Incorporated in 1986, Mainline Health Systems, Inc. (MHSI) provides primary care medical homes to residents of eight counties in the rural southeast Arkansas Delta (Ashley, Bradley, Chicot, Cleveland, Desha, Drew, Grant, and Lincoln), covering 4,742 square miles. MHSI operates 33 health center sites, which includes 19 school-based health centers, providing access to high quality, affordable primary medical, obstetric, and dental services with integrated behavioral health, nutrition counseling, and health education programs within a patient-centered medical home model of care. In 2023, MHSI served 30,618 unduplicated patients (29,463 medical; 1,629 dental; 1,629 mental health; and 10,353 who received enabling services to support their care). MHSI patients are poor - only 2% are known to have household incomes greater than 200% of the Federal Poverty Level. Funding from this grant will allow MHSI to expand mental health services and add substance use disorder services including medications for opioid use disorder (MOUD). By the end of 2025, MHSI will serve 2000 mental health patients, 500 substance use disorder patients, and 100 patients will receive MOUD. A total 500 new unduplicated patients will be served in the Behavioral Health Program with BHSE funding.