Wisconsin Community Health Centers Demonstrate Lessons Learned in Addiction Care

For more than a decade, public officials in Wisconsin have been working to address the state’s opioid overdose crisis, during which opioid-related deaths doubled from 2015 to 2022. However, from 2023 to 2024, the state experienced a turnaround, achieving a 55% decrease in these deaths and a 38% decrease in opioid-related emergency room visits. The reason for this success? A strengthened overdose prevention and treatment infrastructure that includes a substantial increase in the number of substance use disorder (SUD) and mental health providers at community health centers, according to the Wisconsin Primary Health Care Association (WPHCA).

But many community health centers (CHCs)—nonprofit community-based organizations that provide comprehensive primary care regardless of a patient’s insurance status or ability to pay—have lacked readiness or capacity to offer medication for opioid use disorder (MOUD) services. This has left a critical segment of the population with SUD without adequate access to treatment. Some CHCs, particularly in rural areas, have reported concerns about the impact of behavioral health provider shortages, because losing even one clinician can mean the difference between routine access to care or having to drive an hour for an appointment.

The Pew Charitable Trusts—with funding from Bloomberg Philanthropies—supported WPHCA in convening a learning collaborative to help community health centers expand MOUD treatment across both urban and rural parts of the state. Seven CHCs participated in the collaborative from December 2024 to September 2025, representing various geographic regions and populations in Wisconsin.

WPHCA and the CHCs evaluated their operational and clinical readiness to implement MOUD services by analyzing staffing levels, provider experience, training needs, and infrastructure. To build foundational knowledge, CHC staff attended virtual sessions on opioid use disorder (OUD), MOUD, and the integrated physical and behavioral treatment care model, an evidence-based approach combining physical and mental health and substance use care services in a single, coordinated system. Next, prescribers received in-person training on MOUD initiation, prescribing, and monitoring and visited a clinic with an established MOUD program to engage in peer-to-peer learning. Finally, from May to August, the CHCs received tailored site visits from MOUD clinical faculty and staff from the University of Wisconsin offering hands-on support. Throughout the process, these CHCs collaborated with peers and consultants to address implementation challenges and refine workflows suited to their specific care models.

The collaborative produced an October 2025 report summarizing the initiative’s outcomes and providing lessons for other states or community health centers interested in expanding MOUD access.

Key takeaways from the learning collaborative

Integrate care: Participants emphasized embedding MOUD within primary care and strengthening collaboration with behavioral health providers to deliver comprehensive treatment. This ensures a “no wrong door” approach, in which patients can seek out a primary or behavioral health care provider and be directed to MOUD through any provider at the CHCs.

Build interdisciplinary teams: Successful implementation relied on engaged prescribers and interdisciplinary care teams, including medical, behavioral health, care coordination, and operations staff. All team members benefited from targeted training on OUD treatment; support in learning to communicate clearly and consistently with patients; and guidance in engaging community partners. These multidisciplinary teams combine the diverse expertise of the CHC’s staff and promote whole-person care, addressing both physical and mental health needs.

Address operational and workflow barriers: CHCs face challenges in developing efficient, replicable workflows tailored to their settings, and variation in screening tools, triage processes, and documentation requirements can complicate adoption of those workflows. Participants called for a standardized, simple SUD screener adaptable across CHCs, consistent patient messaging, and greater use of self-administered screening tools where appropriate.

Address stigma: Participants underscored the importance of stigma reduction through staff training and community outreach to build acceptance of MOUD. Attitudes toward people receiving the medication vary considerably among clinical teams and the broader community. Many CHCs lack visible, normalizing educational materials about OUD and MOUD in patient-facing spaces, inadvertently reinforcing stigma.

Prioritize workforce strategies: State-level reforms are essential to address ongoing behavioral health and treatment provider shortages. Increased funding for loan repayment, tuition support, and clinical training pipelines; expanded reimbursement for bachelor’s-level care coordinators, peer recovery specialists, and community health workers; and streamlined provider certification and supervision requirements could help strengthen the CHC staff. Additionally, sustainable workforce strategies should include investments in provider well-being, cross-training opportunities, and telehealth infrastructure to reduce burnout and expand reach to patients in rural areas.

The Wisconsin collaborative demonstrated the value of CHCs learning from each other and underscored the need for ongoing collaboration among health settings, academic institutions, and policymakers to ensure high-quality services for people affected by SUDs. CHCs seeking to expand similar treatment for populations at high risk of overdose can implement lessons from the collaborative to integrate MOUD into their care model.

Alexandra Duncan works on The Pew Charitable Trusts’ substance use prevention and treatment initiative.