From 2010-2013, Maricopa County, Ariz., Drug Court attempted a detox-to-residential program that yielded 12% outcomes in “compliance” for individuals with opioid use disorder. Since implementing medication-assisted treatment in 2015, the program’s average of “compliance” is around 75%. Community Medical Services works with system partners and behavioral health agencies to provide patients a continuum of care and additional supports for better outcomes. Maricopa County has established itself as a national leader when it comes to integrating MAT into criminal justice programs. Community Medical Services supports three state departments of corrections, six county jails, and four diversion courts. With close communication between the courts, jails and system partners, offenders have been provided a better set of options and opportunities on the road to recovery. Maricopa County also developed and implemented the first 24/7 opioid treatment on demand (OTOD) clinic, a center of excellence supported through AHCCCS and the State Targeted Response Grant. Use of the collective impact model for opioid use disorder was successfully implemented in Arizona and has been replicated in North Dakota, Montana and Alaska. Often these programs start with supporting high-risk populations, such as hospital discharges after an opioid encounter or individuals who are involved with the criminal justice system. The model also supports individual providers or smaller agencies with access to additional community resources so that their clients and the provider can be better supported. Audience members will leave the presentation with a working knowledge of how to develop and implement initiatives, using collective impact, implementing and sustaining peer support, outcomes for criminal justice programs, along with an analysis of the country’s first 24-hour opioid treatment clinic and how it continues to change the ability to respond to community partners. "