The concern with disparities in mental health outcomes of racial and ethnic minorities in the state's mental health system is the history of Multiethnic Advocates for Cultural Competence, Inc. (MACC). In 1984, the Ohio Department of Mental Health (ODMH) established the Minority Concerns Committee to examine the mental health service utilization of minority populations in Ohio. Throughout the 1980s, the Minority Concerns Committee issued reports and recommendations on service utilization language on cultural competence to include in the Mental Health Reform Act of 1988, and it held the first Annual Cultural Diversity Mental Health Conference in Ohio. The Ohio Department of Mental Health established the Multiethnic Mental Health Consortium in 1990. In 2003, the Consortium formally organized Multiethnic Advocates for Cultural Competence, Inc. (MACC) to make cultural competence a cornerstone in Ohio's behavioral health system. MACC conducted the first-ever statewide mental health needs assessment among eleven racial, ethnic, and cultural communities, titled "Learning Your Needs," Cultural Competence Needs Assessment Project 2006; the report was updated in 2008 to include Somali culture. In late 2010, the organization completed and released its latest report, which included the cultures of veterans and their families. In 2010, the organization worked with Ohio's state departments, cultural organizations, consumers, families, and others to adopt the first in the nation-state cultural competence definition to assist Ohio in moving towards cultural competence in service and care. In 2023, MACC partnered with Central State University, Mental Health Addiction Advocates Coalition (MHAC), and Ohio University to undertake a statewide data research project focusing on the BIPOC (black, indigenous, people of color) community. Also, in 2023, MACC contracted with Deloitte to oversee cultural competence in developing the Governor's Wellness Workforce Initiative. Since 2010, the organization has expanded its work beyond the behavioral healthcare sector to include organizations and individuals seeking to understand better, work with, and serve diverse populations.​ Through our mission and work, Multiethnic Advocates for Cultural Competence (MACC) has improved the quality of life for previously underserved populations throughout Ohio and expanded our efforts nationwide.