Multiple epidemiological studies have shown in the major killer of persons with serious mental illness is not suicide but undiagnosed and inadequately treated chronic medical illnesses. Persons with serious mental illness die years earlier than persons of similar age and gender without mental illness. Persons with serious mental illness have much higher rates of lifestyle risk factors including obesity, physical inactivity, and smoking. Persons with serious mental illness are much less likely to receive routine screening and treatment for chronic medical illnesses. Persons with serious mental illness constitute a significant portion of the medical services in medical care expenses due to chronic medical illnesses and national healthcare systems. The majority of the premature deaths and excess medical costs are detectable, preventable, and treatable. The managers of healthcare systems need to treat persons with serious mental illness is a health care disparities population and track and address their excess burden of illness has the national epidemic that it is. This presentation will provide participants with the pertinent science and background information regarding extent and causes of premature death in persons with serious mental illness and with a list of concrete actionable recommendations to address the epidemic. The presentation will conclude with a report of improved outcomes from implementing a range of these recommendations in Missouri.