Last Updated: April 2018
Author: Alcohol & Drug Abuse Programs, Vermont Department of Health
In 2013, the general Assembly passed Act 75, an act relating to strengthening Vermont's response to opioid addiction." In response, the Care Alliance initiative began in 2013 as a partnership between the Vermont Department of Health Division of Alcohol and Drug Abuse Programs (ADAP) and the Department of Vermont Health Access (DVHA). The Care Alliance is system where patients receive the care they need including Medication Assisted Treatment (MAT) for opioid addiction, mental health and substance abuse counseling, pain management, life skills, family supports, job development and recovery supports. Hubs use methadone or buprenorphine to treat those with opioid addiction; spokes may only use buprenorphine to treat opioid addiction.
The model is such that buprenorphine patients who no longer need the full array of services available in the hubs be transferred to spoke (individual providers). Without additional spoke capacity, patients can't be referred and thereby block access to care for a new patient.
Treatment capacity is no longer expanding as rapidly as in the past, primarily due to workforce shortages. It is difficult to recruit and maintain adequate staff with the skills needed to work with this population. The region of the state with the greatest number of people waiting for services is in the northwest. A new hub, an opioid treatment facility in St. Albans, opened in July 2017 to increase treatment capacity in the region. The increase in people waiting in July 2017 is due to people waiting for access to the new site -- some of these individuals have been receiving care in Burlington and are seeking a transfer to a location nearer their homes. There is also insufficient "spoke" capacity in some regions of the state (e.g., Northeast Kingdom).
Please note that a person waiting for service as defined in this measure means a person who has requested service but does not yet have an appointment to receive this care.