Catawba CMHC/Community Medicine Foundation Primary Care Initiative - The South Carolina Department of Mental Health (SCDMH) is proposing the following project, which will co-locate primary and specialty care medical services in three additional community mental health clinics of Catawba CMHC. The project will demonstrate measureable improvements in the physical health status of adults with serious mental illnesses and those with co-occurring substance use disorders who have or are at risk for co-morbid primary care conditions and chronic diseases. Catawba Community Mental Health Center (CCMHC) serves a three county area in northern South Carolina (SC), which includes York, Chester and Lancaster Counties. CCMHC currently serves a total of 2,437 patients (1,734 adults), and in FY 2014 served a total of 5,082 adult consumers (duplicated count). The targeted population for this project would be active adult clients (consumers) of Catawba CMHC. The objective of the proposed project is to improve the health status of adults with SMI and those with co-occurring substance use disorders, to enhance the consumer experience of care through improved access and quality, and to reduce the cost of care. The primary goals of the project are to initiate a screening program, to develop a wellness program, to provide primary care to 175 consumers in the first year and 720 clients in year 4, to reduce ER use by 10% in year 1 and by 25% in year 4; and to provide enhanced case management to these consumers. These goals will be accomplished through a partnership with Community Medicine Foundation (CMF). CMF is a private, non-profit, Federally Qualified Health Center (FQHC) founded in 1992. Both CCMHC and CMF are members of Upper Midlands Rural Health Network (UMRHN), a mature vertical network that was organized in 2004. Partners of UMRHN have long-term success working together to improve the health outcomes of the communities they serve.