Kentucky Peer Support Services Guide

Kentucky has a well-established peer support workforce spanning adult behavioral health, substance use recovery, family services, youth services, community mental health, crisis services, hospitals, recovery organizations, and other community settings.

The Commonwealth recognizes several distinct peer pathways, including:

• Adult Peer Support Specialists
• Kentucky Family Peer Support Specialists
• Kentucky Youth Peer Support Specialists
• Registered Alcohol and Drug Peer Support Specialists for certain licensed substance use disorder settings

A major change took effect on January 1, 2026. Peer workers providing substance use disorder services in programs licensed as an Alcohol and Other Drug Entity or Behavioral Health Service Organization are now subject to a separate registration pathway through the Kentucky Board of Alcohol and Drug Counselors. Certified Peer Support Specialists continue to work in mental health, family, youth, and SUD settings that are not licensed as AODEs or BHSOs. (Cabinet for Health and Family Services)

Kentucky Medicaid covers certain peer support services when they are provided through eligible behavioral health providers and in accordance with applicable certification, supervision, medical necessity, service-plan, documentation, and billing requirements. Kentucky Medicaid regulations expressly recognize adult, family, and youth peer support specialists. (Kentucky Legislature)

Kentucky Peer Support Quick Facts

What Is Peer Support?

Peer support is assistance provided by someone whose relevant lived experience informs how they support another person.

Kentucky defines adult peer support as emotional support provided by an Adult Peer Support Specialist to people with similar mental health, substance use, or co-occurring disorders to help achieve desired social or personal change. Adult Peer Support Specialist services are structured and scheduled nonclinical therapeutic activities. (Kentucky Legislature)

Peer support may involve:

• Building relationships grounded in shared experience
• Supporting recovery goals
• Encouraging participant voice and choice
• Sharing relevant lived experience
• Promoting self-advocacy
• Helping people identify strengths
• Supporting recovery planning
• Connecting people with community resources
• Supporting participation in treatment or recovery services
• Facilitating community connection
• Helping people navigate systems
• Supporting transitions
• Encouraging wellness and self-management
• Supporting families
• Providing developmentally appropriate support to youth
• Participating on behavioral health teams
• Documenting peer services when required

Kentucky’s adult peer regulations specifically direct peers to use relevant personal stories, serve as role models, encourage consumer voice and choice, support consumers in meetings, and promote self-advocacy. (Kentucky Legislature)

Peer professionals are not automatically clinicians. The peer role is grounded in lived experience and recovery rather than clinical authority.

How Peer Support Is Organized in Kentucky

Kentucky does not use a single peer credential for every peer service.

Instead, the Commonwealth historically organized peer support around three major certified pathways:

• Adult Peer Support Specialist
• Kentucky Family Peer Support Specialist
• Kentucky Youth Peer Support Specialist

Each pathway is governed by a separate Kentucky Administrative Regulation. The current regulations are 908 KAR 2:220 for adult peer support, 908 KAR 2:230 for family peer support, and 908 KAR 2:240 for youth peer support. (Kentucky Legislature)

Beginning January 1, 2026, an additional distinction became especially important for substance use disorder services.

Kentucky now separates peers according to the setting in which SUD services are provided:

• Certified Peer Support Specialists may provide peer support in mental health, family, youth, and SUD settings that are not licensed as an AODE or BHSO.
• Registered Alcohol and Drug Peer Support Specialists provide peer support in SUD programs licensed as an Alcohol and Other Drug Entity or Behavioral Health Service Organization. (Cabinet for Health and Family Services)

This distinction is critical for organizations employing peer workers in Kentucky.

A worker’s required credential can depend not only on the population being served but also on the facility’s licensure and the type of service being delivered.

Adult Peer Support Specialists in Kentucky

What Is an Adult Peer Support Specialist?

Kentucky defines an Adult Peer Support Specialist as a self-identified consumer of mental health, substance use, or co-occurring mental health and substance use disorder services who has successfully completed the required peer support training. (Kentucky Legislature)

Adult peer support is intended to use the worker’s lived experience and recovery to help other consumers pursue personal and social change.

Adult Peer Support Specialists may work in settings such as:

• Community mental health centers
• Behavioral health programs
• Recovery community organizations
• Hospitals
• Primary care settings
• Crisis programs
• Community organizations
• Outreach programs
• Certain substance use recovery settings
• Other organizations employing qualified peer workers

Beginning in 2026, however, peer workers providing SUD services within licensed AODE or BHSO programs must follow the Registered Alcohol and Drug Peer Support Specialist pathway instead. (Cabinet for Health and Family Services)

Adult Peer Support Specialist Eligibility

Under 908 KAR 2:220, an Adult Peer Support Specialist must be at least 18 years old and have a current or past diagnosis of a mental health, substance use, or co-occurring disorder. (Kentucky Legislature)

The regulation contains additional eligibility requirements, and applicants should review the current regulation and DBHDID application materials before enrolling in training.

Adult Peer Support Specialist Training

Kentucky requires Adult Peer Support Specialists to successfully complete a DBHDID-approved training curriculum unless an applicable training waiver is granted.

The regulation requires approved adult peer support curricula to include at least 30 hours of training based on a nationally recognized model. (Kentucky Legislature)

Required training topics include areas such as:

• Problem solving
• Wellness Recovery Action Planning
• Stages of recovery
• Effective listening
• Establishing recovery goals
• Using support groups to promote and sustain recovery

The training curriculum must also include assessment of trainee knowledge, with a passing aggregate assessment score of at least 70 percent. (Kentucky Legislature)

DBHDID maintains approved peer support training providers and approves curricula used to prepare Kentucky Peer Support Specialists. (Cabinet for Health and Family Services)

Training Waivers

Kentucky allows certain individuals to request a waiver of the Adult Peer Support Specialist training requirement.

An applicant may submit documentation showing completion of a comparable peer support training sponsored by another state or federal entity.

The comparable training generally must have occurred within five years before the waiver request.

DBHDID reviews the request and determines whether the training satisfies Kentucky requirements. (Kentucky Legislature)

Adult Peer Support Specialist Responsibilities

Kentucky identifies several responsibilities for Adult Peer Support Specialists.

These include:

• Using relevant personal stories to assist other consumers
• Serving as a role model
• Encouraging consumer voice and choice
• Supporting consumers in development and implementation of plans
• Attending team meetings at the consumer’s request
• Accompanying consumers to meetings when requested
• Promoting self-advocacy
• Helping providers understand the importance of consumer voice and choice
• Maintaining continuing education requirements

These responsibilities illustrate Kentucky’s emphasis on maintaining a distinct lived-experience role rather than turning peer support into traditional clinical treatment. (Kentucky Legislature)

Kentucky Family Peer Support Specialists

What Is a Kentucky Family Peer Support Specialist?

A Kentucky Family Peer Support Specialist, or KFPSS, is an eligible parent or other family member who uses relevant lived experience to support another family navigating behavioral health services for a child or youth.

Kentucky defines relevant lived experience as experience navigating services and supports for a child or youth related to that child’s mental health, substance use, or co-occurring behavioral health condition. (Kentucky Legislature)

Family peer support differs from adult peer support because the lived experience belongs primarily to the parent or family member navigating systems on behalf of a child or youth.

What Does a Family Peer Support Specialist Do?

Depending on the setting, family peers may:

• Support parents and caregivers
• Share relevant family-system experience
• Help families understand behavioral health systems
• Promote family voice and choice
• Help families advocate for their child
• Support participation in treatment planning
• Help families navigate schools and community systems
• Connect families with resources
• Support transitions
• Help caregivers develop confidence navigating services
• Support family-driven planning
• Participate in multidisciplinary teams
• Promote recovery and resilience

Kentucky’s regulation specifically establishes minimum eligibility, training, and supervision requirements for the KFPSS role. (Kentucky Legislature)

Kentucky Family Leadership Academy

Kentucky’s family peer framework includes the Kentucky Family Leadership Academy, or KFLA.

The regulation describes KFLA as prerequisite leadership training designed for parents, family members, caregivers, and youth leaders. (Kentucky Legislature)

Applicants should confirm current KFLA and core competency training requirements directly with DBHDID because training schedules and delivery organizations may change.

Family Peer Continuing Education

Kentucky Family Peer Support Specialists must complete and document at least six hours of related training or education in each year following their initial peer training or approved waiver.

Training records are submitted to the department every three years. (Kentucky Legislature)

Kentucky Youth Peer Support Specialists

What Is a Kentucky Youth Peer Support Specialist?

A Kentucky Youth Peer Support Specialist, or KYPSS, is a young person with relevant lived experience who is specially trained to support other young people facing behavioral health challenges.

Kentucky has established youth peer support as a distinct workforce pathway rather than simply applying the adult peer model to younger people.

The regulation defines a KYPSS as an eligible youth who has completed the requirements of 908 KAR 2:240. (Kentucky Legislature)

Youth peer support may help young people with:

• Behavioral health engagement
• Self-advocacy
• Youth voice and choice
• Education
• Employment
• Career planning
• Life skills
• Healthcare navigation
• Community connection
• Transition to adulthood
• Recovery goals
• System navigation

Kentucky’s TAYLRD initiative, for example, serves youth and young adults ages 16 through 25 and uses Youth Peer Support Specialists with personal lived behavioral health experience. (Cabinet for Health and Family Services)

Youth Peer Training

Kentucky Youth Peer Support Specialists complete a state-defined competency training process.

Kentucky’s youth peer regulations also incorporate the Kentucky Family Leadership Academy as part of the state’s youth and family leadership infrastructure. (Kentucky Legislature)

After employment, a KYPSS must complete the department-approved Youth Peer Support 101 training.

Youth peers must also complete at least six hours of related education or training every subsequent year. (Kentucky Legislature)

Adult, Family, and Youth Peer Support: What Is the Difference?

These roles should not be treated as automatically interchangeable.

Eligibility, training, supervision, Medicaid requirements, and the relevant lived experience differ among the three pathways.

Major 2026 Change: Registered Alcohol and Drug Peer Support Specialists

One of the most important developments in Kentucky peer services took effect on January 1, 2026.

The Commonwealth now distinguishes between Certified Peer Support Specialists and Registered Alcohol and Drug Peer Support Specialists based partly on the setting in which substance use services are provided.

Certified Peer Support Specialists

Certified Peer Support Specialists continue to provide peer services in:

• Mental health settings
• Family services
• Youth services
• SUD settings not licensed as an AODE or BHSO
• Recovery Community Centers
• Other community-based organizations
• Hospitals
• Primary care clinics
• Other qualifying settings

(Cabinet for Health and Family Services)

Registered Alcohol and Drug Peer Support Specialists

Registered Alcohol and Drug Peer Support Specialists provide peer services in substance use disorder programs that are licensed as:

• Alcohol and Other Drug Entities
• Behavioral Health Service Organizations

(Cabinet for Health and Family Services)

The Kentucky Board of Alcohol and Drug Counselors administers the alcohol and drug peer registration pathway. (KY Board of Alcohol and Drug Counselors)

January 1, 2026 Deadline

Kentucky’s official peer support FAQ states that the change became effective January 1, 2026 and did not include a grace period.

Peers working in AODE or BHSO settings were required to become a temporary or fully Registered Alcohol and Drug Peer Support Specialist through the Board by that date in order to continue providing services in those settings. (Cabinet for Health and Family Services)

This is an important compliance distinction for Kentucky organizations.

A peer who previously qualified as an Adult Peer Support Specialist may need a different credential if the peer moves into an SUD program operating under an AODE or BHSO license.

Are Family and Youth Peer Credentials Affected?

Kentucky specifically states that the 2026 AODE/BHSO changes do not alter the Youth or Family Certified Peer Support Specialist requirements. (Cabinet for Health and Family Services)

Organizations should therefore distinguish among:

• Adult peer support
• Youth peer support
• Family peer support
• SUD peer support in non-AODE/BHSO settings
• SUD peer support in licensed AODE/BHSO settings

Is Peer Support Covered by Kentucky Medicaid?

Yes.

Kentucky Medicaid recognizes peer support as a behavioral health service when applicable requirements are satisfied.

Kentucky Medicaid regulations expressly recognize:

• Adult Peer Support Specialists
• Family Peer Support Specialists
• Youth Peer Support Specialists

and connect those qualifications to the respective DBHDID regulations. (Kentucky Legislature)

Kentucky’s public Medicaid materials describe Peer Support Services as social and emotional support provided by qualified adults and youth in recovery or family members of individuals with mental health conditions. (Cabinet for Health and Family Services)

Coverage does not mean every peer interaction is automatically billable.

Medicaid reimbursement may depend on:

• Member eligibility
• Diagnosis or service eligibility
• Medical necessity
• Provider type
• Organizational enrollment
• Peer qualification
• Supervision
• Treatment or service planning
• Authorization
• Place of service
• Procedure code
• Modifier
• Units
• Documentation
• Managed care requirements
• Applicable provider regulations

Can an Individual Peer Bill Kentucky Medicaid Directly?

Organizations and peer workers should not assume that certification as a Peer Support Specialist creates independent Medicaid billing authority.

Kentucky Medicaid behavioral health services are delivered through specified enrolled provider types and organizations.

The applicable billing structure depends on the type of provider, service, Medicaid regulation, and managed care arrangement.

A peer professional should therefore distinguish between:

• Being qualified to deliver a Medicaid peer service
• Being independently eligible to enroll as a Medicaid provider
• Being employed or contracted by an organization that can submit claims

These are not necessarily the same thing.

Kentucky Medicaid maintains provider-specific information describing enrollment and service requirements. (Cabinet for Health and Family Services)

Kentucky Medicaid Behavioral Health Provider Settings

Peer services may be delivered within several Medicaid-recognized behavioral health structures.

Examples may include:

• Community Mental Health Centers
• Behavioral Health Services Organizations
• Behavioral Health Multi-Specialty Groups
• Licensed behavioral health practitioners and groups
• Residential crisis stabilization services
• Other eligible Medicaid behavioral health providers

Kentucky Medicaid regulations for behavioral health organizations expressly reference peer workers qualified under 908 KAR 2:220, 2:230, and 2:240. (Kentucky Legislature)

Organizations should consult the exact Medicaid regulation applicable to their provider type rather than applying requirements from another provider category.

Supervision of Kentucky Peer Support Specialists

Supervision is a formal requirement within Kentucky’s peer support framework.

DBHDID states that regular supervision is required for qualified Peer Support Specialists. (Cabinet for Health and Family Services)

Adult Peer Supervision

Under 908 KAR 2:220, Adult Peer Support Specialist services must be delivered under supervision by an eligible professional.

The regulation identifies a range of qualified supervising professionals that begins with:

• Physician
• Psychiatrist
• Advanced practice registered nurse

and includes other qualified behavioral health professionals specified in the regulation. (Kentucky Legislature)

Supervision meetings must:

• Occur at least twice each month
• Include at least one individual supervision session
• Last at least 30 minutes

The supervising professional must maintain a written record documenting each supervision meeting. (Kentucky Legislature)

The record must include:

• Date
• Signatures
• Topics discussed
• Specific actions to be taken
• Updates on prior issues requiring follow-up
• Additional training needs

Family Peer Supervision

Family Peer Support Specialists are also required to work under an eligible supervising professional under 908 KAR 2:230. (Kentucky Legislature)

Youth Peer Supervision

Kentucky Youth Peer Support Services must also be delivered under supervision by an eligible professional.

The supervisor must complete the department-approved Youth Peer Support 101 training. (Kentucky Legislature)

This additional requirement is particularly important for organizations employing youth peers.

Continuing Education

Kentucky requires qualified Peer Support Specialists to complete at least six hours of related training or education each year. (Cabinet for Health and Family Services)

This applies across the adult, family, and youth pathways under their respective regulations.

Organizations should maintain systems for tracking:

• Initial training
• Training provider
• Date of completion
• Peer qualification
• Annual continuing education hours
• Continuing education topics
• Due dates
• Records submitted to DBHDID when required
• RADPSS registration when applicable

Scope of Practice for Kentucky Peer Support

Kentucky peer services are structured around lived experience, recovery, support, empowerment, and consumer choice.

Depending on the peer role and program, peers may:

• Build recovery-oriented relationships
• Share relevant lived experience
• Encourage participant voice and choice
• Support recovery goals
• Promote self-advocacy
• Attend meetings with participants
• Support participation in treatment planning
• Help participants identify strengths
• Help participants navigate behavioral health systems
• Connect participants with community resources
• Support wellness
• Help develop natural supports
• Encourage community participation
• Support transitions
• Facilitate groups when permitted
• Support families
• Support youth development
• Participate in multidisciplinary teams
• Document services

Activities Generally Outside the Peer Role

Unless separately licensed and acting within that professional license, peer workers generally should not:

• Diagnose mental health or substance use disorders
• Provide psychotherapy
• Prescribe medication
• Independently develop clinical diagnoses
• Conduct clinical assessments requiring professional licensure
• Make involuntary treatment decisions
• Represent themselves as licensed clinicians
• Make legal determinations
• Make Medicaid eligibility decisions
• Perform duties outside the applicable peer service definition

Organizations should establish written peer role descriptions and escalation procedures.

Documentation for Kentucky Peer Support Services

Peer support documentation should accurately demonstrate the service that occurred while maintaining the distinct nonclinical nature of the peer relationship.

Kentucky documentation requirements vary by:

• Medicaid provider type
• Service
• Payer
• Managed care organization
• DBHDID program
• Contract
• Grant
• Organizational policy

A peer support note may include:

• Participant name or identifier
• Date of service
• Start and end time
• Service duration
• Location
• Modality
• Peer service type
• Participant-defined goal
• Treatment or recovery-plan goal
• Peer intervention
• Relevant use of lived experience
• Recovery-oriented activity
• Resources discussed
• Participant response
• Progress
• Follow-up plan
• Peer worker name
• Peer qualification
• Required signature or attestation

Good Peer Documentation

Documentation should be:

• Accurate
• Timely
• Person-centered
• Recovery-oriented
• Strengths-based
• Relevant
• Respectful
• Specific to what occurred
• Consistent with the peer role
• Connected to applicable goals
• Consistent with Medicaid and organizational requirements

Documentation Should Avoid

• Unsupported diagnoses
• Stigmatizing language
• Clinical interpretations outside the peer role
• Copy-and-paste notes
• False or exaggerated services
• Unnecessary trauma details
• Personal opinions presented as clinical facts
• Generic statements that fail to explain what occurred
• Documentation created solely to fit a billing code

Documentation and Billing Are Not the Same Thing

A well-written peer support note does not automatically make a service reimbursable.

Payment may also depend on:

• Medicaid eligibility
• Medical necessity
• Diagnosis requirements
• Provider enrollment
• Qualified staff
• Supervision
• Service authorization
• Correct procedure code
• Required modifiers
• Units
• Place of service
• Telehealth requirements
• Managed care rules
• Timely filing
• Contracting

Kentucky’s 2026 Behavioral Health Fee Schedule is effective April 1, 2026 and was revised July 15, 2026. The state specifically notes that appearance of a code or rate on a fee schedule is not itself a guarantee of coverage or payment. (Cabinet for Health and Family Services)

Confidentiality and Information Sharing

Kentucky peer programs may handle sensitive mental health, substance use, family, and healthcare information.

Depending on the organization, requirements may include:

• HIPAA
• 42 CFR Part 2
• Kentucky confidentiality law
• Medicaid requirements
• Managed care contracts
• Consent requirements
• Special protections for minors
• Organizational policies
• Program-specific confidentiality requirements

Peer workers should receive role-specific training addressing:

• What information they may access
• What should be documented
• What may be shared
• Participant consent
• Communication within care teams
• Text messaging
• Electronic communication
• Telehealth
• Social media
• Crisis situations
• Substance use records
• Legal requests
• Privacy of youth and family information

Organizations providing SUD services should specifically assess whether 42 CFR Part 2 applies to their program and records.

Where Peer Support Is Delivered in Kentucky

Community Mental Health Centers

Kentucky’s regional Community Mental Health Centers are a major part of the Commonwealth’s behavioral health infrastructure.

Peer specialists may work alongside behavioral health professionals while maintaining their distinct lived-experience role.

Recovery Community Centers

Kentucky specifically identifies Recovery Community Centers as examples of settings where Certified Peer Support Specialists may continue delivering SUD peer support without becoming RADPSS, provided the organization is not licensed as an AODE or BHSO. (Cabinet for Health and Family Services)

Substance Use Disorder Programs

SUD peer services are delivered across treatment and recovery settings.

As of January 1, 2026, whether the peer requires Certified Peer Support Specialist status or RADPSS registration depends significantly on the facility’s licensing status.

Hospitals

Kentucky recognizes hospitals as another setting where Certified Peer Support Specialists may work. (Cabinet for Health and Family Services)

Peers may support:

• Behavioral health engagement
• Overdose response
• Recovery connections
• Discharge transitions
• Community referrals
• Treatment engagement

Primary Care

Primary care clinics are also identified by Kentucky as examples of settings where Certified Peer Support Specialists may provide services outside the AODE/BHSO registration requirement. (Cabinet for Health and Family Services)

Behavioral Health Service Organizations

BHSOs provide behavioral health and substance use services under Kentucky licensure.

Peer workers delivering SUD services within a BHSO must pay particular attention to the 2026 RADPSS requirements.

Alcohol and Other Drug Entities

AODEs are another licensed SUD provider category affected by the 2026 peer registration changes.

Crisis Services

Kentucky Medicaid regulations permit qualifying crisis programs to employ peer workers meeting the adult, family, or youth peer regulations.

Residential crisis stabilization regulations, for example, require qualifying peer specialists and ongoing continuing education and technical assistance. (Kentucky Legislature)

Youth and Transition-Age Programs

Programs such as TAYLRD incorporate Youth Peer Support Specialists into services for young people navigating behavioral health challenges. (Cabinet for Health and Family Services)

Family Behavioral Health Programs

Family Peer Support Specialists may work within child and family behavioral health programs supporting caregivers navigating services on behalf of children and youth.

Community-Based Organizations

Kentucky explicitly recognizes other community-based organizations as potential Certified Peer Support Specialist settings. (Cabinet for Health and Family Services)

Recovery Housing

Kentucky continues to expand its formal recovery housing infrastructure.

The Kentucky Recovery Housing Network launched an online certification and recertification portal in July 2026. (Cabinet for Health and Family Services)

Peer professionals may play important roles in recovery residences, although organizations must separately evaluate recovery housing, peer credentialing, Medicaid, and facility requirements.

Kentucky 1915(i) RISE Initiative

Kentucky has also expanded community behavioral health infrastructure through the 1915(i) Recovery, Independence, Support and Engagement Initiative, known as RISE.

CMS approved Kentucky’s 1915(i) State Plan Amendment in March 2025 with an effective date of July 1, 2025. (Cabinet for Health and Family Services)

The initiative targets adults age 18 and older with:

• Serious mental illness
• Co-occurring serious mental illness and substance use disorder

(Cabinet for Health and Family Services)

RISE includes home and community-based services such as:

• Assistive technology
• Case management
• In-home independent living supports
• Medication management
• Planned respite for caregivers
• Supervised residential care
• Supported education
• Supported employment
• Tenancy supports
• Non-medical transportation

(Cabinet for Health and Family Services)

RISE is not simply a peer support benefit, but it is highly relevant to Kentucky’s broader relationship-based and community behavioral health infrastructure.

Organizations employing peers may interact with RISE participants or collaborate with RISE providers around recovery, housing, employment, education, and community integration.

Starting a Peer Support Program in Kentucky

Organizations developing peer services in Kentucky should begin by defining the population and service rather than starting with a billing code.

Step 1: Define the Population

Determine whether the program serves:

• Adults with mental health conditions
• Adults with substance use disorders
• People with co-occurring conditions
• Youth
• Transition-age youth
• Parents and caregivers
• People leaving hospitals
• People in recovery housing
• People experiencing crises
• People returning from incarceration
• Other specific populations

Step 2: Determine the Correct Peer Pathway

Identify whether workers need to qualify as:

• Adult Peer Support Specialists
• Family Peer Support Specialists
• Youth Peer Support Specialists
• Registered Alcohol and Drug Peer Support Specialists

For SUD services, determine whether the organization is licensed as an AODE or BHSO.

This question became especially important after January 1, 2026.

Step 3: Determine the Funding Model

Potential funding may include:

• Kentucky Medicaid
• Medicaid managed care
• DBHDID contracts
• State funding
• Federal grants
• Opioid settlement funding
• Hospital funding
• Local government
• Recovery-oriented grants
• Philanthropy
• Private contracts

Funding sources may impose requirements beyond the underlying state peer credential.

Step 4: Confirm Qualifications

Verify:

• Age requirements
• Lived-experience requirements
• Required training
• Approved curriculum
• Training completion
• Training waiver status
• RADPSS registration when applicable
• Continuing education
• Supervision
• Additional employer requirements

Step 5: Design the Workflow

Map:

• Referral
• Intake
• Eligibility
• Consent
• Assignment
• Matching
• Scheduling
• Service delivery
• Documentation
• Supervision
• Crisis escalation
• Follow-up
• Transition or discharge
• Outcomes
• Billing

Step 6: Establish Scope and Boundaries

Develop policies addressing:

• Peer scope
• Use of lived experience
• Confidentiality
• Crisis response
• Transportation
• Gifts
• Social media
• Dual relationships
• Communication outside work hours
• Home visits
• Participant contact after discharge
• Clinical escalation
• Staff wellness
• Role drift

Step 7: Build Supervision

Determine:

• Who supervises each peer
• Whether the person meets 908 KAR requirements
• Frequency of supervision
• Individual versus group supervision
• Documentation requirements
• Training needs
• Clinical escalation procedures
• Support for peer role fidelity

Step 8: Track Credentials and Training

Organizations should monitor:

• Peer role
• Initial training
• Approved training provider
• Training date
• Annual continuing education
• Supervision
• RADPSS status if applicable
• Renewal or reporting deadlines
• Additional specialty training

Step 9: Measure Outcomes

Useful measures may include:

• Engagement
• Retention
• Participant-defined progress
• Recovery capital
• Community connection
• Treatment engagement
• Recovery housing stability
• Education
• Employment
• Family empowerment
• Youth self-advocacy
• Satisfaction
• Referral outcomes
• Crisis utilization
• Peer workforce retention
• Documentation timeliness

Step 10: Verify Billing Requirements Before Launch

Before submitting claims, verify current requirements with:

• Kentucky Department for Medicaid Services
• DBHDID
• Kentucky Board of Alcohol and Drug Counselors when applicable
• The applicable Medicaid managed care organization
• Provider-specific regulations
• Current fee schedules
• Contracts
• Qualified billing and compliance professionals

Common Challenges for Kentucky Peer Programs

Navigating the 2026 SUD Credential Changes

The new distinction between Certified Peer Support Specialists and Registered Alcohol and Drug Peer Support Specialists creates an additional compliance responsibility.

Organizations must know whether they operate under an AODE or BHSO license and determine the proper credential for each worker.

Multiple Peer Pathways

Kentucky separately regulates adult, family, and youth peer professionals.

Organizations serving multiple populations may need to track several peer credential types simultaneously.

Supervision Requirements

Kentucky establishes concrete supervision requirements for peer services.

Organizations need systems for:

• Scheduling supervision
• Documenting supervision
• Tracking individual supervision
• Maintaining signatures
• Identifying training needs
• Supporting supervisors

Continuing Education

Peer workers generally need at least six hours of related continuing education each year. (Cabinet for Health and Family Services)

Organizations should not wait until reporting deadlines to reconstruct training records.

Documentation Burden

Peer professionals often enter the workforce because of their ability to connect with people, not because they want to spend substantial amounts of time completing administrative documentation.

Documentation should support accountability without erasing the relational nature of peer services.

Role Drift

Peers may gradually be assigned duties associated with:

• Case management
• Clinical assessment
• Transportation
• Administrative work
• Surveillance
• Crisis decision-making
• Other professional roles

Organizations should actively maintain peer role fidelity.

Fragmented Technology

Programs may use separate systems for:

• Referrals
• Caseloads
• Scheduling
• Documentation
• Supervision
• Training
• Credentials
• Participant communication
• Outcomes
• Claims
• Grant reporting

Fragmentation makes peer programs harder to operate and oversee.

Demonstrating Outcomes

Traditional clinical measures may not capture the full value of peer support.

Programs may need to demonstrate changes in:

• Hope
• Recovery capital
• Connection
• Engagement
• Self-efficacy
• Community participation
• Family empowerment
• Youth voice
• Recovery stability
• Participant-defined progress

Frequently Asked Questions

Is peer support covered by Kentucky Medicaid?

Yes. Kentucky Medicaid covers certain behavioral health peer support services when applicable provider, qualification, supervision, medical necessity, documentation, and billing requirements are satisfied. Kentucky Medicaid regulations recognize adult, family, and youth peer support specialists. (Kentucky Legislature)

What is an Adult Peer Support Specialist in Kentucky?

An Adult Peer Support Specialist is a self-identified consumer of mental health, substance use, or co-occurring behavioral health services who has completed the required peer support training. (Kentucky Legislature)

How much training does an Adult Peer Support Specialist need?

Kentucky requires DBHDID-approved adult peer support curricula to include at least 30 hours of training. (Kentucky Legislature)

Do Kentucky Peer Support Specialists need continuing education?

Yes. Qualified Peer Support Specialists must complete at least six hours of related training or education annually. (Cabinet for Health and Family Services)

What is a Kentucky Family Peer Support Specialist?

A KFPSS is an eligible parent or family member with lived experience navigating behavioral health services and supports for a child or youth who uses that experience to support other families. (Kentucky Legislature)

What is a Kentucky Youth Peer Support Specialist?

A KYPSS is an eligible young person with relevant lived behavioral health experience who completes Kentucky’s youth peer training requirements. (Kentucky Legislature)

What changed for substance use peer support in 2026?

Beginning January 1, 2026, peers providing SUD services within programs licensed as an AODE or BHSO must use the Registered Alcohol and Drug Peer Support Specialist pathway through the Kentucky Board of Alcohol and Drug Counselors. (Cabinet for Health and Family Services)

Was there a grace period for the new SUD peer requirement?

No. Kentucky’s official FAQ states that the requirement became effective January 1, 2026 without a grace period. (Cabinet for Health and Family Services)

Do the 2026 changes apply to family and youth peers?

No. Kentucky states that the changes do not alter the Youth or Family Certified Peer Support Specialist requirements. (Cabinet for Health and Family Services)

Can an Adult Peer Support Specialist still provide SUD peer support?

Yes, in certain settings. Certified Peer Support Specialists may provide SUD peer services outside programs licensed as AODEs or BHSOs. In licensed AODE or BHSO SUD settings, the RADPSS requirements apply. (Cabinet for Health and Family Services)

Can peers work in hospitals?

Yes. Kentucky identifies hospitals as one example of a setting where Certified Peer Support Specialists may provide services. (Cabinet for Health and Family Services)

Can peers work in primary care?

Yes. Kentucky also identifies primary care clinics among non-AODE/BHSO settings where Certified Peer Support Specialists may work. (Cabinet for Health and Family Services)

Can peers work in Recovery Community Centers?

Yes. Recovery Community Centers are specifically identified as potential Certified Peer Support Specialist settings. (Cabinet for Health and Family Services)

Do Kentucky peer workers need supervision?

Yes. Regular supervision is required, and the specific requirements vary by peer role. (Cabinet for Health and Family Services)

How frequently does an Adult Peer Support Specialist need supervision?

Under the current adult peer regulation, supervision occurs at least twice each month, with at least one individual session, and each meeting must last at least 30 minutes. (Kentucky Legislature)

Can an individual peer bill Kentucky Medicaid independently?

Do not assume so. Peer qualification and independent Medicaid provider enrollment are separate issues. Billing depends on the service and enrolled Medicaid provider structure.

Are peer support specialists clinicians?

Peer support is a nonclinical role based on lived experience. A peer may separately hold a clinical license, but the peer role itself should remain distinct from licensed clinical practice.

Can peer specialists write progress notes?

Yes. Peer specialists may document services when required by Medicaid, an employer, contract, grant, or other program requirements.

Can peer support be delivered through telehealth?

Some behavioral health services may be delivered through telehealth when permitted by the applicable Medicaid, provider, and service rules. Organizations should verify the current rule for the specific peer service rather than assume all peer services are reimbursable remotely.

What is Kentucky’s RISE Initiative?

RISE stands for Recovery, Independence, Support and Engagement. It is Kentucky’s 1915(i) Medicaid home and community-based services initiative for eligible adults with serious mental illness or co-occurring SMI and SUD. CMS approved it in March 2025 with an effective date of July 1, 2025. (Cabinet for Health and Family Services)

Official Kentucky Peer Support Resources

Certification and Training

Kentucky Recovery and Peer Support

Official DBHDID resource for recovery-oriented services and Kentucky’s peer workforce, including Adult, Family, and Youth Peer Support Specialists, continuing education information, training resources, and related state guidance.

Last checked: August 19, 2026. (Cabinet for Health and Family Services)

Kentucky Peer Support Specialist Curriculum Approval Process

Official DBHDID resource describing the process for organizations seeking approval to deliver Kentucky Peer Support Specialist training and providing access to information about Adult, Family, and Youth peer curricula.

Last checked: August 19, 2026. (Cabinet for Health and Family Services)

908 KAR 2:220, Adult Peer Support Specialist

Official Kentucky Administrative Regulation establishing eligibility, training, responsibilities, continuing education, training waiver, and supervision requirements for Adult Peer Support Specialists.

Last checked: August 19, 2026. (Kentucky Legislature)

908 KAR 2:230, Kentucky Family Peer Support Specialist

Official Kentucky Administrative Regulation establishing eligibility, training, responsibilities, continuing education, training waiver, and supervision requirements for Kentucky Family Peer Support Specialists.

Last checked: August 19, 2026. (Kentucky Legislature)

908 KAR 2:240, Kentucky Youth Peer Support Specialist

Official Kentucky Administrative Regulation governing eligibility, training, continuing education, waiver, and supervision requirements for Kentucky Youth Peer Support Specialists.

Last checked: August 19, 2026. (Kentucky Legislature)

2026 Substance Use Peer Requirements

DBHDID Information on New Peer Support Regulations

Official Kentucky guidance explaining the January 1, 2026 distinction between Certified Peer Support Specialists and Registered Alcohol and Drug Peer Support Specialists based on service setting and AODE/BHSO licensure.

Last checked: August 19, 2026. (Cabinet for Health and Family Services)

Kentucky Peer Support 2026 Frequently Asked Questions

Official state FAQ explaining the transition to the RADPSS pathway, January 1, 2026 effective date, lack of a grace period, and how the changes apply to different peer roles and settings.

Last checked: August 19, 2026. (Cabinet for Health and Family Services)

Kentucky Board of Alcohol and Drug Counselors

State board responsible for the Registered Alcohol and Drug Peer Support Specialist pathway and other alcohol and drug counseling credentials.

Last checked: August 19, 2026. (KY Board of Alcohol and Drug Counselors)

Medicaid and Reimbursement

Kentucky Medicaid Provider Information

Official Kentucky Medicaid hub providing enrollment and provider-specific requirements for current Medicaid provider types.

Last checked: August 19, 2026. (Cabinet for Health and Family Services)

Kentucky Medicaid Behavioral Health and Substance Use Disorder Services

Official member-facing Kentucky Medicaid resource describing behavioral health benefits, including Peer Support Services.

Last checked: August 19, 2026. (Cabinet for Health and Family Services)

Kentucky Medicaid Behavioral Health Fee Schedules

Official Department for Medicaid Services resource containing current Kentucky Medicaid behavioral health rates and fee schedules.

Last checked: August 19, 2026. (Cabinet for Health and Family Services)

2026 Kentucky Medicaid Behavioral Health Fee Schedule

Current fee-for-service Behavioral Health Fee Schedule effective April 1, 2026 and revised July 15, 2026.

Last checked: August 19, 2026. (Cabinet for Health and Family Services)

Kentucky Medicaid Provider Letters and Resources

Official source for current Medicaid provider communications, updates, and policy materials.

Last checked: August 19, 2026. (Cabinet for Health and Family Services)

State Agencies

Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities

Primary state behavioral health agency overseeing Kentucky’s behavioral health system and Certified Peer Support Specialist infrastructure.

Last checked: August 19, 2026.

Kentucky Department for Medicaid Services

State agency responsible for administering Kentucky Medicaid and Medicaid provider coverage, reimbursement, enrollment, and policy.

Last checked: August 19, 2026.

Kentucky Board of Alcohol and Drug Counselors

State regulatory board responsible for alcohol and drug counseling credentials and the Registered Alcohol and Drug Peer Support Specialist pathway.

Last checked: August 19, 2026. (KY Board of Alcohol and Drug Counselors)

Community and Behavioral Health Resources

Kentucky Transition Age Youth Programs

DBHDID resource describing services for transition-age youth, including TAYLRD and Youth Peer Support Specialists.

Last checked: August 19, 2026. (Cabinet for Health and Family Services)

Kentucky 1915(i) RISE Initiative

Official Kentucky resource for the Recovery, Independence, Support and Engagement Medicaid initiative serving eligible adults with serious mental illness or co-occurring serious mental illness and substance use disorder.

Last checked: August 19, 2026. (Cabinet for Health and Family Services)

Kentucky Recovery Housing Network

Official Kentucky recovery housing infrastructure supporting certification and recertification of qualifying recovery residences.

Last checked: August 19, 2026. (Cabinet for Health and Family Services)

Resource Links

Kentucky Recovery and Peer Supporthttps://chfs.ky.gov/agencies/dbhdid/Pages/rps.aspx

Peer Support Specialist Curriculum Approval Processhttps://chfs.ky.gov/agencies/dbhdid/Pages/pss.aspx

908 KAR 2:220, Adult Peer Support Specialisthttps://apps.legislature.ky.gov/law/kar/titles/908/002/220/

908 KAR 2:230, Kentucky Family Peer Support Specialisthttps://apps.legislature.ky.gov/law/kar/titles/908/002/230/

908 KAR 2:240, Kentucky Youth Peer Support Specialisthttps://apps.legislature.ky.gov/law/kar/titles/908/002/240/

Kentucky 2026 Peer Support Regulation Informationhttps://chfs.ky.gov/agencies/dbhdid/Pages/inrrpss.aspx

Kentucky Board of Alcohol and Drug Counselorshttps://adc.ky.gov/

Kentucky Medicaid Provider Informationhttps://chfs.ky.gov/agencies/dms/provider/Pages/default.aspx

Kentucky Medicaid Fee Scheduleshttps://chfs.ky.gov/agencies/dms/Pages/feesrates.aspx

Kentucky Medicaid Behavioral Health and Substance Use Disorder Serviceshttps://chfs.ky.gov/agencies/dms/member/pages/substanceabuse.aspx

Kentucky 1915(i) RISE Initiativehttps://chfs.ky.gov/agencies/dbhdid/Pages/1915iriseinitiative.aspx

Kentucky Recovery Housing Networkhttps://chfs.ky.gov/agencies/dbhdid/Pages/krhn.aspx

Technology for Kentucky Peer Support Programs

Kentucky’s peer workforce has become increasingly complex because organizations may need to manage multiple peer roles, different service settings, Medicaid requirements, and the new SUD registration rules.

Technology supporting Kentucky peer programs should account for:

• Adult Peer Support Specialists
• Family Peer Support Specialists
• Youth Peer Support Specialists
• Registered Alcohol and Drug Peer Support Specialists
• Work setting and facility licensure
• AODE/BHSO status
• Training completion
• Annual continuing education
• Supervision frequency
• Individual supervision requirements
• Supervisor qualifications
• Training waivers
• Credential and registration records
• Peer-specific documentation
• Participant-defined goals
• Recovery-oriented language
• Referrals
• Caseloads
• Scheduling
• Individual and group services
• Participant communication
• Outcomes
• Medicaid documentation
• Claims workflows
• Role-based permissions
• Sensitive behavioral health and substance use information
• Community-based service delivery
• Youth and family workflows

The distinction between a peer worker’s credential and the organization’s licensure is especially important in Kentucky after the January 1, 2026 SUD peer changes.

A system should be able to identify not simply that an employee is a peer professional, but which peer qualification that person holds and whether it is appropriate for the service and setting in which the person is working.

Generic clinical records may capture encounters but fail to capture recovery goals, lived-experience interventions, community connections, family empowerment, youth voice, and other aspects of peer support that distinguish the service from traditional clinical treatment.

Technology should strengthen peer practice rather than force Kentucky’s peer workforce 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, billing workflows, and day-to-day operations.

Peerakeet does not determine whether a Kentucky service is billable and does not replace guidance from DBHDID, Kentucky Medicaid, the Kentucky Board of Alcohol and Drug Counselors, managed care organizations, attorneys, compliance professionals, or state and federal agencies.

Editorial Disclaimer

This guide is provided for general educational purposes. It is not legal, billing, credentialing, clinical, or regulatory advice.

Kentucky peer support requirements may vary by service, payer, provider type, facility license, contract, credential, population, and program.

The January 1, 2026 changes affecting substance use peer workers make it particularly important to determine whether an organization operates under an Alcohol and Other Drug Entity or Behavioral Health Service Organization license.

Regulations, Medicaid requirements, fee schedules, provider manuals, registration rules, training requirements, managed care policies, and state guidance may change after publication.

Organizations and peer professionals should verify current requirements with DBHDID, Kentucky Medicaid, the Kentucky Board of Alcohol and Drug Counselors, applicable Medicaid managed care organizations, provider regulations, and qualified professional advisors.

Last reviewed: August 2026.