Join the PROSPER Network

PROSPER Network Membership Application

Complete the application below to join the Peer and Recovery Organization Sustainability Planning Equity and Research (PROSPER) Network. Along with the recovery community and stakeholder organizations, RecoveryPeople creates a social impact network to address complex problems. The purpose of PROSPER is to strengthen the capacity of peer and recovery organizations to:

Drive state, local and organization policies;
Access a more diverse set of revenue streams; and
Advance the integration and provision of recovery support services across coordinated state and local recovery-oriented systems of care.

Learn more about PROSPER

Name(Required)

First Last

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Residential Zip Code

What is the zip code of where you live?

ZIP Code

Email(Required)

What email can RecoveryPeople use to send you updates on progress, events and news as well as opportunities for you to contribute qualitative and quantitate data?

Phone

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Gender(Required)

What is your gender identity?

Male

Female

Transgender (Male to Female)

Transgender (Female to Male)

Gender non-conforming

Prefer Not to Answer

Other

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Race(Required)

What is your race and/or ethnicity? You may select more than one.

Black or African American

White

American Indian

Alaska Native

Asian Indian

Chinese

Filipino

Japanese

Korean

Vietnamese

Other Asian

Native Hawaiian

Guamanian or Chamorro

Samoan

Other Pacific Islander

Other

Prefer not to answer

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Hispanic, Latino/a, Spanish Origin(Required)

Are you Hispanic, Latino/a, or Spanish origin?

Yes

Prefer not to answer

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Orientation(Required)

What is your sexual orientation?

Straight or Heterosexual

Homosexual (Gay or Lesbian)

Bisexual

Queer

Pansexual

Questioning

Asexual

Prefer not to answer

Other

Organization(Required)

What organization do you represent? (If you represent more than one, you are welcomed to enter multiple organizations separated by a comma ",". If you do not represent an organization, please enter N/A)

Title / Role(Required)

What is your title or role within the organization?

Organization Address(Required)

What is the address of the organization (personal, local or regional)?

Street Address Address Line 2 City State ZIP Code

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Nonprofit Status(Required)

What is the IRS designation of this organization?

501c3 Nonprofit

501c6 Nonprofit

501c4 Nonprofit

Government Agency

Educational or Research Institution

For Profit

Other

Perspective(s)(Required)

What perspective(s) to you bring to the PROSPER network? (Choose at least one)

PRO - We/I provide peer and recovery supports and services to individuals or family members impacted by substance use or mental health challenges.

Payer - We/I fund, award, sub-award, contract, subcontract, scholarship or pay for peer and recovery services for individuals or family members impacted by substance use or mental health challenges.

Stakeholder - We/I have a vested interest in individuals or family members impacted by substance use or mental health challenges receiving peer and recovery supports and services.

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Governance

Which of the following best describes your organization's governance?

Peer-governed - A majority of the governing board or ownership identify as individuals with a history of mental health or substance use challenges

Family-governed - A majority of the governing board or ownership identify as family members affected by mental health or substance use challenges

Peer- & Family- governed - A majority of the governing board or ownership identify as an individual and/or family member affected by mental health or substance use challenges

None of the above

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Billing Administrator

Who in your organization is responsible for billing for services?

First Last

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Billing Administrator's Email

What is the best email for the billing administrator?

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Billing Administrator's Phone Number

What is the best phone number for the billing administrator?

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Peer and Recovery Services

What type of peer and recovery services does this organization provide? (Check all that apply)

Peer Specialist

Recovery Coaching Services

Recovery Groups

Recovery Education

Life Skills Development

Recovery High School

Recovery Center

Recovery Housing

Other

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Other Peer and Recovery Services

What other types of peer and recovery services does this organization provide?

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Population Served

What populations does this organization primarily serve?

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Geography Served

What is this organization's service area? What cities, counties, regions, and/or states?

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Who else should we invite to the PROSPER Network?

The potential impact of a network is measured through the number and quality of the connections within in it. In the spirit of increasing the impact of the PROSPER network, help use invite peer and recovery organizations, payers or stakeholders to join. You can let us know who you will be inviting below, or you can share their name, contact and/or their organization and we will reach out to them.

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Advisory Committee Nominee

If you would like to nominate someone to serve on the PROSPER Advisory Committee, please provide their name.

First Last

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Advisory Committee Nominee's Email

How can we contact the person you are nominating to the PROSPER Advisory Committee

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Advisory Committee Nominee's Bio

What knowledge, skills, abilities, perspectives and experience does your nominee bring to the advisory committee?

Commitment(Required)

By joining the PROSPER network, I commit to its purpose:

The purpose of the Peer and Recovery Organization Sustainability, Planning, Equity and Research (PROSPER) network is to strengthen the capacity of peer and recovery organizations to: 1) drive state, local and organization policies; 2) access a more diverse set of revenue streams, and 3) advance the integration and provision of recovery support services across coordinated state and local recovery-oriented systems of care. This will be accomplished by: 1) expanding the the PROSPER network across peer and recovery organizations (PROs), payers and stakeholders; 2) developing PROSPER sustainability models and a statewide strategic plan; 3) multilaterally identifying policy, knowledge, and capacity strengths, weaknesses, opportunities and threats (SWOT); and 4) multidirectionally developing and implementing solutions (e.g., advocacy, awareness, training and technical assistance).

Please add me to the RecoveryPeople and PROSPER newsletter distribution list.

I reserve the right to withdraw from the PROSPER network at anytime by emailing RecoveryPeople.

Join the PROSPER Network

PROSPER Network Membership Application

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