Our integrated 'health home' project will enhance and build on primary care services currently provided within the 55,000 square foot Community Mental Health Services of Muskegon County (MCMH) facility located in culturally diverse, downtown Muskegon, Michigan. Services will expand to include comprehensive nurse care management, peer and family support, health and nutrition education, wellness programs, and referrals and follow-up for adults living with severe mental illness (SMI) including those with co-occurring substance use disorders (COD) and those who are uninsured/under-insured who receive services at MCMH. We will serve at least 200 persons within these populations in year one; at least 375 persons in year two; at least 475 persons in year three; and at least 600 persons in year four, and plan to continue the project well beyond the life of the grant. We will train nurses in comprehensive care coordination and certify trainers in Motivational Interviewing, Trauma Informed Care, and Recovery and Wellness; recruit medical staff and add dental services and children's healthcare; expand days and hours of operation; utilize electronic prescriptions, laboratory results and health records; add peer and family supports and wellness/cessation programs; and implement continuous quality improvement. Collaborations and care continuums will ensure health needs of are met. We will expand and enhance the current CMH located primary care clinic collaborative. We will recruit and hire or reassign and train 20 FTE staff and integrate them into our integrated clinic. We will provide an array of culturally competent services, to 1,675 persons with severe mental illness or severe emotional disturbance using a team-based, integrated approach to improve overall health and well-being, enhance access to care, prevent unnecessary emergency room utilization and provide early identification of problems by January 2013.