Harbor Homes, Inc. d/b/a Harbor Care will implement a state-wide evidence-based methamphetamine and stimulant use disorder treatment and recovery support services program (MERIT) for priority populations that misuse methamphetamines/ stimulants: (1) adults who are homeless or at risk of homelessness, and (2) adults who have high imminent risk of harm in accordance American Addiction Society of Medicine (ASAM), to include those who have recently overdosed, are intravenous drug users, pregnant/ parenting, and/or who have co-occurring disorders or tri-morbid medical/ behavioral health/ substance use disorders (Target Population). These individuals are the most likely to be polysubstance users and often require residential treatment with significant integrated medical care. The geographic service area includes all cities and towns within New Hampshire, with a focus on Hillsborough County (Target Region). Working with a wide range of statewide community partners including residential and outpatient substance use treatment and recovery housing providers, Federally Qualified Health Centers, and the statewide network of 19 Recovery Community Centers, Harbor Care’s proposed program, known as MERIT (Motivating and Empowering Recovery through Integrated Treatment), will provide integrated primary care, substance misuse treatment (residential and outpatient), mental health care/psychiatry, and oral health care, in conjunction with recovery housing, long-term and enhanced recovery support services, and specialty care services to 165 adults living with methamphetamine and/or other stimulant use (MSUDs) in NH over a 3-year period, including polysubstance users. Harbor Care will implement in-person and telehealth-based universal screening within 25+ service access points throughout NH used by the Target Population, to ensure those with the greatest need are recruited for the program.The project goal is to reduce NH’s most vulnerable community members’ MSUDs while facilitating self-sufficiency, through implementation of evidence-based programming and integrated primary/ behavioral health care throughout the public and private sector that addresses the Target Population’s whole health and wellness, social determinants of health and substance use/ co-occurring disorders. This goal will be met through four objectives over the three-year grant period: 1) Expand a comprehensive recovery-oriented system of care that is team-based and coordinated through all stages of recovery (pre-contemplation, acute treatment, relapse prevention) by integrating behavioral health (SUD treatment and mental health care), primary and oral health care, recovery support services and housing; transforming services across systems in accordance with the SAMHSA/HRSA-defined Level VI Integrated Care platform (Full Collaboration in a Transformed/ Merged Integrated Practice) between substance use disorder, mental health care, primary care, and oral health care providers. 2) Provide outreach to 425 homeless/at-risk individuals - including pregnant and parenting women, veterans, and individuals with co-occurring disorders - with MSUD (125 in Y1, 175 in Y2, 125 in Y3). 3) Provide integrated primary/ behavioral/ oral health care and SUD treatment, intensive case management, and individualized long-term recovery-oriented supports to 165 individuals (50 in Y1, 65 in Y2, 50 in Y3) who enroll in MERIT; 4) Train and/or educate 200 (50 in year one; 50 in year two; 100 in year three) of NH’s first responders, health and human service providers, and medical, behavioral, and peer recovery workforce to increase their capacity to apply best practices that can reduce the rise of MSUDs. Evaluation results will be shared with stakeholders through a conference in year 3 of the grant period. Grant-funded staff will utilize evidence-based practices through a trauma-informed, harm-reduction model to meet the needs of the population of focus.