Sedgwick County, home to 17.6% of Kansas' population, had 22.4% of all opioid-use related deaths in 2017. While opioid misuse in Kansas has not reached the same level of concern as other states, prevention strategies are needed to curb the growing crises. The Sedgwick County Health Department (SCHD) assisted a Federally Qualified Health Center (FQHC) in implementing Screening, Brief Intervention, and Referral to Treatment (SBIRT), an evidence-based practice to identify and prevent risky health behaviors related to substance misuse. A continuous quality improvement process, Plan-Do-Study-Act, was employed. During the Plan phase, SCHD received clinic electronic health record (EHR) baseline data, researched SBIRT processes, provided access to computer-based SBIRT training for clinic staff, secured clinic staff buy-in by facilitating conversations about SBIRT billing and screening for substance use, and recruited "champions" to assist with sustainability of the project. Baseline data from 2018 showed the clinic served 6,417 total patients and documented 47 adult SBIRT full-screenings with one billed. Through this project, 47% of clinic professionals were trained to provide SBIRT. Twenty-three staff members, from a variety of positions, attended a kick-off meeting; seven volunteered as "champions." Formative workflows were created, observations of 24 patient visits were completed, four SBIRT process maps were developed, and 20 recommendations were made for implementation. Thorough knowledge of SBIRT and related reimbursements along with the education of clinic staff were critical for planning SBIRT implementation. Next steps include SBIRT implementation and subsequent evaluation by SCHD to complete the Plan-Do-Study-Act cycle.