Using Medicaid to Support Working Age Adults with Serious Mental Illnesses in the Community: A Handbook. Attachment B: Peer Supports in Georgia


Georgia provides for both peer-delivered and peer support services.

Certified Peer Specialists. The state incorporates “certified peer specialists” (CPS) into many of the services furnished under its rehabilitative services coverage. Peer specialists “perform a range of tasks to assist consumers in regaining control over their own lives and over their recovery processes. Peer specialists model competence and the possibility of recovery and assist consumers in developing the perspective and skills that facilitate recovery.”2 Moreover, according to the official job description, a CPS “provides peer services; serves as a consumer advocate; and provides consumer information and peer support for consumers in emergency, outpatient, or inpatient settings.” Certified peer specialist candidates must meet stringent criteria and demonstrate that they have the necessary skills and philosophy to furnish effective supports. First, specialists must be current or former recipients of mental health services. They also must have had some prior involvement or training in an advocacy or advisory capacity. Candidates go through a two-weeks training program that culminates in written and oral examinations in order to be certified.3 Certified peer specialists are required members of community support and ACT teams and woven into other services. Peer specialists work side-by-side with other program staff and bring a consumer-driven recovery philosophy to services.

Peer Supports. Distinct from but intimately tied to Georgia’s peer specialist initiative is its unique rehabilitative services coverage of peer supports, a consumer-driven and consumer-led service. Georgia’s coverage is as follows:

This service provides structured, scheduled activities that promote socialization, recovery, self-advocacy, development of natural supports, and maintenance of community living skills, under the direct supervision of a mental health professional. Consumers actively participate in decision-making and program operation. Services are directed toward achievement of the specific goals defined by the individual and specified in the Individual Service Plan (ISP), and provided under the direct supervision of a Mental Health Professional. The interpersonal interactions and activities within the program are directed, supervised, guided and facilitated by the Mental Health Professional (MHP)in such a way to create the therapeutic community or milieu effect required to achieve individual treatment goals within a controlled environment. This concept is similar to the manner in group therapy sessions in which the staff leader or therapeutic community setting utilizes the interactions of the group members to achieve the desired individual therapy goals.4

Principles of Peer Supports and Recovery
Peer supports program must actively incorporate the Georgia Consumer Council’s recovery principles into their services and activities:
  • View each individual as the director of his/her rehabilitation and recovery process;
  • Promote the value of self-help, peer support and personal empowerment to foster recovery;
  • Promote peer-to-peer training of individual skills, social skills, community/natural resources and group and individual advocacy;
  • Promote supported employment and education that fosters self-determination and career advancement;
  • Support each consumer to “get a life” using natural occurring resources to replace the resources of the mental health system no longer needed;
  • Support each consumer to fully integrate into accepting communities in the least intrusive environment that promotes housing of his/her choice;
  • Actively seek ongoing consumer input into program and service content so as to meet each individual’s needs and goals and foster the recovery process.

Launched in late 2001, the peer supports program now uses 130 peer specialists who support about 3,000 consumers. The program affords individuals the opportunity to exercise control over their own recovery and provide mutual support to each other. The purpose of peer supports is to “provide an opportunity for consumers to direct their own recovery and advocacy process and to teach and support each other in the acquisition and exercise of skills needed for management of symptoms and for utilization of natural resources within the community.”5 Peer supports are intended for adults with serious and persistent mental illness who:

  • “Require and would benefit from support of peers for the acquisition of skills needed for management of symptoms and for utilization of natural resources in the community AND
  • Need assistance to develop self-advocacy skills in order to achieve decreased dependency on the mental health system OR
  • Need assistance and support to prepare for a successful work experience OR
  • Need peer modeling in order to take increased responsibilities for his/her own recovery OR
  • Need peer support in order to maintain daily living skills.”6

Peer support is incorporated into a person’s Individualized Service Plan (ISP). Through Peer Support, “each consumer should set his or her own individualized goals and assess his or her own skills and resources related to goal attainment. Goals are set by exploring strengths and needs in the consumer’s living, learning, social and working environments …. Each consumer must be provided the opportunity for peer assistance in the development and acquisition of needed skills and resources necessary to achieve stated goals.”7

Peer supports programs are based at a program site but activities also may take place in natural community settings. Peer support programs may be freestanding or affiliated with another organization. In either case, 75% of the members of governing boards/advisory boards for peer support programs must be consumers. Furthermore, individuals who receive peer supports “must be given the opportunity to participate in and make decisions about the activities that are conducted or services offered within the Peer Supports program.”8 In addition, a Peer Supports program must offer a range of skill-building and recovery activities developed and led by consumers. These activities must include those that will most effectively support achievement of the individual consumer’s rehabilitation and recovery goals.”9

A peer supports program must be under the clinical supervision of a mental health professional (preferably one who is also a certified peer specialist) and a peer specialist must lead and manage day-to-day program operations. Additionally, services must be provided and/or activities led by peer specialists or other consumers, supervised by a peer specialist. Peer support centers are open for a minimum of four hours a day, three days per week, and provide an opportunity for consumers to come together and support one another through formal group activities as well as more informal social and recreational endeavors. Programmatic supports are built into center activities such as community outings, art and other leisure activities, community meals, and educational seminars.

  1. Georgia Medicaid Community Mental Health Center Program Manual. Op. cit.

  2. Recovery in the Community.

  3. Sabin, J. & Daniels, N. (2003). Strengthening the consumer voice in managed care: VII. The Georgia Peer Specialist program. Psychiatric Services, 54 (4). 497-498.

  4. See Appendix C

  5. Georgia Medicaid Community Mental Health Center Program Manual. Op. cit.

  6. Ibid.

  7. Ibid.

  8. Ibid.

  9. Ibid.

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