Milwaukee County Behavioral Health Services, Wraparound Milwaukee submits this application for $3,999,186 to address the disparity of services within the system of care (SOC) for children and young adults at risk for or with SED. The focus population are youth, 12-19 years of age, with multiple diagnosis including SED, autism, and developmental, physical, or emotional disabilities and who are co-enrolled in Wisconsin's Children's Long-Term Support (CLTS) and Comprehensive Community Services (CCS) Programs. Services will be delivered in the geographic catchment area of Milwaukee County with a population of 952,085. The project proposes to serve 50 unduplicated individuals throughout the lifetime of the project. Strategies and interventions include: conducting a needs assessment identifying racial and ethnic health disparities, specialized cultural and linguistic needs, current conditions, and desired services or outcomes for CLTS/CCS youth with complex diagnosis; modifying the evidence-informed Coordinated Specialty Care (CSC) model to provide low-barrier access to specialized clinical providers for teams CLTS/CCS youth with complex diagnosis; adapting the CSC fidelity tool to reflect the needs of CLTS/CCS youth with complex diagnosis; providing child-serving system cross-training for CCS and CLTS provider networks focusing on the integrated needs of CLTS/CCS youth with complex diagnosis; implementing an evidence-based screening tool to identify problematic substance use; providing workforce training for CCS, CLTS, and Wraparound Milwaukee HMO Provider Networks in the evidence-informed practices to better engage youth and families, and resolve complex and COD, interrelated problems; and conducting self-assessments of the strengths and needs of the SOC principles and infrastructure for CLTS/CCS youth with complex diagnosis. Project goals are to: expand the use of evidence-based practices (EBP) programs, and services; improve the SOC child-serving partnerships; focus additional attention on co-occurring mental and substance misuse, substance use disorders (COD); and promote SOC expansion and sustainability. Measurable objectives are to: conduct a needs assessment to address service delivery gaps for 101 young adults, ages 12-19, with SED and significant developmental, physical, or emotional disabilities; provide evidence-informed and culturally appropriate mental health services for teams of 14 CLTS/CCS youth with complex diagnosis; advance cross-sector system relationships to provide collaborative services for the target population; develop a well trained workforce to better engage youth and families, and resolve complex, interrelated problems; improve the identification of, and services for, youth with COD; and assess the strengths/needs of SOC principles and infrastructure for CLTS/CCS youth with complex diagnosis. Anticipated outcomes include: integration of needs assessment results into the project's overall plan and approaches; development and implementation of an integrated care coordination module for CCS/CLTS youth; CSC model fidelity; identification of youth at risk or with a SUD and referrals to services; and a well-trained workforce in mental health and related practices.