In a public address carried live by PBS NewsHour, Secretary of Health and Human Services (HHS) Robert F. Kennedy Jr. (RFK Jr.) outlined the administration’s new model for addiction recovery. The event was part of “Prevention Day” and, like other administration events, it was sponsored by a private company.

Secretary Kennedy was interviewed by Tom Coderre, a long-time recovery activist and Deputy Assistant for Mental Health Services at SAMHSA, the Substance Abuse and Mental Health Services Administration. The Guardian reports that “about a third” of SAHMSA’s 900 employees were laid off last year.

What Secretary Kennedy describes would be a revolution in addiction treatment. He describes incentivising three-year recovery rates. In other words, providers only get paid when the patient is cured, not when treatment is provided. That would require a complete rewiring of addiction treatment, which is currently based on payment when services are rendered.

The Centers for Medicare & Medicaid Services (CMS) is currently the “single largest payer of behavioral health services in the US.” Over 20% of CMS’s budget is for addiction treatment. Roughly 8.1% of all the people receiving Medicare are receiving treatment for substance use disorder (SUD). 

Secretary Kennedy referred to the system of paying for services rendered “a death spiral.” He said: 

People have an economic incentive to make sure you don’t get well.

The solution, he says, is to treat the whole person, and to assign responsibility from the start to one person for ensuring the three-year outcome is positive. The model is borrowed from “the Netherlands,” said Kennedy, who described it following this chain:

• detox
• treatment
• housing
• workforce training
• employment
• self-sufficiency

I don’t quite understand how you can avoid paying the emergency room for three years while waiting to find out if an overdose patient gets a job. That seems unrealistic. That’s why I’m going to dig deeper in Part 2 of this blog post to find out how CMS interacts with Housing and Urban Development (HUD) and the other agencies that are part of the Great American Recovery Initiative (GARE), including the departments of Labor, Interior, Veterans Affairs, Education, and Justice.

As near as I can tell from reading the briefings and press accounts, RFK Jr. is creating an uber-organization to sit in judgment of the progress of all the departments in fulfilling long-term goals. In theory, each patient’s care would be supervised from day one by a single person or entity who is responsible for making sure the patient moves along successfully to the next phase of care before payment is rendered.

Does that mean the hospital is only paid for detox if the patient enters a treatment program? And the treatment program only gets paid when a patient gets a job? How long does the patient get to find a job before being kicked out of the treatment program or subsidized housing? Stick around for Part 2 as I dig for more answers.

For the moment, the big announcement is $100 million in funding for the STREETS Initiative. STREETS stands for Safety Through Recovery, Engagement, and Evidence-based Treatment and Supports. The HHS briefing is long on acronyms and short on details. How is it funded? How long is it funded for? Will it be funded long enough (three years) to span the time Secretary Kennedy said recovering addicts should be tracked?

The $100,000 million “initiative” is a mere 5% of the $2 billion in addiction treatment grants HHS abruptly stopped on January 14, only to restart two days later. Somehow, with 5% of the funds, GARA is tasked with oversight not only of HHS but also of seven other departments that deal with addicted persons between the emergency room and the workforce.

Secretary Kennedy’s proposal calls for eight regional pilot programs. He believes these programs will be collaborative and competitive in finding improved ways of moving the addicted person from detox to employment. The Secretary’s dedication to housing is impressive, with $45 million of the $100 million budget going to “sober housing.” This means subsidized housing for as long as the patient is in treatment and testing negative for substance use.

What happens when the patient fails a drug test or loses subsidized housing or graduates addiction treatment without finding a job? Secretary Kennedy and Deputy Assistant Coderre place a lot of faith in peer support networks. The STREETS Initiative supposedly opens up funding for faith-based groups providing recovery services.

The administration has a carrot-and-stick approach to addiction treatment. The carrot is housing if you stay in treatment, and the stick is jail if you don’t. However, half the homeless are disabled, and the other half are employed at least 20 hours per week. Provide homeless people with housing they can afford, and they will disappear off the streets in a matter of weeks.

Secretary Kennedy and Deputy Assistant Coderre are correct that peer support programs such as Alcoholics Anonymous (AA) are an important part of recovery. But a person needs to survive to be able to keep attending weekly sessions, and they can’t survive without medical care, addiction treatment, and housing. So if you pull all the funding out of this very precarious, largely volunteer support network, and throw back 5%, I seriously doubt you will achieve the objectives set out in the GARA initiative.

Join us tomorrow for Part 2 of our Prevention Day coverage.

Written by Steve O’Keefe. First published February 12, 2026.

Sources:

“Secretary Kennedy Announces $100 Million Investment in Great American Recovery,” U.S. Health and Human Services Administration, February 2, 2026.

“WATCH: RFK Jr. and others launch new addiction and homelessness initiative,” PBS NewsHour, February 2, 2026.

“RFK Jr announces $100m in grants to address homelessness and substance use,” The Guardian, February 2, 2026.

Image courtesy of PICRYL, used under Creative Commons license.