Efforts to involve community residents maximally, in a meaningful way, in policy making, while the university holds the purse strings and the Office of Economic Opportunity has the final say, have led to many organizational problems. In this report one of these problems, intergroup conflict, is described. Illustrations of conditions thought to be necessary for such conflict are presented. Consideration is given to how intergroup conflict has been influenced by: (1) the felt need for joint decision-making among the OEO, the medical school and a lay community health council, (2) differences in perception of goals; (3) differences in perception of reality. The ways in which these three situations have arisen and the effects they have had on realization of the objectives of the program are considered. Attention is also directed to the coalitions which have been formed among the government, the university and the community, and the stability of these coalitions.