In 1986, a group of New York City psychiatrists began voluntarily offering services at dilapidated commercial SRO hotels and at parks and shelters where they knew they would find persons struggling with homelessness and treatable mental illnesses. Within a decade, their efforts, known as the Project for Psychiatric Outreach to the Homeless (PPOH), had attracted the support of funding agencies, and by 2005 PPOH was providing services at 32 programs in the city. In 2005, PPOH was acquired by the Center for Urban Community Services (CUCS), a comprehensive human services agency that serves over 25,000 people each year and is the nation’s largest provider of supportive housing social services. PPOH is now called Janian Medical Care, and it is the primary provider of psychiatric services for CUCS, employing 40 full- or part-time psychiatrists at more than 55 locations throughout the city. Beginning in 2012, Janian began offering badly needed primary care to CUCS clients. Janian plays a unique role in training psychiatrists to work in nontraditional settings, a subspecialty that to this day lacks formally endorsed standards or best practices. Despite all the changes since 1986, Janian Medical Care has remained true to its roots. In recognition of its innovative program that provides community-based care for persons at high risk of homelessness, CUCS Janian Medical Care was selected to receive APA’s 2013 Gold Achievement Award in the category of community-based programs. A detailed description of the program is available in an online supplement.