Date:
October 27, 2026, and November 17, 2026 20
To: Board of Supervisors
Title
Receive County Medical Services (CMS) Reform Analysis, Approve Recommendations on Reforms to CMS, Approve Amendments to Board Policy A-67, and Adopt an Ordinance Amending the San Diego County Administrative Code Relating to Liens for Health and Human Services Costs (10/27/2026 – First Reading; 11/17/2026 – Second Reading, unless the ordinance is modified on second reading) (Districts: All)
End
Overview
On March 3, 2026 (17), the San Diego County Board of Supervisors (Board) approved a comprehensive review of County Medical Services (CMS), an effort brought forward by the Social Safety Net and Behavioral Health Systems Transformation Ad Hoc Subcommittee (Subcommittee).
As part of this action, the Board directed the Chief Administrative Officer (CAO) to analyze the feasibility, fiscal implications, and equity impacts of targeted reforms to CMS and make recommendations, including but not limited to: revisions to CMS eligibility standards; modernization of enrollment processes; eliminating the CMS lien requirements and reforming existing property limits; expanding phone and virtual application options; reviewing covered services; analysis of how cost-sharing protocols impact patients’ ability to access services; review the branding and renaming of CMS to be reflective of potential revisions to eligibility standards; and evaluating fiscal impacts associated with any proposed changes.
Additionally, the Board directed the CAO, in coordination with the Subcommittee, to engage collaboratively with organizations representing hospitals in the region, with primary emphasis on acute care hospitals, for the purpose of obtaining input related to the evaluation and development of the recommendations outlined.
Today’s item requests the Board receive the CMS Reform Analysis; approve implementation of the initial recommended changes to the CMS program for 2027; adopt revised Board Polic...
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