In the previous section, we presented selected opportunities to improve access to evidence-based treatment within the parameters of current laws and regulations. But access for all who need care will remain elusive until those rules and regulations reflect the best available evidence. Philanthropy can help make that happen.
Currently, a complicated network of rules and regulations determines who gets care and what kind of care they receive. Many policies make good sense in isolation and are enacted with the best of intentions. But policy change is a slow and complicated process, and it’s not uncommon for policies to remain in place long after the evidence indicates a different approach. (The federal funding ban on needle exchanges is one example.) Other examples of restrictive policies that don’t align with the evidence include:
- Residential treatment centers with more than 16 beds can’t bill Medicaid for services provided to low-income adults.
- The medication buprenorphine is recommended by physicians as the first-line therapy for opioid use disorder, but federal regulations make it difficult for this medication to be provided within treatment centers.
- Common “Fail First” insurance policies mandate that patients be given lower-cost treatments first, regardless of what kind of treatment their doctor recommends.
- Many SUD treatment programs don’t track patient outcomes, and regulations for SUD treatment professionals are inconsistent and often lax.
Changing these policies is a high-impact opportunity for philanthropists. In the following pages, we present examples of non-profits with the demonstrated ability to make that change happen. Funding organizations that work to change these policies is quite different from funding a direct-service organization. The impact on the people you hope to help is more removed from the point of funding, and the chain of cause and effect can be more difficult to see clearly. But those downsides are, for some funders, balanced by the potential to impact large numbers of people in lasting and meaningful ways as a result of a single change—sometimes with the stroke of a pen. This is not a section full of sure bets, but donors who seek game-changing tools for coping with the burden of SUDs will find exciting opportunities and strong organizational partners here.
Changing the system is a high-impact opportunity, and philanthropy can help make it happen.