Tackling Family-Based SUD Treatment for Pregnant and Parenting Families
Washington Thriving is partnering with Bloom Works to take on a key challenge in Washington state’s behavioral health system: making sure pregnant and parenting people who need substance use disorder (SUD) treatment can actually get it and feel safe seeking it - for themselves and their families.
The perinatal period – pregnancy through a child’s earliest years – is one of the best points to set children and families up for lifelong health. Recognizing this high-leverage starting point, the Washington Thriving Strategic Plan identified perinatal well-being as one of its First Initiatives. This work will support efforts under that initiative.
This engagement builds on a previous collaboration between Washington Thriving and Bloom Works in 2024, which included deep dive research into four areas of Washington’s behavioral health system for young people and families. The insights from that work directly informed Washington Thriving’s strategic planning process, and this new phase of work – funded by the Ballmer Group – builds on them.
Bloom Works helps build government capacity to deliver services well so that people get the public services they need, frictionlessly and with dignity. The work is grounded in human-centered design research with the people those services are meant to serve.
The challenge at hand
SUD during and after pregnancy contributes to some of the toughest outcomes a family can face. It’s a leading factor in pregnancy-related deaths and in child welfare involvement and family separation.
That risk of child protective services involvement also makes the problem worse: fear of losing custody keeps many parents from seeking treatment at all, and stigma around SUD compounds that fear. So the people who most need care are often the least likely to seek it.
What makes perinatal SUD care especially hard is that treatment must work for not just an individual, but the whole family. A parent seeking care often needs a program that can also accommodate their children, and sometimes a partner or co-parent too. Very few programs are built that way, and even where good options exist, families run into similar barriers that people face elsewhere - services are hard to find, have long waitlists, or have stringent eligibility requirements.
The approach: three interconnected sprints
Instead of trying to solve this everywhere at once, Bloom Works will run three 12-week “sprints.” A sprint is a focused period of research where the team goes deep on understanding a specific problem before designing or building a solution. Together, the sprints will look at the problem from the perspective of lived experience of families—to understand where and how people are hitting roadblocks in the system, as well as the provider side—to understand what providers need to serve the people they work with. The sprints seek to surface short-term improvement opportunities, and longer-term structural issues that will take more time and coordination to fix. Each sprint also informs the next; early learnings will shape later phases.
The first sprint kicks off in July 2026 focused on the Spokane region. Spokane has among the highest rates of SUD need in Washington state, existing infrastructure to study (including Pregnant and Parenting Women programs, Substance Using Pregnant People services, a Center of Excellence hospital, and relevant family-centered models), and a mix of urban and rural communities. By looking closely at the conditions in one locality (i.e., the Spokane area), this work can go deep enough to understand not just what’s happening, but why, and to distinguish barriers that are structural and statewide (e.g., Medicaid rules, workforce shortages, licensing impacts) from those that are more specific to Spokane’s own geography, providers, or infrastructure. This statewide lens – including a plan to compare findings against other regions – will be part of the thinking throughout the work.
Bloom Works’ team will work directly with families and people with lived experience, providers, tribal partners, and community organizations, alongside our state agency partners at the Health Care Authority (HCA), Department of Children, Youth, and Families (DCYF), and the Department of Health (DOH).
What to expect
The Bloom Works team will share learnings throughout this process—starting with Sprint 1 findings later this fall—which will help shape the direction of the sprints that follow. We welcome input and questions at info@washingtonthriving.org.