Hawaii recognizes peer support as a distinct behavioral health service delivered by people who use relevant lived experience to promote recovery, resiliency, engagement, self-advocacy, natural supports, and community living.
The state’s primary adult mental health peer credential is the Hawaii Certified Peer Specialist (HCPS), administered by the Hawaii State Department of Health Adult Mental Health Division, or AMHD. Hawaii also operates a specialized Hawaii Forensic Peer Specialist (HFPS) training and internship pathway for peers working with people affected by behavioral health conditions and justice-system involvement. (Hawaii Department of Health)
Hawaii Medicaid, administered through the Med-QUEST Division, formally covers Peer Support Services. The current Medicaid State Plan allows peer support for beneficiaries with mental health conditions, physical illnesses, and/or substance use disorders and also recognizes services involving parents, caretakers, and family members when provided for the direct benefit of the Medicaid beneficiary. (MedQuest Hawaii)
Hawaii’s Medicaid framework is broader than the HCPS program alone. Peer services may be delivered by a Peer Support Specialist certified through AMHD’s HCPS program or through another state-agency peer program that meets established national peer-support criteria. The State Plan also specifically recognizes Certified Youth Peer Partners and Certified Parent Partners. (MedQuest Hawaii)
Peer professionals may work in adult mental health services, child and adolescent behavioral health, substance use recovery, forensic and reentry programs, clubhouses, community organizations, hospitals, crisis programs, Medicaid behavioral health services, and other community settings.
Hawaii Peer Support Quick Facts
Category | Hawaii overview |
|---|---|
State Medicaid program | Hawaii Medicaid / Med-QUEST |
Primary adult mental health credential | Hawaii Certified Peer Specialist |
Credential abbreviation | HCPS |
Certification authority | Hawaii Department of Health Adult Mental Health Division |
Forensic peer pathway | Hawaii Forensic Peer Specialist |
Youth peer role | Certified Youth Peer Partner |
Family peer role | Certified Parent Partner |
Medicaid peer coverage | Peer Support Services are covered under the Hawaii Medicaid State Plan |
Medicaid populations | Mental health, physical illness, and/or substance use disorders |
Family services | May be provided to family members, parents, or caretakers for the direct benefit of the beneficiary |
Common Medicaid code | H0038 |
Unit | 15 minutes under current CAMHD fee schedule |
Current CAMHD H0038 rate | $25.33 per 15-minute unit in the current approved State Plan fee schedule |
Peer service formats | Individual and group |
Prior authorization | Required under current State Plan language |
Visit limits | No fixed visit limit when medically necessary under current State Plan language |
Care planning | Must be coordinated through an individualized written plan of care |
State behavioral health authority | Hawaii Department of Health |
Adult mental health agency | Adult Mental Health Division |
Child behavioral health agency | Child and Adolescent Mental Health Division |
Medicaid agency | Med-QUEST Division |
Last reviewed | August 2026 |
The Medicaid information above reflects Hawaii State Plan Amendment 24-0011, approved March 26, 2025 with an effective date of December 28, 2024. (MedQuest Hawaii)
What Is Peer Support?
Peer support is assistance provided by someone whose relevant lived experience informs how they support another person’s recovery and wellness.
Hawaii Medicaid defines Peer Support Services as culturally competent individual and group services promoting:
- Recovery
- Resiliency
- Engagement
- Socialization
- Self-sufficiency
- Self-advocacy
- Natural supports
- Identification of strengths
The State Plan describes peer providers as people who self-identify as consumers and are in recovery from mental illness, physical illness, and/or substance use disorders. (MedQuest Hawaii)
Peer support differs from traditional clinical treatment. Peer professionals may work alongside psychiatrists, psychologists, social workers, nurses, mental health counselors, marriage and family therapists, substance use professionals, case managers, and other healthcare workers, but peer practice is grounded primarily in lived experience.
Common Peer Support Activities
Depending on the service and program, Hawaii peer professionals may:
- Build trusting peer relationships
- Share relevant lived experience
- Promote hope
- Support recovery goals
- Encourage treatment engagement
- Help people identify strengths
- Promote self-advocacy
- Build natural supports
- Support community living
- Help people navigate behavioral health services
- Provide resource navigation
- Facilitate peer groups
- Support socialization
- Support transitions
- Promote wellness
- Help people develop coping and problem-solving skills
- Support relationships
- Participate with other members of a care team
- Document covered peer services
Peer workers generally should not diagnose behavioral health disorders, prescribe medications, conduct psychotherapy, or represent themselves as licensed clinicians unless they separately hold an applicable professional license and are acting within that licensed role.
Hawaii Certified Peer Specialists
What Is an HCPS?
A Hawaii Certified Peer Specialist is a person in recovery from mental illness who has received certification from the Hawaii Department of Health Adult Mental Health Division.
AMHD states that HCPS professionals:
- Promote self-determination
- Promote personal responsibility
- Promote community integration
- Instill hope
- Serve as role models
- Serve as champions of recovery
Certification is awarded only after completion of HCPS training and successful completion of both written and oral examinations. (Hawaii Department of Health)
Hawaii HCPS Certification
Hawaii’s HCPS program is directly administered through AMHD rather than through an independent private credentialing board.
The program was modeled after Georgia’s Certified Peer Specialist Project. (Hawaii Department of Health)
The pathway generally involves:
- Meeting current eligibility requirements
- Applying for HCPS training
- Completing the approved training
- Passing the written examination
- Passing the oral examination
- Receiving AMHD certification
- Maintaining applicable continuing education and credential requirements
AMHD maintains an HCPS registry identifying specialists who have met certification standards and have agreed to have their names publicly listed. (Hawaii Department of Health)
Organizations should use the current HCPS Handbook and training application because eligibility requirements and training schedules may change.
HCPS Lived Experience
HCPS certification is rooted in personal mental health recovery experience.
AMHD describes HCPS professionals as individuals in recovery from a mental illness who have completed the state’s certification process. (Hawaii Department of Health)
This makes the traditional HCPS pathway primarily a mental health peer credential.
However, Hawaii’s Medicaid peer-support benefit is broader than HCPS alone and expressly includes peer support for beneficiaries affected by:
- Mental illness
- Physical illness
- Substance use disorders
The Medicaid State Plan also permits another state agency to establish a qualifying peer program if it meets established national peer-support criteria. (MedQuest Hawaii)
Hawaii Forensic Peer Specialists
Hawaii also operates a specialized Hawaii Forensic Peer Specialist training and internship program.
The program is coordinated through the Adult Mental Health Division and was developed with support from the federal Second Chance Act for improving reentry outcomes among adults with co-occurring substance use and mental health conditions. (Hawaii Department of Health)
What Does a Forensic Peer Specialist Do?
Depending on the program, forensic peers may support individuals affected by:
- Incarceration
- Reentry
- Mental illness
- Substance use disorders
- Co-occurring conditions
- Court involvement
- Community supervision
- Housing barriers
- Employment barriers
- Behavioral health system navigation
Potential activities may include:
- Sharing relevant justice-system lived experience
- Supporting reentry planning
- Helping people connect with behavioral health treatment
- Supporting recovery goals
- Connecting participants with housing and employment resources
- Building natural supports
- Supporting community reintegration
- Promoting self-advocacy
- Helping individuals navigate complex systems
Hawaii’s HFPS program also offers internship opportunities arranged on an individual basis. (Hawaii Department of Health)
Certified Youth Peer Partners
Hawaii Medicaid specifically recognizes Certified Youth Peer Partners.
Under the current Medicaid State Plan, a Certified Youth Peer Partner must:
- Have personal experience with children’s or adolescent mental health, child welfare, the judicial system, or similar system involvement
- Be willing to share personal experience for the benefit of the people they support
- Have at least a high school diploma or GED
- Successfully complete a state-approved Peer Specialist training program (MedQuest Hawaii)
Youth Peer Supervision
Current State Plan language requires Youth Peer Support Services to be supervised by either:
- A former peer partner with at least two years of experience, or
- A professional with at least one year of experience working with peer partners (MedQuest Hawaii)
Youth Peer Activities
A Youth Peer Partner may:
- Build engagement with young people
- Support youth voice and choice
- Share relevant lived experience
- Promote self-advocacy
- Help young people navigate behavioral health systems
- Support treatment engagement
- Help youth develop recovery goals
- Support transitions
- Help build natural supports
- Participate with youth and family teams
- Support community and school functioning
Certified Parent Partners
Hawaii Medicaid also expressly recognizes Certified Parent Partners.
Under the current State Plan, a Certified Parent Partner must:
- Have personal experience parenting a child or adolescent with mental health challenges or involvement with child welfare or judicial systems
- Be willing to share that experience for the benefit of families
- Hold at least a high school diploma or GED
- Complete a state-approved Peer Specialist training program (MedQuest Hawaii)
Parent Peer Supervision
Certified Parent Partner services must be supervised by:
- A former peer partner with at least two years of experience, or
- A professional with at least one year of experience working with peer partners (MedQuest Hawaii)
Parent Peer Activities
Parent Partners may:
- Help caregivers navigate behavioral health systems
- Support family voice and choice
- Help families understand services
- Support advocacy
- Share relevant caregiver experience
- Help caregivers prepare for meetings
- Connect families with community resources
- Support transitions
- Promote family participation in care
- Help strengthen natural supports
Family peer support remains distinct from psychotherapy, legal representation, and traditional clinical family therapy.
Is Peer Support Covered by Hawaii Medicaid?
Yes.
Hawaii Medicaid expressly covers Peer Support Services under the State Plan.
The current benefit includes culturally competent individual and group peer services for beneficiaries with:
- Mental health conditions
- Physical illnesses
- Substance use disorders (MedQuest Hawaii)
Peer services may also involve:
- Family members
- Parents
- Caretakers
when those services are provided for the direct benefit of the Medicaid beneficiary. (MedQuest Hawaii)
Who Can Provide Medicaid Peer Support?
Current State Plan language permits services to be delivered by:
- Peer Support Specialists certified by AMHD through the HCPS program
- Peer Support Specialists certified through another state-agency peer program meeting established national peer-support criteria
- Certified Youth Peer Partners
- Certified Parent Partners (MedQuest Hawaii)
Peer providers must complete state-defined training and certification and meet ongoing continuing-education requirements. (MedQuest Hawaii)
Hawaii Medicaid Peer Support Code
Hawaii uses H0038 for Peer Support Services within its current CAMHD fee schedule.
The current approved State Plan fee schedule identifies:
H0038, Peer Support Services, Child/Adolescent Program Modifier: HA Provider: Certified Peer Specialist Unit: 15 minutes Rate: $25.33
and:
H0038, Peer Support Services, Adult Non-Geriatric Program Modifier: HB Provider: Certified Peer Specialist Unit: 15 minutes Rate: $25.33
These rates appear in SPA 24-0011, effective December 28, 2024. (MedQuest Hawaii)
Providers should confirm the current fee schedule before billing because reimbursement rates and coding requirements may change.
Peer Services Included in Other Programs
Hawaii also includes peer support within certain bundled or multidisciplinary behavioral health programs.
The current CAMHD fee schedule identifies peer support as one component of HI OnTrack, alongside:
- Individual and group psychotherapy
- Family education and support
- Psychopharmacology
- Care coordination and management (MedQuest Hawaii)
Organizations should therefore determine whether peer activity is:
- Separately billed under H0038
- Included within another bundled service
- Paid through another state or Medicaid program
- Grant funded
- Non-billable community support
Prior Authorization and Medical Necessity
Hawaii’s State Plan currently states that Peer Support Services are available without a fixed limit on the number of visits when medically necessary.
However:
- Prior authorization is required
- Monthly assessments are performed to ensure ongoing medical necessity (MedQuest Hawaii)
This makes Hawaii more operationally specific than states where peer services have simple unit limits.
Programs need workflows that support:
- Authorization tracking
- Monthly reassessment
- Medical-necessity documentation
- Service-plan review
- Peer documentation
Individualized Plan of Care
Hawaii Medicaid requires peer support to be coordinated within a comprehensive individualized plan of care.
The plan must:
- Reflect participant needs
- Reflect participant preferences
- Contain individualized goals
- Include measurable outcomes (MedQuest Hawaii)
Covered peer services are available only to Medicaid-eligible recipients with a written plan of care developed with participation from a qualified mental health professional. (MedQuest Hawaii)
This means a peer interaction may be meaningful and appropriate without automatically qualifying as a Medicaid Peer Support Service.
Medicaid Peer Support Components
The State Plan identifies several specific components of covered peer support.
Educational Skill Building Groups
These groups provide supportive environments in which beneficiaries and families learn coping and problem-solving skills.
They may promote:
- Socialization
- Recovery
- Self-sufficiency
- Self-advocacy
- Natural supports
- Maintenance of skills learned in other services (MedQuest Hawaii)
Engagement
Engagement includes Peer Support Specialist-led activities and coaching intended to help beneficiaries participate in treatment.
Engagement may involve:
- Supporting transitions
- Encouraging treatment participation
- Developing personal recovery goals
- Developing individualized recovery processes (MedQuest Hawaii)
Therapeutic Activity
Despite the term “therapeutic,” Hawaii defines this as a structured nonclinical activity delivered by a Peer Support Specialist.
Activities may promote:
- Recovery
- Wellness
- Self-advocacy
- Relationship enhancement
- Natural supports
- Self-awareness
- Values
- Community-living skills
- Resource navigation
- Advocacy
- Collaboration with families and other supports (MedQuest Hawaii)
The use of “therapeutic activity” in the State Plan should therefore not be interpreted as giving peer specialists authority to provide psychotherapy.
Can a Peer Specialist Bill Hawaii Medicaid Independently?
Organizations should not assume that HCPS certification allows an individual peer specialist to independently enroll and submit Medicaid claims.
Certification establishes the peer worker’s qualifications.
Billing depends on additional factors such as:
- Medicaid provider enrollment
- Eligible provider organization
- Applicable state program
- Member eligibility
- Written plan of care
- Qualified mental health professional participation
- Prior authorization
- Medical necessity
- Correct service code
- Correct modifier
- Documentation
- Billing arrangement
Organizations should verify current Med-QUEST and behavioral health program rules before creating an independent peer billing model.
Med-QUEST
Hawaii Medicaid is administered through the Med-QUEST Division of the Hawaii Department of Human Services.
Med-QUEST administers Medicaid coverage and Hawaii’s QUEST Integration managed care system.
Current Medicaid member materials identify Peer Specialist among covered additional behavioral health benefits. (MedQuest Hawaii)
Organizations providing Medicaid-funded peer services should determine:
- Which Medicaid program applies
- Which health plan is responsible
- Whether services are delivered through AMHD, CAMHD, or another system
- What provider enrollment requirements apply
- What authorization is required
- What claims process applies
Adult Mental Health Division
The Adult Mental Health Division of the Hawaii Department of Health is central to Hawaii’s peer-support infrastructure.
AMHD:
- Certifies Hawaii Certified Peer Specialists
- Maintains the HCPS registry
- Coordinates HCPS training
- Coordinates the Hawaii Forensic Peer Specialist program
- Provides adult mental health services
- Maintains provider resources and guidance (Hawaii Department of Health)
Child and Adolescent Mental Health Division
The Child and Adolescent Mental Health Division, or CAMHD, is especially important to Medicaid peer services involving youth and families.
The current Medicaid State Plan and CAMHD fee schedule identify:
- Certified Youth Peer Partners
- Certified Parent Partners
- H0038 Peer Support Services
- Child/adolescent peer services
- Adult non-geriatric peer services
- HI OnTrack peer-support components (MedQuest Hawaii)
Substance Use Peer Support
Hawaii’s Medicaid peer benefit expressly extends to beneficiaries with substance use disorders. (MedQuest Hawaii)
Peer professionals working in substance use recovery may:
- Support treatment engagement
- Help identify recovery goals
- Support multiple pathways of recovery
- Connect people with mutual support
- Help navigate treatment systems
- Build recovery capital
- Support transitions
- Help participants access housing and employment resources
- Support harm reduction where appropriate
- Promote community connection
Hawaii’s Alcohol and Drug Abuse Division also oversees the broader statewide substance use service system.
Programs should verify whether their peer role is governed through:
- AMHD
- ADAD
- CAMHD
- Medicaid
- Another state-funded program
rather than assuming HCPS certification alone defines every substance use peer role.
Peer Navigation in Hawaii
Hawaii has continued developing broader peer-navigation infrastructure.
The Hawaii Department of Health’s 2025 Peer Navigation Summit described peer support and navigation as involving trained professionals who draw on lived experience with areas including:
- Mental health
- Substance use
- Trauma
- Housing instability
- Other life challenges
The statewide discussion reflects a movement toward peer navigation across multiple public-health and behavioral-health settings. (Hawaii Department of Health)
Peer Support and Physical Health
One unusually broad aspect of Hawaii’s Medicaid State Plan is that it expressly refers to peer support for beneficiaries with physical illness, in addition to mental illness and substance use disorders. (MedQuest Hawaii)
This creates the potential for peer roles extending into areas such as:
- Chronic disease
- Complex health conditions
- Community health navigation
- Integrated behavioral and physical healthcare
- Recovery from serious health events
Organizations should still confirm the specific covered benefit and credential requirements before assuming any health-navigation service qualifies for reimbursement.
Peer Support Scope of Practice in Hawaii
Peer professionals provide recovery-oriented, nonclinical support based on lived experience.
Activities Commonly Associated With Peer Support
Depending on the program, peers may:
- Engage participants
- Share lived experience
- Promote hope
- Support self-determination
- Encourage personal responsibility
- Support recovery goals
- Promote self-advocacy
- Build natural supports
- Facilitate groups
- Provide skill-building activities
- Support treatment engagement
- Help with transitions
- Navigate community resources
- Support socialization
- Promote wellness
- Support relationships
- Participate on multidisciplinary teams
- Document services
Activities Generally Outside the Peer Role
Unless separately licensed or qualified, peers generally should not:
- Diagnose mental health disorders
- Diagnose substance use disorders
- Provide psychotherapy
- Prescribe medication
- Practice medicine
- Represent themselves as licensed clinicians
- Perform restricted clinical assessments
- Independently determine medical necessity
- Make legal determinations
- Perform clinical tasks outside their qualifications
Supervision of Peer Professionals in Hawaii
Supervision is explicitly incorporated into Hawaii Medicaid’s peer-support structure.
Youth and Parent Peer Partners must receive supervision from:
- A former peer partner with at least two years of experience, or
- A professional with at least one year of experience working with peer partners (MedQuest Hawaii)
Other programs may establish additional supervisory requirements.
Administrative Supervision
May address:
- Scheduling
- Caseload
- Attendance
- Documentation
- Organizational policies
- Productivity
- Authorization tracking
Peer Practice Supervision
Should address:
- Intentional use of lived experience
- Mutuality
- Peer ethics
- Boundaries
- Recovery orientation
- Self-determination
- Advocacy
- Community relationships
- Role fidelity
- Staff wellness
Clinical Consultation
Clinical professionals may provide consultation on:
- Diagnosis
- Treatment
- Medication
- Medical necessity
- Acute clinical risk
- Other clinical matters
Clinical consultation should not erase the distinct nature of peer practice.
Documentation for Hawaii Peer Support Services
Hawaii Medicaid documentation should establish that the Peer Support Service relates to the beneficiary’s individualized plan of care and measurable goals.
Common Documentation Elements
A peer note may include:
- Beneficiary name or identifier
- Date of service
- Start and end time
- Units
- Location
- Modality
- Service component
- Individualized plan-of-care goal
- Recovery goal
- Peer activity
- Skill-building activity
- Relevant use of lived experience
- Resource navigation
- Participant response
- Progress
- Barriers
- Follow-up plan
- Peer specialist
- Credential
- Required signature
Peer Documentation Should Be
- Accurate
- Timely
- Person-centered
- Recovery-oriented
- Culturally responsive
- Strengths-based
- Respectful
- Connected to measurable goals
- Consistent with peer scope
- Limited to relevant information
- Compliant with Medicaid requirements
Peer Documentation Should Avoid
- Unsupported diagnoses
- Clinical interpretations outside peer scope
- Stigmatizing language
- Identical copy-and-paste notes
- Services that did not occur
- Unnecessary trauma details
- Personal opinions presented as clinical facts
- Documentation created solely to justify reimbursement
Documentation and Billing Are Not the Same Thing
A complete peer note does not automatically result in Medicaid reimbursement.
Payment may separately depend on:
- Medicaid eligibility
- Provider enrollment
- State program
- Peer certification
- Service authorization
- Written plan of care
- Medical necessity
- Monthly reassessment
- Correct H0038 coding
- Modifier
- Units
- Place of service
- Managed care or state-agency requirements
Confidentiality and Information Sharing
Hawaii peer programs may handle highly sensitive behavioral health and health information.
Applicable requirements may include:
- HIPAA
- 42 CFR Part 2
- Hawaii confidentiality law
- Medicaid requirements
- AMHD requirements
- CAMHD requirements
- Child welfare confidentiality
- Juvenile justice confidentiality
- Organizational policies
- Consent and authorization requirements
Peer workers should receive training on:
- Information access
- Documentation
- Participant consent
- Family involvement
- Care-team communication
- Substance use records
- Text messaging
- Mobile devices
- Telehealth
- Social media
- Crisis situations
- Legal requests
- Community boundaries
Where Peer Support Is Delivered in Hawaii
Adult Mental Health Services
HCPS professionals may work throughout AMHD’s community mental health system.
Child and Adolescent Behavioral Health
Certified Youth Peer Partners and Certified Parent Partners may work alongside CAMHD services and youth/family behavioral health teams.
Substance Use Treatment and Recovery
Peer workers may support individuals affected by substance use disorders throughout treatment and recovery.
Forensic and Reentry Programs
Hawaii’s Forensic Peer Specialist program specifically supports peer workforce development in justice and reentry settings. (Hawaii Department of Health)
Clubhouses
AMHD includes clubhouses within its adult mental health community infrastructure. (Hawaii Department of Health)
Clubhouses may support:
- Community integration
- Social connection
- Employment
- Education
- Recovery
- Peer relationships
Hospitals and Crisis Services
Peers may work with people during or following:
- Psychiatric crises
- Hospitalization
- Substance-related crises
- Behavioral health emergencies
Community-Based Programs
Peer services may be provided in community settings when consistent with the individual’s plan of care and program requirements.
Youth and Family Programs
Youth Peer Partners and Parent Partners are expressly recognized within Medicaid’s peer-support framework. (MedQuest Hawaii)
Justice and Reentry Programs
Forensic peers may help people transition from correctional and forensic systems into community behavioral health and recovery services.
Collegiate Recovery Programs
Hawaii colleges and universities may employ:
- Student peer mentors
- Recovery coaches
- Peer leaders
- Collegiate recovery staff
These roles do not automatically qualify as Medicaid Peer Support Services.
Geographic and Cultural Considerations
Peer support in Hawaii should account for the state’s unique geography and cultural context.
Programs may serve people across:
- Oahu
- Hawaii Island
- Maui
- Kauai
- Molokai
- Lanai
- Other island communities
Operational challenges may include:
- Inter-island travel
- Limited specialist availability
- Rural access
- Workforce shortages
- Transportation
- Broadband access
- Small-community confidentiality
- Cultural differences
- Integration with Native Hawaiian communities
Hawaii’s Medicaid State Plan expressly describes covered Peer Support Services as culturally competent, making cultural responsiveness part of the formal service definition rather than merely an optional program value. (MedQuest Hawaii)
Native Hawaiian and Community Context
Programs serving Native Hawaiian communities should avoid simply importing mainland peer-support models without adaptation.
Effective peer support may need to account for:
- ʻOhana
- Community relationships
- Cultural identity
- Place
- Traditional practices
- Community leadership
- Historical and intergenerational experiences
- Local definitions of health and recovery
These considerations should be incorporated thoughtfully while ensuring that any Medicaid-billed service still satisfies the applicable state service definition and documentation requirements.
Starting a Peer Support Program in Hawaii
Step 1: Define the Population
Determine whether the program serves:
- Adults with mental health conditions
- People with substance use disorders
- People with chronic physical health conditions
- Youth
- Parents and caregivers
- Justice-involved individuals
- People leaving hospitals
- Rural or neighbor-island communities
- Native Hawaiian communities
- College students
- A specific geographic or cultural population
Step 2: Select the Appropriate Peer Role
Determine whether the program requires:
- Hawaii Certified Peer Specialist
- Hawaii Forensic Peer Specialist
- Certified Youth Peer Partner
- Certified Parent Partner
- Another state-approved Peer Support Specialist
- Community peer worker
- Volunteer peer
Do not assume that one credential applies to every population.
Step 3: Determine the Funding Model
Potential funding sources may include:
- Hawaii Medicaid
- QUEST Integration
- AMHD funding
- CAMHD funding
- ADAD funding
- Federal block grants
- State Opioid Response funding
- Federal grants
- Hospital funding
- Justice funding
- Philanthropy
- University contracts
- Private payment
Step 4: Confirm Credential Requirements
Determine:
- Appropriate peer certification
- Training
- Written examination
- Oral examination
- Youth or parent qualifications
- Supervision
- Continuing education
- Employer requirements
- Program-specific qualifications
Step 5: Confirm Medicaid Provider Eligibility
Determine:
- Who is the billing provider?
- Is the organization enrolled with Medicaid?
- Which state division administers the service?
- Is prior authorization required?
- Does the participant have a written plan of care?
- Has a qualified mental health professional participated?
- Is monthly reassessment required?
- What code and modifier apply?
- Is the service individually billed or bundled?
Step 6: Build the Workflow
Map:
- Referral
- Medicaid eligibility
- Intake
- Consent
- Authorization
- Individualized plan of care
- Assignment
- Matching
- Scheduling
- Service delivery
- Documentation
- Supervision
- Monthly reassessment
- Clinical escalation
- Follow-up
- Transition
- Outcomes
- Billing
Step 7: Establish Role Boundaries
Develop policies addressing:
- Scope of practice
- Confidentiality
- Crisis response
- Transportation
- Inter-island travel
- Gifts
- Social media
- Dual relationships
- Small-community relationships
- Communication outside work
- Home visits
- Cultural considerations
- Staff wellness
- Role drift
Step 8: Build Quality Measurement
Programs may consider:
- Referral-to-contact time
- Engagement
- Treatment participation
- Recovery goals
- Resiliency
- Self-advocacy
- Natural supports
- Community connection
- Socialization
- Recovery capital
- Successful transitions
- Satisfaction
- Peer workforce retention
- Supervision completion
- Credential compliance
- Authorization status
- Documentation timeliness
Common Challenges for Hawaii Peer Programs
Multiple Peer Pathways
Programs may need to distinguish among:
- HCPS
- HFPS
- Youth Peer Partners
- Parent Partners
- Other state-approved peer programs
Medicaid Authorization Requirements
Current State Plan language requires prior authorization and ongoing assessment of medical necessity. (MedQuest Hawaii)
Organizations need systems for tracking these requirements.
Individualized Plans of Care
Medicaid peer services need to connect to measurable individualized goals rather than operate as completely unstructured social support. (MedQuest Hawaii)
Geographic Access
Island geography may complicate:
- Staffing
- Transportation
- Supervision
- Training
- Referrals
- Specialty care
- Workforce development
Cultural Responsiveness
The Medicaid service itself is defined as culturally competent.
Programs should build cultural responsiveness into workforce development, service design, and documentation.
Workforce Capacity
Neighbor-island and rural communities may have limited access to trained and certified peer workers.
Documentation Burden
Poorly designed workflows can shift peer workers away from relationship-building and into excessive administrative work.
Fragmented Technology
Programs may use different systems for:
- Medicaid authorization
- Scheduling
- Peer documentation
- Participant communication
- Plans of care
- Supervision
- Credential tracking
- Continuing education
- Medicaid billing
- AMHD reporting
- CAMHD reporting
- Grant reporting
- Outcomes
Frequently Asked Questions
Is peer support covered by Hawaii Medicaid?
Yes.
Hawaii’s Medicaid State Plan expressly covers Peer Support Services for qualifying beneficiaries with mental health conditions, physical illnesses, and/or substance use disorders. (MedQuest Hawaii)
What is Hawaii’s main peer credential?
The primary adult mental health peer credential is Hawaii Certified Peer Specialist, or HCPS. (Hawaii Department of Health)
Who certifies HCPS professionals?
The Hawaii Department of Health Adult Mental Health Division. (Hawaii Department of Health)
Is lived experience required?
Yes.
HCPS professionals are people in recovery from mental illness, and Hawaii’s broader Medicaid peer framework is explicitly based on lived experience. (Hawaii Department of Health)
Is an examination required?
Yes.
HCPS certification requires successful completion of both written and oral examinations after training. (Hawaii Department of Health)
Does Hawaii recognize youth peers?
Yes.
The Medicaid State Plan explicitly recognizes Certified Youth Peer Partners. (MedQuest Hawaii)
Does Hawaii recognize parent or family peers?
Yes.
Certified Parent Partners are expressly recognized in the Medicaid State Plan. (MedQuest Hawaii)
Does Hawaii have forensic peers?
Yes.
The Adult Mental Health Division operates a Hawaii Forensic Peer Specialist training and internship program. (Hawaii Department of Health)
Can peers support people with substance use disorders?
Yes.
Hawaii Medicaid explicitly covers peer services for beneficiaries with substance use disorders. (MedQuest Hawaii)
Can peer services involve family members?
Yes.
Peer support may be provided to family members, parents, or caretakers when the service is for the direct benefit of the Medicaid beneficiary. (MedQuest Hawaii)
What code does Hawaii use for Medicaid Peer Support Services?
The current CAMHD fee schedule uses H0038. (MedQuest Hawaii)
What is the current H0038 rate?
The approved CAMHD State Plan fee schedule currently lists $25.33 per 15-minute unit for certified peer specialist services under the relevant child/adolescent and adult non-geriatric modifiers. (MedQuest Hawaii)
Is prior authorization required?
Yes under the current State Plan language. (MedQuest Hawaii)
Is there a fixed visit limit?
The current State Plan states that peer support may be provided without a fixed limit on visits when medically necessary, subject to prior authorization and monthly assessments. (MedQuest Hawaii)
Do peer services need to be in a plan of care?
Yes.
Covered Medicaid peer services must be coordinated through a written individualized plan of care with measurable goals and participation from a qualified mental health professional. (MedQuest Hawaii)
Can an HCPS independently bill Medicaid?
Do not assume so.
HCPS certification establishes peer qualifications. Medicaid provider enrollment, authorization, organizational eligibility, and billing authority are separate issues.
Are peer specialists clinicians?
No.
Peer specialists provide nonclinical support unless they separately hold a professional clinical credential and are acting within that role.
Can peer specialists write progress notes?
Yes when required by Medicaid, AMHD, CAMHD, the provider organization, contract, or another payer.
Documentation should accurately describe the peer service and connect to applicable individualized goals.
Official and State-Recognized Hawaii Peer Support Resources
Certification and Training
Hawaii Certified Peer Specialist Program
Official Adult Mental Health Division resource for the HCPS credential, training, examinations, certification, handbook, applications, professional references, and HCPS registry.
Last checked: August 12, 2026 Link: https://health.hawaii.gov/amhd/consumer/hcps/
Hawaii Certified Peer Specialist Handbook
Official AMHD handbook containing current HCPS certification requirements, competencies, training standards, and credential information.
Last checked: August 12, 2026 Link: https://health.hawaii.gov/amhd/consumer/hcps/
Hawaii Forensic Peer Specialist Program
Official AMHD resource for Hawaii’s forensic peer training and internship pathway serving people affected by behavioral health conditions and justice-system involvement.
Last checked: August 12, 2026 Link: https://health.hawaii.gov/amhd/consumer/hfps/
Adult Mental Health Division
State adult mental health authority administering HCPS certification, forensic peer training, community mental health services, provider guidance, and recovery resources.
Last checked: August 12, 2026 Link: https://health.hawaii.gov/amhd/
Adult Mental Health Division Provider Resources
Official state resource containing AMHD provider guidance, forms, bulletins, and behavioral health program materials.
Last checked: August 12, 2026 Link: https://health.hawaii.gov/amhd/provider/resources/
Medicaid and Reimbursement
Hawaii Med-QUEST
Official Hawaii Medicaid program and primary state resource for eligibility, QUEST Integration, managed care, provider policy, State Plan materials, and Medicaid coverage.
Last checked: August 12, 2026 Link: https://medquest.hawaii.gov/
Hawaii Medicaid Peer Support State Plan Amendment 24-0011
Current approved State Plan Amendment governing major portions of Hawaii Peer Support Services, including service definitions, HCPS and other peer qualifications, Youth Peer Partners, Parent Partners, supervision, care planning, authorization, and reimbursement.
Last checked: August 12, 2026 Link: https://medquest.hawaii.gov/content/dam/formsanddocuments/med-quest/hawaii-state-plan/spa-memos/24-11%20SPA%20Distribution%20Memo%20and%20Attachment.pdf
Hawaii Medicaid State Plan
Official Med-QUEST repository containing Hawaii’s federally approved Medicaid State Plan and amendments governing covered services and provider requirements.
Last checked: August 12, 2026 Link: https://medquest.hawaii.gov/en/plans-providers/medicaid-state-plan.html
Hawaii Medicaid Covered Services
Official member resource identifying covered QUEST Integration services, including Peer Specialist and other behavioral health benefits.
Last checked: August 12, 2026 Link: https://medquest.hawaii.gov/content/medquest/en/members-applicants/quest-integration-coverage/covered-services.html
Child and Adolescent Mental Health Division Fee Schedule
Current Medicaid State Plan fee schedule containing H0038 Peer Support Services rates and modifiers for certified peer specialists.
Last checked: August 12, 2026 Link: https://medquest.hawaii.gov/content/dam/formsanddocuments/med-quest/hawaii-state-plan/spa-memos/24-11%20SPA%20Distribution%20Memo%20and%20Attachment.pdf
State Agencies
Hawaii Department of Health
State health agency overseeing public health, mental health, substance use, child behavioral health, and other health programs.
Last checked: August 12, 2026 Link: https://health.hawaii.gov/
Adult Mental Health Division
Primary state division responsible for adult public mental health services, HCPS certification, forensic peer development, and community mental health programs.
Last checked: August 12, 2026 Link: https://health.hawaii.gov/amhd/
Child and Adolescent Mental Health Division
State division responsible for behavioral health services for children and adolescents and a central agency for Medicaid youth and parent peer-support structures.
Last checked: August 12, 2026 Link: https://health.hawaii.gov/camhd/
Alcohol and Drug Abuse Division
State division responsible for substance use prevention, treatment, recovery services, certification, and statewide substance use policy.
Last checked: August 12, 2026 Link: https://health.hawaii.gov/substance-abuse/
Med-QUEST Division
Hawaii Medicaid agency responsible for QUEST Integration, Medicaid coverage, provider requirements, managed care, and State Plan administration.
Last checked: August 12, 2026 Link: https://medquest.hawaii.gov/
Community and Peer Recovery Resources
Hawaii Adult Mental Health Division Community Resources
State resource connecting individuals and families with community mental health, co-occurring disorder, jail-diversion, recovery, and related support resources.
Last checked: August 12, 2026 Link: https://health.hawaii.gov/amhd/
Hawaii Clubhouses
AMHD-supported clubhouse programs offering community integration, peer connection, socialization, employment, education, and recovery-oriented opportunities for adults with serious mental illness.
Last checked: August 12, 2026 Link: https://health.hawaii.gov/amhd/consumer/clubhouses/
Hawaii Peer Navigation Resources
State peer-navigation initiatives and workforce-development resources addressing peer support across mental health, substance use, housing, trauma, and other community needs.
Last checked: August 12, 2026 Link: https://health.hawaii.gov/substance-abuse/
Hawaii CARES
Statewide behavioral health access and crisis resource connecting people with mental health, substance use, crisis, and community services.
Last checked: August 12, 2026 Link: https://hicares.hawaii.gov/
Technology for Hawaii Peer Support Programs
Technology designed for Hawaii peer programs should account for the state’s credentialing, Medicaid, geographic, youth/family, and cultural requirements.
Programs may need technology supporting:
- HCPS credential tracking
- Written and oral examination status
- HCPS registry status
- Hawaii Forensic Peer Specialist workflows
- Youth Peer Partner qualifications
- Parent Partner qualifications
- Peer-specific supervision
- Continuing education
- H0038 documentation
- Child/adolescent HA modifier workflows
- Adult non-geriatric HB modifier workflows
- Prior authorization
- Monthly medical-necessity reviews
- Written plans of care
- Measurable individualized goals
- Individual peer services
- Group services
- Skill-building groups
- Engagement services
- Nonclinical therapeutic activities
- Recovery goals
- Natural supports
- Resource navigation
- Participant communication
- Scheduling
- Caseloads
- Substance use recovery
- Forensic and reentry services
- Youth and family programs
- Medicaid billing
- Med-QUEST workflows
- AMHD reporting
- CAMHD reporting
- Grant reporting
- Outcomes
- Role-based permissions
- Sensitive substance use information
- Mobile workflows
- Neighbor-island services
- Remote supervision
- Cultural responsiveness
Hawaii creates a particularly strong need to integrate peer practice with authorization and care-plan requirements. A peer worker may be delivering valuable recovery support, but a Medicaid claim also depends on prior authorization, an individualized plan of care, measurable goals, medical necessity, and ongoing reassessment.
Geography also matters. A statewide platform needs to support organizations serving multiple islands without assuming staff, supervisors, participants, and services are all located in the same physical region.
Technology should strengthen culturally responsive, relationship-based peer practice rather than force peer services into a purely clinical model.
About Peerakeet
Peerakeet builds infrastructure for organizations delivering peer support and recovery services.
The platform supports peer-specific documentation, program workflows, supervision, participant engagement, scheduling, reporting, credential management, and day-to-day operations.
Peerakeet does not determine whether a service is billable and does not replace guidance from Hawaii Medicaid, Med-QUEST, the Adult Mental Health Division, Child and Adolescent Mental Health Division, Alcohol and Drug Abuse Division, attorneys, compliance professionals, or other applicable authorities.
Editorial Disclaimer
This guide is provided for general educational purposes. It is not legal, billing, credentialing, clinical, cultural, or regulatory advice.
Hawaii peer-support requirements may vary by Medicaid benefit, state division, population, provider type, credential, contract, island, and program. Medicaid rates, State Plan provisions, credential requirements, authorization rules, and program guidance may change after publication.
Organizations and peer professionals should verify current requirements with Med-QUEST, the Hawaii Department of Health, AMHD, CAMHD, ADAD, current Medicaid State Plan materials, applicable health plans and contracts, and qualified professional advisors.
Last reviewed: August 2026.