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...
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...
Retention-By-Design in Community SUD Service Models: Missed Visits, Outreach Cadence, and “Return Anytime” Pathways
Community SUD programs lose people when missed visits trigger administrative discharge rather than structured re-engagement. This cornerstone guide shows how to design retention workflows: outreach ladders, peer navigation, re-entry rules, and governance controls that keep care moving while remaining auditable and fundable. Read more...
Low-Threshold MAT in Community SUD Service Models: Same-Day Starts Without Losing Clinical Governance
Low-threshold MAT expands access only when “same-day” is operationally real: intake, prescribing, pharmacy coordination, follow-up, and safety escalation all work without delays. This cornerstone guide sets out a practical same-day MAT operating model with governance controls, audit trails, and day-to-day workflows commissioners can trust. Read more...
Post-Overdose Outreach and Warm Handoff Models That Prevent Repeat Events and Build Engagement
Non-fatal overdoses are among the strongest predictors of future fatal overdose. This article explains how counties design post-overdose outreach and warm handoff models that operate at real-world speed—linking EMS and ED touchpoints to follow-up, naloxone reinforcement, and voluntary treatment access without coercion. Read more...