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To provide a broad view of the widespread and costly impact of the opioid epidemic, United Hospital Fund (UHF) convened a meeting on October 3-4, 2018, supported by the Alfred P. Sloan Foundation, with the collaboration of the Milbank Memorial Fund. The title of the meeting, “The Ripple Effect: Children and Kinship Caregivers Affected by the Opioid Epidemic,” was intended to convey the far-reaching scope of the problem. The goal of the meeting was to produce a high-level policy and programmatic agenda to address the effect of the opioid crisis on women, children, and families. This paper lays out that agenda.