Witnesses across the session described methadone as a lifesaving treatment limited by federal and state program design. Joe Fagee, community relations supervisor at Center for Life Solutions, said daily dosing requirements for new opioid treatment patients create a transportation barrier that many cannot meet.

"To get the methadone, people have to come every day off the bat," Fagee said, describing how initial requirements can prevent clients from stabilizing and obtaining take-home doses.

Task force member Rachel Winograd, of the University of Missouri–St. Louis and the Missouri Institute of Mental Health, urged the group to consider two technical changes that could expand access: mobile dosing units and stationary medication units co‑located at other behavioral health clinics.

Winograd said medication units — sometimes described to policymakers as secure dispensing devices — allow an enrolled OTP to dispense methadone at satellite clinic locations without requiring full OTP licensing at each site. These units and mobile vans have been piloted in other states and, she said, could reduce daily travel burdens for patients who live far from one of Missouri’s federally regulated OTPs.

Why it matters: Witnesses said methadone is often more effective than other medications for people who have high‑potency opioid exposure, and that Missouri has a limited number of OTPs. Winograd told the committee medication units and well‑designed mobile programs are feasible but require upfront investment in secure dispensing technology, DEA‑compliant workflows and staffing.

What providers want: Providers asked for state help to pilot mobile or satellite dispensing, for clearer guidance on federal and state licensing, and for targeted grants (opioid settlement, SOR, or DMH network funds) to procure vehicles or medication units and to cover startup licensing and staffing.

Next steps: Winograd and task force members recommended follow-up briefings with DMH, DHSS/DSS (MoHealthNet), and federal partners to identify regulatory steps and funding paths. Several members also requested comparative examples from other states where mobile OTP units or medication kiosk programs were implemented.