This NOFO invites applications to establish and support State-based Healthcare Extension Cooperatives (referred to as Cooperatives) to conduct an initiative that is based on PCOR evidence to improve care for medically underserved people; the initiative's focus must be on behavioral healthcare. To support this initiative, the Cooperative will (1) engage key stakeholders including Medicaid agencies, managed care organizations, and other organizations that address the health needs of people who are medically underserved in identifying and addressing barriers and facilitators to implementing patient-centered healthcare delivery improvements that are based on PCOR evidence, (2) work with healthcare policy, payment, community, care delivery, and research organizations that serve people who are medically underserved to build their capacity to implement patient-centered healthcare delivery improvements based on PCOR evidence, and to support ongoing learning, (3) conduct evaluations of the Cooperative's activities and (4) provide the support structure to ensure these activities are integrated and aligned.