TACHI (Texas Accountable Communities for Health Initiative) was initiated to grow the adoption of the Accountable Communities for Health (ACH) framework within Texas. ACH is an evolving and flexible framework that creates the conditions where  cross-sector partners can collaborate to improve community health and achieve greater health equity on a sustainable basis. The ACH framework has shown to positively impact health in other states, like California. TACHI aims to support the development and evolution within Texas. 

After a learning about ACH over the span of a year, six communities made a commitment to adopting the framework. While the sites share a commitment to health equity and addressing their communities pressing health needs, the six sites differ in their approach to the framework, the assets that they bring and the communities they serve.  

To create a new paradigm that values cross-sector partnerships and health equity, sites need support. Through TACHI, site partners receive a unique and place-centered toolbox of support, including technical assistance, learning opportunities and flexible funding. 

The Episcopal Health Foundation (EHF) launched TACHI in 2020 with an $8 million multi-year investment. The intent was to learn alongside community partners, respond to what is learned in each site and identify how the ACH framework could result in financially sustainable social determinants of health (SDOH) strategies that improve health outcomes and move us toward health equity. 

Other funders are recognizing the promise of TACHI. Over the course of two years, the St. David’s Foundation has invested $1 million in TACHI and has contributed as a thought-partner in advancing the ACH framework. Other funders and health care organizations are investing directly in the sites. 

What are accountable communities for health?

Essentially, ACHs serve as a local platform for bringing stakeholders and community residents together to transform systems to improve community health and achieve greater equity on a sustainable basis rather than provide “one-time” interventions based solely around a health care delivery system.

The process by which communities embrace a multi-sector approach to population health varies by community. As a result, standing up ACHs requires genuine community leadership, intentionality, resources, technical assistance, and opportunities to learn from each other.