Perinatal Substance Use Disorder (SUD) Project Update
Last month, we shared how Bloom Works is partnering with Washington Thriving, Behavioral Health Catalyst, and state agency partners to explore how we might improve substance use disorder (SUD) care for pregnant and parenting people in Washington. Read that post here for the full context on the project, the challenges it seeks to address, and our goals and approach.
This is the first in a series of monthly updates tracking Sprint 1 of the perinatal SUD project — a look at lived experience and front-line realities for pregnant and parenting people engaging with SUD treatment and related supports. This sprint runs from July-October 2026 with the goal to build a foundation for understanding where the opportunities are behind the scenes, which we'll dig into more in Sprint 2 (Nov 2026 - Feb 2027).
Sprint 1 kicked off a few weeks ago, and these dispatches are meant to be a window into the work in motion — we aren't drawing any conclusions yet, just want to share what we're seeing and hearing in real-time.
Highlights
24 research sessions completed as of August 21 — with parents, treatment provider staff, community-based organization (CBO) staff, and subject matter experts (SMEs)
We're on-site in Spokane this week (Aug 24-28) with facility leadership, frontline staff, and CBOs
Early signals below are just that — signals, not findings. We’ll share findings and deliverables in October.
Who we’ve talked with:
9 parents who've gone through SUD treatment while pregnant and/or parenting
6 staff from treatment provider facilities (hospitals, clinics)
13 CBO staff (peer navigators , employment programs, early learning and childcare, parent education, family resource centers, legal aid)
3 SMEs (state agencies, Substance Use Disorder Professional (SUDP) roles)
Plus about 30 scoping and intro conversations in the weeks leading up to kickoff
What we're hearing: on people's needs
Relationships and community (through staff, peer support roles, and other families) keep coming up as what draws people into treatment, supports them through it, brings them back after a relapse, and sustains them in recovery.
Programs that build community — alumni networks, social events, faith-based connections — matter beyond the clinical care itself.
Parents benefit from wraparound service integration (e.g., employment, food, housing, transportation, childcare) alongside behavioral health treatment. This also prevents dropoff by overcoming transportation/logistical barriers.
Treatment programs can be too short and too rigid. Early in a program, people sometimes “go through the motions” before fully detoxing and benefitting from treatment enough to feel motivation to stay in recovery. Several parents have told us they needed up to a year in a residential or housing-attached program to get to where they are today.
People’s treatment and recovery journey can involve moving around the state, including between eastern and western regions. Sometimes this is driven by life circumstances, and sometimes where services and capacity exist. In other words, people may not always stay in one region.
We’re hearing about what a "family-centered" service means to parents — that children can come with a parent, and/or that partners co-parents can attend together. Some told us they didn’t want to enter treatment unless their partner could go together with them.
What we're hearing: on provider and system pressures
Facility licensing has come up as a pressure point for behavioral health providers. They're sometimes navigating multiple licensing authorities, and the specific licenses a provider holds shape what they can offer and how they must operate (e.g., staffing ratios).
Detox and longer-term treatment facilities are often not co-located, which makes the timing of transitions between them a recurring problem.
For more holistic programs that offer both behavioral health services and wraparound supports (housing, childcare, etc.), financial sustainability risks seem to be on the wraparound side. Those services depend more on braided, less-reliable funding streams (not all Managed Care Organizations (MCOs) reimburse for childcare, for example). Models that include robust non-clinical supports like Rising Strong and Maddie's Place seem especially impacted. Since the wraparounds seem to be critical enablers of success for the behavioral health program, we might ask why these things are not all funded together.
What's next
Questions we're digging into in the remainder of this sprint, with more from us in our September update and findings/deliverables in mid-October:
What makes referral pathways work, and where do they break down?
How do Tribal systems serve this population, and how do those models compare?
How do the funding models of different types of programs and services shape what providers can offer or sustain? How are providers navigating that funding complexity?
What drives wait times for detox, MAT (Medication-Assisted Treatment)/MOUD (Medications for Opioid Use Disorder), and treatment beds, and why are they rarely co-located?
A few questions we're starting to touch on now, but that will be more central in Sprint 2 (kicks off in November):
How do MCO billing practices shape what providers can actually deliver?
How will the shift to American Society of Addiction Medicine (ASAM) 4 change assessment, patient choice, and access to care?
What licensing and permitting requirements slow down new, co-located, or integrated facilities — and how might we streamline those?
What opportunities exist to influence training for mandatory reporters?
Have context, data, or reports related to any of these questions?
We'd love to hear from you — reach out any time. Contact wa-bh-perinatal@bloomworks.digital