The Summit County Medication-Assisted Treatment Expansion (SC-MATx) will enhance and expand services by providing robust, trauma-informed, evidence-based, and coordinated medication-assisted treatment (MAT) within Community Health Center Addiction Services (CHC) for community persons 18 years and older with opioid use disorder (OUD) and co-occurring mental health disorders in Summit County, Ohio. There is a great demonstrated need for OTP service expansion in Summit County. Notably, Ohio has been at the center of the opioid pandemic with the Ohio Attorney General warning in January 2021, that the pandemic is only getting worse as a result of COVID-19. Drug use among Summit County’s residents has continued to rise with the 2019 Summit County Community Health Assessment finding that abuse of both legal and illegal drugs, especially opiates, has sharply increased overdose death rates (76 in 2013 to 310 in 2016). Additionally, a community health needs assessment conducted by Cleveland Clinic Akron General (2019) reported that deaths due to “accidental poisoning by and exposure to drugs and other biological substances” have been increasing across the state with the rate in Summit County now exceeding the Ohio average by over 50 percent. In 2019 and 2020, CHC provided MAT to over 700 patients each year, yet the need for MAT is greater and in 2020 turned away approximately 500 patients seeking MAT. The goals of SC-MATx are (1) Provide MAT services, using FDA-approved medications, combination with comprehensive and evidence-based psychosocial services to at least 350 (50 in the year one, and 75 each for years two through five) additional patients, including an expansion of services through an office-based opioid treatment model; (2) Conduct clinical assessments to determine patients meeting eligible criteria for MAT; (3) Check the PDMP for each new admission to prevent medication diversion; (4) Conduct screenings and assessments for co-occurring substance use disorders and mental health disorders and ensure adequate delivery and coordination of services; (5) Establish and implement a diversion plan to ensure appropriate medication use by MAT patients; (6) Develop outreach and engagement strategies to at-risk diverse populations that increase access to and participation in MAT; (7) Ensure all applicable practitioners obtain a DATA waiver; (8) Build funding mechanisms and service delivery models with rural and resource-limited areas/municipalities and organizations to provide robust treatment and RSS to effectively identify, engage, and retain individuals in OUD treatment and facilitate long-term recovery; (9) Use telehealth services or other innovative interventions, as clinically appropriate, to reach, engage, and retain OUD patients in treatment; (10) Provide RSS, including peer recovery services, designed to improve access to and retention in MAT and facilitate long-term recovery for MAT patients