Table 4.

Facilitators for implementation of peer recovery coaches in emergency departments

Facilitators	Description	Quote
Resources	Supportive resources, such as available trainings and funding to support implementation	“[W]e do have supervision training for those that are supervising the recovery coaches… So, it's only a one-day training, and we highly recommend that whoever would be supervising would attend this training.” Organizer, March 29, 2018
PRC certification	Certifications for PRCs through formalized training	“[T]he recovery coach certification is based on more of the motivational interviewing, is most likely going to be a person with lived experience with addiction and is now in long-term recovery. There’s a lot of ethical training in that, and that’s like a week-long course.” PRC, December 20, 2018
Program champions	Hospital and CMH staff who are program champions promoting use of PRCs and MOUD	“We have a specific [ED] physician that’s really taken this on board and is reaching out specifically to the coach themselves.” Hospital Administrator, October 11, 2018
Expansion to jails	Pursuit of program sustainability by having PRCs move beyond ED to the local jail context	“I’m going to be doing some [jail-referred] intakes here soon, probably right after the holidays, and then I have a peer coach that is going to be going over [to the jail] one day a week and she’s going to be doing groups and individual sessions, so that will probably help out a lot.” PRC Supervisor, November 21, 2019
Billing	EDs ability to bill for PRC and MOUD services	“I hope our experiences with COVID [billing Medicaid for telehealth PRC contacts] becomes a thing, and you guys can continue billing for Medicaid after all of this wraps up.” Organizer, April 23, 2020
Telehealth	PRC utilization of telehealth for contact with patients in the ED	“[W]e had the peers in the ED, and now, you know, we’re all working from home. And trying to reach all of our individuals via the phone, or we can video chat with them.” PRC Supervisor, April 23, 2020

ED emergency department; MOUD medication for opioid use disorder; PRC peer recovery coach.