In an ASPE Issue Brief in early 2015, the U.S. Department of Health and Human Services defined expansion of Medication-assisted Treatment (MAT) as one of three target priority areas to combat opioid abuse in the United States. Since 2013, Vermont has employed a system known as the Hub and Spoke Model to deliver MAT services to those suffering from opioid substance abuse disorder. The Chittenden Clinic, also known as the Northwest Hub, has had an active wait list since January 2014, the earliest that wait list information was reported statewide. Though wait times have been tracked in the past, the methodology used to record them has been inconsistent and trend information has rarely been reported. The CCOA aims to provide a forum where these numbers can be reported in a reliable fashion, using consistent methodology, moving forward. Currently, only two factors are mandated for consideration when prioritizing individuals as they wait for service at the hub, and while wait time is not one of the mandated factors, it is likely a strong determinant in the triage process.
Contemporary figures suggest there has been a steep drop in the wait times experienced by those seeking services at the Chittenden Hub, as figures as recent as October 2015 indicate active participants were waiting on average over 350 days for treatment. While it is difficult to determine what exactly may have caused the dramatic decrease in wait times, in November 2015 only 837 individuals were receiving treatment at the hub, the 5th lowest volume ever reported. This decline in service levels may have been the result of reduced staffing at the Hub. Since that time, treatment volumes have increased to the highest levels reported, reaching 972 individuals in January 2017. This rise in treatment is concurrent with trends across Vermont, and may have allowed individuals who had been waiting longest for treatment to be served. More information on statewide treatment and wait list volumes can be found in the Opioid Use Disorder Treatment Census and Wait List report, produced by the Vermont Department of Health.