Certified Community Behavioral Health Clinic (CCBHC) Service Expansion - PermiaCare proposes the project "Certified Community Behavioral Health Clinic (CCBHC) Service Expansion" under Funding Opportunity Announcement No. SM-21-013. This project focuses on increasing access to critically needed CCBHC services for Medicaid, low-income, and uninsured residents in an eight-county region across rural West Texas. 6 of the 8 counties lie within 100 kilometers of the U.S./Mexico border. The project's target population is adults and children dealing with needs related to mental health, substance use disorder, and/or serious emotional disturbance. PermiaCare proposes to deliver services to 2000 individuals in year one of the project and 2500 individuals in year two of the project: 4500 individuals over the project's life. The population in the proposed service area has numerous unmet needs, including access to mental health care, access to substance use disorder treatment, disproportionate outcomes among primary health related measures as compared to the state, and access difficulties for systems related to social determinants of health. The interventions proposed by PermiaCare to meet these needs include increasing the number of providers of substance use disorder treatment, psychiatric treatment, primary care screening, care coordination, peer services, and psychiatric hospitalization follow-up. Regarding the region's need for substance use disorder treatment, PermiaCare will use staff enhancement to deliver treatment to 80 individuals in the first project year and 120 individuals in the second project year. Regarding the region's need for mental health treatment, PermiaCare will use staff enhancement to provide care for 220 individuals in project year one and 260 individuals in project year two. Regarding the need related to poor performance on primary health metrics, PermiaCare will use staff enhancement to provide enhanced primary care screening and referral services to 2000 patients in the first project year and 2500 patients in the second project year. For the need related to access to systems for social determinants of health, PermiaCare will use staff enhancement to provide care coordination services to 450 individuals in the first project year and 500 individuals in the second project year. PermiaCare proposes the following measurable objectives, 5% improvement in the achievement of treatment plan objectives for individuals receiving substance use disorder treatment in the second project year above a baseline established in year one, improvement on scores for associated need domains for 15% of patients receiving peer/care coordination services above a baseline established in year one, and provision of continuity of care follow up within seven days for 50% of individuals discharged from state hospitals in both project years.