Abstract
Background: The US 21st Century Cures Act provided $7.5 billion in grant funding to states and territories for evidence-based responses to the opioid epidemic. Currently, little is known about optimal strategies for sustaining these programs beyond this start-up funding. Methods: Using an inductive, conventional content analysis, we conducted key informant interviews with former and current state leaders (n = 16) about barriers/facilitators to sustainment and strategies for sustaining time-limited grants. Results: Financing and reimbursement, service integration, and workforce capacity were the most cited barriers to sustainment. Status in state government structure, public support, and spending flexibility were noted as key facilitators. Effective levers to increase chances for sustainment included strong partnerships with other state agencies, workforce and credentialing changes, and marshalling advocacy through public awareness campaigns. Conclusions: Understanding the strategies that leaders have successfully used to sustain programs in the past can inform how to continue future time-limited, grant-funded initiatives.
Original language | English (US) |
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Article number | 84 |
Journal | Substance Abuse: Treatment, Prevention, and Policy |
Volume | 15 |
Issue number | 1 |
DOIs | |
State | Published - Dec 1 2020 |
Funding
This paper was supported by National Institute on Drug Abuse (NIH/NIDA) grants (R01DA037222 and R01DA037222-05S1, McGovern PI, and P30DA027828, P30DA027828-10S1, Brown PI). Acknowledgements We thank the 16 former and current state leaders for their public service and for their participation in this study. We also acknowledge Barbara Cimaglio, Rick Harwood, and Melanie Whitter and others who extended their expertise in the development of interview guides and participant recruitment. We are grateful to our colleagues Drs. Helene Chokron Garneau and Mehret Assefa for their support in manuscript preparation. The content of this article is solely the responsibility of the authors.
Keywords
- Barriers and facilitators
- Grant funding
- Health policy
- Opioid use disorder
- Opioid use disorder treatment
- Sustainability
- Sustainment
ASJC Scopus subject areas
- Health Policy
- Psychiatry and Mental health