By creating a Health Home we improve access, clinical quality, and the efficiency of health care delivery by: improving communication and coordination of care; reducing unnecessary tests and procedures; leveraging information technology and process improvement techniques to reduce operational and administrative redundancies; and fostering research and evaluation. Goals include: 1. Improve health status, increase life expectancy and quality of life for consumers 2. Improve management of chronic conditions 3. Achieve efficiency in utilization of health care resources resulting in cost savings 4. Enhance consumer's experience of care 5. Transform health care systems by coordinating community resources and influence flexibility in funding of care coordination. We are expanding our current integrated care program that began in 1994 with collocated primary care services in our clinic, but with limited interactions between physicians and behavioral health staff, to a second generation of increased collaboration, to this third generation that reflects integration of treatment plans, health promotion/education and introduces Care Support Specialists to promote enhanced coordination and integration of health care services. Care Support Specialists blend the roles of care coordinators and case managers. Of the projected 1,650 adults to be served, they reflect largely low-income, uninsured or Medicaid enrolled individuals who are Black/African American (85%), between the ages of 18 and 85 (75% between 18 and 64), and equally representative of females and males. We expect to reduce unnecessary health care services, resulting in an overall decrease in annual health care expenses by 25 percent of the Michigan average for persons with dual eligibility (Medicare and Medicaid).