Establishing a Local Wellness Fund: Early lessons from the California Accountable Communities for Health Initiative

In the past decade there has been rapidly growing interest and funding for multisector health collaboratives to improve community health. This momentum is the result of increased recognition that traditional medical care and public health approaches alone are insufficient to produce optimal health. Conditions such as diabetes, trauma, substance use, asthma, and others necessitate a dedicated and coordinated effort that supports health improvement at a population or community scale. Multi-sector health collaboratives require careful strategy development and trust building to bring public health and health care together, along with other partners and residents, to determine where there are leverage points for innovation and true system changes.

The California Accountable Communities for Health Initiative (CACHI) is developing locally governed Wellness Funds as a critical component of an Accountable Community for Health (ACH) multi-sector collaborative. Wellness Funds are emerging as a strategy designed to pool and align a range of resources for greater impact and to create financial management capacity that complements innovative intervention and infrastructure-building work. CACHI started in 2016 to focus on transforming community health in fifteen grantee sites by building a more expansive, connected, and prevention-oriented health system. 

This issue brief shares early insights on critical dimensions of Wellness Fund development, including governance, funding sources, an administrative model, and key capacities. The final sections of the brief suggest ways in which funders and federal, state, and local government can support locally governed Wellness Funds through investment and policy decisions.