The opioid crisis has hit rural communities in places like Oswego County (NY) particularly hard. According to the NY State Department of Health, Oswego County had the second highest opioid death rate in the region in 2017. Additionally, rural areas face unique infrastructural, social, and economic challenges when dealing with the crisis. A consortium of treatment and prevention providers in Oswego County are partnering to find ways to strengthen the County’s opioid use disorder (OUD) system. To inform their planning, CGR worked with Oswego County Opportunities, Inc. (OCO) and its partners, Farnham Family Services, ConnextCare, Harbor Lights Chemical Dependency, and the Oswego County Health Department, to conduct a comprehensive, community-informed needs assessment and gap analysis. Our assessment identified opportunities for strengthening Oswego County’s system, including: ∞ Expanding or establishing evidence-based approaches such as ∞ medication assisted treatment (MAT) ∞ Naloxone/NARCAN training and availability, ∞ safe syringe exchange services, and ∞ emergency department bridge programs; ∞ Expanding internet connectivity to accommodate expanded telehealth services resulting from COVID-19 that could be extended post-pandemic; and ∞ Expanding supportive housing, particularly for women and women with children, recovery centers, and peer support.; The assessment was conducted as part of a U.S. Health Resources and Services Administration (HRSA) Rural Communities Opioid Response Program (RCORP) Planning Grant to OCO and its partner organizations.