Sununu, state officials unveil ‘hub and spoke’ opioid treatment partnerships 

  • Department of Health and Human Services Commissioner Jeff Meyers speaks at an event unveiling the providers in the state’s “hub and spoke” opioid plan on Tuesday. Ethan DeWitt / Monitor staff

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    Craig Stenning, Senior Vice President for the New England Region at Granite Pathways in Manchester, speaks at an event unveiling the providers in the state's "hub and spoke" opioid plan, Oct. 16, 2018. Ethan DeWitt—Ethan DeWitt

Monitor staff
Published: 10/16/2018 6:01:27 PM

A sweeping plan to create a “hub and spoke” system of care for New Hampshire victims of the opioid crisis came a step closer to completion Tuesday, with the announcement of nine providers to head up the regional “hubs” that comprise the system.

In a press conference, Gov. Chris Sununu unveiled the providers making up the hubs, who will serve regions based in Berlin, Concord, Dover, Hanover, Keene, Laconia, Littleton, Manchester and Nashua. 

Most areas will be served by hospitals – Concord and surrounding towns will be served by Concord Hospital – though two of the state’s major cities will be served by Granite Pathways, a treatment organization, according to the governor.   

“We know that this is a tremendously powerful disease ... and the losses that we’ve experienced are unbearable,” said Peter Evers, vice president of behavioral health at Concord Hospital and CEO of Riverbend in Concord. “So the timing of this is just amazing.”

Under the system, each hub will take in anyone seeking treatment, acting as a front door to direct people to services in the area, officials say – a scaled up version of the “Safe Stations” program in Manchester and Nashua. That includes screenings, referrals and a comprehensive case management system that will track those in the system and collect usage data.

Collectively, the hubs will receive around $9 million a year, a piece of the $45.8 million in federal heading to opioid treatment efforts in the state over the next two years. That $9 million will be distributed to the hubs based on their region’s demand, as measured by existing Department of Health and Human Services data, Commissioner Jeff Meyers said Tuesday. 

The hubs will be accompanied by a 24/7 hotline allowing New Hampshire residents to call “211” and get directed to treatment at any hour of the night, according to officials. 

Sununu hailed the system as an innovative approach modeled after successful programs in Vermont and other states. 

“This isn’t just about throwing money to the front lines; it’s really about building a strategic partnership that is a coordinated effort,”  Sununu said, at an announcement that featured leaders of the providers serving as hubs. “Doing things quite a bit differently than we’ve done in New Hampshire. And really being a model that the rest of the country can truly envy.”

The announcement clears up what had been a significant area of uncertainty for the state: whether it could find health care providers to fill the hubs ahead of federal deadlines.

“We had to move quickly, and we have moved quickly,” Meyers said. 

Under the federal conditions attached to the federal grants, the state must start spending down its money by the end of the year. At an executive council meeting two weeks ago, Meyers said seven hospitals had agreed to serve as hubs, but he cited “unique circumstances” in Nashua and Manchester.

In the end, Sununu said, the state went with a local provider because regional hospitals in those cities declined to participate. 

“My initial design was to have hospitals, given their 24 hour access become the hubs across the state,” he said. “We approached hubs in Manchester and Nashua, and they didn’t want to participate under the contracts that we provided.”

“... It’s great that in those areas we have a lot of options,” he added, praising Granite Pathways.

For Granite Pathways, the contracts represent the latest in a series of major expansions this year. Earlier this month, the Manchester organization was approved to build up the state’s first substance use disorder treatment facility for teenagers in the Sununu Center in Manchester.

In recent months, treatment advocates in Manchester had raised concern over whether the hub and spoke framework would interfere with the Safe Stations system that helps deliver care to those who seek help in fire stations. 

But Craig Stenning, senior vice president for the New England Region, said the two systems would be compatible moving forward. 

“As part of the hub network, we will be able to build upon the existing and new networks and new relationships in these communities to forge an even stronger web of treatment, transportation, and clinical partners,” he said. 

The contracts will be presented before the Executive Council at its Oct. 31 meeting. Sununu and Meyers say the hub and spoke model is expected to open its doors by Jan. 1.

“Is it going to work perfectly on Day 1? No; probably not,” Sununu said. “But that’s okay. It’s about having now a coordinated system to get the feedback from different regions of the state – to get the information, to get the data. So we’re constantly making the system better.”

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