BOARD OF SUPERVISORS ADVANCES SAFETY NET BRIDGE PROGRAM PILOT
San Diego, CA — (March 25, 2026) Today, the San Diego County Board of Supervisors voted to move forward with developing a pilot program for the Safety Net Bridge Program, a proposed system of free services championed by Monica Montgomery Steppe to support residents at risk of losing health care, food access, and prescription medication.
The Board’s action builds on Supervisor Montgomery Steppe’s proposal to create a no-cost support system for residents who lose their healthcare benefits in the aftermath of H.R. 1, a federal policy change that introduces new eligibility and paperwork requirements for public benefits programs. The approved recommendations mark a significant step toward implementation, authorizing County staff to move forward with a targeted pilot program in high-need communities.
“Residents are counting on us to respond with urgency and deliver real solutions,” said Supervisor Montgomery Steppe. “This program is about meeting people where they are and making sure families can still access a doctor, pick up their medications, and put food on the table even through the red tape and paperwork.”
Under new federal requirements, tens of thousands of residents are projected to face disruptions in access to programs such as Medi-Cal and CalFresh beginning January 1, 2027. In September 2026, the County conducted an analysis that estimates approximately 100,000 residents may be at risk of skipping medications, delaying care, or going without basic health services.
To respond to these gaps, the County developed six potential ‘Transitional Access Clinic’ models with flexible ways to deliver care quickly in communities where residents lose coverage:
- Telehealth Transitional Access Clinics — Scalable virtual care model with minimal facility needs
- Expanded Capacity at Existing Free Clinics — Strengthening established networks to add more support and assistance
- Mobile Medical Units at Live Well Centers — Establishes mobile clinics at County Live Well Centers to provide flexible, community-based care
- County-Operated Clinics at Live Well Centers — Permanent fully integrated primary care clinics within existing County facilities
- Community Health Fairs — Rapid deployment of targeted services in underserved areas
- Contracted Community Health Center Services — Subsidizes visits, medication, and food through existing clinics, allowing for continuity of care
Discussion during the Board of Supervisors meeting indicated interest in a hybrid model implementing all options except for the County-operated clinics at Live Well Centers.
The County will now develop a pilot program focused on ZIP codes with the highest risk of Medi-Cal disenrollment. Staff will return to the Board within 180 days with detailed plans, including funding requirements, refined site selection, and recommended clinic models to implement the pilot. The Office of Sustainability and Environmental Justice will also report back to the Board within 45 days with implementation plans and cost estimates for food access.
“The Board’s approval today is about delivering results and building a system that works for people in real time,” Montgomery Steppe added. “We cannot afford to wait until residents lose care. This is what responsive government looks like.”
By advancing this initiative, the Board of Supervisors are taking decisive action to preserve access to essential services and strengthen the region’s health and social safety net during a period of major federal policy changes.
