Youth with intellectual and developmental disabilities (I/DD) who also experience mental health conditions often face significant barriers to receiving effective, coordinated care. In Oregon, services are delivered across multiple systems, including the Oregon Department of Human Services and the Oregon Health Authority, each with distinct funding structures, regulations, and priorities. These system-level complexities can make it difficult for providers, families, and youth to access the right supports at the right time. This session will explore the challenges of serving youth with co-occurring I/DD and mental health needs within Oregon’s service system and highlight lessons learned from Albertina Kerr’s Dual Diagnosis Initiative, an innovative approach that brings together behavioral health, residential, and developmental disability supports. Participants will gain practical insights into how cross-system collaboration and integrated service models can improve outcomes, increase stability, and better meet the needs of youth with complex support needs.