New Hampshire has been among the top 10 states for drug mortality deaths for five years, and is still in the process of building an effective infrastructure to manage the prescription drug and opioid epidemic. Harbor Homes, Inc. d/b/a Harbor Care, an integrated health and housing organization located in Nashua, NH, has played a leadership role in this statewide response and specializes in treating adults experiencing homelessness and at-risk patients with complex needs. With support from SAMHSA, Harbor Care will expand and enhance southern NH’s MAT treatment and recovery capacity by building and testing an “Integrated Recovery Support Services (RSS) MAT+ Care Model” tailored for adults experiencing homelessness. This innovative MAT+ model integrates Community Recovery Support Workers (CRSWs) into the care team, incorporating the vital peer recovery support function within the standard Nurse Care Manager-based Office Based Opioid Treatment (OBOT) model. Harbor Care will treat 600 homeless/at-risk adults with OUD over a 5-year period and reduce addiction severity by an average of 50%, and improve recovery outcomes for adults with OUD by 40% at 6 months. As part of this model, working with MAT providers and licensed behavioral health clinicians, NCMs and CRSWs will roll out and test a set of Evidence-Based Practices (EBPs) over time and according to their scope of practice. These include a comprehensive trauma-informed approach (which combines seeking safety, EMDR, and CBT), motivational interviewing and motivational enhancement therapy, the Matrix Model, Contingency Management, and the Community Reinforcement Approach, Integrated Dual Diagnosis Treatment, and Supported Employment. Evaluation support from MDRC will enable Harbor Care to build an evidence base for the MAT+ EBPs and determine which combination of EBPs best support the target population in treatment and long-term recovery. In Years 4 and 5, Harbor Care will offer training and technical assistance to expand the Integrated RSS MAT+ Care model to at least three additional provider organizations in NH, reducing illicit drug use and prescription drug misuse and supporting adults in recovery.