In August 2008, Washington State Department of Social and Health Services (DSHS) chose four sites to receive grants from the Centers for Medicare and Medicaid Services (CMS) with which to implement two-year emergency room diversion pilot projects. The projects aim to decrease non-emergent emergency room use by building collaborations between hospitals and community health centers and connecting patients with medical homes at community health center clinics. The Washington Association of Community and Migrant Health Centers contracted with DSHS to co-manage the grant sites and provide technical support, collect monthly monitoring data, conduct site visits, and advocate for the health centers involved. DSHS provides contract management and technical assistance as well. The University of Washington and DSHS Research and Data Analysis will be conducting the project evaluation.