
Building stronger, healthier, more equitable communities
California Accountable Communities for Health Initiative (CACHI) supports multi-sector collaboratives across California dedicated to making lasting transformational change to improve community health and well-being.
CACHI has funded 36 ACH communities across California.
Accountable Communities for Health
A Framework for Transformational Change
ACH Core Principles
Breaking Barriers to Build Health Equity
For decades, long-standing inequities have exacerbated health issues in low-income communities and communities of color, resulting in persistent health disparities.
Accountable Communities for Health (ACHs) provide a powerful framework for tackling those inequities by breaking down barriers and promoting a new way of working together.
36 communities.
100s of organizations.
1,000s of lives changed.
Building Stronger ACHs
Technical Assistance and Resources
CACHI is a multi-sector, systems-change initiative that serves as both a funder and a strategic partner for the ACHs. We provide support, technical assistance, and guidance in three priority areas: ACH governance, state initiatives, and transformational equity.
Funding, Partnership, and Guidance
Establishing a Wellness Fund: Lessons from Accountable Communities
Originally published in 2019 and updated in 2025, this brief provides practical guidance for designing, governing, and sustaining locally controlled wellness funds as part of the Accountable Communities for Health (ACH) model. At its heart, the concept remains simple but powerful: pool and align resources across sectors, center community voice in decisions, and create a lasting financial structure that supports equity-focused systems change.
The updated edition draws on new case examples and the experiences of ACH collaboratives across California. It highlights:
Why Wellness Funds Matter – how they break down silos, prevent “wrong pocket” problems, and provide flexibility and shared governance.
Wellness Funds in Action – real-world examples, including the One San Pedro Alliance’s resident-led participatory budgeting process and the East San José PEACE Partnership’s collaboration with a foundation to manage funds.
Fiscal and Administrative Models – approaches such as blending, braiding, and aligning funds, plus practical guidance on selecting the right administrative model.
Steps for Development – a ten-step roadmap for building a fund, from articulating a value proposition to formalizing governance agreements.
Recommendations for Policymakers and Funders – strategies for supporting local wellness funds, including pilot investments, shared-savings arrangements, and policy levers that keep resources accountable to communities.
This resource is designed for multisector collaborative leaders, funders, and policymakers who are working to embed equity and sustainability in their communities. It frames wellness funds not as a “magic bullet,” but as a living strategy—tested, adapted, and refined in partnership with residents—to align resources with community priorities and build more resilient systems.
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