Counties Face New, Expanded Health Care Challenges

California’s 58 counties face an array of health care challenges — some new, some longstanding but about to grow. Realignment is shifting more responsibility for health care from state to county governments, a lingering recession is making it increasingly difficult to make budgets balance at every governmental level and big changes are under way as part of the Affordable Care Act.

For years, California’s disparate county governments — as different and far removed from each other as some of the United States are from each other —  have played a leading role in providing medical and mental health care for low-income, underserved and uninsured populations.

That role — interpreted differently by each county using a patchwork of federal and state programs and funding — is about to become more complex, if not more difficult. The influx of millions of newly insured Californians along with added tasks from the state and what appears to be a long-term financial pinch make for rocky roads ahead.

While their responsibilities are usually limited to a portion of the population, counties’ successes and failures at delivering health care can have a significant impact on the whole population.

We asked stakeholders and experts to predict what strategies might help policymakers navigate health care challenges. What pitfalls and problems are looming and how can they be avoided?

We got responses from: