This project will provide evidence-based expansion and implementation of screening, brief intervention, and referral to treatment (SBIRT) services for alcohol and other drugs in large safety-net hospitals throughout Texas. The project team will provide an integrated, public health approach for the delivery of early intervention to individuals with risky substance use, and the timely referral to substance use treatment for those who are identified as having a substance use disorder while in the hospital setting. The project will collaborate with these hospitals to establish policies and procedures to implement universal screening; brief intervention; and timely referral to services. Current hospitals include: Dell Seton Medical Center at The University of Texas (Austin, TX); Dell Children’s Medical Center (Austin, TX); and Ben Taub Hospital (Houston, TX).