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Hub and Spoke System (H&SS) Program

Providing grant funding and training and technical assistance to eligible providers statewide.

Expanding Access to Medication-Assisted Treatment Across California

The California Department of Health Care Services (DHCS) is committed to addressing the opioid use and stimulant use disorder crises by expanding the geographic reach and closing the gap in access to providers of medications for opioid use disorder (MOUD) and other medication assisted treatment (MAT) and related services for people with substance use disorders (SUD) including opioid use disorder (OUD) in California.

As part of this commitment, DHCS is working with Advocates for Human Potential, Inc. (AHP) to implement the Hub and Spoke System (H&SS) project, providing grant funding and training and technical assistance to eligible providers statewide.

Grantees Are Substance Use Disorder (SUD) Treatment Organization That Will Use Funding to Support:

Prevention Activities

Substance Use Disorder (SUD) Treatment, Including MAT

Recovery Services

Reaching the Most In-Need, Underserved Californians

The H&SS model is built around a series of “Hubs”: centralized licensed narcotic treatment programs (NTPs) with experts in MAT, MOUD, and related services. These Hubs work with “Spokes”: usually smaller, office-based providers who are licensed to provide buprenorphine (a common OUD maintenance medication) in smaller, more remote, or underserved communities. This collaboration allows people all over the state to access top-of-the-line treatment for OUD. This model has proven to be highly successful in Vermont, Illinois, and California, where the H&SS project has been active since 2017.

Hubs: Experts and Consultants in MAT

In California’s H&SS project, Hubs are for-profit and non-profit (501(c)(3)) Medi-Cal providers licensed to provide MAT in California, including MOUD. These are referred to as narcotic treatment programs (NTPs) or office-based narcotic treatment network (OBNTN) facilities. They also provide detoxification, maintenance treatment, medical evaluation, and rehabilitative services. In the H&SS model, the Hubs offer staff support, education, training, and a guaranteed referral resource for their Spoke partners’ patients with complex needs.

Spokes: Community Connections to Treatment and Maintenance

Spokes are for-profit and non-profit (501(c)(3)) federally approved DATA 2000 waivered prescribers who prescribe or dispense buprenorphine in office-based settings. Buprenorphine is an FDA-approved medication for OUD. Spokes are community based and may include federally qualified health centers (FQHCs), mental health clinics, or private practice primary care physicians with appropriate training and education to help their patients with OUD maintain their recovery—without having to travel long distances for MAT.

Why MAT and MOUD for Substance Use Disorders?

Certain FDA-approved medications, combined with behavioral health treatment, are among the most effective ways to treat OUD. Medications for opioid use disorder can support recovery, reduce cravings, prevent overdose, and save lives. These medications normalize brain chemistry, block the euphoric effects of alcohol and opioids, relieve physiological cravings, and normalize body functions without the negative and euphoric effects of the substance previously used.[1] There are three FDA-approved medications for OUD:

Need Help? If you need substance use treatment services or want help with your drug or alcohol use, the SAMHSA Behavioral Health Treatment Services Locator is a confidential and anonymous source of information for people seeking treatment facilities in the United States or U.S. Territories for substance use, addiction and/or mental health problems.