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Spotlight on Development of President Trump’s Children’s Health Strategy

This week, our In Focus section highlights President Trump’s Make America Healthy Again (MAHA) executive order, which is designed to address the challenges driving chronic diseases in the United States. Our article delves into the key components of the order, presents a data snapshot about the state of children’s health, and discusses implications for stakeholders seeking to prepare for and inform the transitions impacting the future of children’s health.

Presidents can use executive orders to communicate their priorities and set a framework and timelines for federal agency actions. Historically, these orders have provided strong signals for the initiatives and policy direction that federal departments and agencies will pursue. Health Management Associates (HMA), experts are monitoring the MAHA directive and several other executive orders, alongside other Trump Administration actions.

Executive Order: Making Children Healthy

On February 13, 2025, President Trump signed an executive order establishing the Make America Healthy Again Commission, chaired by US Department of Health & Human Services (HHS) Secretary Robert F. Kennedy, Jr. The commission, which builds on the Secretary’s prior work, is charged with combating “critical health challenges facing citizens, including the rising rates of mental health disorders, obesity, diabetes, and other chronic diseases.”

Initially, the commission will focus on studying and addressing childhood chronic diseases. The order directs the commission to release within 30 days an assessment that summarizes what is known about the childhood chronic disease crisis, identifies gaps in knowledge, and includes international comparisons. This report will serve as the foundation for developing a strategy to improve the health of children, which is due within 180 days of the order.

Data Snapshot: Childhood Chronic Conditions

Evaluating existing data and identifying gaps in data for children are critical initial steps toward developing a comprehensive and evidence-driven federal policy agenda. At present, 90 percent of the $4.5 trillion in annual US healthcare expenditures are used to provide services to people with chronic and mental health conditions. Many of the risk factors for developing these conditions begin in childhood and some are preventable. For example:

Obesity affects 20 percent of children and 42 percent of adults, putting them at risk of chronic diseases such as type 2 diabetes, heart disease, and some cancers. More than one in three young adults ages 17−24 are too heavy to join the US military. The youth obesity rate from 2017−2020 was 19.7 percent, a 42 percent increase from the rate in 1999−2000. Lifestyle choices, combined with social and environmental factors like access to healthy foods and neighborhood walkability and safety can significantly reduce the risk of developing obesity.
In 2022, diabetes and the complications associated with it accounted for $413 billion in total medical costs and lost wages in the United States. While few children have type 2 diabetes, nearly one in five adolescents (12−18 years old) have prediabetes and may develop diabetes in adulthood. Like obesity, both personal choices and adverse social and environmental factors can increase the lifetime risk of developing diabetes.
Approximately 4.9 million children in the United States have asthma, which is incurable but can be managed. Asthma is one of the main causes for missed school days among children. Many US schools have poor indoor air quality, which can expose children to allergens, irritants, and triggers such as mold, dust, and pests. Conditions in children’s homes also can exacerbate asthma.

How Federal Programs Impact Children’s Health

Numerous federal programs directly and indirectly affect children’s health. Examples include:

Nationally, more than 38 percent of children have Medicaid coverage, with rates exceeding 50 percent in some states and territories (e.g., Louisiana, New Mexico, Puerto Rico). Medicaid’s requirement to cover Early Periodic Screening, Diagnostic and Treatment (EPSDT) has long been the vehicle for addressing the chronic healthcare needs of children on Medicaid. For example, for children with asthma, in addition to covering medications to prevent and treat exacerbations, some states will reimburse providers for conducting home health assessments to identify and remediate triggers in the home. In addition, federal funding through both Medicaid and US Department of Education supports school nurses and school-based health centers, which can be critical resources in addressing the chronic healthcare needs of students, such as the administration of Insulin or providing inhalers to children experiencing asthma.
To receive funding through the National School Lunch and School Breakfast programs, schools must provide meals aligned with the “meal pattern” established by US Department of Agriculture, which specifies the amount of food among various groups and an age-based maximum for calories, saturated fat, and sodium. Under current guidelines, by 2027, school meals also will be expected to comply with limits on added sugars.
Participants in the Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC), which provides participants with certain foods to meet their nutritional needs, have a lower risk for preterm birth, low birthweight infants, and infant mortality.

Federal programs affect children’s home and school environment in other ways, and the health implications of those funding choices may not be explicitly recognized or prioritized. For example:

Housing assistance programs in some cases prevent families from experiencing homelessness but may place them in living situations where exposure to environmental hazards such as mold, pests, or pollution and neighborhood factors like crime and lack of walkability may adversely affect their health.
Some federal agriculture programs are specifically designed to make nutritious foods available (e.g., Gus Schumacher Nutrition Incentive Program, or GusNIP), while others support agriculture without specifically bringing a health lens to those programs.

Implications for Stakeholders

The President has directed that the strategy address “appropriately restructuring the Federal Government’s response to the childhood chronic disease crisis, including by ending Federal practices that exacerbate the health crisis or unsuccessfully attempt to address it, and by adding powerful new solutions that will end childhood chronic disease.” Though we do not know what the Make our Children Healthy Again Assessment and Strategy will recommend, we anticipate it will present both opportunities and risks for organizations focused on children’s health. As the commission begins its work, organizations can take the following actions:

Consider policy opportunities: Review your organization’s strategic plan as well as your operational and policy priorities and consider how they may fit into this framework. This could be the time to suggest changes to federal grants you receive or federal regulations or requirements that negatively affect your ability to keep children healthy.
Prepare for potential funding disruptions: It is possible that programs you rely on will have changes in scope or funding levels. Review your offerings for children with chronic conditions and identify substitutes or complements to your main priorities. Consider partners you might work with to keep work going that may not have the same level of federal support in the future.
Be prepared to share the real-world impacts of policy changes: Begin gathering data, stories, and compelling information to share about chronic conditions affecting children that can be used in future public comment opportunities, shared with the media, and discussed with your federal, state, and local representatives. Think about how to talk about these issues in a clear and compelling way that will resonate with each of those audiences.
Find partners and allies: As you consider the policy opportunities and risks, think about other organizations that share your interests and how you can work with them in complementary ways. It can be compelling to policymakers when stakeholders who might not naturally be aligned on other issues can unite around a specific policy area.

Connect with Us

Healthcare stakeholders with a commitment to healthy children and healthy adults have an opportunity to support the specific policies and funding opportunities that may emerge from the MAHA order. To learn more about these policy changes, the impact on your organization, and actions your organization can take, contact our one of our featured experts below.

A Closer Look at Gubernatorial Healthcare Priorities: 2025 State of the State Address Overview

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This week, our In Focus section examines governors’ healthcare priorities from their 2025 State of the State addresses. This article highlights common themes in addresses delivered between January 6, 2025, and January 16, 2025, and delves into specific proposals in Georgia, Iowa, New York, and Oregon, as analyzed in the Health Management Associates (HMA), Information Services (HMAIS) interim report, 2025 State of the State Overview.

State of the States in the Current Environment

Governors use their State of the State addresses to outline their priorities for the year, giving insight into the agendas and initiatives that their executive branches may pursue independently or in collaboration with their state legislature. These priorities often are informed by the status of the state’s budget, with some governors advancing healthcare proposals that will address budget deficits and others seeking to invest in services and workforce initiatives.

Monitoring governors’ policy priorities and initiatives is especially important in 2025 given the changing federal landscape. The transition in both the administration and Congress will require state leaders to carefully consider the risks and opportunities. As detailed below, governors’ responses will unfold differently across states and markets.

Common Threads

In all, 24 governors delivered a State of the State Address between January 6, 2025, and January 16, 2025. Many gubernatorial leaders have similar areas of priority and concern, with some continuing multiyear initiatives to address unmet behavioral health needs and control healthcare costs. Table 1 identifies the themes emerging from the first group of addresses.

Governors also are considering possible policy changes under the new Trump Administration. For example, some governors reported that their state is looking to strengthen or add Medicaid work requirements to their programs, resuming initiatives that were initially pursued during the first Trump Administration. Though not directly related to healthcare, governors’ decisions to mirror President Trump’s Department of Government Efficiency, with Iowa as an example, could indirectly affect local programs and markets. Other states are considering the implications of possible changes to federal Medicaid funding. A deeper look into the priorities in Georgia, Iowa, New York, and Oregon follows.

Georgia

Gov. Brian Kemp delivered Georgia’s State of the State address on January 16, 2025, during which he focused his healthcare remarks on the state’s Pathways to Coverage Section 1115 demonstration. Georgia’s waiver extends Medicaid coverage to able-bodied adults who earn up to the federal poverty level if they meet certain work requirements. The governor emphasized that he intends to work with the Trump Administration to further advance innovative approaches to healthcare access.

Governor Kemp stated that his administration is making it easier to apply for Medicaid coverage and will submit an amendment to the Centers for Medicare & Medicaid Services (CMS) that would extend the Pathways demonstration for five years beyond the current expiration date of September 30, 2025. The state plans to request several changes to the demonstration, including:

Changing the reporting requirements for qualified work activities
Adding more activities that qualify for program eligibility
Adding a retroactive coverage policy
Removing premiums and Member Reports Accounts

The governor’s proposed fiscal year (FY) 2026 budget includes $324 million to fully fund projected Medicaid enrollment and utilization growth and $36 million in additional support for pharmacy benefits, including recently approved gene therapy treatments for sickle cell disease.

Iowa

Iowa Gov. Kim Reynolds delivered the Condition of the State Address on January 14, 2025, during which she called for increased Medicaid reimbursement rates for OB/GYNs and primary care physicians who provide care to people with complex pregnancy cases, as well as certified nurse midwives. The governor also said she was in favor of adding doula services as a covered Medicaid benefit. Governor Reynolds is one of several governors who have announced plans to pursue a Section 1115 demonstration for Medicaid work requirements for able-bodied adults.

Governor Reynolds’s proposed FY 2026 budget includes investing $642,000 in newly unbundled Medicaid maternal rates, and more than double investments in five existing state healthcare loan repayment programs. The governor also proposes to establish a Medicaid Graduate Medical Education enhanced payment to draw down more than $150 million in federal dollars for more residency spots in Iowa’s teaching hospitals.

New York

New York Gov. Kathy Hochul delivered her State of the State Address on January 14, 2025, at which time she also released a State of the State Book. Addressing behavioral health is one of her chief priorities, and proposals include:

Allowing more involuntary commitments for people with severe mental illness
Developing programs to support youth mental health through after school programs
Expanding peer support programs
Improving the diagnostic process for children with complex needs
Supporting mental wellness in historically marginalized neighborhoods
Expanding Mobile Medication Units to bring opioid treatments to underserved areas

Governor Hochul intends to expand support for the state’s healthcare safety net. This part of her agenda would provide financial assistance to struggling medical facilities and hospitals through expansion of the state’s Safety Net Transformation Program and participation in the US Food and Drug Administration’s program that allows states to import lower-cost drugs from Canada.

The governor’s proposed $252 billion budget for FY 2026 would allocate $35.4 billion for the state Health Department’s Medicaid budget—a 14 percent increase from last year. Governor Hochul plans to offset some of the spending hike with revenue from the newly approved managed care organization tax, which is expected to raise $3.7 billion to help balance the state budget over three years.

Oregon

Gov. Tina Kotek delivered Oregon’s 2025 State of the State Address on January 13, 2025. The governor has a significant focus on mental health and substance use disorder treatment, as well as housing as an HRSN. Governor Kotek wants to strengthen the behavioral health system and proposed adding new treatment beds, increasing treatment capacity, eliminating backlogs at the state’s health licensing boards to improve access to qualified counselors, improving the provider pipeline, and increasing worker retention. During her speech, the governor also called for improved frontend care coordination to decrease the overflow of people at the Oregon State Hospital.

In addition, the governor intends to work toward improving care for the civil commitment population (i.e., people who are involuntarily detained in a psychiatric hospital) by dedicating permanent supportive housing funds to expanded residences with onsite services. Governor Kotek has directed her team to develop a new intensive permanent supportive housing model to more effectively support people with serious mental health needs.

Governor Kotek’s proposed budget for the 2025−2027 biennium includes $39.6 billion for the Oregon Health Authority, representing a 10.4 percent increase from the approved budget for 2023−2025. This budget includes $29.6 billion for the state Medicaid program and $1.6 billion for the Behavioral Health Division, in addition to $732.4 million for the division from the General Fund.

Connect With Us

HMAIS has prepared a comprehensive report summarizing each State of the State Address, which is available to HMAIS subscribers. The report also examines proposed budgets, highlighting key financial commitments and allocations that underscore these priorities for the upcoming year. The first iteration of the report covers AR, AZ, CO, CT, GA, IA, ID, KS, KY, MA, MT, ND, NE, NH, NJ, NV, NY, OR, RI, SD, VA, VT, WA, and WY. The document will be updated periodically as speeches occur.

Contact our experts below for more information about the report or to connect with one of HMA’s state policy and market experts.

Major changes to Medicare Advantage and Part D proposed by CMS for 2026

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This week’s In Focus section examines a comprehensive proposed rule that the Centers for Medicare & Medicaid Services (CMS) released on November 26, 2024. These highly anticipated regulations—which represent the last major Medicare regulations from the Biden Administration—include several significant and far-reaching proposals designed to strengthen plan oversight and enhance beneficiary protections for millions of Medicare beneficiaries who have coverage through Medicare Advantage and Medicare Part D plans beginning in contract year 2026. The rule also comprises proposals with fiscal and policy implications for state Medicaid programs.

Comments on the proposed rule are due by January 27, 2025, and the incoming Trump Administration could make significant changes before finalization. New administration officials may choose to delay certain provisions, scale back, or eliminate certain proposed policy changes when they finalize the regulations next year.

This article explains several of the proposed policies, considerations for healthcare stakeholders, and developments that Health Management Associates (HMA) experts will be tracking in the coming weeks.

Coverage of Anti-Obesity Medications Under Medicare Part D and Medicaid

In the proposed regulations, CMS seeks to expand coverage of anti-obesity medications (AOMs) under the Medicare Part D and Medicaid programs. Under current Medicare Part D coverage rules, medications used exclusively for weight loss are excluded from the definition of a Part D covered drug. Through the proposed change, CMS is seeking to align Medicare and Medicaid coverage policy with the prevailing medical consensus that recognizes obesity as a chronic disease.

Under the proposed reinterpretation, CMS would expand eligibility for Part D coverage of AOMs for Medicare beneficiaries with obesity. AOMs used for weight loss or chronic weight management would continue to be excluded from Part D coverage under the proposed regulation.

As it relates to Medicaid, CMS’s proposed reinterpretation would require Medicaid coverage for anti-obesity medications when used for weight loss or chronic weight management for the treatment of obesity. State Medicaid programs would continue to have discretion to use preferred drug lists and prior authorization (PA) to establish certain limitations on the coverage of these drugs, consistent with existing statutory requirements.

CMS estimates the proposal would increase federal costs by $24.8 billion as the result of expanded Part D coverage and $14.8 billion because of expanded Medicaid coverage over a 10-year period.

Key considerations: Though expanded access to innovative medications may improve access and outcomes for obese patients, these considerations may need to be balanced against the proposal’s considerable fiscal costs. In addition, key health nominees put forth by President-Elect Donald J. Trump have different views about how best to prevent and treat chronic disease, creating additional uncertainty about whether this proposed expansion will go forward.

Strengthening Prior Authorization and Utilization Management Guardrails

The proposed rule includes a series of recommendations for reforming Medicare Advantage PA, utilization management (UM), and coverage decisions, which include:

Defining the meaning of internal coverage criteria to clarify when MA plans may apply UM
Ensuring MA plans’ internal coverage policies are transparent and readily available to the public
Requiring plans to inform beneficiaries of their appeal rights
Revising the current metrics for the annual health equity analysis on the use of PA to require more detailed and granular reporting to allow CMS to determine whether MA plans disproportionately deny certain services

Key considerations: Continued scrutiny of MA plans’ PA practices and strong bipartisan support for reforms increase the likelihood that certain changes will be made to these policies within the next year.

Enhancing Medicare Plan Finder to Include Information on Plan Provider Directories

Another notable proposal would require MA plans to make provider directory data available to CMS for inclusion in Medicare Plan Finder (MPF), the online tool that allows beneficiaries to compare coverage options, including Medicare Advantage and Part D plans. At present, provider directories must be accessible on MA plans websites.

CMS seeks to enhance MPF with searchable provider information for all MA plans while requiring plans to attest to the accuracy of the provider directory data, including updating data within 30 days of receiving notification that provider information has changed. CMS would ensure compliance with this expectation by requiring plans to meet data compliance and quality checks, which will be detailed in upcoming technical guidance.

Improving Access to Behavioral Health Care

The proposed rule furthers federal policymakers’ initiatives to address the nation’s behavioral health crisis. CMS proposes to establish the following three standards to ensure that beneficiary cost sharing in Medicare Advantage is no greater than in Traditional Medicare:

A 20 percent coinsurance or an actuarially equivalent copayment rate for mental health specialty services, psychiatric services, partial hospitalization, and outpatient substance abuse services
No cost sharing for opioid treatment programs
All (100 percent) of the estimated Traditional Medicare cost sharing for inpatient psychiatric services

Improve Oversight and Administration of Supplemental Benefits

MA plans may offer a variety of supplemental benefits such as vision, dental, and gym memberships, which have come under increasing scrutiny by CMS. CMS proposed several actions to reduce misuse of these benefits, including:

Outlining proper usage by MA organizations and enrollees
Adding disclosure rules for transparency
Ensuring enrollees can access covered services through alternative methods
Requiring real-time electronic links between debit cards and covered services
Defining acceptable over-the-counter products.

Key Considerations: CMS officials in President-Elect Trump’s first administration expanded flexibility for plans to offer supplemental benefits. Incoming policy officials may seek an opportunity to fully review the Biden Administration’s proposals. Data and experience-informed comments from MA plans and stakeholders can support such discussions.

Improve Care Experience for Dual Eligibles

CMS proposed the following two new federal requirements for Dual Eligible Special Needs Plans (D-SNPs) that are applicable integrated plans (AIPs):

AIP D-SNPs will need to have integrated member ID cards for their Medicare and Medicaid plans.
D-SNPs will be required to conduct an integrated health risk assessment for Medicare and Medicaid, rather than separate ones for each program.

Key Considerations: These proposals further CMS’s multi-year work to advance integrated care by applying Medicare-Medicaid Plan features into D-SNP requirements. States and MA and Medicaid plans should plan for operational and policy changes if the proposals are finalized.

Formulary Inclusion and Placement of Generics and Biosimilars

CMS proposes to require Part D formularies to provide beneficiaries with broad access to generic, biosimilar, and other low-cost drugs while also ensuring that tier placement and UM practices do not limit access to these drugs as compared with more expensive brand name and reference products.

Key considerations: If finalized, the proposal would require MA-PD and Part D plans to update their approach and considerations for plan formulary development. Consumer groups and other stakeholders should consider the possibility that the proposal will improve access to lower cost products.

Other Topics in the Proposed Rule

In addition, the proposed rule calls for the following:

Guardrails for artificial intelligence to protect access to health services, such as requiring that MA plans ensure services are provided equitably, regardless of delivery method or origin (i.e., human or automated systems)
Changes to MA and Part D medical loss ratio (MLR) reporting to improve the meaningfulness and comparability of MLR across plan contracts
Expanded Part D medication therapy management eligibility criteria
Adding and updating measures addressed in this proposed rule, beginning with the 2028 Star Ratings
Promoting community-based services and enhancing transparency of in-home service providers, including new definitions and standards for community-based organizations
Codifying existing guidance related to implementation of the Medicare Prescription Payment Plan, which is part of the Inflation Reduction Act (IRA)

What to Watch

During the lame duck session, Congress could advance legislation related to some proposals in this rule. Specifically, PA has been an area of significant bipartisan interest, along with access to and cost of GLP-1 products. CMS will need to ensure the final MA and Part D policy and technical rule for contract year 2026 reflects approved statutory changes.

In addition, HMA is watching key appointments within the US Department of Health and Human Services, including individuals selected to lead CMS’ Medicare and Medicaid centers. These appointments will provide valuable insights on the emerging policy agenda of the incoming administration.

Connect with Us

HMA’s Medicare and Medicaid experts will continue to assess and analyze the policy and political landscape, which will determine the final policies in the MA and Part D policy and technical rule for contract year 2026. HMA’s experts have the depth of knowledge, experience, and subject matter expertise to assist organizations that engage in the rulemaking process and to support implementation of final policies, including policy development, tailored analysis, and modeling capabilities, as well as quality improvement initiatives and plan benefit design.

For further analysis of the MA and Part D proposed rule and potential impact on MA and Part D plans, Medicaid programs, providers, and beneficiaries, contact our featured experts below.

Strategic Expenditure Planning: Empowering County Government Agencies to Optimize Opioid Settlement Funds

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The Client

The Lake County Behavioral Health Services Department and the residents of Lake County, California.

Background

In 2021, opioid manufacturer Janssen Pharmaceuticals along with three opioid distributors, McKesson, Amerisource Bergen, and Cardinal Health (collectively known as The Distributors) reached settlements for their roles in the opioid epidemic that amount to $26 billion. These settlements will be distributed to states that participated in the joint lawsuits. It is estimated that California will receive approximately $2.05 billion over 18 years to focus on opioid abatement activities within the state. As a participating subdivision, Lake County is set to receive a portion of California’s Abatement Fund and began receiving payments on November 15, 2022. The County will receive approximately $18 million over the course of eighteen years.

HMA was tasked with creating an expenditure plan for the opioid abatement settlement funds distributed to the Lake County Behavioral Health Services Department and the residents of Lake County. HMA facilitated community engagement to gather stakeholder feedback and align community priorities with the High Impact Abatement Activities (HIAA) and goals as defined by the California Department of Healthcare Services.

Download and read the approach and results.

Webinar Replay: How Community Care Hubs Can Enhance Family Caregiver Support Services

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This webinar was held on December 3, 2024.

To better support family caregivers and the older adults who they care for, Area Agencies on Aging and other aging network agencies are creating Community Care Hubs (CCH) to address social determinants of health, integrate health and social care, and reduce care costs. In this webinar with LTSS policy experts and providers, we described the implementation of the CCH model in projects in Massachusetts and New York.

Learning Objectives:

Describe the Community Care Hub (CCH) model for integrating health and social care
Identify key CCH features to enhance family caregiver support services
Illustrate the implementation of the CCH model for supporting family caregivers with projects in Massachusetts and New York

Featured Speakers:

Kristie Kulinski, MSW, Director of Office for Network Advancement, Administration for Community Living
Nikki Kmicinski, MS, RD, CDH, Chief Executive Officer, Western New York Integrated Care Collaborative
Jennifer Raymond, JD, MBA, Chief Strategy Officer, AgeSpan

In behavioral health, parity is essential, but not enough

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Today’s post is by Linda Rosenberg, who has recently joined HMA as a Senior Advisor. In this blog she offers her perspective on parity rules for behavioral health from her many years of experience in the field, most recently as the President and CEO of the National Council for Mental Wellbeing until her retirement in 2019 and as part-time faculty member at the Columbia University Department of Psychiatry.

Attending the 2024 Alignment for Progress conference and experiencing the collective commitment to the 90/90/90 goals, I was once again struck by the groundbreaking nature of the Mental Health Parity and Addiction Equity Act of 2008. The legislation was the critical step in ensuring mental health and substance use is treated on equal footing with physical health. Patrick Kennedy, both as the driver of the Act and in his ongoing advocacy helped us to reshape national conversations and policies.

The new regulations released by the Biden administration add much-needed teeth to the Mental Health Parity and Addiction Equity Act. The regulations take on one of the biggest ongoing challenges: the lack of adequate provider networks. Behavioral health clinicians are far harder to find in-network compared to medical providers, with many leaving networks due to low reimbursement rates. Under the new regulations, insurers must maintain adequate networks, regardless of the challenges, which will likely come with significant costs to entice clinicians back.

Implementation of the regulations won’t be simple. The insurance industry is sorting out what compliance will mean to their operations and bottom line. The federal government is struggling to fund and build a monitoring infrastructure. State governments need to understand their roles and responsibilities. And patients and the people who love them need to learn about their expanded rights and how to exercise those rights. Everyone has a job to do.

The intent of the parity law was about ensuring that mental health and addiction services are treated with the same urgency, seriousness, and respect as any other form of medical treatment. And yet parity has remained a promise unfulfilled for too many. The new regulations are a welcome and necessary step forward, but they cannot address all that needs to be done. Parity is essential, but it’s not enough.

Early on in my tenure and long before I retired from the National Council for Mental Wellbeing, a very special member and mentor Carl Clark MD, CEO of WellPower in Denver shared a secret with me. There are “wicked” problems, and wicked problems don’t have a single solution. A wicked problem is complex and interconnected … and has no stopping rule, rather wicked problems are opportunities for progress.

For too long I’ve listened to too many talks and read too many reports about “fixing” or “creating” a behavioral health system, but the reality is far more complex, far more “wicked”. Fragmentation is endemic to all of healthcare in the USA, we have no single healthcare system and no unified behavioral health system either. We have thousands of systems—public, private, nonprofit, hospital-based, and government-run – each serving different populations and communities with varying levels of resources and approaches and each dependent on a bottom line.

The fight for parity was never just about changing laws—it’s about changing hearts, minds, and systems, reshaping the way we understand and deliver care across all these thousands of systems we’ve created and continue to create.

Well intentioned programs with layered initiatives focused on whole health, social determinants of health, and other efforts are adding complexity to a system that’s already overwhelming for the very people these systems are supposed to serve.

What we need is a financing model that ties all the pieces together – Certified Community Behavioral Health Centers (CCBHCs) are a promising start – a financing model that pays for the continuum of services, inpatient and community, rather than the current fragmented approach that pays for pieces separately. At the same time, we need to leverage technology to alleviate pain points, establish desperately needed standards of care, and provide decision support for both clinicians and patients. With technology, we can measure and benchmark care across systems, creating transparency and accountability at every level.

By aligning financing with the full spectrum of services and using technology to drive transparency and accountability, we can finally begin to address the wicked problems that prevent effective mental health and addiction care. As I help non-profits, health technology companies, and venture firms build growth strategies that result in consumer and economic benefits, I understand that the new regulations give us a foundation to build on—the rest is up to us.

Why Are Family Services Critical to Improving Children’s Health?

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Uma Ahluwalia, managing principal at HMA, discusses the importance of keeping families at the center of children’s health and welfare services and highlights how government should provide services in support of the family unit. The conversation emphasizes that addressing family issues like poverty, trauma, and lack of resources is key to improving child welfare. She also explores the need for integrated services—across health, behavioral health, education, and safety—to address the interconnected challenges families face. Uma shares why it’s so important to sustain the commitment to long-term transformation, proper funding, and enabling local governments to provide holistic, family-centered care.

New HMA analysis explores options to improve California’s substance use disorder treatment system

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In recognition of National Recovery Month this September, our In Focus section spotlights a new report from Health Management Associates, Inc. (HMA), Substance Use Disorder in California: A Focused Landscape Analysis. Published in August 2024 with support from the California Health Care Foundation, this analysis provides valuable insights into California’s substance use disorder (SUD) treatment system and offers actionable recommendations for improvement that can be applicable for other states.

The SUD Landscape in California

SUDs continue to be a significant issue both nationally and in California. In 2022, approximately 9 percent of Californians ages 12 and older met the criteria for SUD, compared with 16.5 percent nationally in 2021. The prevalence of SUD is also on the rise: in 2015, 8.1 percent of Californians ages 12 and older met SUD criteria, rising to 8.8 percent in 2022. Of the Californians struggling with SUD, only 10 percent received treatment for their condition, compared with 6 percent nationally in 2021. Overall, 81 percent of US adults who received care for SUD reported struggling to access necessary services.

California’s public behavioral health system siloes specialty mental health (MH) services, mild-to-moderate MH services, and SUD treatment services, resulting in a fragmented and inconsistent system that struggles to effectively support people with co-occurring conditions.

County plans administer specialty behavioral health (BH) services. They all have memorandums of understanding with the state’s Department of Health Care Services that are separate from the state arrangements to provide physical healthcare services. BH programs vary significantly across the state because counties operate them differently, with key variations in access policies, quality monitoring, services, and programming. Mild-to-moderate (non-specialty) MH benefits are administered by Medicaid managed care plans. Much of the state’s SUD treatment is operated by the Drug Medi-Cal Organized Delivery System (DMC-ODS).

Barriers to Care: Key Findings

System barriers prevent many Californians with SUD from accessing adequate care. Interviewees received a pre-interview questionnaire to determine the factors they believe have the greatest impact on access to SUD treatment. According to 11 out of 14 respondents, lack of access to housing and residential services is a “huge barrier” to SUD treatment.

Other barriers to care access, ranked in order, include limited access to food, transportation, and other social drivers of health (SDOH), SUD provider shortages, stigma against people with SUD, disparities in service availability across racial/ethnic groups and other populations, and complex referral and intake processes.

Respondents also identified factors that could negatively affect clinical outcomes for people with SUD. Insufficient access to stable housing ranked first, followed by inadequate care coordination, and limited access to residential SUD treatment. Respondents ranked 11 factors as follows:

Figure 1: Factors Leading to Reduced Outcomes, Ranked from a List of 11

Service gaps pose another significant barrier to people accessing SUD treatment, and some populations are more likely to encounter challenges than others. According to the respondents, by various population groups, Latine/Hispanic populations, African American/Black populations, and Native American/Alaska Native populations are most likely to experience SUD service gaps. By age, people who are 19−25 years old (transition-age youth) and adults ages 26−65 are most likely to face service gaps.

Opportunities to Support Improvements in SUD Care

Findings and recommendations to enhance support for individuals are informed by surveys and interviews conducted with SUD stakeholders from across the state. Recommendations highlighted in the report include:

Investments in the workforce. By addressing the shortage of licensed clinicians and implementing peer support workers into the care continuum, the state would increase access to care. Many stakeholders have positioned themselves to meet SUD needs, but they cannot do so without an adequate workforce. Furthermore, the workforce would benefit from strengthening culturally responsive training in evidence-based practices.
Expansion of residential treatment services and housing options. There is a growing need, especially among transition-age youth, for residential treatment and SUD recovery housing.
Increased access to and training around harm reduction. Although stigma around harm reduction has decreased, training and access remains a barrier. Respondents highlighted the need to better manage contingencies, make methadone more accessible, establish safe consumption sites, expand medication assisted treatment for SUD and AUD, and improve the availability of Narcan.
MH and SUD treatment integration. Offering concurrent MH and SUD treatment with the same providers can help improve access to care for people with co-occurring conditions and minimize duplication.
Improved care coordination. Respondents suggested funding formal care coordination positions—a recommendation that is consistent with the national movement toward the coordinated care model applied in certified community behavioral health centers.
Improved data literacy. Behavioral health organizations need support and technical assistance to learn how to track and use data to support continuous quality improvement.

What to Watch

The overarching challenges facing California’s recovery system are present in other states. These states can adapt the strategies discussed in this report to address their own SUD concerns. In California, as in other states, an important aspect of addressing SUD treatment involves strategic allocation of opioid settlement dollars. These funds, resulting from legal settlements with opioid manufacturers and distributors, are expected to play a significant role in improving the state’s SUD treatment infrastructure, especially when considered alongside available federal funding, demonstrations, and regulatory flexibilities.

Connect With Us

The upcoming HMA event, Unlocking Solutions in Medicaid, Medicare, and Marketplace, will offer more opportunities to engage with leaders from various sectors who are advancing solutions to improve access to care and reducing access disparities. Throughout the conference, federal and state officials, community leaders, and national experts will shed light on the challenges and solutions to these issues.

Housing services and supports are critical to the mission of improving health for all Americans

Homelessness in America has hit a record high and housing instability is widespread. Millions of Americans are vulnerable to inadequate housing and half of all U.S. renters are spending far more than the recommended 33% of their income on rent.

For many Americans, housing costs are out of reach, as 13 of the 20 largest occupations in the U.S. pay less than the housing wage. This housing crisis is impacting overall health and well-being and utilization of healthcare. Individuals and families struggling with homelessness often experience lower infant birthweights, mental health challenges, chronic disease, and higher mortality.

HMA works at the intersection of housing and healthcare in a variety of ways, including policy, programs, financing, and evaluation. A safe and secure place to live is fundamental to all of the healthcare and human services work we do at HMA. Our experts have developed and worked within programs in public housing authorities, hospital housing partnerships, shelters and transitional housing, post-incarceration transition and 1115 waiver supports, rural housing, and other housing supports.

HMA experts are former state and local public health leaders, directors of community-based organizations, and former senior officers from key federal agencies, setting us apart from other consulting companies.

We understand the complexity of designing and implementing change beyond the theoretical level – we have walked in the shoes of our clients and understand how to provide insight that is meaningful, actionable, and realistic.

Organizations we support

Federal, state and local government agencies

Managed Care Organizations

Public Housing Authorities

Community-based health/behavioral health and human service organizations

Provider organizations (FQHCs, CCBHCs)

Schools and universities

Departments of behavioral and public health

Healthcare systems and providers

Philanthropic organizations

Jails and correctional facilities

We Help Our Clients

Transform their community’s response to homelessness

Improve local housing delivery systems

Facilitate new or expanded community partnerships

Address systemic barriers

Build capacity of local partners and resources

Help with targeted impact improvements

Scale interventions to match resources and need

Increasing system capacity

Provide management tools for improved decision making

Planning and implementation support for continuum of homeless services

Affordable housing needs assessment

Consultation on shelter and outreach team best practices

Project Spotlight

The problem:
With new funding available and a homelessness crisis growing more acute, the JOHS requested an evaluation of the department’s effectiveness and barriers, as well as the governance model over all homelessness response functions.

How we helped:
HMA conducted a discovery process consisting of 40 stakeholder interviews with local elected officials, County and department staff, and contracted service providers. We also reviewed key contracts, policies and procedures, and other foundational documents; and completed a summary of national best practices to inform future program development. This resulted in a summary of gaps, opportunities and recommendations that HMA presented to a joint meeting of County and City Commissioners, and HMA continues to assist in implementation

The outcome:
HMA presented leaders with findings and recommendations, including reforms to provider payment, system governance, inter-agency partnerships and more). Subsequent contracted initiatives to support implementation include the renegotiation of an Inter-Governmental Agreement and action plans to improve to the shelter system and street outreach systems.

The problem:
Tens of thousands of residents of HUD assisted senior housing in California are dually eligible for Medicaid and Medicare and have complex medical, behavioral health, and health-related social needs. Affordable housing developers, owners and operators do not have financing to enhance resident supports to prevent homelessness, avoidable hospitalizations, or institutional care transitions. While evidence shows that Medicaid, Medicare and D-SNP plans and healthcare providers would reduce avoidable inpatient and urgent care costs from enhanced resident services, mechanisms to partner with housing organizations have been elusive due to different incentive structures, infrastructure, and cultures in each sector.

How we helped:
Through contracts with LeadingAge California, HMA supported California housing organizations to develop a compelling value proposition for strategic discussions with payers, providers, and foundations. HMA is developing a financing plan and gap analysis to braid and blend Medicaid, Medicare, D-SNP, workforce, behavioral health, and other funding streams to sustainably support enhanced services provided by trusted, culturally and linguistically responsive on-site service coordinators.

The outcome:
California DHHS and Department of Aging leadership endorsed the goals of the CICH model and are guiding next steps to develop the infrastructure and braided/blended financing plans. Two health plans in southern California are interested to partner in piloting the model.

The problem:
Housing and community development organizations are trusted resources in low-income rural and urban communities across the US; and they were instrumental during COVID in engaging high-risk communities in prevention activities. While housing and community development organizations are a natural place for successful CHW programs, most CHW models and training programs have been developed for healthcare organization environments.

How we helped:
HMA co-led a cohort of NeighborWorks network organizations to co-design three housing and community-development organization-centered CHW program models and a toolkit covering every element of standing up and sustaining a CHW program within housing and community development structures, values, and resources. We provided coaching and technical assistance to learning cohort participants to test toolkit components.

The outcome:
Web-based toolkit Community Health Workers: A Promising Program Model to Advance Health & Well-Being in Affordable Housing and Community Development – NeighborWorks America

The problem:
The organization has requested assistance with establishing healthcare partnerships, designing health care services to meet resident health needs in each affordable housing development, and identifying opportunities to expand health and wellness services.

How we are helping:
HMA is providing guidance in service planning, partnerships, resources, budgeting, and strategies. This may include identification of potential health care partners, design of the health care model, assistance with budgeting for health care service costs, and other consultation as requested.

The outcome:
HMA presented leadership with insight on how to expand embedded health services to optimize resident health across their housing portfolio, assisted with the design of health care services, and helped to build healthcare partnerships.

Our HMA experts are ready to help your organization support your communities.

Contact our experts:

Boyd Brown

Associate Principal

Boyd Brown is a seasoned policy and operational leader in behavioral health, housing and homelessness, and human service operations including … Read more

Michael Butler

Associate Principal

Michael Butler is an experienced strategist and evaluator working across a wide array of health and human service sectors including … Read more

Tia Cintron

Managing Director, Housing and Health Solutions

Tia Cintron is a seasoned executive with over 35 years of experience in housing and healthcare. She has led impactful programs … Read more

Anthony Federico

Senior Consultant

For 15 years, Anthony Federico has worked in housing, homelessness, and healthcare across the government, community-based organization (CBO), and consulting … Read more

Paul Fleissner

Managing Principal

Working to integrate services across systems and communities, Paul Fleissner is a seasoned executive who has developed programs and policies … Read more

Trish Marsik

Principal

Trish Marsik has extensive experience supporting providers, healthcare organizations, and local and state governments to improve behavioral health services, including … Read more

Charles Robbins

Principal

Charles Robbins has been transforming communities for the past three decades. His extensive community-based organization career spans healthcare, child welfare, … Read more

Madeleine (Maddy) Shea

Principal

Maddy Shea has a passion for health equity and the federal, state and local cross-sectoral expertise to guide community health … Read more

Nicholas Williams

Associate Principal

Nicholas Williams is a social sector leader, analyst, writer, and consultant with extensive experience and proven results in academic, business, … Read more

HMA fosters harm reduction from street to suite

HMA’s trusted experts have a wealth of harm reduction experience, from training volunteers for community outreach to managing state procurement processes for harm reduction tools, to policy analyses at all levels of government.

Our consultants have worked with stakeholders of all walks of life including people with lived and living experience of drug use, sex work, and homelessness. In fact, we believe in talking to them first to understand local needs and feasible solutions.

What is harm reduction?

The term “harm reduction” is often used to describe:

provision of risk reduction tools, like condoms, naloxone, and sterile syringes;

approach of meeting people where they are and supporting them at their own pace, without judgement, to pursue self-determined goals; and,

philosophy that promotes equitable access to resources for people who use drugs and struggle to meet basic needs due to the impact of social structures.

The Substance Abuse and Mental Health Services Administration (SAMHSA) defines harm reduction as a practical and transformative approach that incorporates community-driven public health strategies — including prevention, risk reduction, and health promotion — to empower people who use drugs and their families with the choice to live healthier, self-directed, and purpose-filled lives.

The President’s National Drug Control Strategy is the first-ever to champion harm reduction to meet people where they are and engage them in care and services.

People are dying from drug overdose at an alarming rate in the U.S. For the fourth year in a row, we have lost over 100,000 people (enough to fill the University of Michigan stadium). Many of these deaths are preventable. Harm reduction interventions proven to stop overdose deaths include making the overdose reversal drug naloxone available to all at risk of overdose, reducing barriers to medications that treat opioid use disorder, and providing supervised drug consumption services for rapid overdose response. Moreover, successful harm reduction programs rely on reducing the stigma of drug use and people who have an addiction.

How HMA can help

Harm reduction is more than handing out naloxone or syringes; it’s a nonjudgemental approach that affirms participant autonomy and engages people in care over the long term.

Here are just a few services HMA can offer to help clients establish, expand, or improve services for people who use drugs, respond to overdose and infectious disease syndemics (combinations of two or more diseases or health conditions that interact within a population, often due to social and structural factors and inequities), and prevent the next drug crisis.

HMA provides training and technical assistance to a range of clients – from community-based organizations conducting outreach, to medical providers wishing to better serve their patients, to large hospital systems wishing to incorporate drug user health into their systems. HMA can:

Plan, coordinate and evaluate learning collaboratives.
Provide 1-1 coaching to staff and teams.
Produce and implement industry-specific toolkits aimed at reducing overdose, like for construction businesses, restaurants or harm reduction vending machines.
Train different audiences and teams, including youth treatment providers, primary care settings, and carceral settings, on harm reduction.
Support startup of new naloxone distribution and/or syringe services programs and develop capacity building plans for program growth.
Improve access to medications for opioid use disorder.

A quality improvement (QI) strategy is vital for healthcare organizations to maximize patient outcomes and satisfaction, achieve efficiency, and ensure compliance with regulations. HMA can:

Apply established QI models to increase reach of harm reduction and drug user health services within community-based programs, government agencies, and provider programs and systems.
Plan, assess, and evaluate QI efforts.
Increase team buy-in for harm reduction as a QI initiative.
Provide QI tools such as rapid assessment participant surveys, risk screeners, provider checklists, and guides.

Many funding opportunities require (or can benefit from) a detailed assessment of the community’s need for the services being funded. Our experts can help gather both quantitative data and qualitative stakeholder input to ensure that the client’s proposed plan targets the populations, communities, and gaps in service for which resources will be most impactful. HMA can:

Conduct interviews and focus groups with people who use drugs and the service providers they interact with to identify local needs and solutions.
Assess and predict drug user health syndemics using infectious disease and overdose metrics.
Demonstrate trends among diverse populations, including youth and racial, ethnic, sexual, and gender minorities .
Guide efforts to integrate harm reduction into a broader continuum of care, including prevention and treatment interventions.

The legal landscape related to drug use varies across communities and does not always facilitate a public health approach. HMA can:

Identify policy options and facilitate choice of the most effective and feasible one for the client’s local context.
Evaluate new or existing policies that impact people who use drugs such as Good Samaritan laws, opioid treatment program regulations, and criminal charges.
Apply statistical methods to policy evaluation such as time-interrupted analysis.

Multi-sector collaboration is essential to develop sustainable, impactful solutions to reduce physical and structural harms related to drug use. HMA can:

Facilitate workgroup-driven policy recommendations for expansion of behavioral health treatment and overdose prevention approaches such as safer supply.
Design social media campaigns that center the voices of people most impacted by overdose.
Strategize, create, and plan marketing and communications campaigns for harm reduction, stigma reduction, or program promotion.
Facilitate community mobilization efforts and multi-sector alliances to generate and implement strategies for policy change.
Build harm reduction resource libraries for stakeholder use.

HMA consultants work with clients to review program efficacy and cost efficiency based on process, outcomes, costs and more, considering quantitative and qualitative data sources and using data-driven tools to assess and measure impact. HMA can:

Conduct environmental scans of jurisdictional resources to highlight opportunities for and threats to harm reduction programs .
Build maps that overlay various metrics of drug user health, including infectious disease burden, overdose, and socio-economic indicators.
Map overdose fatality and naloxone saturation to prioritize distribution efforts in areas of high-need.
Conduct regression analysis to identify risk profiles and predictive values to evaluate impact.

Project Spotlight

COMPASSIONATE OVERDOSE RESPONSE SUMMIT

WASHINGTON STATE SAFER SUPPLY WORKGROUP

Contact our experts:

Anika Alvanzo

Principal

Dr. Anika Alvanzo is a distinguished healthcare executive with over 15 years of experience in specialty addiction treatment, behavioral health … Read more

Jennifer Bridgeforth

Associate Principal

Jennifer Bridgeforth is a dedicated executive with more than 17 years of experience in the healthcare industry. She is a … Read more

Ana Bueno

Senior Consultant

Ana Bueno is a bilingual senior consultant with over 20 years of experience leading nonprofit organizations and delivering strategic solutions … Read more

Mayur Chandriani

Senior Consultant

An experienced non-profit manager, Mayur Chandriani is committed to programs focused on immigrant healthcare, maternal and child health and community … Read more

Liddy Garcia-Bunuel

Principal

Liddy Garcia-Buñuel has the vision, passion and expertise to effect organizational and systematic change. She takes a collaborative approach. She … Read more

Rachel LaFlame

Research Associate

Rachel LaFlame, MPH, is a driven, early career professional interested in the intersection of public health and policy. She is … Read more

Nicole Lovitch

Research Associate

Nicole Lovitch is a skilled generalist researcher in the public health and healthcare space. Prioritizing partnerships that bridge gaps between … Read more

Trish Marsik

Principal

Trish Marsik has extensive experience supporting providers, healthcare organizations, and local and state governments to improve behavioral health services, including … Read more

John O’Connor

Managing Director

John O’Connor is a seasoned executive with extensive program planning, evaluation, management, strategy, and complex funding experience in dynamic healthcare, … Read more

Charles Robbins

Principal

Charles Robbins has been transforming communities for the past three decades. His extensive community-based organization career spans healthcare, child welfare, … Read more

Deborah Rose

Principal

Dr. Deborah Rose is a licensed clinical psychologist with demonstrated success designing and scaling new behavioral health initiatives. She has … Read more

Erin Russell

Principal

Erin Russell is a harm reduction expert with a strong foundation in public health and equity. She has 15 years … Read more

Harnessing opioid abatement funds to prevent overdoses and enhance community care

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This week, our In Focus section recognizes International Overdose Awareness Day (IOAD), August 31, by highlighting how states can use opioid abatement funds to mitigate the persistent overdose crisis in communities across the country.

In honor of IOAD, the August 2024 edition of HMA’s Podcast, Vital Viewpoints, features Erin Russell, a Principal at Health Management Associates (HMA), who discusses the importance of emphasizing harm reduction as a compassionate approach to drug policy. Meanwhile, this article addresses current gaps, opportunities, and strategies for applying opioid abatement funds to make further progress in addressing overdoses and the crisis.

Context for Opioid Abatement

Overdoses have claimed more than one million lives since the late 1990s, with more than 100,000 deaths occurring annually. Exacerbating the overdose epidemic and the racial and ethnic disparities in fatal overdoses are persistent inequities in access to evidence-based treatment, which extend to biases based on physical and/or mental ability, sexual orientation and gender identity, geographic location, and socioeconomic and housing status.

In 2021, nationwide settlements were awarded to resolve all opioid litigation that states and local subdivisions brought against pharmaceutical distributors and manufacturers, with subsequent agreements reached in 2022 against pharmacy chains and additional manufacturers. These historic opioid settlement agreements, which total more than $56 billion, will provide funds to state and local governments to address the crisis in their communities.

Policy changes and investments to address this epidemic remain critical. These approaches require careful consideration of the data and evidence-based strategies that are responsive to the crisis. In 2024, the US Department of Health and Human Services issued a rule that updates the regulations regarding the governance of opioid treatment programs; for example, removing barriers to the treatment of substance use disorder (SUD) and expanding access to care. The State Opioid Response and Tribal Opioid Response grant programs are another significant tool to improve prevention, expand treatment, and deliver free, lifesaving medications. Medicaid, including Medicaid managed care plans, also can be instrumental in supporting harm reduction strategies and enhancing access to addiction treatment and recovery support.

Opioid abatement funds offer states the opportunity to apply innovative solutions in response to the overdose epidemic. Despite their potential, however, HMA experts have identified significant opportunities across many states to effectively use available opioid abatement funds.

Opioid Abatement Funds and planning for Community Needs

Strategic planning processes allow state and community leaders to understand the needs of residents, examine current services offered and their existing strengths, and explore barriers to accessing care to make informed decisions about how the settlement funding can be used successfully. A strategic plan can assist in tracking progress and establishing a clear vision for an organization’s future and can yield a living document that guides the most advantageous use of the funds. HMA experts supported a strategic planning process for Carrabus County, NC, that identified strategies for designing, implementing, and evaluating tailored solutions for disbursing opioid abatement funds. The following are examples of approaches that are included in strategic plans for opioid abatement.

Sequential intercept model (SIM). SIM, one of the models used to support communities in building a stronger system of care, helps identify intervention opportunities with the highest potential for success based on a community’s strengths and needs. SIM maps out the stages of intervention to pinpoint gaps and opportunities, ensuring funding is used to address the most critical areas for improving community care systems, including those integrated within Medicaid managed care delivery systems (see Figure 1).

Figure 1: Sequential Intercept Model

Low-barrier/low-threshold recovery supports and treatment. The expansion of low-barrier/low-threshold recovery supports and treatment, including access to medications for opioid use disorder, is essential to reducing overdose deaths. States, local jurisdictions, and individual providers can redesign their treatment delivery systems to incorporate person-centered, low-barrier treatment access, including flexible scheduling and walk-in visits, same-day admission and medication initiation, and revision of clinic policies and procedures to eradicate practices that produce high barriers to treatment.

Though expanding low-barrier care in traditional treatment settings is an essential element of the response, implementation of nontraditional delivery modalities is another important target for using opioid abatement funds. Examples include:

Emergency medical service (EMS)-initiated buprenorphine
Medication units in unconventional locations (e.g., housing units)
Mobile medication units and delivery of street/shelter medicine in which SUD treatment and services are brought to disenfranchised and marginalized communities.

Finally, the availability of opioid abatement funds can introduce opportunities for local governments to partner with community members, including people with both past and current lived experience, to design, implement, and disseminate culturally responsive and tailored SUD treatment and recovery support services, including services to address health-related social needs to mitigate barriers to treatment entry and engagement.

Continuous quality improvement (CQI) plans. Locales that receive opioid abatement funds have the opportunity to develop strategies to create transformational systemic change. Each entity should have an intentional CQI plan in place. Ensuring the presence of strong CQI processes can streamline and improve services, connect data to practice, and ensure interventions are progressively more effective.

Connect with Us

The upcoming HMA event, Unlocking Solutions in Medicaid, Medicare, and Marketplace, will offer more opportunities to engage with leaders across multiple sectors and industries advancing innovations in the design of mental health and SUD systems, value-based purchasing, and care strategies. Notably, state Medicaid and behavioral health directors, insurance commissioners, health plan executives, and community leaders, among others, will share insights into major initiatives under way in their states to manage ongoing crises in mental health and SUDs.

HMA has a strong, diverse bench to help communities maximize opioid abatement funds and build a stronger system of care. We provide technical assistance in large-scale initiative implementation, convening stakeholder groups, designing CQI strategies, developing planning documents, and facilitating strategic discussions. For more information about HMA’s work, contact our featured behavioral health experts below.

HMA believes “together we can” end the overdose crisis on IOAD

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On International Overdose Awareness Day (IOAD), August 31st, communities worldwide come together to honor, without stigma, the people who have lost their lives to overdose. It’s a day for families to recognize their loved ones and for all of us to acknowledge the grief of family and friends who have experienced this loss. It’s also an opportunity to think critically about the programs and policies our communities need to finally put an end to the overdose crisis. In honor of this year’s IOAD theme, “Together we can,” HMA recognizes the power of community when we all stand together with a united goal of ending overdose.

Overdose can affect anyone. In the last twelve months alone, there were more than 100,000 reported overdose deaths across the U.S., and 42 percent of Americans now report they know someone who has died of drug overdose. More than ever, we need strong, multifaceted coalitions to shift the narrative around overdose and ensure we are using resources effectively to reduce harm, increase chances of overdose survival, and promote quality of life for people who use drugs, people in recovery, and the communities where they live.

HMA brings together people with lived and living experience, local community members, and public health professionals to plan, evaluate, and implement meaningful programs across the continuum of care to address overdose as the health crisis that it is. Our trusted subject matter experts have their own lived experience that influences HMA’s approach, and we strive to center the voices of people who are most impacted at every opportunity.

HMA is committed to helping clients prioritize effective solutions to the overdose crisis, which includes promoting services that are evidence-based and designed with robust input from community stakeholders. HMA supports naloxone distribution by engaging in street-based outreach, developing mapping tools for organizations to see the impact of their efforts in real time, and training healthcare providers on harm reduction. In 2024, HMA also hosted the Compassionate Overdose Response Summit to address questions about naloxone dosing and the long-term effects of precipitated withdrawal. HMA continues to be a leader in helping clients revolutionize treatment, particularly for priority populations such as children’s behavioral health and the justice involved. Earlier this year HMA led a webinar series called the Substance Use Disorder (SUD) Ecosystem of Care Webinar Series: Pivoting to Save Lives describing a whole person, integrated, solutions-based approach to the ongoing overdose epidemic. The series encourages leaders to reconsider standard attempts to solve this crisis and be willing to pivot away from approaches that have not yielded the level of impact that this crisis demands.

On IOAD, and every day, HMA stands united with the communities that are left behind to experience the long-lasting impacts of grief, and we celebrate the thousands of people who have experienced overdose and survived. Every overdose survival is another opportunity to uplift the strategies that work to save lives. We honor everyone impacted by overdose by using a community-led approach that encourages collective action to prevent, and ultimately end, all overdoses.

For more information on HMA overdose prevention services, visit our Harm Reduction solutions page or contact our featured experts below.

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Homelessness in America has hit a record high and housing instability is widespread. Millions of Americans are vulnerable to inadequate housing and half of all U.S. renters are spending far more than the recommended 33% of their income on rent.

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What is harm reduction?

How HMA can help

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