The Substance Abuse and Mental Health Services Administration (SAMHSA), as appropriated by the Garrett Lee Smith Memorial Act, awarded a grant to the Pennsylvania Department of Welfare to help pilot this program from 2008 to 2014. The projects had four aims (see Figure 1). First, to build community input and buy in, we developed state and county level stakeholder’s task forces to ensure that the program fit within the ecology of the targeted communities. Second, to increase the Primary Care Provider’s (PCP) patient’s access to mental health services, we enhancing the coordination of care between these two providers services. Third, to help providers feel more comfortable and knowledgeable about suicide, we developed feasible training programs for PCP’s on suicide risk assessment. Finally, to increase the utilization of a screening tool, we implemented an empirically validated, web based tool that could be completed and automatically scored at the time of the visit, integrated into medical records and sent to the referring mental health provider. The project continues to support screening in medical settings but has turned its focus to school and mental health agencies.