Title:One alumna’s ‘Why not me?’ approach to making a difference

Courtney Pladsen (G’11,’17) made history as the first nurse practitioner (NP) to serve as the Medicaid medical director in the state of Maine.

A graduate of Georgetown’s masters in nursing and Doctor of Nursing Practice (DNP) programs, Pladsen also works as a family medicine NP with a clinical focus on substance use treatment and harm reduction for people experiencing homelessness. Her work with Health Care for the Homeless for the past 13 years gives her particular insight into current challenges with harm reduction care.

“After a Jesuit education, I feel an ethical obligation to develop a health care system that meets everyone’s needs, especially the most marginalized,” she says.

As the state’s Medicaid medical director, Pladsen provides clinical leadership, informing the development of policy and addressing systemic challenges. “It’s a big job. My goal is to ensure all Mainers have access to high-quality health care,” she says.

Maine’s Medicaid program covers a third of the state, half of all children and deliveries, and two-thirds of seniors in long-term care facilities or nursing homes. As one of five states without managed care, Maine directly runs its Medicaid office within the Department of Health and Human Services. Pladsen leverages Medicaid to provide innovative pilot programs like the Food is Medicine initiative and traditional healing therapies for the Wabanaki Nations.

Designing personalized health systems

Pladsen’s early experiences influenced her career, motivating her research at Georgetown screening and addressing social determinants of health in primary care, and later, her projects improving the health care safety net though MaineCare.

“I grew up in poverty and experienced homelessness, so I know what it’s like to be a Medicaid recipient and have to navigate it,” she says. “I remember a year when the state legislature didn’t have funding, and they cut dental benefits. I remember the indignity of living at the whim of those benefits.”

“I also have a sibling who has been incarcerated and spent time in federal prison. I want to make sure that whoever’s moving through these systems gets the care that they need and deserve to be their healthiest selves,” she adds.

“When I’m designing a system that works for everybody, I think of a system that I would want for my own family. It’s not an abstraction; it’s real and close,” she says.

Building Maine’s reentry program for prisoners

For the last year and a half, Pladsen has also led the development of Maine’s 1115 waiver. This re-entry program for prisoners gives Maine permission to use Medicaid to pay for services for people who are incarcerated 90 days prior to release.

“The health outcomes of individuals in the two weeks following release from jail or prison are poor, with high rates of overdose deaths, hospitalizations, and all-cause mortality,” she says. “Having a plan for that first day upon release and having that safety net built in to build a continuum of healthcare.”

Pladsen will work with the Department of Corrections and the Centers for Medicare and Medicaid Services to design the program to expand services for people in jails and prison, with the goal of implementing it in 2027.

“To build the program, I systematically toured every jail and prison, meeting with sheriffs, jail administrators, people working in partnership with the Maine Reentry Network and the Maine Prisoner Advocacy Coalition, and people who’ve been imprisoned,” she says.

“We have rural counties with 30-person jails, and densely populated counties with 300-person jails. They require different resources and services,” says Pladsen. “We’re working with each county to design services that best fit their needs.”

Three months before people leave jails and prisons, the program will develop their plan of care, scheduling appointments with psychiatric, substance use treatment, or primary care providers; identifying their housing options; and connecting them to jobs. It will also secure their access to treatment and medicine before they leave.

“This is a massive transformation of our entire system,” says Pladsen. “This is the first time Medicaid will be paying for services for people in jails and prisons, the first time carceral health care providers will have a role in Medicaid. I can’t overstate how transformative this could be, because right now we have no window into the care being provided in jails and prisons.”

With the reentry waiver program, MaineCare will have quality assurance reviews to ensure people in prisons and jails are receiving high-quality behavioral health, substance use treatment, and primary health care. Pladsen hopes raising the standard of care will reduce overdose deaths, all-cause mortality, and ER utilization and hospitalization, improving their health outcomes.

“It’s a big project, many years in the making, and it will be transformative across our entire state. I’m feeling really hopeful about the positive outcomes that will come from it,” Pladsen says.

Using the DNP’s transferable skills

Pladsen credits her Georgetown support network for her success today. She is still in touch with her doctoral mentor, Edilma Yearwood, and her DNP cohort peer, Danielle McCamey (G’11, ’17). McCamey and Pladsen were recently inducted as fellows in the American Academy of Nurse Practitioners.

“I’m immensely grateful to Georgetown that my path crossed with Yearwood and McCamey,” she says. “They have been unbelievably supportive of me personally and professionally.”

Ultimately, she believes the DNP gave her essential tools, transferable to many leadership roles—including her role as a leader in state government. “Nurses need to think about how transferable nursing skills are,” Pladsen says. “We just have to say, ‘Why not me? I have the skill set for those jobs.’”