Association for Public Policy Analysis & Management

Fulfilling its state mandated requirement, San Bernardino County offers its medically indigent residents last resort health care services through the San Bernardino County Medical Services Plan (CMSP). The San Bernardino CMSP program serves residents aged 19-64 who are 100% below the federal poverty level. Program patients have a share of the costs while in the program and copay for prescriptions, has an eligibility period of 12 months, and uses a provider delivery system for their indigent care model where county owned hospitals and clinics are employed to provide patients health services (Insure the Uninsured Project, 2017). Using this care model, an estimated 280,000 people are served through this program per year (California Department of Healthcare Services, 2009). This program, however, does not offer health services to its nearly 82,000 uninsured undocumented residents (Migration Policy Institute, 2014). This variation in health care access among San Bernardino county residents further widens the health disparity gap felt among undocumented residents. This report examines three California county MISP programs as comparative tools to develop a MISP proposal for San Bernardino County that includes services for its undocumented residents. Using county comparisons and PEST analysis, this report presents program recommendations for San Bernardino County Medical Services Plan to provide healthcare to its uninsured, undocumented population. Program recommendations are limited by missing data and heterogeneous program management and implementation.