During 1997 and 1998, the Regional Healthcare Advisory Council (RHAC)—created in June 1997 by the County of San Diego Board of Supervisors—developed a master plan for health care services in the county.
Project leadership put together a local collaborative process intended to evaluate the existing health care delivery system in San Diego County to predict what the system would look like in two to five years if nothing changed, and to recommend changes that would ensure access to high-quality health care.
Recommendations of the project have started to "bear fruit," according to the project director. For example:
- Community clinics have begun to get ready for managed care.
- The public health agency is broadening its scope, moving the agenda on fluoridation further along, and including newer public health issues, such as bioterrorism.
- Recommendations concerning consolidation and mergers among five major medical centers that have been in competition have reenergized those centers' conversations at a high level, and the project director observed that these may lead to consolidations.
Health care became a "front-burner" issue for the San Diego Board of Supervisors, according to the project director.
This may have lead to the unexpected board vote to designate to health care all of its share of funds from the 1998 legal settlement between the state of California and the tobacco industry, which amounted to some $900 million over 25 years for the state as a whole.