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This paper presents the background and multiyear outcome data for a limited benefit safety-net care program in Michigan. It is a possible solution for policymakers and hospital/clinic administrators to consider when evaluating plans to provide primary care for the 30 million uninsured Americans who will be affected by the Affordable Care Act.

Community-Based Participatory Research (CBPR) has the twin goals of generating data and shaping policy decisions, yet examples that combine these goals are scarce in the literature. We describe how a community-based survey was created and used to help develop a county health plan. The Genesee Health Plan (GHP), a community-initiated non-profit organization, provides primary care, prescription drugs, and specialty care to uninsured, low-income adults through a network of independent physicians, clinics, and hospital systems. As part of an advocacy effort, GHP supporters used results from the Speak to Your Health! Community Survey to gain financial and political support for GHP. Our study, which used CBPR principles, was created by the community, local health department, and university partners. As a result, Genesee County became one of the first counties in the United States to make basic health care available to nearly all of its uninsured, low-income adults.

The Michigan Health Care Institute administers the Rural Health Project--a W. K. Kellogg Foundation funded project to assist Michigan's rural communities with assessing and improving their health status and health care systems. We have talked to the experts, the veterans, and the consultants: worked closely with the Michigan Department of Public health to launch a state-wide community health assessment and improvement initiative: and been closely involved with Michigan's rural sites. The following is our best advice to those communities just beginning a health assessment and improvement initiative. It is the last in a two-part series about the process of improving community health.

For the past eighteen months, the Michigan Health Care Institute has been administering the Rural Health Project--a W.K. Kellogg Foundation funded project to assist Michigan's rural communities with assessing and improving their health status and health care systems. During that time, MHCI staff have observed community health assessment initiatives all over the country. We have talked to the experts, the veterans, and the consultants; worked closely with the Michigan Department of Public Health to launch a state-wide community health assessment and improvement initiative; and been closely involved with Michigan's rural sites. The following is our best advice to those communities just beginning a health assessment and improvement initiative. It is the first in a two-part series about the process of improving community health.

Learn about a new community development project for rural health and the MHA Michigan Health Care Institute's involvement in housing and administering this $1.5 million rural community-based project.