Spurwink Services, a nationally accredited behavioral health non-profit in Portland, Maine proposes to expand access to and improve the quality of patient-centered and fully integrated continuum of community-based mental health, primary care, and substance use disorder treatment services through a Community Behavioral Health Clinic serving Cumberland County, Maine. The population of focus includes consumers with serious mental illness, substance use disorders, co-occurring mental and substance use disorders, and children with serious emotional disturbance and Intellectual and Developmental Disabilities. The CCBHC will address the behavioral health disparities experienced by low-income individuals who are MaineCare eligible or under/uninsured, veterans who lack access to care due to discharge status, homeless individuals, and asylum seekers. Cumberland County, Maine is home to 303,069, with 9% individuals and 9.2% children living in poverty, 7.8% no health insurance, 7.2% veterans, 11.4% living with a disability, 6% foreign born, 7.1% speaking a language other than English at home, and 5.3% unemployed. Portland, Maine is the only New England city designated Tier 1 by FEMA for asylum seekers, with 1,600 people seeking services. These populations experience lower life expectancy, higher incidence of disease, higher rates of mental health, and lack of access to care and culturally competent care. Spurwink's CCBHC is designed to address key community needs: mental health, social determinants of health, access to care, and substance/alcohol use. Spurwink will serve 850 unduplicated CCBHC clients throughout the lifetime of the project with 150 served in Year 1, 200 in Year 2, 250 in Year 3, and an additional 250 in Year 4. Although there are four other service providers in the catchment area, there is insufficient capacity to meet demand. Without coordinated, person-centered care through the Spurwink CCBHC, the population of focus is at risk of poor outcomes including higher rates of hospitalization, substance use, suicide, incarceration, homelessness, and mortality. Spurwink's CCBHC goals include: 1) Expand access to integrated evidence-based behavioral health care in Cumberland County, 2) Improve behavioral health/physical health integration across programs, and 3) Increase meaningful participation of adult consumers with mental illness, adults recovering from substance use disorders, and family members in agency governance. Service improvements include building a fully integrated care model with enhanced data tracking and utilization and increased meaningful participation of consumers, strengthening mental health services for the population of focus, reducing long waits for services through same-day access to reduce long waitlists, implementing interim care coordination to address service gaps, and providing peer-led outreach and mutual aid groups to ensure increase access to services for under-resourced populations. Spurwink EHR updates will improve tracking and reporting of client data and population health health and clinical decision support. The CCBHC will provide: crisis mental health services; screening assessment and diagnosis, including risk assessment; patient-centered treatment planning including risk assessment and crisis planning; comprehensive outpatient mental health and substance services; outpatient primary care screening and monitoring; targeted care management; psychatric rehabilitation services; peer support, counselor services, and family supports; sommunity-based mental health for veterans; and a Client Advisory Board. Evidence-based practice models include Person-Centered Recovery Planning, Children and Residential Experiences, Cognitive Behavioral Therapy (CBT) and CBT for Psychosis, Motivational Interviewing, Assertive Community Treatment, Medication Assisted Treatment, Trauma Focused-CBT, Trauma Systems Therapy for Refugees, and Attachment, Regulation, and Competency.