2SHB 1427
SignedHouse
Peer support specialists
Concerning certified peer support specialists.
How does a bill become law?
- Introduced: The bill is filed and assigned a number.
- Committee: A subject-matter committee holds hearings, takes public testimony, and decides whether to advance the bill.
- Floor Vote: The full chamber (House or Senate) debates and votes on the bill.
- Opposite Chamber: The bill repeats the committee and floor vote process in the other chamber.
- Governor: The Governor reviews the bill and decides whether to sign or veto it.
- Signed: The bill has been signed into law.
AI Analysis
This bill expands access to certified peer support specialists by allowing them to work in diverse settings (e.g., primary care, hospitals, victim services), bill insurance for their services, and obtain endorsements in specialized areas like domestic violence and sexual assault. It also creates new training, certification, and billing pathways, and establishes performance payments for crisis response teams.
- Expands access to peer support services by requiring health carriers to cover certified peer support specialists and trainees by July 1, 2026, and allowing billing for services in non-traditional settings like primary care clinics and hospitals.
- Creates new endorsements for peer support specialists to serve survivors of domestic violence, sexual assault, and human trafficking—voluntary for most, but required if the specialist works for a victim services agency and seeks reimbursement from Medicaid or insurers.
- Requires the Washington Health Care Authority to develop and offer new training and certification courses for peer support specialists, including 80-hour foundational training, supervision training, and 40-hour specialized training in peer crisis response.
- Directs the Office of Crime Victims Advocacy to develop and offer no-cost endorsement-specific training courses by July 1, 2026, and collaborate with the Department of Health to verify completion.
- Creates a performance payment program for mobile rapid response and community-based crisis teams that meet network adequacy and response time standards, with enhanced payments for top-performing teams.
- Mandates that by July 1, 2025, the Health Care Authority contract with an external entity to develop proposals for expanding billing for peer support services across settings—including law enforcement diversion, recovery navigator, and homeless outreach programs—and to explore capitated payment models instead of fee-for-service.
Who is affected
- Certified peer support specialists and trainees — Certified peer support specialists and trainees gain new pathways to certification, expanded practice areas (including domestic violence, sexual assault, and human trafficking), and clearer pathways to bill insurance for their services.
- Victim services agencies — Victim services agencies can now bill insurance for peer support services when staff hold relevant endorsements, expanding funding options and service reach.
- Health carriers (insurance companies) — Health carriers (insurance companies) must expand coverage to include peer support specialists and trainees, and may adopt new payment models like capitation.
- Primary care and urgent care clinics and hospitals — Primary care clinics, urgent care clinics, and hospitals gain support to integrate peer support specialists into clinical teams and bill for those services.
- Individuals receiving behavioral health services — Medicaid enrollees and others seeking behavioral health services gain improved access to peer support services across more settings and with broader insurance coverage.
Pro/Con Analysis
Stronger case for benefits
Potential Benefits (5)
Requires health carriers to cover certified peer support specialists and trainees by July 1, 2026, significantly expanding insurance access to peer support services for Medicaid and commercially insured individuals—especially low-income and underinsured people who previously had no coverage for these services.
HealthcarePeopleRef: Sec. 2 (new), 48.43.825Expands the practice of peer support services beyond Medicaid-only settings to include primary care, hospitals, and urgent care clinics, enabling integration of lived-experience support into mainstream clinical care and reducing fragmentation for people with complex behavioral health needs.
HealthcarePeopleRef: Sec. 2 (new), 18.420.005(2)Authorizes endorsements for peer support specialists working with survivors of domestic violence, sexual assault, and human trafficking—voluntary for most, but required for billing when employed by victim services agencies—ensuring culturally grounded, trauma-informed support for vulnerable populations.
Rights & LibertiesPeopleRef: Sec. 2 (new), 18.420.005(2)Establishes a performance payment program for mobile rapid response and community-based crisis teams meeting network adequacy and response time standards, incentivizing faster, more reliable crisis response and reducing reliance on law enforcement for behavioral health emergencies.
Public SafetyPeopleRef: Sec. 2 (new), 71.24.903(10)Mandates development of an 80-hour foundational training course for certified peer support specialists, plus specialized 40-hour training in peer crisis response—expanding the qualified workforce and improving service quality while prioritizing culturally appropriate delivery.
EducationPeopleRef: Sec. 2 (new), 71.24.920(1)
Potential Concerns (4)
Mandates health carriers to cover certified peer support specialists and trainees by July 1, 2026, increasing administrative and network management obligations for insurers without offsetting compensation or risk-adjusted reimbursement changes.
Business & EmploymentPeopleRef: Sec. 2 (new), 48.43.825Caps certification and renewal fees at $100 for peer support specialists (2025–2030) and substance use disorder professionals (2024–2029), reducing state licensing revenue and potentially shifting costs to other regulated professions or public programs.
Business & EmploymentLean peopleRef: Sec. 2 (new), 18.420.020(2)Creates a performance payment program for mobile rapid response and community-based crisis teams, with enhanced payments tied to response time metrics—benefiting larger, better-resourced teams in urban areas more than smaller or rural providers.
Business & EmploymentPeopleRef: Sec. 2 (new), 71.24.903(10)Requires the Office of Crime Victims Advocacy to develop and offer no-cost endorsement-specific training courses by July 1, 2026, creating new state administrative costs and potentially diverting resources from other victim services without clear cost-sharing or sustainability plan.
Business & EmploymentLean peopleRef: Sec. 2 (new), 43.280.080(1)
Who Is Most Affected
Peer support specialists gain expanded practice settings, insurance billing pathways, and specialized endorsements—especially those working with survivors of gender-based violence. The $100 fee cap reduces financial barriers to certification, and new training pathways improve professional credibility and career mobility.
Victim services agencies gain new billing options for peer support services when staff hold relevant endorsements, increasing revenue potential and enabling integration of peer support into trauma-informed care—though compliance with endorsement requirements adds administrative burden.
Health carriers must expand coverage to include peer support specialists and trainees, increasing benefit obligations but also enabling new reimbursement streams and potential cost savings through reduced ER visits and hospitalizations. The $100 fee cap reduces state licensing revenue, indirectly affecting public programs.
Primary care, urgent care, and hospital systems gain support to integrate peer support specialists into clinical teams and bill for those services, improving whole-person care capacity—especially for patients with co-occurring behavioral and physical health needs.
Individuals receiving behavioral health services—especially Medicaid enrollees, survivors of violence, and people in crisis—gain improved access to peer support across settings and with broader insurance coverage, reducing barriers to recovery-oriented care.