Despite jails being required to provide medical care, only around 20% offer medications to treat opioid addiction, and even fewer provide easy access to these treatments. Rural jails, which make up two-thirds of all jails, face big challenges in offering these programs due to operational and logistical difficulties, resulting in inconsistent access to proper care. This study focuses on a new strategy called Jail ECHO Operations, Planning, and Strategy (J-ECHO OPS), which aims to increase access to opioid treatment medications in rural jails. In 40 rural jails across the country the team is providing virtual learning sessions, discussions, and knowledge sharing among jail leaders, staff, and community healthcare providers.