Table 1.

Emergent themes: barriers and facilitators categorized within EPIS framework

	Theme responses by leader type
	Current (n = 8)	Former (n = 8)
	n (%)	n (%)
SUSTAINMENT BARRIERS
Outer Context
Service-Environment
Medicaid coverage & reimbursement	4 (50.0)	4 (50.0)
Rely on continued funding	3 (37.5)	X
Infrastructure	2 (25.0)	3 (37.5)
Inter-organizational
Reduced timeframes	4 (50.0)	X
Opioid-specific funding cliff	3 (37.5)	X
Opioid-specific data collection	2 (25.0)	X
Inner Context
Intra-organizational
Costs to integrate services	3 (37.5)	4 (50.0)
Lack of adequate workforce	2 (25.0)	3 (37.5)
Individual† Adopter Characteristics
Competing priorities	3 (37.5)	5 (62.5)
Shifting priorities	X	2 (25.0)
SUSTAINMENT FACILITIATORS
Outer Context
Inter-organizational
Positioning within the state	8 (100.0)	4 (50.0)
Access to governor office	3 (37.5)	X
Access to Medicaid office	6 (75.0)	X
Professional networks	X	3 (37.5)
Consumer Support/Advocacy
External pressure/public support	2 (25.0)	3 (37.5)
Service-Environment
Flexibility in spending	2 (25.0)	2 (25.0)
Technical assistance	3 (37.5)	1 (12.5)
Inner Context
Intra-organizational
Strategic planning	6 (75.0)	4 (50.0)
Demonstration of outcomes	1 (12.5)	X

X: Not identified as a theme among interviewees in this group

Note. This table only reflects responses to the barrier and facilitators prompt, in-text citation may differ when referencing separate prompt

^†“Individual” within the inner context of the EPIS framework is interpreted as unit-level factors influencing adoption of a practice within a system. For our analysis, the inner context unit is at the organizational-level