Mississippi State Department of Health Expands Access to Substance Use Disorder Treatment

A novel statewide program from the Mississippi State Department of Health (MSDH) is expanding access to substance use disorder care across all 82 counties by identifying risk earlier, reducing barriers to treatment, and bringing support closer to where patients live.

“This work reflects a simple principle: Substance use disorder care should be available earlier, closer to home, and as part of normal health care, not only after a person reaches crisis,” said Dr. Dan Edney, MSDH Executive Director and State Health Officer. “Mississippi is showing what is possible when clinical leadership, public health infrastructure, and technology are aligned around patients.”

Many challenges in Mississippi make forward-looking programs like this essential. In 2023, 49% of households were either in poverty or earned less than the cost of basic needs. Overdose deaths rose by more than a third from 2020 to 2021, including a 51% increase in deaths involving synthetic opioids such as fentanyl. As in many rural states, transportation barriers in Mississippi can make in-person care difficult to reach, with some residents of the Delta traveling an average of 75 miles for primary care. This access challenge is compounded in a state where 80 of 82 counties have whole- or partial-county primary care shortage areas and where 78 of 82 counties are designated mental health professional shortage areas.

The Substance Abuse and Mental Health Services Administration estimates that roughly 327,000 Mississippians aged 12 and older who needed substance use treatment did not receive it, based on 2022–2023 annual averages.

“It takes an average of five years before someone’s dependence on a substance causes enough problems to make them seek specialty care, even though many of these patients are open to discussing it much sooner,” said Jonathan Hubanks, Director, Center for Injury Prevention and Control at MSDH. “This earlier window is where we have the best opportunity to intervene and improve outcomes.”

MSDH is one of the very few state departments of health in the country to provide direct, clinic-based substance use disorder treatment.

“We wanted to build something that feels simple for patients and staff, but is powered by sophisticated technology underneath,” said Julio Cespedes, Chief Innovation Officer at MSDH. “By using Epic—our electronic health record—and MyChart to support earlier screening, standardized intervention, and comprehensive follow-up, we have created a model that helps us reach patients before substance use disorder becomes severe. It’s now possible for small, resource-strapped teams like ours to extend a hand to every patient who might need it.”

Rather than reacting only when risk is obvious, clinicians can now meet patients wherever they are on the risk scale. Patients with low-risk screening results receive positive reinforcement, and as patients’ results go up the risk scale, Epic nudges clinicians with standardized guidance for intervention.

“With just four doctors and 18 advanced practice providers serving a statewide population with significant need, we knew we had to approach this challenge creatively,” said Christina Graham, Director of Epic at MSDH. “Now, across all 84 MSDH clinics, all patients—no matter the reason for their visit—complete an annual screening through MyChart before their visit, or on a tablet when they arrive.”

Following a six-county pilot, every county in the state is now using this program, bringing earlier substance use disorder support to patients in both high-volume clinics and smaller, rural communities where treatment might be limited or far away. Patients who screen at high risk typically receive follow-up care from addiction specialists through video visits, removing the barrier of travel to providers who might otherwise be out of reach. As more patients engage successfully in care, MSDH is exploring how to safely extend care for eligible patients into the home, creating a model that is even more accessible, flexible and responsive to patients’ daily lives.

“This is a powerful example of how technology can extend a care team’s reach and increase access to care,” said Trevor Berceau, Director of R&D at Epic. “By meeting patients on their own terms, MSDH is connecting them to the care they need.”