Meridian’s MAT-PDOA program will expand access to medication assisted treatment (MAT)in conjunction with psychosocial services for adult individuals with an opioid use disorder (OUD) residing in 13 counties in North Central/Northeast Florida. The counties, Alachua, Baker, Bradford, Columbia, Dixie, Gilchrist, Hamilton, Lafayette, Levy, Marion, Putnam, Suwannee, and Union, have a combined population of 934,611. Eleven of the counties are U.S. Census designated rural with the remaining 3 urban-designated counties having significant rural communities. Available provisional data (Florida Department of Health, 2021) for the project catchment area during the first nine months of 2020 (January-September 2020) shows a staggering 92% increase in the number of nonfatal opioid overdoses (998) when compared to a full year’s data in 2019. Under SAMHSA funding, Meridian will place primary focus on delivering services to those individuals with OUD whose care is uncompensated by other funding sources or who are underinsured. Pregnant/postpartum women will receive first priority for admission into the program due to the potential harm to the developing baby or newborn as a result of opioid withdrawal. Having no insurance or being underinsured has been associated with a 47% lower likelihood of receiving MAT (Blanco, et al., 2020). Barriers to MAT services are further compounded for individuals in our catchment area's many rural counties and communities, where lack of transportation for lower income residents and geographic distance can jeopardize the ability to adhere to MAT requirements. To mitigate these barriers, the MAT-PDOA program will expand Meridian's existing MAT services and improve outcomes for the focus population with the following goals and objectives: Goal 1: Increase the number of individuals with OUD receiving MAT in conjunction with comprehensive psychosocial services in the 13-county catchment area. Objective 1A: Increase the number of catchment area sites offering MAT with psychosocial services from 3 to 7 to include 2 new MAT clinics providing methadone, buprenorphine and naltrexone by year 1; 1 new medication and treatment unit offering buprenorphine and naltrexone by year 1; and 1 more unit by year 3. Objective 1B: Add 6 new providers receiving DATA 2000 training, obtaining a waiver and prescribing buprenorphine over the course of the grant. Objective 1C: Increase the number of individuals receiving MAT services by 40% over the course of the grant. Goal 2: Decrease illicit opioid use, and prescription opioid misuse among the target population. Objective 2A: 60% of admitted clients will have been retained in MAT services for six months. Objective 2B: At 6-month follow up, 75% of clients retained will show a decrease in illicit opioid use/prescription opioid misuse and 40% will show a decrease in other illicit drug use and alcohol use as indicated in drug screens. Under SAMHSA funding, the MAT-PDOA will serve 100 unduplicated individuals in year 1, 150 in year 2, 225 in year 3, 250 in year 4, and 250 in year 5 for a total of 975 served over the course of the grant.