Citing the need for more collaboration in the treatment of substance use disorder, 10 nonprofit organizations from around Kentucky have banded together to form the Kentucky Nonprofit Recovery Alliance.
Launched publicly on Oct. 2, the founding members — which span from West Kentucky to Ashland — will advocate for Medicaid reforms that prioritize patient outcomes over quantity of services, as well as establish a memorandum of understanding to easily refer patients within the network for the best care.
This will get recovery advocates out of “our organizational silos” and into a formal system of “warm handoffs and linkages into care between every step in the process,” said Jennifer Hancock, the president and CEO of Volunteers of America Mid-States and a founding board member of the new organization.
While overdose deaths in Kentucky have declined in recent years, Kentuckians still suffer from opioid use disorder at one of the nation’s highest rates.
As of 2022, Kentucky had 70.34 treatment beds per 100,000 people, the highest in the country, according to a study released in 2024 by East Tennessee State University’s Center for Rural Health Research. Despite that capacity to treat people, the state has high rates of addiction.
“That dissonance is something that we are deeply concerned about,” Hancock said.
A national report in May showed Kentucky is one of four states where the rate of opioid use disorder is higher than 2.5% of the population aged 12 or older. The others are New Hampshire, Nevada and Massachusetts. Meanwhile, 1,410 Kentuckians died from an overdose in 2024, according to the 2024 Drug Overdose Fatality Report. In 2023, there were 1,984 overdose deaths, which was a decrease from the 2,135 lost in 2022.
Even though deaths are down, the high rate of addiction means “the urgency has never waned” when it comes to treating it, Hancock said.
“Even though fewer people are dying, which is something that we would celebrate, we’re not really seeing that much of an impact in overdoses,” said Abbie Gilbert, the chief policy and external affairs officer with the Kentucky Nonprofit Recovery Alliance. “We have to find other things to show that we’re helping people get healthy (and) move back into the workforce.”
‘Volume over value’
One disconnect in resources and effective treatment, Hancock said, is the reimbursement system.
“The current system incentivizes volume over value,” Hancock said. “Because it’s a fee-for-service model … Medicaid is paying providers to deliver a health care activity, regardless of whether or not that activity is producing positive results.”
Hancock’s organization, Volunteers for America, has “value-based” contracts with Medicaid and its managed care organizations (MCOs), she said: “They are paying us for delivering healthy babies not born substance exposed, graduating a mom who has a living wage job and stable housing.”
She wants to see other organizations land such contracts. The organization will also advocate for the General Assembly to require demonstrated outcomes in Medicaid contracts, she said.
The Kentucky legislature convenes for the 2026 session on Jan. 6, but it’s “too early” to say what bills will be introduced on this, Hancock said. Coalition members are “just beginning” to have conversations about this with members of the Medicaid Oversight and Advisory Board, she said.
“Our coalition believes that the system could be redesigned to incentivize quality outcomes, which would change the behaviors of providers in transformational ways,” Hancock said. “These are significant changes that could be positively disruptive to the system, especially during a time when Medicaid reform is at the top of every policy maker, provider and even citizen’s minds.”
Kentucky Nonprofit Recovery Alliance founding members
These nonprofits have signed a memorandum of understanding to refer patients within the 10-member network:
- Four Rivers Behavioral Health is a private, nonprofit agency providing mental health, substance abuse and developmental disability services in West Kentucky’s Ballard, Calloway, Carlisle, Fulton, Graves, Hickman, Livingston, Marshall and McCracken counties.
- New Vista, based in Lexington, serves 17 central Kentucky counties as a Certified Community Behavioral Health Clinic providing behavioral health, substance use, developmental disability, primary care and crisis services through multiple access points, including a 24-hour helpline.
- Pathways, headquartered in Ashland, serves 10 northeastern Kentucky counties with community-based behavioral health care, including crisis response and stabilization, mental health and substance use prevention, treatment and recovery, residential programs, developmental disability support and primary care.
- People Advocating Recovery, located in Louisville, provides training, access to resources and works to remove barriers and reduce stigma surrounding substance use disorder.
- Ramey-Estep Re-Group, located in Georgetown and the northeastern and northern regions of Kentucky, supports youth, adults and families through mental health, recovery and residential services.
- Seven Counties Services, based in Louisville, offers comprehensive behavioral health, substance use and developmental disability services to residents across Jefferson, Oldham, Bullitt, Shelby, Spencer, Trimble and Henry counties.
- Shepherd’s House, based in Lexington, provides residential and community recovery programs that help adults achieve long-term sobriety through accountability, employment and life skills development.
- The Healing Place, based in Louisville, is a nonprofit providing no-cost, peer-driven addiction recovery.
- The Morton Center, in Louisville, is a nonprofit outpatient counseling center providing integrated substance use and mental health treatment for individuals and families.
- Volunteers of American, Mid-States, is headquartered in Louisville, and operates 30 human service and behavioral health programs in Kentucky, Tennessee, West Virginia and Clark and Floyd Counties in Indiana.