Series
Community Infrastructure
RHTP state applications promise community engagement and CBO partnerships without assessing whether the community infrastructure they assume exists actually does. Series 8 tests that assumption against ten distinct organizational types — from faith communities and civic clubs to tribal governments, farmworker organizations, and school-based health centers — and finds that the organizations with the deepest community roots are almost never the ones capable of meeting federal program requirements. Community assets are real. Community capacity is overstated in nearly every transformation plan that depends on it.
RHTP-08.01
Faith-Based Organizations
The Infrastructure Policy Ignores
In many rural communities, the church is not one organization among many — it is the only organization. But the typical rural congregation has 40 to 60 attenders and an annual …
RHTP-08.02
Social Service Nonprofits
The Professionalization Question
Forty-seven million Americans contacted 211 for help in 2024. Behind every referral stands a community organization expected to respond. The RHTP-funded platform that generates the …
RHTP-08.03
Civic and Volunteer Organizations
Community Glue in an Era of Dissolution
In 1994, roughly 20 percent of residents in typical Iowa small towns belonged to fraternal organizations. By 2024, that figure had fallen to 5 to 6 percent. Eighty-seven percent of …
RHTP-08.04
Community Health Workers and Promotoras
Voice at the Boundary
Healthcare systems value community health workers for their community connection, then frequently attempt to transform them into clinical extenders. More than half of state …
RHTP-08.05
Community Development Organizations
Building Beyond Healthcare While Depending on Healthcare Funding
Community development organizations work on the determinants of health without being healthcare organizations. RHTP's social determinants emphasis creates partnership opportunities …
RHTP-08.06
Advocacy and Mutual Aid
The Partnership That May Silence the Voices That Matter Most
Advocacy organizations derive their value from independence. They can criticize healthcare systems because they do not depend on them. RHTP partnership offers resources that could …
RHTP-08.07
Alternative Ownership Models
Promise vs. Proven Capacity
Twenty of 23 ACA co-op health insurance programs failed within three years of launch, taking with them $1.2 billion in federal loans. HealthPartners, the most cited success case in …
RHTP-08.08
Tribal and Indigenous Organizations
Sovereignty vs. Federal Program Requirements
Tribal nations are sovereign governments. When RHTP requires states to consult with tribal affairs offices, it acknowledges a federal trust responsibility that predates the …
RHTP-08.09
Immigrant and Farmworker Organizations
Serving the Invisible
Approximately 2.4 million farmworkers harvest the nation's crops, process its meat, and maintain its agricultural infrastructure. An estimated 50 percent lack documented …
RHTP-08.10
Schools and Youth Organizations
Future Investment vs. Current Crisis
RHTP runs through 2030. A health careers program that graduates its first class in 2031 produces no rural providers during the funding period. A school-based health center that …
RHTP-08.TD1
Community Organization Capacity Assessment Framework
Practical Tools for Assessing Partnership Readiness
RHTP implementation often assumes community organizations exist and possess capacity to serve as transformation partners. In some contexts that assumption holds. In many it does …