Background: The Advancing a Healthier Wisconsin (AHW) endowment at the Medical College of Wisconsin aims to improve the health of state residents. The behavioral health strategic grant addresses pressing needs in communities around Wisconsin. Responsive grants support Wisconsin-based, multi-sector, community/academic partnerships pursuing systems changes that address key determinants of health. Research grants support innovative studies involving inter-disciplinary teams collaborating to test and sustain promising new ideas. Objective: From 2016-22, AHW is investing $7.4 million in 6 grant-funded projects to improve the early child developmental care and behavioral health systems in the city of Milwaukee and 4 Wisconsin counties totaling 74,000 children under 5 years, 26% living in poverty. Design: The table shows the project years, grant awards, project titles, key partners, and project aims. The community/academic partnerships include sustainable systems development and improvements by working with community coalitions, prenatal care coordination, home visitors, child care programs, primary care medical homes, Birth to 3, Head Starts, school districts, therapists, nonprofit agencies, churches, social service agencies, public health departments, commercial enterprises, economic development associations, 3 state departments, and national experts. The research projects include the sociologic analysis of structural factors, assets, and care delivery; epidemiology studies and biostatistical analyses using prospective surveys, sentinel events, and integrated records from health, education, and social service agencies; and the bioethics of health equity, big data, and stigmatizing policies. Results: Preliminary results include parent engagement in planning, development of data sharing agreements, > 500 child care teachers and clinicians trained in Ages & Stages Questionnaire (ASQ), creation of a future state process map, 90% ASQ screening rate at 20 pediatric sites, 27% increased referrals to Birth to 3, establishment of a city Office of Early Childhood Education, and leveraged Race to the Top grants. Conclusion: AHW has made a major investment in community engagement to improve the early childhood developmental care system and research to understand and evaluate its effectiveness and equity.