As the United States is in the throes of an opioid crisis, methamphetamine and other stimulants are still some of the most commonly used substances in communities across the country. Both opioid and methamphetamine use during pregnancy can lead to neonatal abstinence syndrome (NAS) and an increased risk of negative birth outcomes such as low birthweight and stillbirths. Local health departments have responded to the need to address substance use during pregnancy, for the health of both pregnant people and their infants, in a variety of ways. The Unified Government Public Health Department of Wyandotte County and Kansas City, KS, implemented a screening, brief intervention, and referral to treatment (SBIRT) model specific to high-risk substance use in their STI and family planning clinics. Moreover, Prince William Health District will share their experiences of implementation after the state of Virginia passed a law requiring the reporting of NAS. The webinar will conclude with a discussion of concrete strategies for state Title V agencies to support these efforts at the local level.