The purpose of the Primary and Behavioral Health Care Integration (PBHCI) project is to provide coordinated and integrated services through the co-location of primary and specialty care medical services in a community-based behavioral health setting. Integrated services to be provided through the PBHCI project include: comprehensive care management, care coordination, health promotion and wellness programming, comprehensive transitional care, individual and family support services, referral to community and social support services and ongoing assessment. The targeted population includes total of 1,461 unduplicated severe and persistent mental illness (SPMI) clients over the four-year grant period: 292 will be enrolled in the first year, 731 will be enrolled in second year, 1,169 will be enrolled in the third year, and 1,461 will be enrolled in the fourth year. The demographics of this population are expected to be: 40% African American, 56% White, and 4% Other. Women will make up 66% while 34% will be males. The goal is to improve the physical health status of adults with SPMI and those with co-occurring substance use disorders who have or are at risk for co-morbid primary care conditions and chronic diseases. The objectives are to (1) Improve the physical health of individuals with SPMI by meeting annual PBHCI SAMHSA grant outcome measures for controlling high blood pressure, adult BMI assessment, comprehensive diabetes care, and high cholesterol and triglycerides; (2) Enhance the consumer experience of care (including quality, access, and reliability) by moving from Level 3 to Level 6 Integrated Healthcare; and (3) Reduce/control per capita cost of care by meeting annual Healthcare Effectiveness Data and Information Set (HEDIS) ER/Re-admission measures.