Bureau of Justice Assistance’s 

Comprehensive Opioid, Stimulant, and Substance Abuse Program (COSSAP)

Rural Responses to the Opioid Epidemic

While no corner of the country has gone untouched by the 

opioid epidemic, rural America has been hit particularly 

hard. The Rural Responses to the Opioid Epidemic initiative 

is designed to reduce opioid overdoses among individuals 

who come in contact with law enforcement or are involved in 

the criminal justice system in high-risk rural communities and 

regions.

This initiative, co-funded by the Bureau of Justice Assistance, 

the Centers for Disease Control and Prevention, and the State 

Justice Institute, supports 21 sites to identify current gaps in 

prevention, treatment, and/or recovery services for individuals 

who encounter the criminal justice system within the target 

rural service area, followed by initiating new or augmenting 

existing efforts to address the opioid crisis in their communities.

COSSAP-Supported Rural 

Responses Projects

Each site has identified a project coordinator, tasked with 

guiding the development of the team’s project, formalizing 

processes to support cross-agency collaboration, and 

conducting outreach to team members and community 

stakeholders. Sites also developed new or utilized existing 

stakeholder groups or task forces (such as a criminal justice 

coordinating council or opioid task force) that include 

public safety, public health, and behavioral health agency 

representatives working collaboratively on this initiative. Some 

sites have developed data-focused groups to ensure that 

appropriate data and information are being collected and that 

project goals are being met. 

After completing a six-month planning phase to determine its 

community’s needs, strengths, and opportunities, each team 

will spend 18 months implementing at least three strategies 

aimed at addressing the opioid epidemic—one in each of the 

categories below.

Overview

Strengthening epidemiologic surveillance and 

public health data infrastructure

Activities may include establishing or enhancing an existing 

overdose fatality review team; implementing the Overdose 

Detection Mapping Application Program (ODMAP); tracking 

relevant indicators or conducting rapid assessments to gather 

data; collaborating with medical examiners or coroners to 

expedite access to preliminary data on suspected overdose 

deaths; and implementing systems to identify infants and 

children exposed to parental opioid use.

Implementing effective community-level 

opioid overdose prevention activities

Activities may include providing training and information to 

youth-serving organizations, including schools, on the impact 

of substance abuse on children, youth, and families; increasing 

public education on how to properly administer naloxone; 

engaging community and faith-based organizations to use 

evidence-based messages on prevention, treatment, and 

recovery programs; and implementing year-round drug takeback programs. 

Establishing or enhancing public safety, 

public health, and behavioral health 

collaborations

Activities may include supporting outreach teams to follow up 

with individuals at risk of overdose; developing partnerships to 

identify risk from adverse childhood experiences and connect 

those at risk with prevention resources; establishing courtbased intervention programs to prioritize and expedite services 

to individuals at high risk for overdose; enhancing treatment 

and recovery service engagement among individuals leaving 

jails or secure residential treatment facilities; and establishing a 

coordinated rapid response team.

Sites may also use funding to expand peer recovery and 

recovery support services.
COSSAP-Supported Rural Responses Sites

The 21 sites participating in the Rural Responses initiative are in communities across the country, from Florida to Washington, and 

range in population size from 22,000 to 200,000. Profiles of each site are available at https://rural.cossapresources.org/Sites

Minnesota—St. Mary’s Regional Health Center

New Mexico—County of Rio Arriba

New York—Ellenville Regional Hospital

North Carolina—Project Lazarus

Ohio—Portsmouth City Health Department

Pennsylvania—Northumberland County

South Carolina—Prisma Health–Upstate

Tennessee—Upper Cumberland Human Resources Agency

Tennessee—WestCare Tennessee, Inc.

Washington—Grays Harbor Public Health and Social Services

West Virginia—Marshall University Research Corporation

About BJA 

The Bureau of Justice Assistance (BJA) provides leadership and services in grant administration and criminal justice policy 

development to support local, state, and tribal law enforcement in achieving safer communities. To learn more about BJA, 

visit www.bja.gov and follow us on Facebook (www.facebook.com/DOJBJA) and Twitter (@DOJBJA). BJA is part of the U.S. 

Department of Justice’s Office of Justice Programs.

Visit the COSSAP Resource Center at www.cossapresources.org.

WestCare Tennessee, Inc., TN

Prisma Health–Upstate, SC

SMA Healthcare, Inc., FL

Marcum and Wallace Hospital, KY

Northern Kentucky University, KY

Whitley County Health Department, KY

Marshall University Research Corporation, WV

Franklin County Sheri's Department, MA

Grays Harbor Public Health 

and Social Services, WA

Memorial Regional Health, CO

Porter-Starke Services Inc., IN

Reno County Health Department, KS

St. Mary's Regional Health Center, MN

Rio Arriba County, NM

Arkansas Rural Health Partnership, Inc., AR

Upper Cumberland Human Resources Agency, TN

Project Lazarus, NC

Northumberland County, PA

Portsmouth City Health Department, OH

Mohave Substance Treatment Education 

and Prevention Partnership, AZ

Ellenville Regional Hospital, NY

Arizona—Mohave Substance Treatment Education and 

Prevention Partnership

Arkansas—Arkansas Rural Health Partnership, Inc.

Colorado—Memorial Regional Health

Florida—SMA Healthcare, Inc.

Indiana—Porter-Starke Services, Inc.

Kansas—Reno County Health Department

Kentucky—Northern Kentucky University

Kentucky—Whitley County Health Department

Kentucky—Marcum and Wallace Hospital

Massachusetts—Franklin County Sheriff’s Department