MyCare Family (Merrimack Valley Accountable Care Organization (MVACO)) a partnership between Greater Lawrence Family HealthCenter (GLFHC) and Lawrence General Hospital (LGH) in Lawrence Massachusetts, adverse high poverty community, with 76% of the population Hispanic.Socioeconomic factors and a recent community disaster contribute to high disease burden and mortality rates including Diabetes, Behavioral Health, Asthma and Opioid Addiction. Recognizing the critical needs of the population, MyCare Family sought to develop a collaborative partner telehealth services strategy. The plan would address the critical disease states of clients,Emergency Department overuse, transient behaviors, language barriers,homelessness and lack of transportation. Through stakeholder interviews and studies, current service needs, existing services community needs, strategic priorities and ROI were analyzed with a determination that clients lacked access to care in major areas including: Dermatology, Behavioral Health and Language Services. From an ACO perspective dependence is on providing services through partners. The project results included a clear picture and path defining telehealth services for high quality sustainable access to care and positive clinical and financial return on investment. The results demonstrate how an ACO can propel telehealth as a successful collaborative partner with providers and community services in a challenging patient environment.