Table 4.
Anticipated facilitators and barriers
| State | Technology | Facilitators | Barriers |
|---|---|---|---|
| Iowa | Web-based Computerized Treatment (Recoveration) | Initial funding through SAMSHA TCE Grant | Agency concerns with technology |
| NIATx Improvement Collaborative | Agency inexperience with technology | ||
| Treatment agency champion | |||
| Massachusetts | Smartphone Mobile Device (A-CHESS) | Existing example of successful application (A-CHESS) | Identifying start-up funding |
| Web Screening (Drinkers Check-up) | Potential case rate funding model | Lack of funding for reimbursement | |
| Concerns with meeting HIPAA & 42CFR regulations | |||
| Maryland | Videoconferencing (telesuboxone) | Strong champion (state governor) | Lack of willing and available MDs for suboxone prescribing |
| Limited funding for reimbursement | |||
| Limited models to follow | |||
| Oklahoma | Smartphone Mobile Device (A-CHESS) | Smartphone Mobile device start-up funding is available | Limited reimbursement model |
| Expanded Videoconferencing | Medicaid expansion covered clinical services for videoconferencing | ||
| San Mateo County | Videoconferencing (telesuboxone) | Demonstrated need for greater MD coverage to address opiate addictions | Competing priorities (ACA implementation) |
| Lack of start-up funding | |||
| Lack of funding for reimbursement | |||
| HIPAA compliance concerns | |||
| South Carolina | Videoconferencing (telepsychiatry & telesuboxone) | SSA Director Champion | Competing priorities (significant changes in environment) |
| Smartphone Mobile Device (A-CHESS) | Psychiatrist/ physician availability |