Native American Health Center, Inc. (NAHC) proposes to implement the Indian Health Service 4-in-1 Grant Program through its clinics in the San Francisco Bay Area. NAHC’s service area is defined as Alameda, Contra Costa, Marin, San Francisco, and San Mateo Counties; where 74,064 residents identify as AIAN alone or in combination with another race. The proposed project will serve an estimated total 300 American Indian members per year and holistically improve the overall health outcomes of Bay Area American Indian community members. Project goals by program area are as follows: Mental Health- Improve the mental health of the urban AIAN population served by providing culturally responsive behavioral health screenings, referral, and appropriate treatment. Objectives will serve 100 members annually. Alcohol/ Substance Abuse- NAHC will increase the access and availability of alcohol and substance abuse prevention, early intervention, and outpatient treatment; increase the access and availability of cultural and community based comprehensive prevention and treatment effort; and improve health coordination, knowledge, and equity for AIAN youth and adults. Objectives will serve between 40-50 members annually. Immunization- To increase the overall average of pediatric, adult and elders who are up to date with immunizations. Objectives will increase participation rates annually. HPDP- 1. To promote health and prevent disease in AIAN patients and community members through community education; 2. To promote health and prevent disease in AIAN patients through one-on-one nutrition assessment and counseling; and 3. to promote health and prevent disease in AIAN staff through employee wellness and education activities. Objectives will serve 20 members and 15 NAHC staff annually.