WHITESBURG, KY. — Kentucky Attorney General Russell Coleman announced in April that the Kentucky River District Health Department's Hub initiative will receive a $320,000 state grant. The two-year award will fund a program to help incarcerated women reintegrate into society.

The Hub operates in four rural eastern Kentucky counties: Knott, Lee, Letcher, and Owsley. A fifth location will be established in Perry County. The program addresses substance use disorders, housing, hunger, and employment. Services include peer support, canned food, and sterile syringes.

The new grant follows $545,000 in opioid settlement funds received in 2025, which expanded The Hub from two to five counties. Kentucky holds approximately $1 billion of the $57.8 billion settlement with pharmaceutical companies related to the opioid overdose crisis.

In 2025, the National Association of County and City Health Officials recognized the Hub model as one of 19 public health best practices. JoAnn Fraley, harm reduction program coordinator and Hub initiative director for Kentucky River, described the approach. "In order for anybody to sustain recovery, they have to have financial stability, they have to have transportation, and they have to have a home," Fraley said. "We try to fill those gaps."

On July 24, 2026, the Trump administration issued an executive order stating that programs could no longer expect federal funding for harm reduction efforts. The order stipulated that discretionary grants from the Substance Abuse and Mental Health Services Administration should not be used for such initiatives. The executive order claimed harm reduction efforts "only facilitate illegal drug use and its attendant harm."

Jamie Madden found support at The Hub in Whitesburg for her addiction recovery. Madden became addicted to pain pills by age 16 and methamphetamine by age 30. She lost custody of two children and gave up two others for adoption. Madden resolved to stop using drugs when pregnant at age 40, after serving time in county jail and state prison. "I grew up with the impression that that's how you paid your bills," Madden said. "That's how your kids got things."

Lauren Carr, an advisor to the Kentucky Association of Counties, assists with the utilization of opioid settlement funds. "What jazzes me about it is it's a community approach to harm reduction," Carr said. "Whether that's feeding a hungry stomach, or putting clothes on somebody's back, or giving them clean [syringes], you're meeting that person's needs." Carr added, "It can be that lifeline."

Becky Todd, team leader at the Beattyville Hub, is a community health worker and peer support specialist. Todd was released from jail in April 2024 after serving multiple drug-related sentences. She walked three miles to The Hub upon her release. "I could not have done it without this place," Todd said. "It's my saving grace." Todd is currently working toward a bachelor's degree in social work at Eastern Kentucky University.

Amber McDaniel entered The Hub following more than a decade of addiction, during which she lost her home, children, and family support. "I didn't know where to turn, didn't know what to do," McDaniel said. "I mean, I was about to lose my mind." McDaniel is now a Hub staff member through AmeriCorps.