School psychology has recently reconceptualized its service provision model to include multitiered systems of academic and psychosocial promotion, prevention, and intervention. The availability of evidence-based programs and advances in school consultation theory accompany the paradigm shift of the field. Despite these advances, implementing multitiered systems of support into school settings is teeming with challenges and often results in program abandonment. One often cited reason for such failures is the inattention to local priorities and culture. This article discusses the use of the participatory culture-specific intervention model (Nastasi, Moore, & Varjas, 2004) to build comprehensive systems of support in an elementary school in New Orleans. Co-authored by both researcher-consultants and school administrators, the article highlights the research, consultation, intervention, and collaborative decision-making activities over a 4-year period in a continuing university--school partnership. The discussion focuses on the process, challenges, and successes in consulting to build multitiered systems of support.