This study, funded as part of the Robert Wood Johnson Foundation’s Systems for Action research program, will explore opportunities to strengthen a systems alignment approach to the refugee resettlement process in Virginia. Structural barriers in housing, healthcare, employment, and education can impede the effectiveness of resettlement and integration efforts. The current consultation process to coordinate refugee arrival and resettlement inadequately addresses these barriers while also failing to meaningfully include representatives from the medical, social, public health, and community sectors.