Peer recovery specialists have been key to helping many people struggling with addiction, but Minnesota lawmakers are considering safeguards to prevent bad actors in a growing field that has had little oversight.

"Right now I think we've got the wild, wild West here, unfortunately, in some areas. And we just need to tighten it up without hurting the folks who are doing it right," Rep. Dave Baker, R-Willmar, said at a hearing Wednesday where lawmakers considered additional regulations and oversight.

The peer recovery workers receive professional training and "walk alongside" a person experiencing addiction, helping them set and meet goals, said Wendy Jones, who leads the Minnesota Alliance of Recovery Community Organizations.

"They model from their own lived experience, but they also have a deep knowledge of resources in the community," Jones said. "It fills that spot that a lot of people need."

Peer recovery services came under scrutiny amid concerns about the nonprofit Refocus Recovery and its related for-profit company, Kyros. A KARE 11 series highlighted issues with the company, including problems with improper billing. Minnesota's Department of Human Services Inspector General Kulani Moti said Wednesday they had been aware of concerns with the organizations before the media scrutiny and have an ongoing investigation into Kyros and Refocus Recovery.

Daniel Larson, who founded Refocus Recovery and Kyros, was ill Wednesday and unable to respond to an interview request, a spokesman said.

While lawmakers noted frustrations with the organization, they stressed that many recovery community organizations that run peer programs are doing essential work across the state.

Minnesota started to allow recovery community organizations (RCOs) to bill Medicaid for peer recovery services in 2018. When Minnesota first allowed the billing, there were only a few of the organizations here. Now, Jones said, there are at least 23.

Jones said her group and the national Alliance of Recovery Community Organizations are launching certification processes to more formally vet organizations that want to do the work.

There are various steps the state could also take to ensure those programs' integrity, said Kristy Graume, legislative director for Behavioral Health, Housing, Deaf-Hard-of-Hearing and Disability Services. State officials have been talking to community members since last year about potential additional oversight and enrollment requirements for providers.

The state could mandate that peer recovery specialists develop an individual recovery plan with a client during their first few meetings and require that services be tied to that plan, Graume told lawmakers. Organizations should also be required to keep adequate client files, she said.

Graume also suggested a review of up to 15% of medical assistance claims for peer support services, and said they could limit peer recovery support services to four hours a week for a client unless more is authorized. Currently people can receive up to 14 hours a week.

Where to lodge complaints

Aubrey Kjerstenson is one of the clients who raised concerns about Refocus Recovery. Kjerstenson, 31, was living in a sober home in Minneapolis and receiving peer recovery services through the organization last year. The peer specialists helped arrange appointments and took Kjerstenson to get medications. But after a couple months, Kjerstenson said the organization billed insurance for many hours of service it was not providing.

Kjerstenson asked various state agencies for help, but said those pleas went unanswered. There needs to be a clear place to bring complaints, more transparency in billing, and oversight when peer recovery specialists are billing large sums, they said.

"Most [peer recovery specialists] are really great people and they do really good work," Kjerstenson said. "But if there's issues ... you don't really have anybody who can help you through things like that."

There's a state Office of Ombudsman for Mental Health and Developmental Disabilities, but Rep. Luke Frederick, DFL-Mankato, said he wants to add behavioral health to that title and make it clear that they also handle concerns about peer recovery.

"Whether they are a peer or whether they are somebody receiving services from a peer, if there's something that doesn't feel right or they think is illegal or unethical ... they would have that centralized person to be able to go to and make those reports to," Frederick said.

Caddy Frink, director of programs at Minnesota Recovery Connection, said she sees at least 20 people a month who want to be peer recovery specialists because "they don't want anybody to hurt the way they did, if they can help remove some of the barriers and some of the unknown."

However, she stressed that sufficient training, supervision and care for the peer recovery workers is essential.

"This isn't a wealth growth opportunity," Frink said. "This is a health opportunity."