisms for CHW to provide their unique
contributions in planning and development, being
major decision makers in policy, innovators in the
workplace
 A flexible workforce, moving seamlessly through
healthcare delivery, able to adjust to a wide variety of
environments
 Ensuring availability of updates for a continuously
improving and expanding workforce
Are CRSs also CHWs?
 Do not provide clinical care
 Most do not hold another license
 Experiential knowledge is key to success
 Intense involvement in relationship building
 Relate as peers
 Achieve what others cannot
CRSs as CHWs
 Role in integrated care
 Role in dual diagnosis treatment
 Other Emerging Specialties
 Housing
 Forensic
 Family
 Veterans
 Addiction
Integrated Peer Workforce
 “Leveraging community health workers is an
evidence-based practice known to improve overall
public health,” said Gregory N. Larkin, M.D.,
former Indiana State Health Commissioner
 The CHW umbrella encompasses many job titles
including Certified Recovery Specialist, Care
Transition Coordinator and Patient Navigator.
Health Care Reform
 Focus on health care homes (including person-
centered care and shared decision-making)
 Inclusion of patient navigators (“community
members who are trained in strategies to connect
individuals to care, to help them overcome barriers
to receiving care, and to assist them in various other
ways through their course of treatment”)
Behavioral Activation
 Helping people prepare for health care visits and
ask questions
 Identifying and setting health-related goals
 Planning specific action steps to achieve goals
 Encouraging exercise and good nutrition
 Assisting in daily management tasks and problemsolving
 Providing social and emotional support and
feedback
How to calculate return in an
Accountable Care Environment?
 Consider reimbursement against real cost
 Consider gains in reduction of missed
appointments, in-patient service utilization,
medication compliance
 Consider improvement in efficient use of staff time
as evidenced by preparation for meaningful
appointments with clinicians and prescribers
Distribution of CRSs
“It’s not—like you might think—that you don’t
have the money to offer recovery support
services, but rather that you don’t have the
money not to offer them.”
- Keith Humphreys
Positive Health Outcomes
 Decrease in high-risk behaviors for HIV
 Decreased infant mortality
 Decreased psychiatric symptoms
 Significant decreases in HbA(1c), body mass index,
total cholesterol, LDL cholesterol, and systolic and
diastolic blood pressure among persons with
diabetes
(Davidson, 2012)
More Positive Outcomes
 Increased rates of engagement and retention
 Improved trust and communication between
patients and health care providers
 Improved adherence and self-care
 Improved quality of life
(Davidson, 2012)
To Summarize
 Indiana has a strong Certified Recovery Specialist
Program that has been noted nationally as an
exemplary program.
(Pillars of Peer Support 2011)
 The peer services movement continues to grow
and diversify.
 The provision of peer services adds value to a
recovery-oriented system of care.
 Evidence base is growing along with expansion of
peer workforce.
 Health care reform represents an unprecedented
opportunity to solidify the role of peers in mental
health and whole health.
Questions?
Bruce Van Dusen AAS
Bruce.vandusen@fssa.in.gov
317-232-7912