The State University of New York Downstate Medical Center (SUNY-DMC) proposes to conduct the STAR Health Center Integrated Care Project. The project will be implemented by the Special Treatment and Research (STAR) Program, whose STAR Health Center (SHC) is a well-established provider of outpatient HIV and hepatitis C (HCV) primary care, mental health (MH), substance use disorder (SUD) treatment and related services in Central Brooklyn, NY. This area is underserved with respect to primary and MH care and HIV rates are disproportionately high. The populations of focus, Black and Latino adults (18+) with a SMI or COD living with or at risk for HIV and/or hepatitis, have complex health care and treatment needs. Located in East Flatbush in Central Brooklyn, SUNY-DMC serves a densely urban service area populated by low-income, predominantly (over 75%) Black (including African-American, Afro-Caribbean and African immigrant) and Latino (20%) populations. Barriers to care include poverty, homelessness, unemployment, and lack of education and/or health insurance. Brooklyn leads NYC in new HIV diagnoses (25.2%) and HIV diagnoses concurrent with AIDS diagnoses (26.8%). Nearly 14% of Brooklyn's cumulative AIDS cases among women are directly attributable to injection drug use (IDU) (12% among males); many more heterosexual and MSM cases are indirectly attributable to substance use. Interventions include 1) providing inreach and outreach to inform individuals of available HIV and hepatitis prevention and MH services; 2) providing evidence-based mental and SUD treatment and practices that are trauma-informed and recovery-oriented (e.g., Motivational Interviewing (MI); Seeking Safety (SS); Need-Adaptive Treatment Model/Open Dialogue (NATM/OD); 3) rapid HIV and HCV screening and HAV/HBV vaccinations; 4) PEP/PrEP; 5) comprehensive, interdisciplinary on-site HIV, hepatitis and MH care; 6) peer support services; and 7) case management. Goals: 1) identify adults with a SMI or COD living with or at risk for HIV and/or hepatitis; 2) implement evidence-based interventions (e.g., MI, SS, NATM/OD); 3) provide HIV and hepatitis screening and hepatitis vaccinations; 4) engage and retain those testing positive for HIV and/or hepatitis and/or SUD/COD to primary care and MH services at the SHC. Objectives include providing: inreach and outreach to identify eligible cleints; providing HIV and hepatitis prevention services and linkage to care, peer support and case management to coordinate all aspects of care, including MH, primary care health, and HIV and hepatitis treatment, and other supportive services (e.g., housing, benefits, employment) for 100% of newly-identified positives; implementing MI/NATM/OD for 100% of eligible clients. Numbers to be served: 80 persons in Year 1; 120 each in Years 2 and 3; and 80 in Year 4 (total of 400 over 4 years).