Managed care: Strengthening the consumer voice in managed care: VII. The Georgia peer specialist program.

Abstract

The Surgeon General’s landmark 1999 Mental Health Report gives consumers and their families a prominent place in the mental health system as advocates, participants in overseeing policy, and providers of services (1). Managed care programs, when adequately funded and wisely managed, can, should, and sometimes do promote all three objectives (2). The rationale for a more consumercentric approach to managed care derives from a clinical prediction that services provided in this manner will lead to improved outcomes (3) and a view of democratic process that calls for robust citizen involvement beyond that provided by representative government alone (4). The state of Georgia has pioneered a certified peer specialist program that combines consumer-provided services, consumer advocacy, and consumer influence on policy in a highly innovative manner. In this column, the seventh in a series on strengthening the consumer voice in managed care (5–10), we present lessons about enhancing the consumer role derived from Georgia’s unique program. Although Georgia’s program is currently one of a kind, the values and strategy that inform the program could have wide application. Since 1999, the Georgia Division of Mental Health, Developmental Disabilities, and Addictive Diseases has placed a strong emphasis on recoveryoriented programming and peer support in its approach to providing services for clients who have serious and persistent mental illness (11). Publicsector officials and consumer leaders concluded that in order to achieve stable funding for peer-support services, the services would have to be developed in a way that made them eligible for Medicaid funding under Medicaid’s psychiatric rehabilitation option (12). Accomplishing this objective required melding two cultures: the consumer recovery movement—with its informality, vision, and energy—and Medicaid, with its complex bureaucratic requirements. The certified peer specialist role is