Many children in Pennsylvania cannot access mental health services until they are in crisis. Children First will test a new statewide advocacy model that unites child advocates, mental health practitioners, and parents/youth to drive systemic reforms in Pennsylvania’s Medicaid program. The aim of this project is to look at the mental health crisis from a different perspective—by identifying a clearly defined target for change and pairing it with a thorough and creative systems-level approach rather than an organization- or program-level approach, the project hopes to shift the Medicaid mental health system from a crisis model to one that guarantees comprehensive preventive services for low-income children. If successful, this model expects a set of permanent Medicaid administrative rule changes to take hold that will unleash access to the full continuum of mental health services for the region’s lowest income children.