This chapter considers the community management case studies from the 'Bihar, Madhya Pradesh, Rajasthan and Uttar Pradesh (BIMAROU)' states which make up the economically poorest states in this study. They include Jharkhand, Madhya Pradesh, Odisha, Chhattisgarh and Rajasthan. The chapter explores the support programmes that include the large public agencies responsible for rural water supply that are usually called public health engineering departments (PHEDs) but can also be called variants on this name. It discusses the initial investment through capital expenditure (CapEx) and then goes on to discuss recurrent costs. The non-governmental organisation (NGO)-supported programmes for community management in the neo-patrimonial states come from the Madhya Pradesh and Odisha case studies. In Madhya Pradesh the case covers an example of community management in which a state level NGO called Vasudha Vikas Sansthan supplements the government PHED programme supporting communities to overcome fluoride contamination in local groundwater sources.