Maine Behavioral Healthcare (MBH) is proposing to plan, develop, and implement a Certified Community Behavioral Health Clinic (CCBHC) for the Maine cities of Biddeford and Sanford, located in York County. MBH will provide services to individuals with serious mental illness (SMI) and substance use disorders (SUD), including opioid use disorders (OUD); children and adolescents with serious emotional disturbances (SED) individuals with co-occurring mental and substance disorders (COD); and individuals experiencing a mental health (MH) or substance use-related crisis. Services will be provided regardless of ability to pay. Identified Service Gaps in the catchment area and for the population of focus include lack of mental health and SUD providers/treatment sites, severe lack of psychiatrists, lack of coordination of services, and lack of staffing to address the need. Health disparities abound where 55% of residents reside in a rural and underserved area. Nearly 1 in 8 adults and 1 in 5 children are unable to get enough healthy food on a day-to-day basis. Nearly 1 in 2 has no health coverage. The rental housing market is among the least affordable in the nation. The catchment area is plagued by significant racial disparities when it comes to economic security. In 2017, while approximately 15% of white children lived in poverty, the rate was over 53% for children from Black/African American families. 26% of the homeless population is Black or African American even though they make up only 1% of the population in the catchment area. MBH will serve 625 individuals over the course of the four years of the grant. Goals are to 1) Increase access and availability to behavioral health services, 2) Improve integration of SUD, MH, and COD programming, and 3) Continually work to measure and improve the quality of services. These goals will be achieved by existing and additional key staff including a medical director, care coordinators, peer support specialists, psychiatrist, clinicians, case managers, and a training manager. All staff will be cross-trained in MH and SUD evidence-based practices including the use of the stepped care model to improve patient flow by enhancing care coordination; strengthening team-based care including partnerships with primary care, inpatient psychiatry settings, and substance use treatment programs; as well as maximizing reimbursement and value-based plans along the continuum of care. In conjunction with this, the Comprehensive, Continuous, Integrated System of Care (CCISC) model for organizational change focused on individuals with co-occurring psychiatric and substance disorders (COD) will be implemented. Workflows, protocols, procedures, data-collection, and quality improvement measures will all be improved to ensure compliance with the CCBHC criteria by the end of the first year.