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Rural Health Information Hub

CMH Addiction Recovery Program

  • Need: To help people who use drugs and their families access treatment and counseling in rural Missouri.
  • Intervention: The CMH Addiction Recovery Program provides medication-assisted treatment, counseling, peer and family support, and other related services through a Rural Health Clinic.
  • Results: The program operates 5 days a week and sees 400 patients each month.


The CMH Addiction Recovery Program in rural Bolivar, Missouri, is an outpatient treatment program for people with substance use disorders such as opioid and alcohol use. The program is run through Butterfield Park Medical Center, a Rural Health Clinic (RHC).

The program has a family medicine physician, 2 nurse practitioners, a case manager, a nurse, a full-time counselor, and a peer support specialist (PSS). The RHC in Bolivar is the hub but sends a medication-assisted treatment (MAT) provider to Eldorado Springs, Hermitage, and Osceola for treatment and counseling. The program will soon serve Stockton in January 2024 and will also expand to have a peer support specialist accompany the MAT provider to outreach clinics.

The program is funded through third-party reimbursements (Medicare, Medicaid, and private insurance) as well as Health Resources and Services Administration (HRSA) grants: HRSA 2021 Rural Communities Opioid Response Program - Implementation Award and the HRSA 2023 Neonatal Abstinence Syndrome Award.

Services offered

  • Medication-assisted treatment
  • Counseling for patients and families, including play therapy for children
  • Hepatitis C treatment
  • Collaboration with OB/GYN for prenatal and substance use co-management
  • Community education
  • Nicotine replacement products
  • Gas cards
  • Peer support
  • Case management for social needs

The program also offers contingency management, in which patients receive sobriety coins or other tokens at different milestones: at the beginning of treatment, 90 days, 6 months, and every year. Children of patients also receive a gift or token. After a year of treatment, patients have the option to ring a bell in the clinic and receive a certificate, T-shirt, and picture. Families are invited to celebrate with the patient.


The program had 15 patients in the first month (January 2018) and was open two days a week. Now, the program operates 5 days a week and sees 400 patients each month.

Since the program began offering contingency management, no-show rates for appointments have decreased.

The program is partnering with law enforcement and will start offering MAT at the Polk County jail.

Citizens Memorial Hospital (CMH) was the first business in Missouri to receive the Recovery Friendly Workplace designation.


When program coordinators began looking for partners and champions, some providers turned them down, saying that their communities did not have a substance use problem or that they did not want to serve patients with substance use disorder. These sentiments indicated a need for community education and stigma reduction. Now, these same providers are reaching out to the program to collaborate after seeing its successes. In addition, more individuals are inclined to seek services as treatment becomes less stigmatized.


Before implementing this program, coordinators looked at models that reduced barriers for patients, such as self-referrals, walk-in availability, and starting MAT as soon as possible (medication-first approach).

The PSS was hired using grant money to avoid any issues with RHC-specific billing requirements.

The program partners with law enforcement, OB-GYN programs, a pregnancy resource center, housing assistance, and child welfare services. In addition, the program is working with the Mobile Integrated Healthcare Network, a community paramedic and community health worker program, to start offering MAT in patients' homes. The Osceola program also partners with its community's AA program and transportation assistance.

Contact Information

Christina Bravata, Director of Grants Management
Citizens Memorial Hospital
CMH Addiction Recovery Program

Alcohol use
Behavioral health
Mental health
Outpatient care
Rural Health Clinics
Substance use and misuse

States served

Date added
November 3, 2023

Suggested citation: Rural Health Information Hub, 2023. CMH Addiction Recovery Program [online]. Rural Health Information Hub. Available at: [Accessed 19 May 2024]

Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.