Gov. Scott Walker’s Task Force on Opioid Abuse has released its final report. The report details the Commission on Substance Abuse Treatment Delivery’s analysis of how the hub-and-spoke model of treatment delivery might work in Wisconsin.
The report analyzed the hub-and-spoke model in other states (California, Rhode Island, Vermont, and Washington) and laid out the following clinical model for Wisconsin:
- Timely and effective initiation of treatment, with emphasis on emergency room care and referrals and county crisis services.
- Teams for evidence-based addiction management (TEAMs) of interdisciplinary treatment specialists providing integrated services for patients.
- Treatment by both “hubs” and “spokes.” Hubs would be specialized addiction treatment centers that offer a wide range of treatment services for patients and support for spokes. “Spokes” would be localized, specialized resources complementary to the hubs. Patients can be transferred between hubs and spokes as necessary.
- Recovery support.
The report also suggests utilizing pharmacists in the opioid treatment process. Because pharmacists are highly accessible, they can become a local part of the patient’s treatment team and even provide drug-related counseling.
While the report does not develop a specific payment model, it emphasizes the need for coordinated funding and suggests reimbursement reforms in Medicaid.
Finally, the report suggests several regulatory changes, including finalizing the Department of Health Services emergency rule rescinding § DHS 75.15 that restricts opioid treatment program certification for providers delivering treatment not directly related to opioid addiction. The restrictions also prevent physician assistants from prescribing and adjusting buprenorphine doses, despite federal law allowing such prescriptions by nonphysician prescribers. The report recommends utilizing nonphysician prescribers to “maximize their availability” to treat substance abuse patients.