Contingency management (CM) is an evidence-based intervention that uses incentives to encourage positive recovery behaviors among individuals with substance use disorders. Research shows that CM can improve abstinence, treatment engagement, and medication adherence, including medications for opioid use disorder (MOUD). It is particularly effective for stimulant use disorder, for which no Food and Drug Administration-approved medications currently exist.
As states work to address growing behavioral health needs, many are exploring how to design, implement, and sustain CM programs as part of broader strategies to address stimulant use disorder and support ongoing MOUD use. Key steps include assessing the need for CM, setting program goals, clarifying legal and policy requirements, evaluating provider interest and readiness, identifying funding approaches, and planning for operational and technical implementation.
This Center for Health Care Strategies (CHCS) webinar, made possible by The Pew Charitable Trusts, brought together state leaders and experts to discuss how they are exploring, launching, and scaling CM across various policy and funding environments. Speakers from three states — Delaware, New Jersey, and Wisconsin — shared considerations related to state roles, provider engagement, operational design, and financing approaches, including Medicaid Section 1115 demonstration waivers and State Opioid Response Grants. The discussion highlighted common challenges, emerging solutions, and lessons for states at all stages of CM development.
Agenda
I. Welcome and Introduction
Speaker: Karla Silverman, MPA, MS, RN, CNM, Associate Director, Women’s Health and Clinical Innovation, CHCS
K. Silverman provided an overview of the webinar goals and structure.
II. Overview: Contingency Management in States
Speaker: K. Michelle Peavy, PhD, Scholarly Associate Professor, Elson S. Floyd College of Medicine at Washington State University; Co-Director of the Northwest Rural Opioid Technical Assistance Collaborative
Dr. Peavy provided an overview of CM and the national implementation landscape, highlighting key considerations for states interested in supporting CM adoption.
III. State Perspectives: Planning, Implementing, and Scaling Contingency Management
Presenters from three states described how they are approaching CM planning and adoption in their states, including early exploration and provider engagement, implementation and expansion considerations, and issues related to sustainability and scale.
Presenters:
- Dan Bizjak, MSW, LCSW, ICS, CSAC, Substance Use Services Section Manager, Bureau of Prevention, Treatment, and Recovery, Division of Care and Treatment Services, Wisconsin Department of Health Services
- Sherry Nykiel, MD, Behavioral Health Medical Director, Division of Substance Abuse and Mental Health, Delaware Division of Medicaid and Medical Assistance
- Christine K. Scalise, LPC, LCADC, Manager of Special Initiatives, Women and Families Unit, Office of Treatment and Recovery Supports, Division of Mental Health and Addiction Services, New Jersey Department of Human Services
- Tevis Thompson, MS, Deaf and Hard of Hearing Accommodations, Access and Support Manager and Contingency Management Project Manager, Division of Mental Health and Addiction Services, New Jersey Department of Human Services
IV. Moderated Q&A
Moderator: Hadley Fitzgerald, MSW, Senior Program Officer, CHCS
