AIM Team: After-Hours Peer Response

A Peer-Led, Overnight Model for Rapid Treatment Access

Hamilton County/Cincinnati, Ohio | Addiction Services Council
Ohio Urban Suburban Pop. 838k Launched 2024
Four Addiction Services Council AIM Team peer responders standing beside the AIM Team van in Cincinnati, Ohio, with the van lettered After Hours Individualized Mobile Engagement and the program's crisis line.
Lead Agency
Addiction Services Council (ASC), founded 1949
Location
Hamilton County/Cincinnati, OH (+ Butler, Warren, Clermont counties)
Year Launched
2022 (pilot); relaunched and stabilized 2024 with OneOhio funds
Opioid Settlement
100% OneOhio funded, $500,000+ over two years
People Served
328 overnight crisis calls answered, 314 in-person responses, 215 transports to treatment (2025)
Service Type
Peer Support, Care Navigation, Warm Hand-Off, Co-Responder Model, Street Outreach
328
Overnight Crisis Calls Answered
2025; 96% resulted in an in-person response
215
People Transported Directly to Treatment
2025; 68% of in-person responses
96%
Of Calls Resulted in an In-Person Response
2025

Addiction Services Council's AIM Team uses OneOhio opioid settlement funds to provide 8 p.m. to 8 a.m. peer response and direct transportation to treatment, so people seeking help after business hours can be met in person and connected to care immediately, in the short window when they are ready to act.


The Challenge They Were Addressing

In Hamilton County, the doors to treatment effectively closed by mid-afternoon. A person who reached out at 6 p.m., 10 p.m., or 2 a.m. asking for help would typically be told to call back the next morning, and the next morning, they often did not call. ASC staff sometimes recognized names on the local coroner's overnight report from people who had reached out the day before. The window in which someone is ready to ask for help is short, in ASC's experience, usually less than an hour, and the system was not open during those hours.

With no after-hours alternative, hospital emergency departments and first responders became the default response. They could stabilize a person in crisis, but they had no practical way to move that person from the ED bay or the curb into a treatment program in the middle of the night. Beds existed, but the connection to those beds did not. The same pattern repeated in the local jail, where ASC already operated a treatment program: people leaving custody overnight needed somewhere to go and someone to take them there.

Addiction Services Council, a Cincinnati-based nonprofit founded in 1949, had spent decades providing prevention, treatment, recovery support, and community outreach across hospitals, the justice system, and community settings. The agency could see the after-hours gap clearly because its daytime programs kept hitting it. The AIM Team was built to close that gap with a small, fast, peer-led response designed around one operating principle: when a person says yes, meet them in person and get them to treatment that night.


What They Built

AIM is a small, mobile, peer-staffed crisis response that operates from 8 p.m. to 8 a.m., 365 days a year. Two teams of two certified peer recovery specialists cover the overnight hours. Calls come in from hospital emergency departments, first responders, the local jail, individuals on the street, family members, and community partners. A cloud-based phone system lets peers answer and dispatch from anywhere in the service area, including from home if needed.

When a call comes in, the peer on shift conducts a brief safety screening, confirms what the caller is requesting, and, if an in-person response is requested, deploys to the location. The team typically arrives within about 30 minutes. If the call is from the street, two peers respond together. If the call is from a hospital or other facility, a single same-gender peer can respond, with a second peer joining for any transport. The encounter focuses on brief intervention, peer support, and immediate transportation to treatment. AIM does not currently conduct a full biopsychosocial assessment, and the service is not billed to insurance.

The product is a ride. When a person says they are ready, AIM drives them directly to a treatment program that has agreed to accept after-hours admissions, hands them off to the admitting clinician, and stays as long as needed to ensure the warm hand-off lands. If no immediate placement is available that night, AIM finds a safe place for the person to wait until morning while coordinating admission. Daytime ASC staff support the program by conducting outreach using AIM cards and building referral relationships with hospitals and first responder agencies.

Operational policy is tight and written. A consent script is read aloud at the start of every transport, and the person can end the transport at any time. Belongings are limited to what the person can carry in one trip. The team will only transport to treatment, not to a home, an errand, or any other destination. Vehicle safety is governed by an agency driver handbook, Bureau of Motor Vehicles (BMV) checks on all drivers, non-owned auto and vehicle insurance policies, regular maintenance checks on personal vehicles used in the program, an emergency kit, and a foundation-purchased agency van.

Key Program Components

Two-person peer teams, 8 p.m. to 8 a.m., 365 days a year
Two teams of two peer recovery supporters provide live overnight phone and in-person response covering Hamilton County and the surrounding service area, with daytime ASC staff handling outreach and partner relationships.
Cloud-based phone system and remote dispatch
An app-based phone system lets peers answer and dispatch from anywhere, including from home, so the line is never closed and a peer can be on the road within minutes of a call.
Brief safety screening before deployment
Every call begins with a short screening to confirm location, what the person is asking for, and any safety concerns. Two peers always respond to street calls; same-gender response and two-person transport rules apply in facilities.
Direct transportation to treatment
The core service is the ride itself. AIM transports directly to a partner treatment program that has agreed to accept after-hours admissions, with no insurance paperwork or assessment delay at the door.
Safe-bridging when no immediate placement exists
If no admission is available that night, the team finds a safe place to wait with the person until morning while staff coordinates placement, so the person is not sent back into the situation that prompted the call.
Written consent and transport policies
A consent script is read aloud at the start of every transport. The person can end the transport at any time. Belongings are limited to what can be carried in one trip. The vehicle goes only to treatment.
Documented vehicle and safety operations
Driver handbook, BMV checks, non-owned auto and vehicle insurance, regular maintenance checks on personal vehicles, an emergency kit, and a foundation-purchased agency van.
Daytime relationship-building
ASC daytime staff conduct outreach using AIM cards, including overnight visits to hospitals and first responder stations to keep the program top of mind for the people doing the calling.

Who You Need at the Table

Required Partners
Role
Addiction Services Council (Lead Agency)
Employs the AIM Team, runs the overnight phone line, sets policy, manages vehicles, and integrates AIM with ASC's broader prevention, treatment, jail-based, and outreach programs.
OneOhio Recovery Foundation
Provides opioid settlement funding to pay for the AIM Team. AIM services are not billable to Medicaid or private insurance, so settlement funding is what keeps the program running.
Treatment providers accepting after-hours admissions
Receive AIM transports overnight and admit people on arrival. Without at least one committed treatment partner, AIM has no destination.
Hospital emergency departments
University of Cincinnati Medical Center, Christ Hospital, Good Samaritan, Bethesda (TriHealth), and the Mercy hospital system call AIM when patients are ready for treatment overnight, replacing what would otherwise be a discharge with no destination.
Hamilton County Justice Center/local jail
Routine referral source for people leaving custody overnight. ASC operates a treatment program inside the jail, and the AIM phone number is a free call from inside the facility.
Fire, EMS, and police agencies
Refer people in the field who are seeking help but do not need emergency department care. AIM provides first responders with a treatment-oriented option beyond the ED or jail.
Peer recovery workforce
Provides the trained peer recovery supporters who staff the team. The role requires comfort with overnight community response and the ability to build trust quickly with people in crisis.
Insurance and accreditation compliance support
Internal and contracted support that built the vehicle, transport, and driver policies and that maintains compliance for non-billable peer services.
Helpful Partners
Role
Local foundation (van funder)
Purchased the dedicated agency van used for AIM transports, removing one of the highest one-time costs from the operating budget.
Ohio Deflection Association
State association that connects AIM and ASC to peer programs working on similar pre-arrest and pre-ED engagement models across Ohio.
Local ADAMHS/mental health board
The county behavioral health authority and a long-standing ASC funder for related work inform the local service environment within which AIM operates.
Daytime ASC street outreach (Together Tuesdays)
Daytime outreach programs that hand out AIM cards in the community and create the daytime-to-overnight handoff that brings people to AIM's door.
State legislative champions
State representatives and other elected officials are exploring how to support and scale the AIM model across Ohio.

What made a willing partner essential vs. optional?

A required partner is one without whom AIM cannot dispatch, transport, or admit. OneOhio funding is required because the service is not billable to insurance. A treatment provider willing to accept admissions in the middle of the night is required because that is the destination. Hospitals and first responders are required because many calls originate there. The local jail is required because people exiting custody overnight are one of the populations most at risk and most ready to engage. A trained peer workforce is required because the work is peer work, and the encounter only succeeds when the responder is someone the person in crisis can trust.

Helpful partners expand reach and resilience without being essential to day-one operations. The foundation that purchased the agency van removed a major one-time expense. The Ohio Deflection Association connects AIM to similar models across the state. Daytime ASC outreach programs and the local mental health board create the daytime context that brings people to AIM's overnight door. State-level champions matter for the next stage, scaling the model beyond Hamilton County. None of those are required to answer the phone tonight, but each one strengthens the system around AIM.


"The window of willingness is, in our experience, usually less than an hour long. We need to act right away."
Lisa Mertz, President and CEO, Addiction Services Council

Budget Breakdown

$500K+
AIM Team Project Budget
over two years; ASC has reapplied for continuation
100%
Opioid Settlement Funded
no Medicaid or insurance billing; non-billable funding is essential
~8%
Admin/Indirect Rate
in line with ASC's standard indirect rate
Primary Funding Source
OneOhio Recovery Foundation (Ohio opioid settlement funds); AIM has reapplied for continuation funding
Additional Funding
None for AIM specifically. Agency van purchased by a local foundation outside the OneOhio award. ASC's broader $3M agency budget supports surrounding programs.
Budget Category
Amount
Notes
Personnel/Staffing
Majority of budget
Four full-time Peer Recovery Supporters, plus a portion of the supervisor's salary. Salaries are the single largest cost.
Treatment/Clinical Services
N/A within AIM
AIM does not deliver treatment; clinical services are provided by partner treatment programs that admit patients transported by AIM.
Peer Support/Recovery Coaches
Included in personnel
Peer recovery supporters staff AIM; their wages and benefits are part of the personnel line above.
Technology/Data Systems
Modest
A cloud-based phone system that allows peers to answer and dispatch from anywhere; standard ASC data systems for case tracking.
Equipment/One-time purchases
Funded by foundation grant
Agency van purchased by a local foundation outside the OneOhio award, including an emergency kit and vehicle equipment.
Vehicle/Mileage/Insurance
Significant recurring cost
Mileage, fuel, and maintenance for both the agency van and approved personal vehicles; non-owned auto and vehicle insurance policies.
Contracts
Limited
Compliance and accreditation support for non-billable transport services; treatment partner agreements managed within ASC operations.
Admin/Indirect
~8%
Administrative expense on the AIM project runs about 8 percent, in line with ASC's standard indirect rate.

What is the minimum viable budget to replicate this?

At Hamilton County's scale, AIM runs on about $500,000 over two years to cover four full-time peer responders, supervisor time, vehicle costs, insurance, phone system, and standard agency overhead. A leaner version of the same model is realistic. A rural county starting with $75,000 could pilot one or two trained peers covering limited overnight hours, on-call transport support rather than a dedicated van, a cloud-based phone line, one committed treatment admission partner, and a modest mileage and insurance allocation. The non-negotiable line items are people who can do the work, a phone that gets answered, a vehicle policy that is safe and insured, and a treatment partner who will open the door when AIM arrives.


What Worked and Why

Specific decisions or design features that drove success

Designing the program around the short window in which a person is ready to act is what makes the model work. AIM does not collect insurance information at the door, does not conduct a full clinical assessment on the spot, and does not schedule the person for a next-day appointment. The peer on the phone confirms the person is ready, dispatches, and drives. The simplicity is in the design.

Staffing with peers who are comfortable in overnight community settings, not only in office settings, is the second decision that drives outcomes. The team meets people on sidewalks, in hospital lobbies, in jail discharge areas, and in housing of every kind. People who do this work well are people who can hold a steady, non-judgmental presence at 3 a.m. in places that are not always easy. ASC hires and trains those who fit explicitly, in addition to standard peer credentials.

Locking down operational policy early and sticking to it has kept the program safe and trusted. The consent script at the start of every transport, the rule that the person can end the transport at any time, the one-trip belongings limit, and the rule that the vehicle goes only to treatment are all small choices that, taken together, keep peers and clients safe and keep the program defensible. The vehicle insurance, BMV checks, and driver handbook were built before the first transport, not after.

OneOhio settlement funding stabilized a program that the daytime system has come to depend on. The service is not billable to Medicaid or private insurance, so without dedicated non-billable funding, AIM would not exist. Settlement dollars, in this case, are paying for an after-hours layer that hospitals, first responders, and the jail are now actively routing people into.

Embedding AIM inside ASC, an agency with deep daytime relationships across hospitals, the justice system, and the community, compressed the time to credibility. Hospital ED leadership and first responder agencies already knew ASC. The AIM phone number was a new entry point on top of an existing relationship, not a cold call.

Early outcomes and data

  • 2025 overnight AIM Team activity (services sustained by OneOhio funding): 328 crisis calls answered, 314 in-person responses requested (96% of calls), 215 individuals transported directly to treatment (68% of in-person responses).

  • From 2022 through 2025, 53% of all callers were transported directly to treatment.

  • From 2022 through 2025, 84% of callers received in-person peer support.

  • From 2022 through 2025, 63% of people who received an in-person visit were transported to treatment that night.

  • Live phone coverage 8 p.m. to 8 a.m., 365 days a year, with typical in-person response within about 30 minutes.

  • Embedded in hospital ED and first responder workflows; AIM provides warm hand-offs to treatment instead of next-day referrals.

  • 30, 60, and 90-day follow-up attempts in place; reach is limited because many clients enter residential treatment without phones.


Replication Guide
How to Replicate This Model
Minimum viable version
A county with a limited budget can run a scaled version of this program. The minimum viable model is one or two trained peers covering a defined block of overnight hours, on-call transport support rather than a dedicated van, a cloud-based phone number that gets answered live, written consent and transport policies, and a single committed treatment admission partner who will receive AIM clients after hours. In a rural setting, the drive will be longer, treatment options will be fewer, and the program may need to identify a safe place where peers can wait with the person until morning admission.
First three steps
1
Gather local data and community insight first Map overdose, jail, ED, and EMS data alongside conversations with hospital staff, first responders, and people in recovery. Identify the size of the after-hours gap, who is most affected, and whether local partners are willing to receive AIM clients overnight. The numbers tell you how big to build; the conversations tell you whether you can.
2
Identify and confirm your core partners Line up at least one hospital ED, one treatment center willing to admit overnight, and one referral source from the justice system or first responder community. Ask each one to commit, in writing, to a clear role: who calls AIM, when, and what happens on the receiving end.
3
Build the policy and budget package before going live Draft a policy and procedure manual covering safety screening, transport consent, vehicle and insurance requirements, safe-bridging when no admission is available, and follow-up. Then build a realistic budget around staffing, vehicles, and insurance, and use that package to anchor a funding application to opioid settlement or other non-billable funders.
Common Pitfalls
Designing the response around insurance and assessment If the person on the phone has to verify coverage or schedule a clinical assessment, the window of willingness closes before AIM can dispatch. The model only works because it strips paperwork out of the first encounter.
Hiring on credentials alone Strong peer credentials matter, but comfort with overnight, mobile, community-based response is what makes the role work. Hire for fit with the actual conditions, not only for the resume.
Going live without a vehicle and transport policy Insurance, driver checks, the written consent script, and the transport-only rule should be in place before the first ride, not added after an incident.
Skipping first responder education Fire, EMS, and police agencies will not refer to a program they do not understand. Invest early in face-to-face education with each agency, including overnight visits, so the AIM number is in the right hands at the right hour.
Relying on a service line that is not built for non-billable work AIM cannot be funded by Medicaid or private insurance billing. A program that assumes it can backfill with fee-for-service revenue will not survive the first budget cycle without a dedicated non-billable funding source.
Underestimating the safe-bridging problem in rural areas If the nearest treatment program will not admit overnight, the model still needs a plan for where the person waits with a peer until morning. Build that plan before the first call.

Lessons Learned

  • Make consent explicit at the start of every transport. Reading a consent script aloud and reminding the person that they can end the transport at any time protects everyone in the vehicle and sets the tone for a peer relationship rather than a custody one. It also gives peers a clear, repeatable way to handle hesitation in the first miles.

  • Set transport boundaries before testing. Belongings limited to one trip. Vehicle goes only to treatment, not home or errands. Decide these rules in writing before the first ride. They are easier to hold when they are policy, and they keep the program focused on what it can actually deliver.

  • Invest early in first responder and fire education. Fire, EMS, and police agencies need direct, in-person introductions to AIM, ideally during the same overnight hours that AIM operates. Without that face-to-face education, the AIM number sits in a binder, and the calls do not come. Put time and budget into this in the first year.

  • Hire for comfort with an overnight community response. Peer credentials are the floor. The role also requires being steady at 3 a.m., on a sidewalk, in a hospital parking lot, or in a jail discharge area. ASC has learned to interview and onboard for that specific fit, not just for paper qualifications.

  • Plan for vehicle, insurance, and safety requirements up front. Non-owned auto insurance, BMV checks, a driver handbook, vehicle maintenance routines, and an emergency kit are not afterthoughts. Building them early made it possible to scale safely and defend the program when questions arose from funders, regulators, or partner agencies.

  • Keep the service simple and immediate. The temptation in any new program is to add features. AIM's strength is the opposite: pick up the phone, dispatch, drive, and hand off. Anything that slows that core path is a candidate for removal, not addition.


Primary Contact
Lisa Mertz
President and CEO, Addiction Services Council
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