Veterans with opioid use disorder (OUD) that are experiencing homelessness can present as complex cases. To address this challenging population, the Veterans Affairs (VA) Connecticut Healthcare System developed the Mobile Community-Based Access Team (M-CAT), which delivers medication treatment with buprenorphine via telemedicine and provides community-based case management. The M-CAT team is comprised of a team physician, two social work case managers, a team nurse, a part-time health technician, and a peer support counselor and has the following innovative components:

• On-demand appointments with the team physician through telemedicine (via Facetime) to evaluate the patient for buprenorphine treatment
• Electronic prescriptions were generated so the patient could pick up medication at a local VA pharmacy
• Mobile urine toxicology screens were done to remove the need to travel to a hospital laboratory. Subsequent buprenorphine prescriptions were not contingent on toxicology screens. 
• Peer engagement and case management to ensure treatment retention

Offering low-threshold medication treatment and easily accessible psychosocial services through M-CAT to veterans with OUD experiencing homelessness has shown promising preliminary results. This non-traditional model has the potential to reach a high-risk population that would otherwise not be engaged in treatment. 

The services provided by M-CAT are further supported by other comprehensive support provided by the VA Connecticut Healthcare System, including housing, employment, and mental health services. More information on M-CAT can be found in the webinar here. Guidance on buprenorphine treatment in homeless populations can be found here.