Look at Policymaking through a New PRISM
October 2018

Cultivating the policymaking potential of state Title V programs to address substance misuse and mental health in MCH populations

Stacy Collins
Associate Director, Health Systems Transformation


Reflecting a troubling national trend, state Title V programs have identified women’s mental health and substance misuse as enormous — and often intractable — challenges. Statistics bear witness: Women are the fastest-growing segment of alcohol and drug users in the United States Up to 4.5 million women and adolescent girls in the U.S. have a substance use disorder, 3.5 million misuse prescription drugs, and 3.1 million regularly use illicit drugs. (NCADD, 2018).  Thirteen percent of women in the U.S. smoke cigarettes. One in five U.S. women experiences a mental health condition each year; prevention efforts are lacking, and treatment availability has not kept pace with demand.

Many states are overwhelmed by these challenges and are searching for effective solutions. One solution might be developed through a new federally funded initiative: Promoting Innovation in State MCH Policymaking, known as PRISM.

PRISM is a technical assistance and peer-learning initiative to assist maternal and child health (MCH) leaders and Title V staff in building their capacity to develop and implement state-level policy solutions that address substance misuse and mental health disorders in women. The U.S. Health Resources and Services Administration’s Maternal and Child Health Bureau recently awarded PRISM cooperative agreements to four organizations, including to the Association of Maternal & Child Health Programs (AMCHP) and the Association of State and Territorial Health Officials (ASTHO) to form an innovative partnership. Each $2 million award spans five years  (2018-2023.)

AMCHP and ASTHO each bring distinct knowledge and skills to PRISM. AMCHP will provide MCH-focused government relations expertise, and ASTHO will provide expertise in quality improvement and evaluation. Both organizations offer expertise in substance misuse and mental health. The partnership is a response to feedback from AMCHP members regarding the need for coordination and streamlining of technical assistance opportunities available to state public health departments in the MCH arena.

AMCHP and ASTHO will also work collaboratively with four national association sub-awardees, whose members reflect the coordinated approach needed to advance effective policy solutions at the state level: the National Association of State Alcohol and Drug Abuse Directors, the National Association of County and City Health Officials, the National Association of Medicaid Directors, and CityMatCH, the association of urban MCH professionals.

Four, one-year cohorts of six to eight state teams — with diverse compositions representing state and local public health, behavioral health and health care finance — will participate in PRISM. States can choose a legislative, regulatory, or administrative policy activity as the focus of their project. During the application process, states can receive assistance crafting a project proposal that best meets their state’s unique needs.

Participating states will benefit from virtual learning events, and in-state technical assistance will be available upon request. The capstone event for each cohort will be the PRISM “policy academy” held in conjunction with the AMCHP Annual Conference, each year from 2019- 2023. Travel support for policy academy attendance will be provided to state teams.

For additional information about the project, contact Stacy Collins (scollins@amchp.org).