VOAD PPW will be based in Sioux Falls, SD, and will provide comprehensive services for pregnant and postpartum women with substance use disorders and their minor children in a residential treatment setting. Services will extend to partners, fathers and caregivers of children and extended family members. Population: VOAD PPW will serve eligible pregnant and postpartum women and family members and will not discriminate on the basis of race, ethnicity, language, sex, gender identity, sexual orientation, age or socioeconomic status. The project will target American Indian women and low-income women with limited access to health services. Strategies/Interventions: Outreach and engagement to underserved and vulnerable populations, including American Indians and justice and child welfare systems; screening and assessment for women and children; substance use treatment in a safe residential setting using evidence-based curricula; referrals to medical services, including medications for treating opioid use disorder; supplemental services for women, including education, employment and social services and evidence-based parenting skills education; trauma-informed services; supplemental services for children, including referrals to pediatric health care, screening and referrals for developmental delays, and therapeutic childcare and activities; recovery support services, including case management, connections to recovery housing, family programming, and aftercare support for up to six months; harm-reduction services; and development of a Steering Committee to advise on program design and implementation, identify needs and assist in outreach and engagement efforts. Goals and Measurable Objectives: Goal 1: Decrease substance use; Objectives: provide substance use treatment services to 475 women; 80% of women will experience a decrease in addiction severity at discharge; 50% of women who successfully discharge will remain engaged in recovery 6 months post-intake. Goal 2: Provide outreach and engagement; Objectives: 48% of women will successfully discharge (meet all treatment plan goals); Develop process to identify disparities in successful discharge by the end of Year 1 and strategies to address disparities. Goal 3: Increase safe and healthy pregnancies and improve health outcomes; Objectives: 100% of women will be provided regular prenatal care; 85% of women and children will exit with an identified medical provider; 100% of women using tobacco will be provided cessation resources. Goal 4: Improve mental and developmental health of women and children; Objectives: Screen 100% of women for mental health and make appropriate referrals; 80% of women will experience improved mental health at discharge; Complete PEARLS screener for 100% of children living at New Start and make appropriate referrals; Complete developmental screening for 100% of children living at New Start and make appropriate referrals; Screen 100% of women and children for FASD and make appropriate referrals; Goal 5: Support and sustain recovery efforts; Objectives: Provide case management to 75 women in Year 1 and 100 annually in Years 2-5; 100% of women who successfully discharge will exit to a safe and stable destination; 90% of women will not have any new justice system involvement while at New Start; Goal 6: Preserve and support the family unit; Objectives: 75% of women will have one family member or caregiver participate in their recovery; 80% of women will improve parenting skills at discharge; 75% of women will identify one safe adult to support them in recovery; Goal 7: Establish and incorporate a Steering Committee; Objectives: Hold initial steering committee within 90 days of award, quarterly meetings in Year 1 and semi-annual meetings in Years 2-5; By end of Year 1, Month 3, recruit adequate representation for steering committee. Number of individuals served: 114 mothers and children living on-site in Year 1 and 152 annually in Years 2-5, for a project total of 722.