In 2016, I had the great opportunity to watch and participate in the birth of Pennsylvania’s Opioid Use Disorder (OUD) Centers of Excellence (COEs). In fact, my role at the Department of Human Services (DHS) as special assistant to the secretary was exclusively to support the implementation and operation of the COEs. Today, with a changed vantage point but still close to the COEs, I am afraid I am watching the program’s demise as seven years of consistent requirements and expectations give way to a mishmash of wildly varying requirements across five behavioral health managed care organizations (BH-MCOs) that threaten the integrity and jeopardize the sustainability of the program… [click “continue” button to read more].