key component of the program. Once an immunization rate of 80–90 percent is reached, TAPII activities may be expanded to include parent education.

The panelist emphasized the importance of clearly defining a problem that motivated stakeholders to work together. Partners in the coalition have not yet agreed to work together on other problems but have been able to collaborate effectively on this clearly defined task.

Calhoun County Health Improvement Program12

The Calhoun County Health Improvement Program (CCHIP) is a community-based program that began in 1993. Its mission is to improve community health in Calhoun County, Michigan. The county has a population of 136,000, with a minority population of 17,000. The county's health status indicators fall below statewide averages. CCHIP was developed with funding from the W.K. Kellogg Foundation. A participatory approach that includes providers, consumers, and payers is taken. It views "health care" more broadly than merely the provision of "medical care." Personal responsibility and primary prevention are central to its vision. Its organizational structure is conceived as a circle with improved health at the intersection of four quadrants: neighborhood groups, membership organizations, a governing board, and implementation teams.

Health assessment is conducted through collaboration between the Community Assessment Implementation Team (a CCHIP-based team) and the Calhoun County Health Department. Together, they have developed a health outcomes report and have shared responsibility for community response to the report.

The program has developed long-range goals based on a five-year plan with six focus areas: (1) community decision making, (2) community-wide health care coverage, (3) a comprehensive delivery system, (4) an integrated administrative structure, (5) a community-based health care information system, and (6) community assessment. The goals include decreasing the risks to health, increasing access to cost-effective health care through the establishment of a purchasing cooperative, improving decision making through a community health information network, and changing

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This section is based on a presentation by Bonnie Rencher.



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