Oneida County included in substance use disorder treatment pilot program

Courtesy Wisc. DHS

The Wisconsin Department of Health Services (DHS) has announced it is collaborating with three health care providers in different areas of the state to pilot a new approach to treating eligible BadgerCare Plus and Medicaid members who have substance use disorders and at least one other health condition.

These providers will use an innovative program design to expand beyond traditional substance use disorder treatment services. Wisconsinites served by this new program will include people enrolled in BadgerCare Plus and Medicaid who are struggling with substance use disorders and also have other health conditions that create barriers to their recovery from addiction.

The pilot sites will use a “hub and spoke” model to provide integrated services that give eligible members rapid access to comprehensive addiction and mental health treatment, primary care, and other needed supports to assist their recovery.

The three hub sites, chosen from a field of 17 applicants from across the state, will pilot the new benefit in three different regions. The hubs represent one rural site, one tribal site, and one urban site selected deliberately to help Wisconsin understand how this care coordination model will work in a variety of environments, to inform a future statewide approach.

• The Family Health Center (FHC) of Marshfield, Inc., a federally qualified health center, will provide services through the FHC Minocqua Alcohol and Drug Recovery Center, for Forest, Iron, Oneida, Price, and Vilas Counties, as well as the Forest County Potawatomi Community, the Lac du Flambeau Band of Lake Superior Chippewa, and the Sokaogon Chippewa Community.
• The Oneida Nation Behavioral Health Center, a federally qualified health center, will provide services to any federally enrolled Native American in the Oneida Nation, and Brown and Outagamie Counties.
• Wisconsin Community Services, Inc., a non-profit community based organization, will provide services in Milwaukee County.

“It is past time to get folks the help they need in the way they need it, and we are excited to bring this proven strategy to Wisconsin,” said Governor Tony Evers. “By connecting the dots between substance use disorder treatment and other services, this new model will help us move the needle on ensuring access and effective care for our Wisconsin neighbors who are currently struggling.”

In the hub and spoke model, an organization takes the lead as a “hub” on the care of the Wisconsinites in their program, ensuring that substance use disorder treatment and other health care needs are addressed. The hub then works with a network of “spoke” organizations which provide a range of services that are customized to support each individual’s unique circumstances. Wisconsin has been working since 2018 to develop this innovative model of care. Authorized by 2019 Wisconsin Act 9(link is external), the model is an evidence-based approach that has been proven in other states to be effective in addressing opioid use disorders. Wisconsin is expanding the approach to include people with any substance use disorder.

“This innovative model of care helps people reach their recovery goals by connecting them to a spectrum of behavioral and primary health care. It shifts treatment away from a short-term, episodic, acute care approach to focus on ongoing integrated treatment and support,” said DHS Secretary-designee Karen Timberlake. “Our three pilot sites will lead the way in implementing this new model of coordinating care for people with substance use disorders. What these sites learn will help us continue to improve and expand the benefits and services we support.”

Wisconsin seeks to gather at least two-and-a-half years of data through the pilot in order to inform creation of a permanent benefit. DHS will closely monitor outcomes on an ongoing basis, and will do formal program evaluation to assess the need for changes or expansion.

Members must meet certain criteria in order to take advantage of the new benefit. The ability to accept referred members may be limited during the pilot based on the capacity of the three hubs.