Bilingual students comprise a substantial and growing proportion of U.S. school enrollment and often experience unsatisfactory school outcomes attributed to limited opportunities to learn. Bilingual consultants have the unique opportunity to shape school psychological services and general education supports for all bilingual students by working with monolingual professionals and stakeholders to improve the instructional and mental health services provided to bilingual students, particularly English language learners. In this article, we provide a framework for integrated individual and systemic bilingual school consultation that extends existing consultation models. Specifically, we (a) compare the proposed framework to existing consultation models, (b) identify core competencies for bilingual consultants, (c) describe how the bilingual consultant can contribute to multitier systems of support responsive to the needs of all students, and (d) offer a case study of implementation of the framework. Implications for professional development and research are addressed.