WACGC Crawford County will become a stand-alone CCBHC provider. We will serve 375 new clients in the target population - Children (4+) with, or at risk for, SED, and persons of all ages who have or are at risk for: 1) SMI, 2) SUD, and 3) COD as well as persons of all ages in crisis in the County, adults in the County MHTC, and justice involved adults pre- and post-release. Specific attention will be given to veteran, minorities, and those at risk for major health issues. Crawford County is a predominately rural area in the western most portion of Arkansas with a population of 60,378 and urbanization concentrated in Van Buren (pop. 23,600) (U.S. Census, 2022). Crawford County is a HRSA-designated Medically Underserved Area and Health Professional Shortage Area in the primary health and behavioral health domain. The catchment area is 83.5% Non-Hispanic White, 8.5% Hispanic, 1.5% Non-Hispanic Black / African American, 1.5% Asian, 2.5% Native American, and 3.5% Multiracial. The median household Income in the catchment area is $48,980 compared to $49,724 for the state and nearly $65,000 for the U.S. (Census, 2022). Across the county, about 14.5% of people are in poverty, 13% are experiencing severe housing problems, 20% of children are in poverty and 64% are eligible for free or reduced lunch (County Rankings, 2022). Further, 16% drink alcohol excessively, 17% are food insecure, 25% are in poor to fair health, 17% experience frequent physical duress, 19% experience frequent mental duress, and 13% of adults are uninsured (2022 County Rankings). The suicide rate in the county is 24 per 100,000 persons and the drug overdose rate is 17.5 per 100,000 persons. The number of opioid scripts dispensed per 100 persons in Crawford County for 2020 was 51.4. To meet the needs of the target population in Crawford County we have identified 4 goals. Goal 1: Raise the standard of care in Crawford County by meeting all CCBHC criteria, expanding the provisions and scope of services by 25%, hiring additional staff, addressing accessibility barriers, and providing EBP training for all clinicians and staff and integrated behavioral health service that promotes behavioral health equity, provides trauma informed care and is recovery oriented. Goal 2: Increase the scope and provision of targeted case management by implementing an Assertive Community Treatment (ACT) for Crawford County Mental Health Treatment Court (MHTC), collaborate with law enforcement, medical providers, and the MHTC to identify and serve 50 clients in need of ACT services, and training for recovery care, targeted case management, and SUD/COD treatment. Goal 3: Create a continuum of care for historically underserved populations through standardized procedures for identifying inmates in need of mental and behavioral health services, collaboratively creating targeted case management and re-entry plans with inmates identified as in need of re-entry services. Goal 4: Identify and improve underlying social determinants of health for the target population through standardized assessment (Y1-4), implementation of risk stratification procedures and CPWs to individually address SDOH and create care plans for clients at greatest risk. Finally, raise awareness among local and state community leaders, stakeholders, and organizations about the social challenges that clients are facing and what actions can be taken to improve in the community to create more supportive environments for health. We will join and participate in the CCBHC advisory group of CCBHCs in Arkansas and collaborate on efforts with DHS and the Arkansas legislature on billing reform and other needed changes, in addition to work that will be done internally to ensure that our CCBHC services remain sustainable past the end of the grant period.