The Tennessee Department of Health East Tennessee Region (ETR) established partnerships with county jails to address high rates of neonatal abstinence syndrome (NAS) by providing family planning services to incarcerated women, many of whom have substance use disorders. Through the NAS Education and Expanded Family Planning (NASFP) initiative, women in county jails receive education about all forms of contraception and about risks of substance use during pregnancy. Upon request, women receive access to highly effective contraception (e.g., IUDs or hormonal implants) while incarcerated, and all methods upon release. NAS cases in the NASFP pilot county decreased 52% one year after implementation. All ETR counties adopted the program, as did numerous other Tennessee counties. The program in ETR now includes additional populations: individuals on probation for drug-related charges, rehab/recovery groups, and homeless/domestic violence shelters. In five years, ETR has delivered education to 7,823 attendees and provided 1,099 contraceptive devices. The program has been recognized for its effectiveness by the National Association of County and City Health Officials and the Centers for Disease Control and Prevention. A formal program evaluation conducted in 2018 concluded participants perceived the program as voluntary and estimated the prevention of at least 270 unintended pregnancies and 40 NAS cases in the first year after device placement.