Rural Communities Opioid Response Program-Impact - Kentucky River Community Care, Inc. (KRCC) proposes Nurturing Futures, a Rural Communities Opioid Response Program (RCORP)-Impact initiative to establish a recovery-oriented Regional Substance Use Disorder (SUD) Cascade of Care across eight rural Appalachian counties in eastern Kentucky. The project will expand access to evidence-based SUD and opioid use disorder (OUD) prevention, treatment, recovery, and supportive services through rapid engagement, Family Recovery Navigation, closed-loop referrals, peer recovery support, and connections to medications for opioid use disorder (MOUD). Building upon the existing KyR-CURRE Network and Nurturing Bridges maternal recovery strategies, Nurturing Futures will expand service pathways to people and families affected by or at risk for SUD/OUD. Expected outcomes include increased participation in prevention, treatment, and recovery services; improved linkage to treatment and MOUD; increased referral completion and treatment engagement; reduced barriers to sustained recovery; a stronger rural SUD workforce; and a sustainable multi-sector regional network. The target rural service area includes Breathitt, Knott, Lee, Leslie, Letcher, Owsley, Perry, and Wolfe counties in Appalachian eastern Kentucky. These geographically isolated communities experience poverty, transportation barriers, workforce shortages, housing instability, limited broadband, and limited specialty healthcare and SUD/OUD services. Mountainous terrain and dispersed populations contribute to fragmented care across treatment, supportive services, and recovery. Nurturing Futures will use county-level physical service access points and coordinated regional referral pathways to improve access throughout the eight-county region. Direct SUD services will include prevention and education, rapid identification and engagement, Family Recovery Navigation, recovery capital assessment, Recovery Stability Plans, outpatient SUD/OUD treatment, coordinated MOUD pathways, peer recovery support, maternal recovery navigation, and family resilience programming. Supportive services will address barriers related to transportation, housing stabilization, telehealth and digital access, healthcare, insurance enrollment, food and benefits, employment, education, childcare, and family stability. A Maternal Recovery Priority Pathway will provide enhanced navigation and engagement for pregnant and postpartum individuals within the broader Regional SUD Cascade of Care. Workforce development will strengthen the clinical and peer SUD workforce through evidence-based SUD/OUD and MOUD training; perinatal SUD, family-centered recovery, trauma-informed care, and co-occurring disorders; peer credentialing support; and development of rural peer and Recovery Doula workforce pathways. Train-the-trainer strategies will increase local training capacity, while supervision, professional development, retention strategies, and staff well-being activities will support a sustainable rural workforce. KRCC will use the existing KyR-CURRE Network and Steering Committee to engage multi-sector partners in implementation, performance improvement, and sustainability. Proposed partners include the Kentucky River District Health Department, supporting public health education, prevention, maternal and family health engagement, and regional service access; Daniel Boone Community Action Agency, Inc., supporting transportation and supportive service coordination; and The HUB in Beattyville, supporting community-based recovery engagement and resource linkage. Additional healthcare, MOUD, recovery, housing, justice, transportation, and community partners will support the Regional SUD Cascade of Care, closed-loop referral pathways, workforce development, data-informed continuous quality improvement, and long-term sustainability.
