This summary provides an overview of the work of eleven states that have previously received In-Depth Technical Assistance (IDTA) since 2014 or are currently receiving IDTA. The Program Summary highlights state teams’ efforts to identify barriers and challenges in engaging families affected by prenatal substance exposure, and develop state strategies to improve outcomes for pregnant and postpartum women with opioid use disorders, their infants with prenatal substance exposure, and their families. Through the states’ work, key cross-cutting lessons of successful collaboration to improve policy and practice were identified.