With funding from SAMHSA's MAT-PDOA Program, St. John's Well Child and Family Center (SJWCFC) plans to expand its St. John's MAT Project and proposes to serve low-income adults in South Los Angeles County (South LA) diagnosed with an opioid use disorder (OUD), nearly all of whom will be Latinx and African American and many of whom will be uninsured, undocumented, homeless or unstably housed, and have a co-occurring mental disorder (COD), HIV and/or hepatitis C. We will also be drawing our patient base through our existing programs that serve transgender/gender nonconforming (TGNC) people, people experiencing homelessness (PEH) and reentry individuals. Our project's Office-Based Opioid Treatment model centers on client-centered, team-base multidisciplinary care coordination with a Nurse Care Coordinator, prescribers, a clinical psychologist, a consulting psychiatrist and two Peer Recovery Specialists who will provide psychosocial case management, recovery support services (RSS) and coaching, and linkage to external resources. We will provide MAT services to 55 patients in Year 1, 75 in Year 2, 95 in Year 3, 110 in Year 4, and 115 in Year 5. SJWCFC's overarching goals are to increase the number of South LA residents receiving MAT, addressing the significant gaps in care in a largely impoverished area of Los Angeles County and to facilitate a decrease in illicit opioid use and prescription misuse by (1) improving the capacity of South LA's system of care regarding MAT and OUD recovery support and (2) increasing access to MAT and comprehensive OUD psychosocial support services for South LA residents with OUD. Interventions and project components to be implemented include: outreach, engagement and community involvement (including those directly affected by OUD and overdose), screening and assessment, MAT using buprenorphine, workforce development, RSS, and evidence-based programs such as Cognitive-Behavioral Therapy, the Matrix Model, Seeking Safety and peer coaching. Objectives include: (1) establishing the South LA SUD Right to Health Committee comprised of residents impacted by OUD and overdose, SJWCFC staff and community partners; (2) enhancing existing and forging new referral and collaborative partnerships to promote patient recovery; (3) increasing the number of DATA X-waivered prescribers in our system (4 annually) and providing professional development education and cultural competency about SUD issues to clinic personnel (150 persons annually); (4) engaging 90% of patients in comprehensive case management services; (5) achieving a reduction in illegal drug use by patients by 50%; and (6) engaging 75% of MAT patients in RSS to promote long-term recovery.