Indian Health Center of Santa Clara Valley: Behavioral Health Integration Initiative - Indian Health Center of Santa Clara Valley’s (IHC) integrated behavioral health program will continue long-term work focused on strengthening integration of behavioral health care services into the primary care environment. By focusing on quality of services in a single clinic, IHC intends to scale the work to the rest of the agency to create improvements the health and wellbeing of the American Indian and Alaska Native (AIAN) as well as others served by the clinic. The goals for this project reflect the priority areas for all integration work: a specified care delivery team, workforce development, maximizing use of health information technology, a specified setting and target population/conditions, clinical processes, review of costs, billing structure and sustainability of approaches, and review of management policies and protocols to support changes. The IHC BH2I population of focus are patients engaging in care at the Silver Creek Clinic, one of four medical clinics. Within this site the emphasis will be on process, clinical, and satisfaction outcomes for AIAN patients, as well as those engaging psychiatric care, prescribed psychiatric medication or controlled substances, or with a positive screen for follow-up care on a depression/suicide screener or alcohol use screener. The goals are: 1) To strengthen communication and training of the care delivery team with the goal of improving quality and consistency of integrated care, early identification, and referral; 2) To strengthen clinical processes, digital access, and behavioral health-focused quality improvement processes within the integrated primary care environment; and 3) To advance fiscal, policy, and sustainability mechanisms around integrated care. Project outcomes will focus on both process and outcomes and will include measures related to: Leadership Team; Training Attendance and Participation; Warm Hand-Offs; Panel Management; Clinical Outcomes and Patient Satisfaction. Tools will include process assessment from the Center for Integrated Health Solutions website as well as clinic data (screens, referrals, panels, outcomes), patient satisfaction, training logs.