Recorded presentation

Annette L. Gardner, PhD, MPH and James G. Kahn, MD, MPH. Institute for Health Policy Studies, University of California, San Francisco, 3333 California Street, Suite 265, San Francisco, CA 94143, (415) 514-1543, algard@itsa.ucsf.edu

In California, counties are responsible for addressing the health-care needs of the uninsured, including reducing barriers to care and ensuring appropriate use of services. The last several years have witnessed significant initiatives in many counties to create and launch county-level health-care access initiatives, e.g., insurance expansions targeted to undocumented children. In 2002, UCSF administered a 58-county survey to inventory access programs and key determinants, as well as assess county unmet needs to launch access programs. California counties as a whole had made progress in connecting people to insurance and services though health insurance coverage expansions were less likely than service expansions. A broad array of stakeholders were involved in these initiatives suggesting growing commitment to access to care for the uninsured. Also, counties had significant resources at their disposal, e.g., tobacco settlement funds. Since UCSF conducted this study in 2002, California counties have experienced some serious financial set-backs that could stymie their efforts to increase access to care for the uninsured. To better understand county capacity to engage in significant reform under adverse economic conditions, UCSF is re-administering a modified survey to all 58 counties in March 2004. This survey will provide an updated and more detailed inventory of coverage expansions and their respective funding sources, as well as address questions on key stakeholders and barriers to increased access. We will compare all responses to data collected in 2002.

Learning Objectives:

• Participants will learn about local efforts to expand access to health care for uninsured populations, as compared to data collected in 2002
• Participants will increase their understanding of the barriers and opportunities to expand health insurance coverage and health care service at the local level

Keywords: Access to Health Care, Policy/Policy Development

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation