Among the many truisms of community-based health care is that communities must be intimately involved in the conceptualization of problems, devising of solutions, and the execution and implementation of programs. While community members across the United States organize and collaborate on a number of levels, this activity is often ad hoc in response to specific and often fleeting concerns about pressing issues, such as environmental hazards, crime, or neighborhood blight. Deep investments in community-based health require something more along the line of permanent, enduring institutions. To be successful, such institutions must possess consistency, formal rules, continuous support, and participation, in addition to a shared mission.