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
Maine Legislature, Session 128, LD 1430
Committee: Health and Human Services
Sponsors: VACHON, DILL, CHACE, COREY, HYMANSON, MALABY, SIROCKI, STEWART, CUSHING
Amends: 5 MRSA §20054

Legislative Document
No. 1430
H.P. 984
House of Representatives, April 13, 2017
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
Reference to the Committee on Health and Human Services suggested and ordered printed.
ROBERT B. HUNT
Clerk
Presented by Representative VACHON of Scarborough.
Cosponsored by Senator DILL of Penobscot and
Representatives: CHACE of Durham, COREY of Windham, HYMANSON of York, 
MALABY of Hancock, McCREIGHT of Harpswell, SIROCKI of Scarborough, STEWART of 
Presque Isle, Senator: CUSHING of Penobscot.
Be it enacted by the People of the State of Maine as follows: 
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.