The NCSL Blog


By Charlie Severance-Medaris

Like many states, Massachusetts has seen an alarming increase in opioid over­dose deaths since 2000. In fact, opioid-related deaths in Massachusetts increased more than 350% be­tween 2000 and 2015, spiking abruptly in 2010 and far surpassing the national average.

Group discussionAs part of the state’s policy response, the Massachusetts General Court passed Chapter 55 of the Acts of 2015. The legislation instructed the Massachusetts Department of Public Health to combine and study the available data across multiple state agencies and private partners in the public health and behavioral health sectors to better understand what was driving the epidemic.

The resulting report gave lawmakers a comprehensive picture of all opioid-related deaths in Mas­sachusetts, along with a detailed description of the causes of deaths and the populations most at risk of dying.

The department then recommended public health interventions to the legislature, which would create opportunities to better allocate resources and coordinate care at a systems level. This would not have been possible without efforts to connect public health and behavioral health agencies’ information and systems.

By connecting behavioral health and public health systems, policymakers can better leverage resourc­es across different sectors currently operating independently of each other. Benefits of aligning infrastructure across systems include an improved ability to address priority health problems and use limited resources more efficiently.

NCSL’s new policy brief, “Bridging the Gap: Connecting Behavioral and Public Health Systems” discusses the benefits of connecting traditional public health systems with behavioral health systems and provides policymakers with promising practices from across the U.S.

The brief focuses on three main areas of interconnection:

  • Data: Creating an infrastructure that supports accurate, timely data can give state leaders the neces­sary information to predict, prevent and respond to health threats. For instance, after combining previously siloed data sets, Montana was able to better tailor its suicide prevention efforts to address its most vulnerable communities.
  • Partnerships: Directing collaborative cross-sector partnerships can foster the effective sharing of in­formation and resources, more focused prevention efforts, and more comprehensive solutions to challenging health problems. By creating partnerships among Medicaid, social services, behavioral health agencies and long-term care payment and assessment data systems, Washington can identify Medicaid clients most in need of comprehensive care coordination. This helps the state Medicaid agency coordinate with other agen­cies to provide services and predict health care costs for the most at-risk populations, allowing policymak­ers to allocate resources more efficiently.
  • Financing: Leveraging funding streams across systems and structuring collaborative partnerships can create sustainable financial mechanisms to support population health and improve system efficiencies. Louisiana administers a program with the state’s Medicaid agency and the Louisiana Housing Authority to combine housing assistance with in­dividualized services for people with substantial physical or behavioral disabilities using a braided funding model. An independent 2011-2012 study examined preliminary data that showed a reduction in emergency department use and hospitalizations as a result of the program.

Different demands drive legislative agendas in health policy. By aligning behavioral and public health systems, policymakers can create an opportunity for communities to develop a lasting, data-driven infrastructure across multiple public and private partnerships, while streamlining different funding mechanisms to support population health.  

Learn more about these approaches here.

Charlie Severance-Medaris is a policy specialist in the health program.

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This project is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $250,000 with 100% funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government.

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About the NCSL Blog

This blog offers updates on the National Conference of State Legislatures' research and training, the latest on federalism and the state legislative institution, and posts about state legislators and legislative staff. The blog is edited by NCSL staff and written primarily by NCSL's experts on public policy and the state legislative institution.