In 2024, the New Jersey Division of Mental Health and Addiction Services (DMHAS) and Vital Strategies engaged TAC to develop a model of care and pilot program for older adults in Essex County with unmet treatment needs who use substances and have co-occurring medical or mental health conditions. TAC conducted an extensive engagement process with community health, mental health, and addiction treatment providers; outreach and engagement teams; day drop-in and shelter providers; law enforcement; and people with direct relevant experience. The project culminated in a pilot program design that included financing recommendations, an evaluation framework, and an implementation plan.