History

Mountain Health & Community Services, Inc. (MHCS) is a not for profit, 501(c.)(3) corporation which for nearly 35 years has
served the rural, border area of southeastern San Diego County. The two original health centers were Mountain Empire Family
Medicine in Campo (91906) and High Desert Family Medicine in Jacumba (91934). In May of 2005, Alpine Family Medicine
(91901) was opened in the western portion of the Mountain Empire service area, and recently two urban sites have been
added. These are 25th Street Family Medicine in San Diego (92113) and Escondido Family Medicine (92027) .

The agency also operates the Mountain Empire Community Center (home of the Senior Nutrition Program) and school based
primary care and behavioral health sites on the campuses of Mountain Empire Junior/Senior High School, and Potrero
Elementary School. Work is underway to add at least two mobile vehicles which can rotate to other area schools, particularly
for the provision of mental health services.

The mission of Mountain Health & Community Services, Inc. is to improve the health and well-being of the whole person. We
envision a time when all residents of our most underserved communities have local access to the health and social services
that they need. MHCS has a community-based Board of Directors with members who are representative of the communities
served, who live and/or work in the service area, and who greatly assist leadership and staff in developing the trust of this
rural, isolated population.

In 2008, over 28,000 patient visits were provided to over 8,000 individuals. The population is medically underserved - over
90% of patients served meet the federal definition of "poor" or "working poor", and 29% are self-pay patients who do not
qualify for Medi-Cal or other programs, and who are charged fees based upon their ability to pay. None are refused service.

MHCS provides primary and preventive care, behavioral health and community services to this vulnerable rural population,
which faces many barriers in accessing health care and community services. The neediest populations within our rural area are
seniors, people with disabilities and young families who have limited transportation or financial means to travel outside of the
area to obtain services, or to understand the resources that are available to them. MHCS is known as a leader in providing
rural health care and participates at the County, State and Federal levels in ensuring that access to care addresses the needs
of vulnerable, rural populations.
Bilingual and bicultural staff members who are residents of the area are employed in order to provide quality services at all
levels of patient interaction. MHCS is one of the only local organizations in the rural backcountry with the infrastructure to
compete for private and public funding, bringing programs to meet the area needs.

The 950 square mile rural portion of the service area is the geographically isolated border region directly adjacent on the
south to 100 miles of U.S./Mexico border, on the east by rural Imperial County, and on the north by the Cleveland National
Forest. To reach the closest emergency room, laboratory, or specialist requires a trip of at least 50 - 90 miles over a mountain
pass, which is subject to periodic closure due to snow, ice, fog, fire and high winds. The only pharmacy is in Alpine, as is the
only X-Ray unit, which is operated by MHCS.

There is extremely limited public transportation, and a "trip to town" for health care or other services may require an
overnight stay. The area includes few paved roads, extremely limited basic services, and faces all of the issues related to the
porous border with Mexico. The combination of weather, distance, poverty, and lack of job skills also perpetuates a
multi-generational cycle of unemployment and increased health risk factors within the target population, on both sides of the
border.
MHCS was one of the first CHCs in California to digitize its X-rays. The digitization of patient radiology films has decreased
operational expenses by allowing X-rays to be sent via the internet. Patients have more immediate access to information
related to their condition, and this has improved the quality of services relating to X-ray.

Continuing its commitment to the use of technology to overcome geographical and other barriers to care, MHCS has become
a local leader in the implementation and use of Telemedicine to bridge the rural geographic gaps, and is using the technology
for face to face supervision in the Behavioral Health Department, therapy sessions, provider training, and other health
services.

MHCS was instrumental in organizing The Mountain Empire Bio-Terrorism and Disaster Defense Team (MEBTDD) in
November, 2001, which is still active today. Through the auspices of the MEBTDD committee, MHCS collaborated and
ensured that the rural communities designated Community Disaster Centers and helped design the brochure that was sent to
every home in the Mountain Empire area informing the residents where their Community Disaster Centers are located and
emergency contact information.

The MEBTDD team developed the San Diego County Community Protection/ Evacuation Plan Template for Lake Morena
/Campo, and it was the first to be formally accepted and recognized by the County Board of Supervisors. Several MHCS staff
members have participated in CERT training and are active in promoting CERT in the rural communities so that all residents
understand the importance of emergency preparedness.

The Mountain Empire was one of the most heavily affected during the Firestorm of October 2003. Hundreds of homes were
lost, and thousands of people, along with their pets and livestock, were displaced by the threat of fire. Thousands more were
completely cut off by fire from the basis necessities of life, including food, water, shelter, and health care, and they were
terrified. During this period, MHCS became a leader in ensuring that the rural population and the displaced residents from the
evacuated communities had access to health care and to basic life necessities.

This leadership role was reprised during the Harris Fire in October of 2007, when the Mountain Empire Community Center
became the local evacuation shelter for the areas threatened and/or destroyed. For over two weeks, the center functioned as
the focal point for shelter, health care, mental health care, food and assistance to over 250 people who had either lost their
homes, or were threatened. For several weeks after that, the Center operated as a distribution center for clothing, food and
referrals for needed service.

Mountain Health & Community Services, Inc. continues to fulfill its commitment to improving the health of all within its
reach, and looks forward to moving progressively into the future.

Revised 4-08