Health Recovery Services, Inc. - Medication Assisted Treatment - Health Recovery Services, Inc. Medication-Assisted Treatment (HRS-MAT) Project will allow Health Recovery Services (HRS) to expand services in Athens, Hocking, Vinton, Gallia, Jackson, and Meigs counties in socioeconomically disadvantaged and rural southeastern Ohio by providing MOUD in combination with psychosocial services to those with OUD. The geographic catchment area is largely rural and located in Appalachian Ohio. The combined population of all six counties is approximately 192,705, just 1.7% of Ohio’s population over a combined land area of 2,232.9 square miles. This equates to an average population density (for the six counties) of approximately 87 people per square mile. Residents of the six counties are primarily white and the percent of population living below poverty level is higher than that of the state of Ohio for all six counties. The Appalachian region compared to the non-Appalachian region has seen higher rates of opioid prescribing and opioid overdose deaths (National Association of Counties and Appalachian Regional Commission, 2019). Overprescribing of opioids by physicians and the addition of synthetic opioids such as fentanyl and carfentanyl to the system is continuing to impact Appalachia, attributing increasing drug overdose deaths (Schalkoff et al, 2021). Additionally, there has been a growing use of nitazenes (also termed Frankenstein opioids), which are synthetic opioids that can be up to 40 times more potent than fentanyl that has affected Meigs, Gallia, and Jackson Counties (Ohio Attorney General, 2022). The goals of HRS-MAT 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; (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) Develop and implement outreach and engagement strategies to increase access to MOUD and related services for diverse populations with OUD in Southeastern Ohio; (6) Ensure all applicable practitioners obtain a DATA waiver; (7) 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; (8) Use telehealth services or other innovative interventions, as clinically appropriate, to reach, engage, and retain OUD patients in treatment; (9) Provide RSS, including peer recovery services, designed to improve access to and retention in MAT and facilitate long-term recovery for MAT patients; and (10) Provide harm reduction services on site, either singularly or in collaboration with a community-based harm reduction organization.