Articles

Funding and Contracting Peer Support at Scale: Payment Models, Performance Measures, and Governance That Protect Role Integrity
Peer programs often expand faster than commissioning design, creating unstable funding, productivity pressure, and role drift. This article explains how counties structure contracts, payment models, and performance governance so peer support is funded as continuity infrastructure, measured by defensible outcomes, and protected from becoming informal enforcement or clinical substitution. Read more...
Peer Support Quality Assurance and Fidelity: Building Programs That Stay Safe, Consistent, and Defensible at Scale
Peer programs often look strong in pilots but degrade when caseloads rise, supervisors change, and partners interpret the role differently. This article explains how counties build peer QA systems—fidelity checks, case review, incident learning, and boundary monitoring—so peer delivery stays consistent and safe at scale. Read more...
Designing the First 72 Hours After Discharge: Follow-Up Operations That Prevent Rapid Relapse and Return to Crisis Care
The first 72 hours after detox, ED, or inpatient discharge is where relapse, missed doses, and failed appointments cluster. This article explains how systems build practical follow-up operations—multi-channel outreach, escalation triggers, and documentation routines—that convert discharge into continuity and withstand payer and regulator scrutiny. Read more...
Designing MAT Continuity After Detox and Residential Treatment: Bridge Prescribing, Warm Handoffs, and No-Show Recovery
Detox and residential discharge is where MAT continuity most often breaks—prescriptions lapse, pharmacy access fails, and follow-up becomes “optional” in practice. This article sets out an operational continuity design that uses bridge medication, governed handoffs, and rapid re-engagement workflows so counties can reduce post-discharge overdose risk and document accountable follow-through. Read more...
Care Transitions From Detox, ED, and Inpatient Settings: Building Community SUD Pathways That Prevent Relapse and Readmission
Transitions out of detox units, emergency departments, and inpatient settings are the most fragile points in the SUD care pathway. This cornerstone guide explains how to design closed-loop transition workflows—bridge prescribing, rapid follow-up, harm reduction integration, and accountability controls—so discharge becomes engagement rather than drop-off. Read more...
Contract and Grant Reporting for Community SUD Providers: Proving Safety and Impact Without Paperwork-Only Compliance
Reporting frameworks often fail because they demand volume rather than evidence: forms get completed, but systems cannot see whether access is timely, care is safe, or outcomes are improving. This cornerstone guide shows how to set contract and grant reporting expectations that are feasible for providers, auditable for funders, and aligned with real delivery workflows. Read more...
Outcome Measurement in Community SUD Service Models: Proving Impact Without Reducing Care to Dashboard Theater
Community SUD services are increasingly funded and judged through outcome reporting, but many measurement approaches create paperwork-only compliance and distort clinical priorities. This cornerstone guide explains how to design outcomes that reflect real engagement and safety, with operational definitions, sampling, and governance controls that commissioners can trust. Read more...
Designing Hub-and-Spoke Community SUD Networks: Roles, Escalation, and Data Flows That Work Across Counties, Clinics, and Mobile Teams
Hub-and-spoke SUD networks expand access fast, but they fail when spokes become handoff points rather than treatment settings. This cornerstone guide explains how to design roles, escalation pathways, clinical governance, and information flows so hubs support spokes without centralizing everything or losing accountability. Read more...
Closed-Loop Intake, Triage, and Assessment in Community SUD Service Models: Preventing Early Drop-Off at the Front Door
Intake is the highest-risk point for disengagement in community SUD systems. This cornerstone guide explains how to design closed-loop triage, scheduling, and assessment workflows that move people into treatment quickly, route risk safely, and create audit-ready evidence—without turning access into paperwork. Read more...
Clinical Governance in Community SUD Service Models: Standardizing Safety Without Slowing Access
Community SUD systems fail when speed and safety are treated as opposites. This cornerstone guide shows how to build clinical governance into ordinary work—protocols, escalation pathways, supervision, and audit controls—so same-day access remains possible while decision-making stays consistent and defensible across teams. Read more...
Integrated Harm Reduction Inside Community SUD Service Models: Making Naloxone, Safer Use, and Linkage Part of Routine Care
Harm reduction fails when it runs as a parallel service rather than a built-in workflow inside community SUD programs. This cornerstone guide explains how to operationalize naloxone distribution, safer-use supports, and rapid linkage into routine encounters, with governance controls, documentation standards, and auditable outcomes. Read more...
Fentanyl-Era Buprenorphine Starts in Community SUD Service Models: Induction Pathways That Prevent Early Drop-Off and Precipitated Withdrawal
Buprenorphine access fails when induction is treated as a one-size-fits-all script in a fentanyl-dominant drug supply. This cornerstone guide sets out practical induction pathways—including standard, high-tolerance, and micro-induction options—with escalation rules, documentation controls, and follow-up workflows that keep people engaged and safe. Read more...