Walk-In Recovery Centers Across Seven Rural Counties
A Regional Model for Rural Recovery, Reentry and Barrier Relief
The Hub is a network of recovery support centers across seven rural counties in the Kentucky River District that connect residents with substance use disorder treatment, overdose prevention services, peer support groups, employment and education services, jail reentry programming, and barrier relief through a single trusted door in each community.
The Challenge They Were Addressing
Rural counties in the Kentucky River District were losing residents to substance use disorder faster than the local safety net could respond. People cycled in and out of the jail, the emergency department, and the child welfare system, and returned to communities that did not have a recovery infrastructure to receive them. There was no 12-step programming in most of the small towns, no recovery housing, no medication-assisted treatment provider within easy reach, and no obvious place for a person leaving treatment to walk in on a Tuesday morning and ask for help.
The Kentucky River District Health Department had been running an overdose prevention program in all seven of its counties, which put staff in daily contact with people who were actively using and who were asking a different question than the one the program was designed to answer. They were asking about housing, transportation, food, a state ID, and a way to reunify with their children. Existing organizations were doing important work, but they were doing it in different buildings, on different intake forms, with different eligibility rules, and no coordinated hand-off between them.
In 2022, the Health Department opened the first Hub in Lee County to close that gap. The design started from a simple premise: ask the people who were using the services what would help, then build around the answer. The first program began with a meal and a conversation. It grew from there.
What They Built
The Hub is a physical space in each participating county, staffed by a small team that includes a team lead, a community health worker, and a peer support specialist. Some Hubs are standalone storefronts across the road from the local health department. Others occupy a floor above it. Each Hub is designed to be walked into without an appointment, a referral form, or a diagnosis, and to connect a person to whatever they need next, including a warm meal, a shower, a locker for their belongings, a ride to court, a hygiene kit, or a same-day introduction to a treatment provider.
The regional model does not duplicate services that already exist in a county. Where a partner already runs a 12-step meeting, a food pantry, or a workforce program, the Hub becomes the connection point, and the partner remains the provider. Where a gap exists, the Hub fills it. That is why the exact service mix varies by county. Every Hub is anchored in three core functions. It runs peer-led recovery groups on-site, operates a barrier relief fund, and connects people to clinical care.
Two mobile units extend the model into places where a brick-and-mortar Hub has not yet opened, providing overdose prevention services, community health worker support, and referrals to residents who cannot travel to a fixed site. A new women's reentry program, launched in 2026, adds education and workforce tracks for women leaving local jails, with stipends tied to milestones such as GED completion, entry into vocational training, and employment.
Data collection has been built into the model from the start. Each Hub tracks the number of individuals served, the naloxone kits distributed, the referrals made, and the groups facilitated, and gathers ongoing feedback from participants, staff, and community partners. The Hub Model Manual and a companion toolkit, both authored by the program director, are now used by counties considering replication.
Key Program Components
Who You Need at the Table
What made a willing partner essential vs. optional?
The court system, law enforcement, the local jail, and the behavioral health provider network are required partners in every county because the people the Hub serves move constantly across those systems and need each of them to be ready to accept a warm hand-off. County fiscal courts also sit in the required category for the regional expansion: five of the seven counties contribute local abatement dollars, and those contributions are what make the settlement grant stretch to the additional Hubs.
Helpful partners increase reach and depth without being on the day-one critical path. AmeriCorps and Recovery Corps members, university student placements, and DCBS coordination all add capacity for a Hub to grow. Every county's mix differs, and the steering committee that stands up a new Hub is designed to surface which partners are essential locally and which are duplicative of services already in place.
Budget Breakdown
What is the minimum viable budget to replicate this?
A rural county starting from nothing can open a first Hub on roughly $90,000 a year, which is what the Lee County program launched with in 2022. That figure covers one dedicated coordinator and a single walk-in space, and it assumes the coordinator has the authority to convene local partners and the flexibility to build the service mix around what participants say they need. Everything else, including the peer support specialist, the community health worker, the mobile unit, and the reentry program, can be added as additional funding is secured. Barrier relief is the highest impact use of a small pot of settlement dollars. A $75,000 grant spent on IDs, birth certificates, transportation, and driver's license reinstatement will move more people forward than any other line item at that budget level.
What Worked and Why
Specific decisions or design features that drove success
The first Hub grew out of meals and conversations with residents who were already accessing the overdose prevention program, and every county rollout since has begun by convening a steering committee that includes people with living and lived experience of substance use and recovery. Participants tell the team where the barriers are, and the service mix follows their guidance.
Framing the Hub as a gap-filler opened the partner relationships that make each county rollout possible. Early meetings in some counties surfaced concern that a new program would duplicate existing behavioral health, recovery, or workforce services. The steering committee format addressed the concern directly by mapping every existing service and identifying only the gaps the Hub would fill. Partners quickly recognized that the model made their own funding more effective because participants were routed toward their services rather than pulled away from them.
Providing data and the testimony of people with living and lived experience has been important. For example, Lee County numbers showed the number of people the model was reaching, while testimony from participants who had moved from crisis into stability made those numbers real. Together, they gave county fiscal courts and local behavioral health partners enough confidence to commit abatement dollars and clinical capacity to the expansion.
The staffing pipeline through AmeriCorps and Recovery Corps has protected the program from the workforce shortage that limits rural recovery infrastructure. Members serve a term at a Hub, gain experience in roles they may not have previously considered, and often transition into permanent positions. Several current staff members began as Hub participants, later volunteered, joined a service corps, and ultimately became part of the team. Because many volunteers and staff are entering their first professional role, the program has also identified a need for basic workplace readiness and soft-skills training to help build professionalism, communication skills, and confidence in the workplace.
Public health provides the ground on which the model stands. Locating Hubs inside or adjacent to health departments has kept the door as wide as possible, because a resident who walks into a Hub is not walking into a treatment program, a court-mandated service, or a religious organization. That framing lowers the barrier for people who have been turned away or judged in other settings.
Early outcomes and data
More than 6,000 people have been served in Lee County alone since the first Hub opened in 2022.
Six Hubs are operational across Lee, Leslie, Letcher, Perry, Knott, and Owsley counties; a seventh is in development in Wolfe County.
Two mobile units extend overdose prevention, community health worker services, and referrals into areas without a walk-in Hub.
A recovery court is launching in Lee County to complement the Hub's court-connected reentry work.
Multiple staff members who began as Hub participants have volunteered, joined AmeriCorps or Recovery Corps, and now hold full-time roles.
Court partners are reporting a decline in return-to-jail rates among Hub participants relative to comparable populations, with formal data collection ongoing.
A published Hub Model Manual and companion toolkit that other Kentucky counties are using to design their own replications.
Lessons Learned
Ask the people you intend to serve what they need before you design the program. Every meaningful decision in the Hub model came from a resident, a participant, or a family member who told the team what was in the way. Programming designed without that input solves the wrong problems.
Barrier relief is the highest-impact early investment. Small amounts of flexible funding for IDs, transportation, and other prerequisite documents move more people forward per dollar than almost any other line item and build the trust that later services depend on.
Regional expansion succeeds when local partners keep local control. The Hub model travels well because each county's steering committee decides what the local Hub will do. A one-size template imposed from outside would have collapsed under the weight of county-specific politics and provider dynamics.
Braided funding is the sustainability model. No single grant funds a Hub. State settlement dollars, local county abatement contributions, and additional federal and foundation grants each cover a piece.
Build a workforce pipeline into the design. AmeriCorps, Recovery Corps, university student placements, and internal promotion pathways for participants have carried the program through a rural workforce shortage that would otherwise have limited every expansion decision.