A number of forces — federal and state budget deficits, severe stresses on the safety net, and rising numbers of people losing private health coverage — have been pushing responsibility for improving access to health care for vulnerable populations onto local communities, while at the same time impinging on communities’ capacity to meet the growing needs. Some communities, including the Community Voices sites, have been developing innovative ways to meet the growing challenges they face. Such projects are often best suited to fill in health service gaps, link people to coverage and care, and develop new community relationships and skills because local stakeholders have a keen awareness of community issues and needs. These local efforts also serve as "learning laboratories;" the more successful strategies provide models for larger-scale state or federal reforms. This brief highlights some of these promising approaches. It then describes ways that states and the federal government can directly support local efforts, as well as reduce the burden on communities by expanding public and private coverage on a state-wide basis. It concludes by emphasizing the importance of community initiatives while pointing to the need for broader, multi-level, fundamental reform of the U.S. health care system in the long run.

For more information, please order a free copy or download the policy brief Community Voices: Lessons for National Health Policy.