The New York City Department of Health and Mental Hygiene ("the Health Department") requests funding through the System of Care Expansion and Sustainability Grant from the Substance Abuse and Mental Health Services Administration to deliver a project titled "Centering Children and Families in NYC's System of Care". This project will 1) serve the estimated 55,600-118,600 NYC youth ages 10-21 with severe emotional disturbance (SED) and their parents/caregivers who currently utilize or are eligible to utilize the SOC through engagement with Community-Based Participatory Action Research (CBPAR) and 2) will also provide HFW services to a total of at least 48 unique youth aged 12-21 with SED, multiple system involvement (i.e. foster care, mental health services) who have been referred to or recently discharge from a Residential Treatment Facility (RTF) and their families in Queens over the four year grant period. By engaging in CBPAR and expanding HFW services to Queens, the Health Department intends to: 1) assess the impact of NYS reforms on NYC youth with SED and their families to make structural, policy, or programmatic changes to the local SOC and 2) address gaps in intensive care coordination for youth in Queens to improve health outcomes and demonstrate the cost-effectiveness of the HFW model so it can be scaled and sustained over time. Through the implementation of CBPAR, we intend to build understanding for how recent statewide reforms have impacted access to mental health care and partner with community members to create, act upon, and implement relevant and culturally-sensitive solutions. The expansion of HFW services from two current sites in Brooklyn and the Bronx to a third site in Queens will address the high rates of RTF admission within that borough and support early, intensive intervention to hopefully maintain more children in their homes and communities. At the conclusion of the activities outlined in this proposed project, the Health Department intends to provide CBPAR trainings to stakeholders, implement policy and structural changes to the SOC, and demonstrate the feasibility and cost effectiveness of incorporating HFW into the SOC so it can be scaled and sustained over time.