At the end of 2023, Kentucky’s behavioral health system reached an inflection point. Reports from Managed Care Organizations (MCOs) and the Department for Medicaid Services (DMS) indicated that approximately 85% of billing in substance use disorder (SUD) and behavioral health settings was for non-clinical services, primarily psychoeducation and peer support. That number raised alarms across state agencies. On the ground, however, what providers, peers, and advocates were seeing told a more complicated story.
The problem was not peer support itself.
The problem was how peer support was being misused, misrepresented, and poorly regulated.
When a Promising Model Is Put at Risk
As someone who supervised peer mentors for many years, I know firsthand that the value peers bring to individuals in recovery is incomparable. Peer support is rooted in lived experience, trust, and credibility that no clinical modality can replicate. When done well, it improves engagement, retention, and long-term recovery reintegration outcomes.
But what we began hearing statewide was troubling.
Unscrupulous providers were billing incorrectly, over-utilizing psychoeducation, and placing peer support services at risk of scrutiny and restriction. As DMS and MCOs investigated billing patterns, peer support, despite being one of the most effective and human-centered services in the system, became vulnerable.
Once we dug deeper, the issues became clear.
Certification Without Accountability
At the time, over half of the approved peer support trainers in Kentucky were also providers, creating a serious conflict of interest. In many cases:
- Peer support “trainings” were rushed, or not fully delivered at all
- Test answers were shared informally
- No secure testing site was required
- Trainers verified peers as “qualified” with little oversight
The result? A pipeline that produced billable assets, not necessarily professionally prepared peer supporters.
Even more concerning, many peers reportedly did not meet the one-year recovery requirement, with some entering peer roles with as little as 60–90 days of recovery, often entirely within a treatment setting, without real-world recovery experience.
There was also no meaningful reporting or accountability mechanism for ethical violations. If a peer was terminated for a serious issue, they could simply move to another job with no record following them. This diluted the profession and undermined the credibility of ethical, experienced peer supporters who were doing the work the right way.
Something had to change.
HB 505: A Necessary Step, Not a Final Answer
House Bill 505, passed during the 2024 legislative session, was a well-intentioned attempt to protect peer support in clinical, billable settings. It aligned certain peer supporters with the Kentucky Board of Alcohol and Drug Counselors (CADC) through a new credential: the Registered Alcohol and Drug Peer Support Specialist (RADPSS).
On paper, this credential offered real safeguards:
- GED or high school diploma requirement
- Supervision under a qualified professional
- Secure testing at a testing center
- Ethical oversight and reporting mechanisms
For peers working in clinical, Medicaid-billable environments, this seemed like a viable solution.
Peer support is not clinical, and was never meant to be, but this model provided guardrails where Medicaid billing was involved.
Where the System Broke Down
After HB 505 passed, a series of compounding failures made it clear that placing peer support under the CADC Board was not sustainable long-term:
- No administrative regulations were written
- The CADC Board was not equipped to handle a large influx of applicants
- There were only two board-approved trainers statewide
- Guidance was minimal or nonexistent
- Many providers did not actively assist peers in obtaining RADPSS credentials in a timely manner
Meanwhile, the clock kept ticking.
As January 1 approached, the date when only RADPSS-credentialed peers would be Medicaid billable, fewer than 100 peers statewide had successfully registered.
A major flaw in HB 505 compounded the crisis: the statute allowed temporary RADPSS credentials to be reimbursed at the same rate as fully registered credentials, but DMS later determined it could not legally reimburse temporary credentials. That left providers and peers stranded, with no viable bridge.
Lane13 Stands With Peers
Lane13 Consulting stepped in.
We engaged Shannon Gray, CADC, CSS, to facilitate a board-approved peer support training, developed a robust and interactive curriculum delivered in person and via Zoom, and provided community education sessions for providers and peer supporters across the state.
We did this without grant funding.
Lane13 is a for-profit firm, and the training carries a cost, but it is significantly lower than comparable CEU and certification programs, and it reflects the real expense of delivering ethical, high-quality training.
We have been with peer supporters every step of the way, working against the clock to mitigate harm from the January 1 deadline and advocating relentlessly for clarity, fairness, and sustainability.
Where We Go From Here
Kentucky now faces a critical decision.
Without swift action, we risk losing a significant portion of the peer support workforce, at a time when overdose rates, mental health needs, and reentry challenges demand more support, not less.
The solution is not to abandon peer support.
The solution is to build a long-term, peer-centered regulatory framework that protects the integrity of the profession, ensures accountability, and honors the lived experience at its core, without forcing peer support into a system that was never designed for it.
Lane13 is actively working on a legislative solution to do exactly that.
A Long-Term Solution: A Professional Home for Peer Support
The solution is not to divide peer support into categories of who is “billable” and who is not. The solution is to sustain all peer support while bringing legitimacy, accountability, and long-term stability to the field as a whole.
Kentucky needs a dedicated professional credentialing board for peer support specialists, modeled after other respected professions such as social workers, nurses, and counselors, but intentionally designed for peers. This board must be future-focused and solely committed to peer support, not housed within another discipline.
A peer support board would:
- Credential peer support specialists across all settings, substance use, mental health, justice-involved reentry, recovery housing, community-based services, and beyond
- Establish clear training and testing standards that protect the integrity of lived experience while ensuring professional readiness
- Provide ethical oversight and accountability, so serious violations follow the credential, not the individual, quietly moving from job to job
- Create a career ladder that adds value, stability, and respect to peer support as a profession
- Ensure peer support remains non-clinical, while still meeting the expectations of modern systems, funders, and payers
Most importantly, such a board would honor what makes peer support unique: lived experience, mutuality, and hope, while protecting it from exploitation, dilution, and misuse.
Peer support has grown beyond a single service line or funding stream. It is now a cornerstone of recovery-oriented systems of care. Kentucky has an opportunity to lead by creating a professional home that allows peer support specialists to grow, be held to standards, and thrive, without losing the soul of the work.
Peer support is the foundation of connection, healing, and hope.
Kentucky cannot afford to lose it.