Interdisciplinary controlled substance review committees (CSRC) are increasingly utilized to support providers in navigating challenging cases involving controlled substances and improving patient outcomes. This quality improvement (QI) project was the continuation of a previous project that developed an interdisciplinary CSRC at a federally qualified health center (FQHC) in the Pacific Northwest. It sought to facilitate the referral and case review process to the CSRC via a pilot. However, at the initiation of this project, it became clear that the necessary elements to pilot the CSRC referral and case review process were not in place as anticipated. The focus of the interventions shifted from piloting to re-establishing CSRC membership, establishing an interim referral process, and a monthly meeting for the committee. This project successfully created the foundational infrastructure needed to make a pilot of the CSRC referral and case review process feasible in the future.