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Consistent with the adopted work plan and approved five-year rolling study schedule, San Diego LAFCO has initiated a comprehensive municipal service review on the four healthcare districts in San Diego County – Fallbrook, Grossmont, Palomar, and Tri‐City – and serves as a follow up to an earlier study completed in 2015. LAFCO retains discretion in determining the appropriate scope of each MSR and does so currently by policy delegation to the Executive Officer. Nonetheless, all MSRs must meaningfully address the following statutory factors:  

• Growth and Population Projections  
• Present and Planned Service Capacities
• Adequacy of Services Relative to Community Needs  
• Financial Standing  
• Opportunities for Shared Facilities  
• Accountability of Governmental Structure and Alternatives  
• Any Other Factors Required by Local Policy  
  
  • Environmental Justice (San Diego)