This category, Delivering Affordable, Accessible Care, features three finalists in the NewDEAL Ideas Challenge 2025.
Expanding College Access Through Direct AdmissionLead Author: Christopher Cabaldon, State Senator – California, CA
Category: Economic Opportunity & AffordabilityThe ChallengeFour-year public universities in California are facing notable enrollment declines—nine campuses within the California State University (CSU) system saw enrollment drop 11% or more between 2015 and 2024. At the same time, many high-school seniors who meet the academic criteria for college do not apply or enroll—often hampered by the complexity of application systems, lack of awareness, or uncertainty about next steps.The SolutionSenator Cabaldon’s policy prescribes a direct admission framework for CSU: instead of requiring a standard application, qualified high-school seniors automatically receive a congratulatory admission letter listing campuses where space is available.
Key features include:
Automatic admission letters to eligible students based on preset criteria. The policy reframes college as the “13th grade,” removing both psychological and procedural barriers that prevent degree-pursuit.
Why It MattersBy eliminating the step of submitting an application and increasing clarity around admission, this approach aims to boost college-going rates among students who are academically ready but otherwise don’t move forward. It addresses both the institutional challenges of under-enrollment and the individual barriers to participation.Impact & MeasurementA pilot of the program in one county involved contacting 17,000 eligible students; 13,200 completed the necessary paperwork—3,000 more than in the prior year.
Ongoing metrics being tracked include:
Enrollment trends at under-enrolled CSU campuses. Overall college-going rates among academically qualified high-school graduates.
Read more.
Lead Author: Lee Harris, County Mayor – Shelby County, TN
Category: Improving Quality of LifeThe ChallengeMany communities face high rates of chronic conditions like obesity, diabetes and hypertension, which contribute to cardiovascular disease (CVD)—a leading cause of death. Low-income and medically underserved neighborhoods often have limited access to preventive care, resulting in higher emergency-care use and disproportionate CVD impact on residents of color. The SolutionShelbyCares is a partnership between the county government and the University of Tennessee Health Science Center (UTHSC) adopting their Neighborhood Health Hub (NHH) model. The approach offers free, neighborhood-based health services directly in high-need communities.
Key program features include:
Health screenings for chronic diseases and CVD risk factors. Culturally relevant health coaching and education. Nutrition and fitness programs, tobacco cessation support, and referrals to primary care. Hubs staffed by trained, community-based health coaches, located strategically in high-need ZIP codes.
Why It MattersBy embedding health services directly in underserved neighborhoods instead of relying solely on traditional clinics, the model reduces access barriers, engages residents in culturally relevant ways, and supports earlier intervention. This place-based, person-centered strategy holds promise for improving both health quality and longevity in communities disproportionately burdened by chronic disease. Impact & MeasurementIn two NHH sites between January 2022 and February 2025:
13,199 total visits were recorded. 2,030 unique clients served. 1,432 clients received screenings for obesity, diabetes and hypertension.1,579 clients participated in individual or group health coaching (78% engagement rate).Health improvements included an 18% drop in blood glucose, a 10% reduction in systolic blood pressure and a 6% reduction in diastolic blood pressure. Participant demographics: 94% Black, 67% over age 50, 60% female.Success will continue to be tracked through engagement metrics, clinical outcome tracking, and health system integration efforts.
Health Equity Resource Communities (HERC)Lead Author: Antonio Hayes, Senator – Baltimore City, MD
Category: Improving Quality of LifeThe ChallengeWhere someone lives often determines how well — and how long — they live. Many neighborhoods in Maryland suffer from high rates of chronic disease, behavioral-health needs, housing insecurity and systemic disinvestment, making them among the poorest in health outcomes statewide. The HERC initiative responds to this deep-rooted issue by focusing state resources into the communities that need them most. The SolutionHERC is a statewide, community-based strategy established under the Maryland Health Equity Resource Act. It invests state funds into local coalitions that deliver health and social services in historically underserved neighborhoods.
One key example: the “RICH 2.0” initiative in West Baltimore, led by the University of Maryland School of Nursing and backed by a $5 million grant. It deploys nurse-led clinics, mobile health units, behavioral-health supports and social-service linkages.
The model also emphasizes cultural competency and community-ambassador training, embedding services in schools, recreation centers and churches. Why It MattersBy aligning state resources with trusted local partners in underserved areas, HERC shifts from traditional health-delivery models toward ones rooted in neighborhoods and community expertise. The initiative offers a scalable framework for reducing health disparities and strengthening civic-and-social infrastructure in communities that historically have been excluded. Impact & MeasurementKey metrics being tracked include:
Number of residents reached and services delivered. Reductions in chronic disease rates, preventable hospitalizations and emergency-room use. Improvements in access to primary care, behavioral health, housing and social services. Engagement through trained community ambassadors and local partnerships. Read more.