Ohio Health Grant Medical Centers (GMC) Addiction Medicine Service will provide enthusiastic leadership to the PRO-MAT (Providing Robust Outpatient Medication Assisted Treatment) project that will provide needed addiction treatment services to up to 1560 individuals in Franklin County. Ohio who lack health insurance or cannot afford to pay for medical care, transportation and medications needed to treat addiction to opioids, will save lives. Medications and behavioral health counseling are key to treatment designed to decrease the use of illicit opioid drugs like heroin or fentanyl and/or misuse of prescription opioids, which can lead to serious problems and results in death. Ohio is in the top five states for the highest number of unintentional drug overdoses in the United States since 2014. Of the 88 counties in Ohio, Franklin County had the highest number (803) of overdose deaths in 2020 and saw an increase in unintentional drug overdose deaths from 15.3 in 2014 to 35.7 in 2020 per 100,000. Grant Medical Center (GMC) and the PRO-MAT referring hospitals of Riverside, Doctors, and Grove City, in 2021 saw a total of 25,065 patients with substance use disorder (SUD) including opioid use disorder (OUD) of which an average of 6.5-7% were uninsured. In 2020 in Ohio, the Black non-Hispanic male rate was 55.2 deaths per 100,000, was higher than other races, sex and ethnic group; In Franklin County uninsured was 7.7% similar to 6.5-7%. Of SUD/OUD patients served below federal poverty line: 15.1%, higher than the percentage for Ohio that is 13.6%. ADAMH Alcohol, Drug and Mental Health 2020 Franklin County needs assessment identified service gaps in Addiction and Mental Health services including Psychiatry, Outpatient Counseling and Psychotherapy; need for affordable, appropriate level of care and treatment services including MAT that are affordable, timely, with appropriate level of care; lacking means to pay for services, copays, medications and transportation. PRO-MAT aims to serve 1,590 unduplicated individuals: Years one and two 340 served, year three 320 served, year four 300 served, and year five 290 served. Measurable project goals follow. Goal 1: Expand and enhance access MAT to individuals suffering from OUD particularly who lack access to care. Objective 1a: By the end of year 1, Addiction Medicine Outpatient clinic at GMC will expand patient coverage from the current 2 days a week to 5 days a week. Objective 1b: By the end year 1, outpatient clinic at GMC will accept referrals from all OhioHealth care sites. Objective 1c: By the end of year 2, will have an additional 50 DATA waivered providers within OhioHealth system and 75 by the end of year 3. Objective 1d: By the end of year 1, GMC will provide Technical Assistance to DATA waivered providers, to get answers to patients questions and deliver evidence-based care. Objective 1e: By the end of year 1 provide inpatient hospital consultation to patients admitted to the hospital. Goal 2: Decrease the use of illicit opioids and misuse of prescription opioids by offering MAT to patients suffering from OUD in the community. Objective 2a: By the end of year 1, offer MAT to 100% of patient referrals who are appropriate candidates and meet the criteria for OUD. Objective 2b: By the end of year 1 offer comprehensive psychological services to 100% of patient referrals with OUD. Objective 2c: For patients receiving MAT increase average number of days staying abstinent from substance misuse by 75% from baseline during a period of 6 months following the start of MAT service. Goal 3: Decrease risk of opioid overdose by improving access to MAT and implementing harm reduction strategies, there by resulting in decrease in overdose related deaths in the community. Objective 3a: Offer naloxone to 100% of patients receiving MAT; Objective 3b: Decrease overdose incidence by at least 75% for patients receiving MAT in specified patient years compared to baseline before starting MAT.