Queen of Peace Center, established 35 years ago, to break the cycle of substance use disorders for women, children and families through family-centered services, will respond to the current opioid epidemic by reducing heroin and opiate use problems for women seeking treatment through its Medication Assisted Treatment program, QMAT2, located in the urban core of the City of St. Louis. QMAT2 will provide services to 28 women in Year 1, 60 each in Years 2-5, a total of 286 unduplicated women over 5 years. Further, QMAT2’s enhancement will increase outreach efforts to homeless shelters, streets and jails. QMAT2 will provide the following interventions: provide MAT, conduct an appropriate clinical assessment to determine patients meeting the diagnostic criteria for OUD relative to MAT, use county PDMP for prescription compliance, conduct screening and assessment for co-occurring, substance use and mental disorders, establish and implement a plan to mitigate the risk of diversion of methadone or buprenorphine and ensure the appropriate use/dose of medication by patients, develop outreach and engagement strategies, ensure MAT providers are DATA waivered, build funding mechanisms and service delivery models with rural and resource-limited counties, use telehealth services, provide RSS, implement tobacco cessation programs, services to incarcerated women after release, HIV education and testing, and supportive housing. QMAT2 will accomplish its overarching purpose through the following, quantified goals and objectives. Goal 1: Increase the number of clients with OUD served, engaged, and retained through MAT expansion. Objective 1.1: 268 clients will be provided MAT over the 5-year project period. Objective 1.2: 60% of clients enrolled in MAT will be retained in treatment and/or support services for 6 months. Objective 1.3: 100% of clients will have access to a Recovery Support Specialist. Objective 1.4: 100% of clients needing interpreting/translation services will have access to appropriate services. Goal 2: Improve behavioral and physical health outcomes for individuals with OUD through MAT expansion. Objective 2.1: 60% of clients enrolled in MAT will reduce substance use/ maintain abstinence over 6 months. Objective 2.2: 60% of clients will reduce illicit opioid drug use and prescription opioid misuse by 6-month follow-up. Objective 2.3: 60% of clients in MAT will demonstrate improved functioning by 6-month follow-up. Objective 2.4: 100% of participants that are not covered will have access to assistance with applying and enrolling in eligible benefits programs, including health coverage, food stamps, social security programs, and all benefits for which participants are eligible. Objective 2.5: 100% of clients in need of medical/ psychiatric care, will be linked to a provider for assessment. Goal 3: Increase number of individuals with OUD in wraparound, community-based, and recovery support services provided through MAT expansion. Objective 3.1: 60% of clients will obtain safe, supportive housing when needed, by 6 months after enrollment. Objective 3.2: 70% of clients will improve social connection through community sober support at 6-month follow up. Objective 3.3: 60% of clients with identified need for employment will either be connected with employment, education or resources for employment education at 6-month follow-up. Objective 3.4: 60% clients will experience either decreased criminal justice involvement or avoid reincarceration at 6-month follow-up.