An Act To Develop a Statewide Resource and Referral Center and Develop Hub-and-spoke Models To Improve Access, Treatment and Recovery for Those with Substance Use Disorder

PART A

Sec. A-1. 5 MRSA §20054  is enacted to read:

§ 20054.  Statewide resource and referral center

The department shall operate a statewide resource and referral center. The center must provide resources and referrals for any person seeking substance abuse treatment options, any family member of a person currently receiving substance abuse treatment, friends of a person currently receiving or seeking substance abuse treatment, any member of law enforcement and any substance abuse treatment provider. The center must allow for multiple ways for a person or provider to access the center including a telephone hotline and Internet access. The department must develop protocols for referring a person needing substance abuse treatment to treatment services and must develop networks for providers of substance abuse treatment services. This section does not prohibit any person from obtaining services and treatment for substance use disorder independent from the resource and referral center.

PART B

Sec. B-1. Definitions. For the purposes of this Part, unless the context otherwise indicates, the following terms have the following meanings:

1. "Department" means the Department of Health and Human Services.

2. "Hub" means a licensed substance abuse treatment facility providing comprehensive services with an intensive outpatient program for individuals with acute needs including but not limited to licensed behavioral health providers, community mental health centers, methadone clinics, hospitals and federally qualified health centers.

3. "Integrated medication-assisted treatment" means a combination of medication, counseling and behavioral therapy that has proven effective in treating substance use disorder.

4. "Spoke" means a primary care practice providing evidence-based medication-assisted therapy for substance use disorder, including but not limited to prescriptions for medication proven effective in the treatment of substance use disorder, and incorporating integrated behavioral health treatment either directly or through close relationships with integrated behavioral health providers.

Sec. B-2. Department of Health and Human Services to support hub-and-spoke model for substance use disorder treatment. No later than October 1, 2017, the Department of Health and Human Services shall contract for evidence-based treatment to support individuals with substance use disorder, including, but not limited to, hub-and-spoke models. The department shall seek to support treatment models that serve individuals across the State using integrated medication-assisted treatment. An individual receiving treatment may receive treatment at a hub or a spoke, whichever is most appropriate for the individual's needs, and an individual may move between hubs and spokes as needs change.

Sec. B-3. Department of Health and Human Services to seek federal funding. The department shall seek federal funding to support integrated medication-assisted treatment and a hub-and-spoke model of delivery of services and distribute resources to hubs and spokes based on needs.

Sec. B-4. Development of grant funding for education. The department shall provide grant funding to hubs to provide initial and continuing education and training to primary care providers across the State acting as spokes.

Sec. B-5. Provide treatment to uninsured individuals seeking treatment. The department shall provide funds to support treatment for uninsured individuals seeking integrated medication-assisted treatment. Services provided must include health care provider visits, prescription medications such as buprenorphine, behavioral health treatment, urine drug screening, case management and any other services associated with providing evidence-based medication-assisted treatment.

Sec. B-6. Primary care reimbursement rates. The department shall develop a primary care reimbursement rate for integrated medication-assisted treatment that includes extended patient care visit times, urine drug testing, counseling and any other addiction treatment resources that are provided at a primary care practice.

Sec. B-7. Evaluation and assessment. The department shall develop assessment measures for performance evaluation of the hub-and-spoke model. Assessment measures must include numbers and percentages of referrals of individuals seeking substance abuse treatment; substance abuse treatment success including sobriety, stability and workplace participation; adequacy of counseling services; adequacy of reimbursement rates; and any other relevant measures.

Sec. B-8. Department of Labor to develop program for individuals in recovery. The Department of Labor shall develop a career center program to assist individuals in treatment for substance use disorders or in recovery with career planning and taking advantage of employment opportunities. The Department of Labor and the Department of Health and Human Services shall jointly work to develop referral connections between the hub-and-spoke treatment services and the career center program.

Sec. B-9. Report. No later than January 1, 2020, the department shall report to the joint standing committee of the Legislature having jurisdiction over health and human services matters on the progress and implementation of the hub-and-spoke model, federal funding, grants dispersed and evaluation and assessment measures. The joint standing committee of the Legislature having jurisdiction over health and human services matters is authorized to report out legislation to the Second Regular Session of the 129th Legislature related to the report.

summary

This bill establishes a statewide resource and referral center for individuals with substance use disorders and friends and family members of individuals with substance use disorders, law enforcement and providers of substance abuse treatment. It requires the Department of Health and Human Services to contract with evidence-based substance abuse treatment providers across the State to provide integrated medication-assisted treatment to individuals with substance use disorders. Hubs provide comprehensive services for acute needs, and spokes are primary care facilities that offer behavioral health services or are connected to providers of those services. The Department of Health and Human Services is directed to fund treatment for individuals without insurance and develop a rate of reimbursement that takes into account the multiple parts of treatment an individual with a substance use disorder requires in addition to medication. The Department of Labor is directed to develop a career center program to assist individuals in treatment for substance use disorders or in recovery with career planning and taking advantage of employment opportunities. The Department of Health and Human Services is directed to develop assessment measures to evaluate performance and present a report on progress, implementation and assessment to the joint standing committee of the Legislature having jurisdiction over health and human services matters by January 1, 2020.