Liberty Resources, Inc. proposes transforming its clinics in Onondaga/Oswego Co. into a CCBHC. This will expand access to MH/SUD/PC/Crisis Services for children/adults, more than doubling our service volume, enabling LRI to serve an additional 600 children/adults annually, a total of 1,200 during the grant period; sustained beyond the grant with Medicaid billing. All populations will be served, with special attention to adults with SMI/SUD, including opioid use disorders (OUD), and co-occurring conditions; children with serious emotional disturbance (SED); adolescents and transitioning youth with SED/SUD/OUD or co-occurring disorders; adults/children/adolescents with co-morbid conditions. The impoverished, under-resourced region of Onondaga and Oswego Co. have a combined population of 579,707. Syracuse, NY ranks 18th highest in the nation for poverty at 31.8%, with rates higher among Asian, Black/African American, and Hispanic residents. Oswego Co. is among the top 10 NY counties with the highest levels of poverty (18.9%); city poverty at 28% (Oswego) and 24.8% (Fulton); including 36.3% living below 200% FPL. Onondaga Co. exceeds NYS excluding NYC in the rate of ED visits involving opioids (65 vs 50.2 per 100,000), the rate of hospitalizations involving opioids (17.8 vs 14.9), and opioid deaths (3.5 vs. 1.8). Onondaga’s suicide rate exceeds NYS (10 vs. 8 per 100,000). In the city of Syracuse, 15.4% of adults report experiencing poor MH for 14 or more days in the last month; higher than NYS excluding NYC (11.2%). Depression is the leading cause for ED visits in Oswego Co.; 8 of the top 10 conditions for ED visits are BH related. Oswego Co. has a suicide mortality of 17.3 per 100,000, twice that of NYS. Approximately 12% of children between the ages of 9-17 experience SED. Compared to NYS, Oswego Co. has a higher rate of binge drinking at 22.5% compared to 19.6%, and a higher rate of alcohol consumption at 23.90% compared to 15.70%. Over 26% of Oswego Co. receives Medicaid. This is above NYS at 20.84%; the national trend is 19.91%. Oswego Co. has a higher incidence of MH, higher ED use for MH than comparable NY counties. Adolescents/ transitioning youth are at greatest risk. Screening/assessment/treatment is insufficient for all populations. Oswego Co. has identified expansion of MH services as its number one priority. Wait times for MH treatment range from 12-20 weeks; medication management wait lists range from 5-12 weeks. LRI is well positioned to expand services with existing physical sites and existing MH/PC/SUD services including crisis intervention. It is important to note that LRI is the only designated regional crisis intervention provider for the 5 county region of CNY, including Onondaga and Oswego Co. If awarded these funds, LRI would enhance its existing crisis program from 7 hours/day to 24/7, and expand access to MH/SUD/OUD/PC, thus increasing capacity for care; decrease ED visits, hospital admissions, residential treatment; enhance screening/mobile crisis to assure earlier engagement to lower rates of suicide; increase access to PC for children/adults/adolescents/transitioning youth with SMI/SUD/OUD.