The Healthy Capital District Initiative (HCDI) started with a small group of public health leaders discussing how the capital region could be more effective in identifying and addressing public health problems. Eighteen years later, we are an incorporated not for profit that has helped over 150,000 needy children and adults in the Capital Region get health services that they might not have accessed otherwise. By working together, area hospitals, health insurers, county health departments, catholic charities and others have been able to determine some of the major barriers to health services and develop initiatives to greatly reduce them. Our current initiatives include health planning, facilitated enrollment for public health insurance, elementary school-based preventive oral services, and reducing minority health disparities.