In the implementation of wastewater solutions for underserved communities, there is not a simple one-size-fits-all solution. Solutions must fit the needs and barriers of each community. Small communities that are located in close proximity to existing centralized treatment systems may be best and most affordably served by utilizing small-diameter effluent sewers to connect to that existing centralized treatment system. Existing municipal sewer systems may be in need of upgrades to meet current or additional demand. In cases where population clusters (90+ homes within a 5-mile radius) are not in direct proximity to an existing centralized system, a decentralized collection and local treatment system is likely the most suitable option. Households located in isolated rural areas (without significant numbers of homes nearby) with suitable geology may be best served by conventional onsite systems, whereas households with similar density with unsuitable geology may be in need of more advanced onsite treatment.