Table 1.

Barriers to treatment and how the STATE OBOT program addressed them.

Barriers	How STATE OBOT program addresses the barriers
Physician competing activities	NCMs meet with patients on a more regular basis and share some of the clinical responsibilities not required to be physician delivered. NCMs routinely confer with physicians regarding patient issues as the need arises.
Lack of support staff	State supported start up funding and integration of NCMs. Integration of Medical Assistants to work with NCMs. Education and engagement of non-medical staff.
Inadequate addiction expertise	TTA educates the staff on buprenorphine treatment through a day-long Buprenorphine-101 training. Continued support is provided as needed. Ongoing quarterly trainings for NCMs and Medical Assistants. Ongoing educational updates and sharing of information via email
Payment issues	FQHCs are able to bill for nursing visits at a comparable rate as they would for other licensed clinical providers. Program revenue provides funding for administrative costs.
Administrative obstacles	Education on disease and stigma TTA for administrative staff helps with the implementation. Assisted with systems for: tracking, reporting and visits.