The Tennessee Department of Mental Health and Substance Abuse Services (TDMHSAS) will implement Tennessee Save a Life: First Responders (TNSAL-FR) for first responders serving individuals with an opioid use disorder (OUD) in rural areas to increase capacity/provide accessible, effective, comprehensive, and evidence-based training, harm reduction strategies, and linkages to resources for individuals with an OUD. TDMHSAS established the Tennessee Save a Life program, through the State Targeted Response Grant, as an Overdose Education and Naloxone Distribution (OEND) program to combat the opioid crisis. To address the OEND needs of first responders in rural areas, TDMHSAS will expand its' program which will allow first responders to administer naloxone for emergency treatment of opioid overdose. TDMHSAS utilizes seven regional divisions to determine geographic boundaries for needs assessments and strategic planning efforts. The non-metropolitan rural geographic catchment area, Region 5 South, was selected due to its increasing number of fatal/non-fatal opioid overdose rates in combination with insufficient first responder training (OMB, 2017). The geographic catchment area includes: Bedford, Coffee, Franklin, Giles, Hickman, Lawrence, Lewis, Lincoln, Marshall, Maury, Moore, Perry, and Wayne counties, Tennessee. Among the 3,909 first responders serving individuals with an OUD comprising the population of focus, only 31% (1,211) have been trained in how to administer Naloxone through the State Targeted Response Grant program. Region 5 South is supported primarily by volunteer fire departments (estimated 46% of focus population) that lack the discretionary funding to support specialized trainings in OUD or mental health disorders (TDMHSAS, 2019; US Census, 2016). The Tennessee Fire Services and Codes Enforcement Academy does not currently offer any courses on Mental Health or Substance Use Disorder (SUD) (TNDCI, 2019). The Tennessee Peace Officer Standards and Training Commission (POST) offers a one-hour course on Fentanyl, Opioids, and Naloxone use; however, it does not currently offer courses on interacting with an individual with an SUD/OUD (TNDCI, 2019). In a local needs assessment of Region 5 South Law Enforcement, 59% (1,294) requested naloxone; only 16% (276) of area fire fighters currently utilize state-funded naloxone. It is essential that first responders are provided with OUD/mental health training and increased access to naloxone resources, as they are the primary source of intervention in rural communities. TNSAL-FR will provide outreach/engagement, training, and naloxone distribution to an estimated unduplicated 3,600 first responders and provide outreach and education to 1,000 community stakeholders (e.g., social service workers, medical providers, Veteran-serving agencies) to strengthen relationships for interagency collaboration. TNSAL-FR expects to yield the long-term benefits of enhanced community capacity, increased efficacy of first responder opioid response efforts, decreased number of opioid outbreak events, overall reduced cost to the community, and development of a comprehensive community network.