In 2017, Public Health Solutions and New York City Health + Hospitals (NYC H+H) developed a pilot for improving access to effective LARC provision at Kings County Hospital, a safety-net hospital within the country’s largest hospital system, by tasking a program manager with providing on-site administrative support and patient-centered contraceptive counseling. Provider champions at Kings County worked alongside the program manager and other key stakeholders to create and implement strategies for overcoming institutional challenges to providing LARCs. Staff received support in billing and coding, and, as H+H rolled out a new electronic medical record system, NIRH’s partners ensured that LARC provision was incorporated. The ongoing participation of an interdisciplinary LARC working group addressed new barriers as they came up and moved implementation forward. Ultimately, the working group and other leaders developed tools from this pilot effort to replicate in other hospitals across the H+H system.