Substance use during pregnancy and motherhood is both a public health and criminal justice concern. Negative health consequences associated with substance use impact both the mother and the developing fetus, and there are ongoing attempts to criminalize substance use during pregnancy that put women who are pregnant and substance-using at risk of detection, arrest, and punishment. Additionally, The COVID-19 pandemic changed the landscape of health care delivery overnight. As communities and businesses shut down, behavioral health practitioners were forced to expand in innovative ways to serve their most at-risk community members. The purpose of the Neonatal Abstinence Syndrome (NAS) grant program is to reduce morbidity and mortality rates and reduce incidence of NAS among pregnant women and women of childbearing age who are at high risk for Substance Use disorders and Opioid Use Disorders in six rural counties. This was achieved in three ways: (1) Increasing access to prenatal and postnatal care for both incarcerated pregnant women and women of childbearing age through telehealth services via iPad carts. (2) Increasing awareness and treatment options among medical providers by delivering medication for the treatment of opioid use disorder (MOUD) for physicians to safely treat women. (3) Hosting caregiver support and resources for family members and loved ones impacted by addiction. The poster will show an overview of successful case studies, where rural consortia leveraged telehealth to improve access to care among people who are incarcerated and people at risk of delivering a child with substance use. We will address the effectiveness, challenges, and successes of deploying telehealth services within in rural jails, virtual care coordination using evidence-based practices, and continuum of care for women and families once they exit the justice system.