The Jewish Board of Family and Children's Services (the JB) is one of the largest BH service providers in New York City (NYC), with expertise in trauma informed, culturally appropriate care. The population of focus is people of all ages with SMI/SED/SUD/COD and other BH challenges. The JB will implement a CCBHC to serve Taskforce on Racial Inclusion and Equity (TRIE)-defined high BH inequity areas in Manhattan. The service area (SA) is: Morningside & Hamilton Heights (TRIE 2), Central (TRIE 3) and East (TRIE 4) Harlem, and Washington Heights/Inwood (TRIE 5). The SA has 588,776 residents, 34-59% of whom speak a language other than English at home, generally Spanish; 27 - 68% are Latinx, 7 - 44% are Black and 11 - 36% are white, and 3-10% are Asian, with 21% under 18. 7.9% of adult NY state residents and 12% of Latinx and 9% of non-Latinx NYC high schoolers are LGBTQ+. The SA has higher than NYC average rates of poverty, substance use, drug related deaths, psychiatric hospitalizations, premature mortality, avoidable hospitalizations, new HIV diagnoses, uninsurance, going without needed care and other indicators of chronic lack of access to consistent, linguistically and culturally appropriate, affirming BH, primary, reproductive and other health care. NYC was an epicenter of Covid-19, with mortality doubled for Black and Latinx New Yorkers, increasing BH need while reducing the BH workforce. Black, Latinx and LGBTQ+ New Yorkers have higher rates of unmet BH need, with significant health and BH inequity and access gaps in the SA. The JB has expertise in BH equity, LGBTQ+ affirming care, serving diverse, underserved populations and linguistically and culturally appropriate care, with representative, bilingual staff who can provide all services in Spanish, reducing access barriers. The proposed CCBHC will integrate services currently provided at two main SA sites into a single service hub. We will serve a total of 1035 unduplicated individuals (225 YR1, 248 YR2, 270 YR3 & 293 YR4). Goal 1 is to increase access to/availability of a continuum of integrated BH services in order to reduce BH crisis, psychiatric hospitalization, suicide attempts and overdose deaths. Objectives and activities: 1.1 Improve timely access to BH care via staff hiring; expanding the Facilitated Intake Team (FIT, completes intake activities, initial care planning); Bridges to Care Team (B2C, provides crisis response, follow up and bridge clinical services while arranging for outpatient care), with OP wait times reduced to 10 business days by month 12. 1.2 Reduce inpatient admissions & crisis incidence; by month 12, 75% of crisis clients who are admitted inpatient will have an OP appointment scheduled, and 90% of all clients will have a crisis prevention plan documented. 1.3 Increase outpatient service offerings and availability to adults via staff hiring. 1.4 Training in SUD/COD/harm reduction, MAT, IDDT for 100% of relevant staff by month 12, with the SUD team to be expanded in year 2. 1.5 Increase timely identification of SUD/COD and facilitate access to services via enhanced SUD screening & diagnosis; By month 12, 100% of clients age 12+ will be screened, with 80% of positive screens to receive diagnosis & 75% to receive follow up. 1.6 Improve suicide screening, with 95% of clients screened by month 9, and 90% of positive screens receiving risk assessment & care navigation. By month 12, 95% of clients will be re-screened at treatment review, and 100% of relevant staff will be trained in evidence-based suicide prevention (CAMS). Goal 2 is to reduce historic BH and health disparities in the SA via increased health screening, monitoring, follow up and care coordination. Objectives and activities are: 2.1 Improve capacity for health screening by hiring a nurse & a Patient Navigator by month 6. 2.2 Improve health screening rates; by month 9, 70% of clients will be screened, 95% screened by M12 and 85% of positive screens have f/u included in treatment plans.