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By 2030, 20% of people in Oregon will be over 65 years or older, and currently one in five people nationwide have a mental health or substance abuse problem (Oregon Older Adult Behavioral Health Initiative [OABHI], 2021). These projections and current conditions create significant health care implications for older people in Oregon. The Behavioral Health Initiative (BHI) is program that was initiated in 2014 as a result of legislature that required the Oregon Health Authority (OHA) to increase services for older adults with behavioral health needs and people with disabilities. The funding for the program supports a project director and 24 behavioral health specialists. The goals of the program are to improve access to services, improve knowledge and skills of providers and people who work with patients, and improve the population’s knowledge about monitoring signs and symptoms (OABHI, 2021). This created a challenge for the OHA because they had specific goals to meet and positions to fill within state budgetary constraints.