The purpose of the Health Home Hope (H3) Project is to end the cycle of homelessness for households currently experiencing long term unsheltered homelessness in Tucson and Pima County through the expansion, integration, and coordination of local community behavioral health (BH), physical health and housing support systems. We will provide BH and other recovery-oriented services to those experiencing long-term unsheltered homelessness through (1) intensive street outreach, (2) navigation designed to rapidly connect individuals with substance use disorder and or co-occurring disorders to mainstream treatment and recovery services including Medication Assisted Treatment (MAT), and (3) coordinate housing and services that support sustained recovery and wellness within permanent housing. The population of focus is unsheltered homeless households in Pima County experiencing substance use disorders and chronic health conditions, including single adults, youth and families. Pima County accounted for 15 percent of Arizona’s population and 23 percent of the state’s homeless population in 2017. The proposed (H3) Project includes a part-time medical outreach team (Family Nurse Practitioner, Medical Assistant, and Care Coordinator) to deliver non-emergency medical treatment during outreach visits at Old Pueblo Community Services (OPCS); and a dedicated behavioral health (BH) team (Psychiatrist, BH Professional (Therapist), and BH Case Manager) for all individuals referred by the OPCS navigator and peer guides for SA or COD screening, treatment, and follow up BH and SA care. All participants will be screened using the Vulnerability Index – Service Prioritization Decision Assessment Tool (VI-SPDAT) tool, screened for depression using the PHQ 2/9 tools, Screening, Brief Intervention, and Referral to Treatment (SBIRT) screening tool, and will be provided linkages to housing, health insurance, and a myriad of other services identified through social determinants of health (SDOH) screenings. Our goal is to move 150 of the most vulnerable unsheltered homeless individuals into permanent supportive housing, while increasing their wellness, to include their ability to manage their addictions, mental health symptoms, and acute and chronic physical conditions. This team will initiate approximately 200 contacts with unsheltered homeless individuals each year (1,000 total), offering non-emergency medical assistance, screening for the presence of addiction and mental health concerns, SA/COD treatment and medication monitoring/ MAT, and immediate enrollment into mainstream benefits, such as Medicaid, TANF, and SNAP. Additionally, we will provide intensive navigation assistance to a minimum of 60 individuals per year, 300 during the project. A minimum of 75 patients per year will be seen for medical and MH services for a total of 375 over 5 years. As a result, at follow-up, we expect 45% of participants to experience a reduction in days using drugs or alcohol, 50% a reduction in criminal activity, 75% increase in social connectedness, 50% reduction in emergency room usage, and a 50% increase in income from all sources.