States are implementing policies to improve continuity of care for people leaving jails and prison, including Medicaid 1115 reentry waivers. These policies present an opportunity to expand access to services, particularly services for substance use disorders, as people return to communities. Limited availability of services, however, can pose challenges for creating these connections to care at release. People being treated with medications for opioid use disorder (MOUD) including methadone, naltrexone, or buprenorphine require time-sensitive follow-up care in the community.
In Washington state, a program called the Washington Telebuprenorphine Hotline (“WA Telebupe”) provides a new opportunity to expand access to OUD services at release. Created and operated through a partnership of the Washington State Department of Health and the University of Washington Department of Emergency Medicine, WA Telebupe provides access to short-term care for OUD by offering low-barrier, timely access to buprenorphine through free telehealth visits and comprehensive linkage to care services. Expanded statewide in early 2026 after a successful pilot beginning in 2024, the hotline serves anyone in Washington state with OUD who is over age 13, including individuals recently released from correctional facilities.
How WA Telebupe Works
Individuals can access WA Telebupe between 9AM to 9PM 365 days a year, with additional, after-hours crisis support available through the Washington Recovery Hotline. The hotline is staffed by regionally based linkage to care coordinators (LTCC) and emergency medicine physicians trained to treat people who take their first doses without in-person supervision by a physician.
The LTCC completes an intake interview consisting of basic screening questions to verify the patient’s suitability for WA Telebupe services. If appropriate, the patient is connected with one of the hotline’s physicians, who conducts a telehealth visit to diagnose OUD and, if appropriate, writes a prescription for buprenorphine, which is sent to the patient’s preferred pharmacy. The ability to rapidly access OUD care via WA Telebupe outside of usual business hours is an asset for connecting individuals to MOUD who may be released during evening or weekend hours when other services are not available.
While WA Telebupe is designed to provide short-term care, it also helps individuals connect to ongoing services that can support long-term stability at reentry. LTCCs follow up with patients within 72 hours after a visit to provide information and options for connecting to ongoing OUD care. They also help patients navigate public transit and access primary care and behavioral health services, food banks, and other community resources. While the hotline does not cover medication costs, LTCCs provide information on applying for insurance or contacting Washington Medicaid’s (Apple Health) access number; they also provide pharmacy coupons (via GoodRX/ArrayRX) to lower the out-of-pocket cost of medications.
Growing Impact
The hotline’s impact can already be seen in call volumes and prescription take-up. During the pilot, the hotline received approximately 500 calls per quarter; in 2026 this rose to approximately 1,200 per quarter, with 700 calls in April alone. Currently, 20% of telehealth visits are by individuals who have been recently incarcerated and 30% are by individuals seeking a temporary prescription until they connect with a long-term provider. Based on program data, 80-90% of patients fill the initial buprenorphine prescription they receive from WA Telebupe, and approximately 50% are confirmed to continue their prescription with an ongoing provider after their initial visit.
The Future
WA Telebupe continues to expand. Since January 2026, the hotline has quadrupled its number of referral partners, expanding the referral options for continuing MOUD services after the initial Telebupe visits, including options to seek care via both in-person and telehealth providers.
WA Telebupe is also expanding its partnerships with correctional facilities to increase awareness of their services for people leaving incarceration. Since January 2026, WA Telebupe has been actively reaching out to correctional facilities, particularly case managers in jails in rural counties where fewer OUD treatment resources are available. Correctional facilities have responded by incorporating the hotline into their release paperwork to facilitate timely connections to OUD services at reentry.
The WA Telebupe program is a leading example of how states can leverage new and existing substance use disorder programs to maximize connection OUD services for people as they return to communities after incarceration.