Engineering Recovery-Oriented Systems of Care: Co-Designing a Sustainable Medicaid-Billable Peer Recovery Program Across Residential Substance Use Treatment Settings

Session Description: Co-designing and building sustainable Peer Recovery Support Services requires more than hiring peers within treatment centers. Organizations must develop the infrastructure, supervision, workflows, reimbursement strategies, and organizational culture necessary to support long-term success. While peer services are increasingly recognized as an essential component of substance use disorder treatment, many programs struggle with implementation challenges including role confusion, inadequate supervision, workforce turnover, documentation barriers, and financial sustainability.This presentation provides a real-world case study of developing and integrating Medicaid-billable Peer Recovery Support Services within recovery-oriented substance use treatment systems. Presenters will examine common implementation failures, organizational readiness factors, workforce development strategies, supervision models, documentation and reimbursement considerations, and lessons learned from building sustainable peer services across multiple treatment settings through application of lived experience at all phases of development. Attendees will gain practical tools for strengthening peer workforce retention, protecting role fidelity, improving interdisciplinary collaboration, developing reimbursement-ready service models, and creating recovery-oriented organizational cultures. The session will also explore how effective peer integration supports participant engagement, continuity of care, treatment retention, and long-term recovery outcomes.Participants will leave with actionable implementation strategies, organizational readiness considerations, supervision frameworks, and a practical roadmap for developing sustainable peer recovery services that can be adapted across a variety of behavioral health and substance use treatment settings.