There has been a proliferation of offender reentry programs since the passage of the Second Chance Act in 2008, including an unprecedented expansion of treatment services into underserved rural areas. Review of Second Chance Act programming and observation of unmet mental health and substance abuse needs in justice settings contextualizes description of the Middle Tennessee Rural Reentry Program, a U.S. Bureau of Justice Assistance funded intervention. The program targeted 209 adult female and male higher risk offenders that were dually diagnosed with mental health and substance abuse disorders for evidence based cognitive behavioral change oriented therapeutic treatment. While offender outcome indicators (recidivism and relapse) suggested program impact, barriers to implementing, delivering, and evaluating reentry programming in rural areas were also identified and orient discussion around evidence based demonstration and replication.