California's Health Care Districts

Margaret Taylor

Tracing the 60-year evolution of California's health care districts, this paper examines their origin and development, the variations in how they now operate, and the potential they have to improve community health.

April 2006

The 1940s were a time of economic boom and rapid industrialization in California. As a result, the state faced new challenges, including a critical shortage of hospital beds and medical resources in rural communities. In 1946, policymakers and community leaders responded by passing the Local Hospital District Law. The law allowed for creation of independent districts that could access dedicated, locally-controlled funds to meet specific health needs.

This paper traces the 60-year evolution of California's health care districts — formerly known as hospital districts — and the role they play in the California health care environment. It examines their origin and development, the rules governing them, and in particular, the significant variations in the way they operate today.

A majority of California's 85 health care districts manage public hospitals or rural health care facilities, provide medical care to underserved populations, and often fill gaps in local services. Some offer services ranging from dental care to substance abuse programs, while others function similarly to philanthropic foundations by providing grants to meet specific community health needs.

The author concludes that in an era of limited health resources, there is a tremendous value in these districts and their dedicated health dollars. With the right focus and local input, they have the potential to improve the health status of communities and promote greater interest in community health.

The complete paper is available under Document Downloads.