Hill Country Community Clinic (Hill Country) is non-profit community health center with Federally Qualified Health Center (FQHC) designation, operating three clinic sites, a counseling center, and a mobile crisis outreach van in rural Shasta County, a mountainous region of northern California. In order to maximize access across the county, our Medication-Assisted Treatment (MAT) program, which includes FDA-approved medication and comprehensive psychosocial care, are provided at two clinic sites. One in Redding, at 1401 Gold Street in central western Shasta County, and the other in Round Mountain, at 29632 Hwy 299 E in central Shasta County. The population of focus for our MAT program includes low-income, uninsured, and under-insured residents of Shasta County who have an opioid use disorder (OUD) diagnosis, are justice-involved with OUD, and/or those with co-occurring mental health and OUD. Our geographic catchment area covers all of rural Shasta County, which has a population of about 180,000 people. Data published by the California Department of Public Health (CDPH) and the Controlled Substance Utilization Review and Evaluation System (CURES) database examining rates of opioid use, misuse, overdose, deaths, babies born opioid-exposed, and number of prescriptions written, indicate that Shasta County experience significant disparities, when compared with California data. As such, Hill Country’s MAT Program is critical to reduce gaps in opioid treatment, to increase access to MAT services, and to improve our capacity to treat those with OUD currently unserved and/or not yet identified. We seek to serve 375 unduplicated individuals. The following project goals and objectives are directly aligned with the need in Shasta County. Goal 1: To increase awareness of MAT services available in Shasta County. Objective 1: Conduct targeted outreach to obtain a commitment to treatment from 150 individuals each year; of these, 50% will attend their first MAT appointment. Objective 2: Participate in community leadership and/or coalition groups monthly. Objective 3: develop a resource guide for print and electronic dissemination, highlighting available OUD services and treatment in the county; distribute 20,000 resource guides. Goal 2: To increase access of MAT services to individuals with OUD in Shasta County. Objective 4: 100% of MAT clients will be given the option of receiving ongoing counseling and case management visits via telehealth or telephone. Objective 5: Deploy the mobile unit monthly to rural areas of the county to serve MAT clients. Goal 3: To increase the remission and/or recovery of those engaged in MAT services. Objective 6: 35% of individuals in Tier 1 of the program will stabilize enough to move to Tier 2. Objective 7: 55% of individuals in Tier 2 of the program will stabilize enough to move to Tier 3. Objective 8: MAT clients will participate in 70% of scheduled touches (client contacts) in order to build rapport and reinforce the therapeutic alliance with clients to increase program retention. Objective 9: From client intake to the 6-month re-assessment, 50.0% of MAT clients will demonstrate an improvement in scores on the AUDIT, DAST, ORT, and/or PHQ-9.