The Plateau Wellness Clinic is an innovative approach to improving the health and wellness of people in the Central Appalachian region of Tennessee. Health disparities play a significant role in this region, with poverty and lack of access as primary contributors to poor health outcomes. The population identified for this project and adults living on the Upper Cumberland Plateau of Tennessee and who have serious mental illness or co-occurring addiction. This group is a particularly vulnerable population in which social determinants of health play an impactful role. The primary intervention strategy involves developing a holistic, integrated health clinic embedded in behavioral health services. The target population is familiar with the behavioral health system and are more likely to participate in physical health treatment when affiliated with familiar settings. The incorporation of peer-driven and recovery-oriented care further establishes a setting in which stigma is minimized and individuals are active partners in their own health outcomes. We plan to enroll 1,275 individuals over the course of the four year program, and anticipate realizing multiple positive health outcomes. Planned annual unduplicated enrollment for year 1- 128, year 2 -190, year 3-192 and and year 4 - 765. This includes reductions in key health indicators such as glucose, weight, blood pressure and other individual health factors. Providing access to primary care, care coordination, preventive and chronic disease management provides an opportunity for enrollees to better manage, and change the course of chronic disease. From a population health perspective, the program provides increase in access in an underserved region, improvements in population health outcomes such as incidence and prevalence of disease, morbidity and mortality rates related to the complexities of chronic physical conditions and mental health disorders.