Louisville-Jefferson County Metro is the largest county in Kentucky, spanning 365 square miles and home to 760,000 residents within its consolidated city/county boundaries. It also has the highest number of opioid-related deaths of any county in Kentucky. In 2020, Louisville Metro experienced 604 opiate-related overdose fatalities, a 59 percent increase from the 379 overdoses reported in 2019. Data reported in 2021 indicated a total of 508 overdose fatalities with a total of 85 pending toxicology lab results. The COVID-19 pandemic exacerbated the opioid overdose crisis in Jefferson County. After the pandemic began in March 2020 and Kentucky declared a state of emergency, Governor Andy Beshear took proactive measures and announced a series of restrictions and recommendations to help mitigate the spread of the virus. Schools, universities, and a range of businesses were broadly closed to the public. Residential and outpatient treatment facilities across the state put new protocols in place to social distance, increased health screenings, and moved many group sessions to an online platform. The Kentucky Supreme Court entered an administrative order that included a number of unprecedented measures for the court system, including limited in-person proceedings, encouragement of judges to use telephonic or video technology, and expanded administrative release for those incarcerated. Locally, a range of initiatives were put into place, many by executive order, including the curtailing of nonessential police services and a reduction of the jail population to address the growing concerns of exposure to those incarcerated. With the technical assistance and funding provided by Building Bridges, Metro Corrections continued efforts during the pandemic to expand medication-assisted treatment in the jail. These efforts included maintaining medications for opioid use disorder and implementing effective linkage back to the community upon release from incarceration. Phase one of the project known as IMPACT (Innovative Medication Program for Addiction Care and Treatment) launched in January 2021 and provided maintenance doses of methadone to individuals who were arrested and were connected to a provider in the community prior to arrest. Building Bridges implementation funding was used to hire a substance misuse coordinator, who oversaw the jail’s methadone maintenance program and provided reentry/discharge planning services, as well as coordinated care upon release for individuals maintained on methadone.