BOSTON — A state commission is recommending professional licensing for the recovery coaches who are increasingly sent to emergency rooms, drug treatment centers and courtrooms to help addicts get clean.
A 15-member panel, created as part of a sweeping opioid bill signed into law by Gov. Charlie Baker last year, wants recovery coaches to be regulated under a yet-to-be-created board of registration for the emerging profession.
Recovery coaches should have "lived experience" as former addicts, according to the recommendations, but should be in recovery for at least two years before working with patients. Advocates say it's important that any certification for the coaches not be so rigid as to prevent former addicts who want to help others from getting involved.
"Recovery coaches play a important role in helping people through treatment, and they should be treated as an integral part of the team," said Julie Burns, president of RIZE Massachusetts, an advocacy group that contributed to the report. "So the notion that there will be standardized training and credentialing makes a lot of sense."
To be sure, the panel suggests the state "grandfather in" some recovery coaches without "lived experience" who've already been certified by a state program, and it suggests that health care providers be flexible enough "to hire un-credentialed recovery coaches who have a demonstrated skill or capability but do not have two years of sustained recovery."
Recovery coaches have been around for decades, originally as volunteers who had beaten alcoholism or drug addiction, and wanted to help others. Health officials have turned to them more frequently as the state continues to confront a wave of addiction.
Long-term recovery remains one of the biggest hurdles to breaking the cycle of addiction.
Though the number of opioid-related deaths reported each year has declined in Massachusetts, as have the number of non-fatal overdoses, health officials say the problem is still substantial. There were 497 confirmed and estimated opioid-related overdose deaths in the first half of 2019, more than five per day, according to the Department of Public Health.
Baker and other state leaders want to integrate peer recovery coaches more into the health care system, helping addicts who've taken the first steps toward recovery.
More than 20 states have some kind of recovery coach designation, though requirements vary widely.
In Massachusetts, the Department of Public Health’s Bureau of Substance Abuse Services runs a five-day training that certifies coaches to work at hospitals and other facilities. To date, it has trained 1,078 recovery coaches, and another 369 recovery coach supervisors.
The state agency has set new rules requiring at least 60 hours of training to become certified, among other regulations. The certification is not mandatory for those who work as recovery coaches, however.
At the ER
Several hospitals — including Salem Hospital and Union Hospital in Lynn — have been adding recovery coaches to emergency rooms and long-term substance abuse treatment programs.
Salem Hospital and Union Hospital have hired 10 recovery coaches as part of a project with North Shore Medical Center and Bridgewell, which provides substance abuse treatment. When addicts overdose and show up at the ER, they meet a coach who acts as a case manager.
The state's Medicaid program started reimbursing some costs of recovery coaches last year. MassHealth plans to spend more than $38 million on recovery coach support services over the next five years, according to the Executive Office of Health and Human Services.
On Beacon Hill, lawmakers are considering proposals to expand the use of recovery coaches, including mandatory coverage for their services though MassHealth and other government-backed insurance. Some industry officials warn such a move could drive up the state's health care costs.
Some private insurers have been testing the use of recovery coaches in partnership with health care providers or nonprofit groups, but the current lack of standards means most insurers are still unwilling to pay for their services.
Substance abuse counseling groups say the coaches are effective because they share common experiences with patients.
"They've walked that walk," said Joanne Peterson, executive director of Learn to Cope, a nonprofit that offers resources to families of people struggling with addiction. "When someone is seeking treatment, having someone to talk with who's been through it, who can show that there is a way out, can make an enormous difference in their life."
Christian M. Wade covers the Massachusetts Statehouse for The Salem News and its sister newspapers and websites. Email him at firstname.lastname@example.org.