In 2018, the Camp Fire—the most destructive and deadly fire in California’s history—claimed 85 lives and destroyed over 18,000 structures in rural Butte County. In the town of Paradise, homes, schools, hospitals, clinics, and community-based organizations were gone in a matter of days. With little time to recover, the county endured further crises—the North Complex Fire, COVID-19, and the Dixie Fire—leaving health and public systems decimated, demonstrating the need for collaborative health infrastructure. Local leaders were addressing urgent crises and were overwhelmed, while a provider shortage and barriers to health care access were simultaneously impacting community health.

Understanding that the community needed not just collaborative health infrastructure programs but infrastructure to recover, the California Accountable Communities for Health Initiative (CACHI) funded the launch of Butte County’s Accountable Community for Health (ACH). An ACH brings together cross-sector leaders and community residents—facilitated by a trusted backbone organization—to address complex health and equity challenges that demand long-term coordination and shared leadership. In Butte County, the collaborative came together quickly to identify priorities and, within a year, had launched more than 10 community-led health initiatives, as well as a local Wellness Fund, laying the foundation for long-term systems change. Building on CACHI’s initial investment, the ACH secured support from local co-sponsors and a state grant to move health equity efforts forward.

In Butte County—and in the other 35 ACHs across California—CACHI has seen how support for collaborative infrastructure allows communities to lead with lived experience, set priorities tailored to local needs, and develop solutions that are both responsive and sustainable.

How Collaborative Health Infrastructure Anchors Resilience

CACHI works to advance health and equity by building community-rooted, cross-sector collaboratives that share power and drive lasting change. Through the Accountable Communities for Health model, we invest in local leadership and infrastructure to shift systems, influence policy, and address the root causes of health inequities—so all communities can thrive.

Read the full article about collaborative health infrastructure by Rea Pañares at Grantmakers in Health.