Vermont Hub and Spoke Model of Care for Opioid Use Disorders (1 CME)
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The Vermont Hub and Spoke Model is an integrative state-wide model of care to create a seamless system of treatment for opioid use disorders similar to other chronic illnesses. State wide stakeholders, addiction medicine providers, and health department officials joined together to create this system and the funding mechanism to create it will be described. Hubs were renamed from Opioid Treatment Programs and Spokes were created from office based buprenorphine prescribers and linked in each region of the state. It created regional Hub and spoke connections so that no one would lose care if they became unstable and Hubs would provide consultation and expertise to community buprenorphine providers when needed. MAT teams were created to support buprenorphine prescribers in the office setting and to increase the provider satisfaction in prescribing buprenorphine. Hubs were allowed to use buprenorphine so that people could start in a hub and go to a spoke or go from a spoke to a hub if unstable. Creation of community health teams known as MAT teams (medication assisted treatment) was key to the adoption of the model by buprenorphine providers and the roles of these teams will be explained. Finally, increases in the number of DATA 2000 waivered physicians and the patients they served will be reviewed as the overall penetration of MAT in Vermont exceeded 1% of the total population.
John Brooklyn
MD
Dr. John Brooklyn is Board Certified in Family Medicine and Addiction Medicine. He is Associate Clinical Professor of Family Med and Psychiatry at the University of Vermont College of Medicine and is Medical Director of UVM Substance Abuse Treatment Center with major research interests in heroin and cocaine use and directed multiple studies of buprenorphine past and currently. He helped create the first program in Vermont for treating pregnant opioid users. He currently is the Medical Director of 3 of the opiate treatment programs in Vermont. He is a statewide and national consultant to doctors for methadone and buprenorphine treatment. He conceived of the Hub and Spoke Model in Vermont.He is the former medical director and current staff physician at the Community Health Center in Burlington for 23 years. He is an avid bicyclist and skier and has 3 grown children.
Anthony Folland
BA
Tony Folland is the Clinical services Manager and State Opioid Treatment Authority for Vermont. Prior to the last 7 years in state government, he was employed in the social services field for nearly 20 years, having worked in both rural and urban mental health centers in a variety of capacities including: emergency services, outpatient treatment and case management, program development and staff supervision, Drug treatment courts and Medication Assisted Treatment for opioid use disorders.
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