Kentucky Medication Assisted Treatment - Together Eradicating Reliance on Substances (KY MATTERS) - Kentucky Medication Assisted Treatment - Together Eradicating Reliance on Substances (KY MATTERS) will increase access to medication-assisted treatment (MAT) for individuals with opioid use disorder (OUD) in resource-limited, rural Pike and Estill Counties in Kentucky and help decrease illicit opioid drug use and prescription opioid misuse. WestCare Kentucky, Inc. (WC-KY) proposes to expand and enhance access to medication assisted treatment (MAT) services for individuals with an OUD through existing outpatient and residential treatment programs, court diversion projects, and offender reentry programs. The focus population of adults includes heterosexual, LGBTQ, previously incarcerated adults, those with criminal histories, veterans, and homeless people. WC-KY will serve 134 individuals with OUD in year 1, 200 in year 2, and 200 in year 3. A total of 534 unduplicated individuals will be served over three years. Goal 1: Increase the number of individuals with OUD receiving MAT services in Estill and Pike County, KY. Strengthen/expand engagement/outreach strategies with community partners to implement, increase and maintain MAT services to OUD individuals. 100% of individuals receiving MAT will have a treatment plan that includes FDA-approved medication, dosage, and frequency based on clinical assessment. 80% of clients who achieve stabilization and elect medical withdrawal will abstain from opiates. Goal 2: Decrease illicit opioid drug use and prescription opioid misuse at six-month follow up to program admission. 85% of clients enrolled in MAT will receive evidence-based practices, weekly medical management, urine screens, counseling, behavioral therapy, and case management services. 80% of persons enrolled in KY MATTERS will successfully complete the program. 80% of clients will be free from illicit drug use and prescription drug misuse at six months post intake. 70% of clients facing OUD challenges will adjust their dosage of medication. 100% of clients enrolled in the program will receive a screening/assessment for co-occurring substance use and mental disorders. Goal 3: Provide FDA-approved medications for the maintenance treatment of OUD in combination with comprehensive psychosocial and peer recovery support services (RSS). Provide strength-based case management to 534 clients across the three-year funding period. 80% of clients will have stable living situations at discharge and 6 months post-intake. 80% of clients who successfully complete treatment and had mental health symptoms at admission will exhibit decreased symptoms at discharge and 70% will maintain improved mental health functioning at 6-six months post intake. 80% of the clients who successfully complete MAT will not engage in new criminal activity at discharge, and 70% will not recidivate at six months post intake. 100% of clients who smoke will be referred to tobacco cessation programs. 100% of clients at risk or living with HIV/AIDS, viral hepatitis, or other infectious diseases will be referred for testing or counseling as indicated in their case management plan.