The New York SBIRT Community Outreach Project will implement and evaluate an innovative, culturally responsive model to deliver SBIRT services to underserved adolescent and adult populations historically unlikely to access treatment services (sexual minority [LGBT+]; economically disadvantaged; Latinx immigrant; Native American; and rural) in 4 areas of the State: New York City (NYC); Five Towns, Long Island; Finger Lakes; and St. Regis Mohawk Reservation. SBIRT will be delivered within community-based settings by trained outreach workers from the targeted population. The recommended screening tools to identify substance use (CRAFFT+N 2.1 for adolescents; AUDIT and DAST-10 for adults) and suicide (C-SSRS for adolescents and adults) risk. If screened positive for substance use risk, the individual will receive Brief Intervention (BI) with a Brief Negotiated Interview (BNI) using Motivational Interviewing (MI) techniques. If screened positive for suicide risk, the Safety Planning Intervention (SPI) with follow-up will be used. If brief treatment (i.e., Cognitive Behavioral Therapy) or specialty treatment (i.e., Medication Assisted Treatment [MAT] is warranted, the Active Referral to Treatment (ART) model will be followed to ensure hot handoffs to Substance Use Disorder (SUD), MAT, and/or mental health MH providers. Pre-established and continued collaborations will assist in care transitions. Project goals are to: (1) Develop, refine, and pilot and innovative SBIRT community outreach model to reduces access barriers and increase service use among high-risk populations hesitant to seek services. OASAS will use focus groups and key informant interview data to design a culturally appropriate model, train sites to deliver it, pilot it, and then refine it based on feedback. (2) Deliver the refined model in at least 12 separate community settings documenting cultural modifications to increase service access, decrease health disparities, substance use, risk behaviors, and suicide risk in NYC, Five Towns, the Finger Lakes, and St. Regis Mohawk Reservation. 5,000 screenings, 1,000 BIs, and 350 RTs will be delivered per year. (3) Disseminate our model to other high-risk communities and sustain it. In Years 3-5, at least 3 more providers will implement the SBIRT model and become certified Children and Family Treatment Service Providers. In Years 2-5, new providers will be trained, training materials will be updated and state training capacity increased. In Years 4-5, Training of the Trainer (TOT) will build capacity to sustain our SBIRT model following the grant. (4) Evaluate processes and outcomes of the SBIRT outreach model and impact on service utilization, substance use, and suicide risk. Project sites will collect data by Month 4 and track the number of screens, BIs, RTs, and suicide specific screenings and interventions. Between baseline and 6-month follow-up, OASAS will assess changes in substance use resulting from BI, and starting in Year 2, OASAS will assess increased identification of substance misuse risk and connection to SUD treatment among the target populations as compared to a similar group of individuals receiving only screening and referral.