Resources & Special Projects

Health service delivery in the United States is at a crossroads. Despite high levels of spending and a growing professional workforce, equitable access to timely, culturally relevant care remains a challenge particularly for marginalized communities and rural regions. While mental health offers a visible and urgent example of these gaps, similar barriers affect access to preventive care, chronic disease management, maternal health, and more.

In response, Community-Initiated Care (CIC) has emerged as a promising framework for empowering communities to take an active role in health support. Built on task- sharing principles, CIC trains community members, not just professionals, to provide brief, structured support across a range of health issues in everyday settings.

This discussion document aims to expand understanding of CIC as a scalable, person-entered model that extends the reach of health systems by integrating trained community members into the continuum of care. While mental health remains a primary entry point for CIC, the principles and practices outlined here are applicable across a range of health domains—from chronic disease support and maternal health to substance use prevention and elder care. By grounding health support in trusted community relationships and culturally responsive methods, CIC not only complements existing services but also strengthens local capacity to promote well-being in diverse, equitable, and sustainable ways.