Assisting the County of San Diego’s County Medical Services (CMS) program with their system transformation redesign initiative to improve efficiency and quality of health care services for San Diego’s low income adult populations. The project includes an end to end evaluation of the CMS program. As of this date, this process involved onsite interviews with internal and external stakeholders, including two facilitated meetings with County clinics, hospitals, physicians, and client advocates. The result of these activities is a series of recommendations. The next steps are to conduct an environmental scan of the clinics for medical home readiness, develop a strategic plan for implementing a medical home model, and assess the ASO contract for administering the CMS program.