Guiding Principles for SNMI

We commit to improving care for people in communities where high-quality care is either inaccessible or at risk of disappearing, ensuring that human need—not institutional survival—anchors every decision and action.

We acknowledge uncomfortable truths about system failure and choose transformation over preservation of the status quo.

Every decision must protect and strengthen the relational capital between safety net institutions and the communities they serve understanding that trust cannot be engineered overnight and must be fully prioritized throughout transition.

Health equity is achieved through intentional system architecture, aligned incentives, and accountable governance and not through aspirational statements disconnected from resource allocation.

Every public and private dollar deployed must be tied to measurable outcomes and system sustainability, recognizing that today's inefficiency is tomorrow's service denial.

Organized around patients' comprehensive physical, behavioral and social needs rather than institutional convenience or reimbursement categories.

Transformation must honor the commitment and expertise of legacy institutions and the safety net workforce through transparent transition planning, retraining pathways, and protection of institutional knowledge.

Interoperability and information-sharing are not vendor preferences but civic utilities essential to coordination, accountability, and patient safety.

No single stakeholder—state, hospital, MCO, or community—can transform the safety net alone; success requires binding commitments across sectors with transparent performance measurement.

We reject band-aid solutions and politically expedient patches in favor of fundamental redesign that creates sustainable infrastructure for generations.