Author: niatxfou

  • What MAPS Delivers

    What MAPS Delivers

    NIATx MAPS is an integrated framework that helps organizations improve systems, services, and outcomes. It brings together process and quality improvement, cultural responsiveness, and implementation context to align change efforts with the unique realities of each individual organization.

    In essence, NIATx MAPS helps organizations understand who they are serving, what needs to improve, and how to make practical changes that fit the real-world setting.

    At its core, the NIATx Improvement Model serves as the engine for change—emphasizing practical testing, continuous learning, and measurable results. NIATx MAPS strengthens that model by ensuring process improvement strategies are culturally responsive and grounded in the realities of the organization: 

    • Cultural responsiveness ensures that improvement strategies are relevant and engaging by shaping how they are designed, communicated, and received by the people most affected.
    • Implementation context anchors the work in the realities of your organizational climate, considering the setting, workforce, systems, history, and external pressures that influence whether change can be successfully adopted and sustained.

    Ultimately, MAPS helps organizations improve access, engagement, quality, and outcomes through cultural responsiveness and practical, measurable change:

    • Identify priority areas such as access, retention, and quality of care.
    • Align improvement strategies with the cultural and community needs of clients.
    • Select the right level of support—from foundational guidance to intensive, hands-on assistance for complex system change.
    • Implement changes that are effective, sustainable, and responsive to the people you serve. 

    Learn more about NIATX MAPS…

  • How MAPS Works

    How MAPS Works

    NIATx MAPS brings together context, culture, and process improvement so organizations can turn data and community understanding into practical measurable change. The framework begins with a structured intake process that helps organizations:

    • Define improvement priorities.
    • Identify the cultural and operational factors that influence success.
    • Match support to their goals, readiness, and context. NIATx uses responses to the intake to align NIATx MAPS expertise, determine the appropriate support configuration, and shape the scope and sequencing of improvement work.

    After the intake, the MAPS framework follows a 3-step process to implement culturally responsive organizational change:

    STEP 1. WHAT: The organization determines what they are trying to improve by identifying the organization’s relevant fields, setting(s), and priority needs. This step focuses on accurately describing the implementation context, including where the work occurs and what outcomes matter most.

    STEP 2. WHY: The organization identifies the cultural conditions that influence whether improvement efforts will be effective and selects the appropriate culture scope (e.g., broad cultural responsiveness, CLAS, community-specific). The MAPS framework treats culture is treated as a condition of effectiveness, not an add-on or afterthought.

    Organizations also select the appropriate technical assistance (TA) level, which determines the depth and intensity of support

    • Universal TA focuses on foundational guidance, shared learning, and broadly applicable strategies.
    • Targeted TA provides more focused support for specific populations, settings, or challenges.
    • Intensive TA offers sustained, hands-on support for complex contexts, high-need populations, or significant system change efforts.

    Note that culture scope and TA level are selected independently and may be combined in different ways. This flexibility allows cultural considerations and support intensity to be intentionally aligned with the organization’s goals, readiness, and implementation context.

    STEP 3. HOW: The organization determines how to implement process changes using one of the following options:

    • Full NIATx MAPS Team: Some organizations that are new to structured improvement work, cultural responsiveness, or implementation across complex settings need a full NIATx MAPS team to support foundational skill-building, shared understanding of the field and setting, and practical application of improvement methods. Under this option, NIATx provides a three-person team with complementary expertise in process and quality improvement, implementation context, and cultural responsiveness. This approach is especially helpful when building capacity from the ground up or working across multiple systems or population.
    • Targeted NIATx MAPS Support: Some organizations that already have deep expertise in their field, setting, and evidence-based practices require more targeted support. For this option, NIATx employs a two-person team with deep expertise in process and quality improvement and cultural responsiveness to complement internal capacity and contextual knowledge. This configuration allows teams to move efficiently deepen implementation effectiveness and strengthen cultural alignment without duplicating existing expertise or capacity.

    Support is flexible. The goal of NIATx MAPS is to provide the right level of guidance to help teams move improvement work forward and sustain results. Importantly, NIATx MAPS treats cultural responsiveness as a condition for success to ensure services are relevant, engaging, and effective for the populations the organization serves. At the same time, it grounds improvement efforts in the organization’s realities, including staffing, systems, and external pressures that affect implementation and sustainability.

    Learn more about NIATx MAPS…

  • In Memoriam: A Tribute to Dr. David Gustafson

    In Memoriam: A Tribute to Dr. David Gustafson

    There is not enough space to document all the ways Dave’s work as a professor of Industrial Engineering impacted human experience. Whether designing computer-based predictive models for suicide prevention in the late 1960s, creating technology to improve the lives of patients and their families facing health crises, or developing process improvement systems to help behavioral health agencies deliver quality care, his guiding force was the same: keeping the human individual at the center of the work.

    In a 2020 interview, when the Department of Industrial Engineering’s Chair was named in his honor, Dave said, “It’s just so darn important we keep in mind that there are people out there who are suffering, who we need to be helping. We just have to remember who we’re trying to help.”

    That belief shaped not only what Dave studied, but what he built. He founded the Center for Health Enhancement Systems Studies and co-founded the Institute for Healthcare Improvement—work rooted in the idea that better systems should always amount to higher quality, more human, care. Dave was also a member of the National Academy of Engineering and the American College of Medical Informatics, recognition that reflected the impact of a career guided by that same principle. His legacy is captured well in two pieces—one from the Agency for Healthcare Research and Quality, “Using Technology with a Fundamental Focus on the Patient” and another from the UW-Madison College of Engineering, “New endowed ISyE chair honors health systems engineering pioneer”.

    Dave published over 270 reviewed publications including seven books. His research interests focused on developing systems engineering tools to support sustainable individual and organizational improvement. He served on the National Advisory Council, U.S. Substance Abuse and Mental Health Administration, and was part of the National Academy of Engineering and NIH Dissemination and Implementation Research in Health Study Section. He was recognized with the 2011 Translational Health Communication Scholar Award: DC Health Communication Conference; 2009 Award of Merit: University of Michigan College of Engineering; 2006 Blanket of Honor: Native American Connection; 2000 Robert A. Ratner Professorship in Industrial Engineering; and 1999 Instructor of the Year Award–Industrial Engineering Student Award.

    Dave’s impact has been immeasurable, and he will be deeply missed by all who had the opportunity to work with him.

  • Welcome Guy Hardcastle, Vice President of Client Engagement & Operations

    Welcome Guy Hardcastle, Vice President of Client Engagement & Operations

    Guy Hardcastle, MPA, has joined the NIATx Foundation as Vice President of Client Engagement and Operations. Guy brings more than 20 years of experience in behavioral health and recovery to the NIATx team. Before joining the NIATx Foundation, he served as CEO and partner of a privately held residential treatment center, where he helped build a culture grounded in evidence‑based practices and individualized care.

    Guy’s commitment to the NIATx Foundation is rooted in alignment between its mission and his own professional values. Throughout his career, he has focused on creating environments where integrity, innovation, and compassion coexist with accountability and measurable results. NIATx’s emphasis on improving access, retention, and organizational effectiveness reflects the same principles that have guided his leadership across multiple treatment settings.

    By contributing his time and experience, Guy sees an opportunity to support a national effort that helps organizations learn, adapt, and improve—ensuring that high‑quality care is not dependent on individual heroes, but embedded in the way systems operate. His involvement reflects a belief that lasting recovery is best supported when organizations themselves are equipped to learn, evolve, and serve people well over time.

  • Meet Our Team: Spotlight on Dick Dillon

    Meet Our Team: Spotlight on Dick Dillon

    Dick Dillon serves as the Vice President and Treasurer of the NIATx Foundation Board of Directors. Dick has worked in the behavioral health field for over 35 years, starting with a volunteer coordinator role and holding most clinical and management positions, including COO of a large Midwest non-profit counseling agency. In November, 2011, he formed his own consulting organization, Innovaision, LLC. The work of Innovaision focuses on helping behavioral health and other human services organizations become more innovative and effective by combining common sense, vision, creative and innovative programming, evidence-based practices, and cutting-edge technology.

    Dick has a deep history with NIATx and is a firm believer in the Foundation’s mission to help behavioral health organizations improve access, care, and outcomes:

    I first became aware of the original NIATx project when I heard Dr. Dave Gustafson speak about using engineering principles to address issues complicating access to treatment at a national addictions conference. I had been–and still am–a big fan of borrowing good ideas from other fields to address problems in innovative ways, and Dave’s outline was brilliant. I remember telling him shortly afterwards that if I was ever able to make it happen, I would come work with him for free. I think I may have achieved that goal!

    I was on the Board of the State Associations of Addictions Services (SAAS) group, and that group embarked on a collaboration with NIATx Foundation on a few annual conferences. Additionally, I worked directly with the NIATx team at the University of Wisconsin-Madison on at least one innovative project of my own: using video game technology to deliver counseling services. We provided a national demo of this project and published a paper on it.

    Perhaps inevitably, I was asked to serve on the NIATx Foundation Board. I believe as of this moment, I am the longest continuous serving Board member. Over the past years, I have held all of the offices, including Treasurer, which I am currently doing for the second go around. I am firmly committed to the goals and directions of the NIATx Foundation and believe that this group represents the pinnacle of “out-of-the-box” thinking in the addictions/behavioral health field. NIATx represents the very best concepts of collegiality, strategy, and the aggressive development of innovative, yet solid, practices. 

  • 2026 Outlook: A Letter from NIATx Foundation President Dr. Todd Molfenter

    2026 Outlook: A Letter from NIATx Foundation President Dr. Todd Molfenter

    Dear Colleagues and Partners,

    Our field stands at a pivotal moment.

    Across the nation, behavioral health organizations are facing unprecedented pressures: rising demand for services, workforce shortages, increasing regulatory complexity, tighter margins, evolving payer expectations, and a growing urgency to demonstrate measurable outcomes. At the same time, individuals and families are relying on our systems more than ever. The stakes could not be higher—and the strain on providers has never been greater.

    Yet amid these challenges lies opportunity.

    The NIATx Foundation was created precisely for moments like this. Our mission is not to add burden to organizations, but to remove it by helping you effectively serve the people who depend on you. We bring a practical, data-driven approach to improvement that helps organizations do more with what they already have.

    Through the NIATx Model for Process Improvement, we help teams:

    • Reduce wait times.
    • Improve access.
    • Strengthen engagement and retention.
    • Create sustainable operational change.

    All without costly technology investments or disruptive overhauls.

    We further recognize that today’s challenges are not just clinical. They are also operational, financial, and strategic. That is why NIATx supports leaders in aligning processes, quality, outcomes, and overall business performance. Our objective is to help organizations build systems that are not only compassionate, but also resilient, efficient, and scalable.

    The key is collaboration.

    What makes NIATx unique—and our solutions successful—is our partnership model. Our coaches don’t arrive with a checklist in hand; we arrive with curiosity, a spirit of collaboration, and proven methods to empower your teams to own the solutions. We firmly believe that change is something you must build from within, not something imposed from the outside.

    Behavioral health is essential to the well-being of our communities. You are doing extraordinary work under extraordinary circumstances. The NIATx Foundation is here to walk alongside you, providing tools, coaching, evidence-based methods, and a shared commitment to continuous improvement. I encourage you to reach out to continue this important conversation.

    Together, we can transform challenges into momentum, and momentum into lasting impact.

    With gratitude for your leadership and dedication,

    Todd Molfenter, Ph.D.
    NIATx Foundation President

  • Horizon Podcast: Building a Culture of Continuous Improvement with NIATx

    Horizon Podcast: Building a Culture of Continuous Improvement with NIATx

    NIATx consultant Matt Russo recently sat down with Horizon Treatment Services to unpack how a relationship-first framework, rapid testing, and staff voice turned a chronic pain point into a durable win: medication errors in residential and withdrawal management dropped from 55 to just four in a month, with daily audits and a higher census.

    Tune in to Horizon Treatment Services’ Podcast to learn about NIATx, celebrate the execution of its framework at Horizon, and discuss why the NIATx process is important.

  • Increasing Access to Medication for Addiction Treatment (MAT)

    Increasing Access to Medication for Addiction Treatment (MAT)

    Challenge

    In 2022, the California Advancing and Innovating Medi-Cal (CalAIM) initiative was launched to improve the health and well-being of Medi-Cal enrollees with complex needs, including improving the quality of outcomes related to mental health and Substance Use Disorder (SUD) treatment. Pharmacotherapy has become widely accepted over the past decade as a leading treatment for Opioid Use Disorder (OUD); unfortunately, access to Medication for Addiction Treatment (MAT) remains limited, and the need for MAT exceeds its availability.

    As part of California’s broader initiative, the California Commission for Behavioral Health, California Institute for Behavioral Health Solutions (CIBHS), and the Los Angeles County Public Health Substance Abuse Prevention Control (SAPC) have entered into a multi-year partnership to design and facilitate training and assistance to increase prescriber capacity and increase access to MAT beyond OUD to include other SUDs (e.g., alcohol, nicotine).

    Solution

    The SAPC MAT Prescribing Clinician startup project addresses substance use in California by removing barriers and improving access to MAT through a financially sustainable model. The objectives of the pilot project are to:

    • Increase the availability of MAT in the SUD Specialty System of Care by increasing the number of prescribers.
    • Explore whether Medi-Cal reimbursement rates will support and sustain the salary and associated costs of prescribers in the county’s provider network.
    • Identify best practices for integrating prescribers and medical services into traditionally non-medical programs in small, medium, and large counties.
    • Identify any barriers to this process concerning Incidental Medical Services (IMS) certification, recruitment of prescribers, and billing for MAT and related medical services.

    CIBHS has contracted with the NIATx Foundation to provide six of the twelve coaches, who support the project and apply their expertise in MAT and NIATx evidence-based practice implementation. These coaches are focused on advising addiction treatment providers on best management practices for implementing MAT treatment. This includes clinical skills (e.g., which medications to prescribe, how to use them); workflows to effectively provide MAT; billing mechanisms to accurately capture services (e.g., Medi-Cal); and leadership support.

    Specifically, coaches provide the following training and technical assistance (TTA):

    • Coaching calls: Schedule regular calls with assigned sites to assist providers in designing an integrated care model and navigating the implementation process.
    • Monthly collaborative calls: Attend and facilitate training and small group discussions.
    • Technical assistance and resource development: Collaborate with the CIBHS project team to develop training modules and resources.
    • Quality improvement (QI) training: Provide consistent training on best practices, NIATx process improvement, and business models to support expansion.

    Outcomes

    This project is pushing forward the progressive trend to increase the use of This project is pushing forward the progressive trend to increase the use of pharmacotherapies and expand their use to other SUDs beyond OUD (e.g., alcohol and nicotine). With year one establishing the baseline, the project will measure outcomes in the following areas in the next fiscal year:

    • Increased prescriber capacity.
    • Increased access to MAT Education, within the provider agency, and broader care community.
    • Broadened the uses of MAT to alcohol and nicotine use disorders.
    • Increased the frequency of MAT use for all SUDs.

    Offering MAT further offers a business opportunity and a competitive advantage in an increasingly competitive healthcare landscape, where providers and clinics seek to attract patients by offering valued services that improve patients’ continued recovery.

  • Developing Change Leader Capacity

    Developing Change Leader Capacity

    Challenge: Systems-level Adoption and Sustainment of New Practices

    Implementation science has demonstrated over the past decade that training is necessary but not sufficient to successfully implement a new practice. This holds especially true for the NIATx model as an evidence-based practice. Technical assistance in the form of coaching, mentoring, and train-the-trainer models can help increase system-wide adoption and sustainment.

    Services for the Underserved (S:US) has been working with the NIATx Foundation for several years to train Program Directors on how to use the NIATx model for continual improvement and the associated core NIATx tools (i.e., walkthrough, flow chart, nominal group technique, and plan-do-study-act (PDSA) rapid cycle testing) using Change Leader Academy (CLA) training. S:US’s vision is to develop and leverage the change management skills of the agency’s three Performance Improvement (PI) Managers to ensure sustainable NIATx implementation throughout the agency.

    Solution

    S:US’s vision is well aligned with NIATx Foundation’s prioritization on sustained change, and so NIATx Foundation and S:US worked together to develop a plan to incorporate a robust train-the-trainer component into the CLA to help ensure sustainable implementation.

    Under the supervision of the Assistant Vice President of Practice Advancement, the PI Managers work closely with quality assurance staff and other administrative services departments across S:US to support practice improvements. The NIATx Foundation implemented a train-the-trainer model focused on developing the PI Managers through strong mentoring and regular individual and group coaching sessions. The objective was to equip them to then train, coach, and support Program Directors in their practice improvements efforts across the wide array of S:US’s programs.

    At the beginning of the train-the-trainer process, the PI Managers had modest familiarity with NIATx or other Continuous Quality Improvement (CQI)/PDSA change models. As such, the NIATx coach implemented an intentional coaching model to develop the PI Managers’ skills, increase their independence over time, and ensure a strong and lasting skill set:

    • Initially, the NIATx expert coach heavily supported much of the PI Managers’ early coaching work with the Program Directors to introduce the NIATx model. This approach provided the PI Managers with the opportunity to build their skills with real-time support and guidance from an expert.
    • The plan evolved to gradually increase the PI Managers’ independence, as they moved from providing program support with the assistance of a NIATx expert to providing independent coaching to the programs, which were subsequently reviewed with the NIATx expert to identify opportunities for continual learning.
    • Team meetings continued as the PI Managers coached more independently to encourage ongoing improvement. Concurrently, the Assistant Vice President of Practice Advancement met individually with the NIATx expert to ensure that the PI Managers continued receiving the individualized support needed to advance their NIATx coaching skills.  

    Outcomes

    The PI Managers began their NIATx journey with motivation and enthusiasm but very limited understanding of the PDSA change model. As a result of three six-month rounds of project implementation over two years across a wide array of S:US programs and services, the PI Managers have emerged with strong skill and confidence levels. The PI Managers are now able to effectively coach Program Directors in the NIATx model to sustain continual improvement. Further, they have advanced the use of the NIATx model within S:US by implementing some creative applications of the NIATx tools, including an enhancement to the nominal group technique related to choosing strategies that are easy to do and have a high impact (i.e., Ease and Impact).

    This approach to developing change leader capacity is a clear demonstration of the following training principles:

    • It takes time. A train-the-trainer mentoring model requires an investment over time. In this case, S:US committed to multiple rounds with a NIATx expert coach who employed an intentional model of increased independence with the PI Managers to ensure a strong and lasting skill set.
    • It requires a culture committed to learning. The S:US administration demonstrated a strong commitment to the NIATx improvement model, as well as a keen awareness of the importance of sustaining practice improvement to achieve the full return on investment. The S:US team did their initial homework by exploring several PDSA models and then committed to the NIATx model. Ongoing support from senior management enabled the project to achieve strong and lasting results.  

    The NIATx Foundation continues to evolve toward using more e-learning and implementation coaching as critical supplements to the traditional didactic training focus. These new approaches will enable other organizations to join S:US as they build NIATx into the foundation of their quality improvement journeys.

  • Upcoming ASAM Criteria Trainings

    Upcoming ASAM Criteria Trainings

    Ready to enhance your clinical skills and stay ahead with the latest ASAM Criteria updates?

    Join the NIATx Foundation and Train for Change Inc. this fall for virtual training sessions that empower you to deliver person-centered, evidence-based care. Whether you’re a clinician, facilitator, or program leader, these sessions offer practical tools you can apply immediately.

    Register today for our upcoming sessions:

    • 8/12-13: Virtual Two-day ASAM Criteria 4th Edition Skill Building Training
    • 9/23-24: Virtual Two-day ASAM Criteria 4th Edition Skill Building Training
    • 10/6-7: Virtual Two-day ASAM Criteria 3rd Edition Skill Building Training
    • 10/30-31: Virtual Two-day ASAM Criteria 4th Edition Skill Building Training
    • 12/2-3: Virtual Two-day ASAM Criteria 4th Edition Skill Building Training
    • 12/16-17: Virtual Two-day ASAM Criteria 3rd Edition Skill Building Training

    About the Events

    Virtual Two-day ASAM Criteria 4th Edition Skill Building Training

    This two-day, application focused training will provide participants with an in-depth look at some the significant changes and improvements in the ASAM Critieria Fourth Edition. Participants will have opportunities to apply and practice key components of the Criteria, including but not limited to, the following:

    • Six dimensions
    • Level of care assessment
    • Application of risk ratings to each of the dimensions
    • Dimensional admission criteria decision rules
    • Shared decision making
    • Overview of service characteristic standards, discharge, and transition criteria.

    Virtual Two-day ASAM Criteria 3rd Edition Skill Building Training

    This two-day, application-focused training provides participants with an in-depth look at the theoretical foundations of the Criteria, including clinically driven services, biopsychosocial assessment, the six dimensions, continued stay and transfer/discharge criteria. Incorporating the use of the 3rd Edition of the ASAM Criteria, participants have opportunities for skill practice at every stage of the treatment process: assessment, engagement, treatment planning, continuing care and transfer or discharge.