This paper argues that tenant participation in the substance of the housing environment is a major avenue for developing and maintaining viable public housing communities. If tenants participate in shaping basic decisions, a healthy encounter can develop with management from which can flow an atmosphere of battle-tested mutual trust and respect. A successful effort of tenants at Columbia Point in Boston illustrates the effectiveness of tenant participation. The paper proposes the creation of a tenants' health council to negotiate a contract with a health agency to provide agreed-upon health services in a public housing community. Success of a tenants' council depends on inner resources of tenants themselves and willingness of the power elite to recognize an independent—even dissident—role for tenants' organizations.