County Health System ( Field Site 1 ) is a large public integrated delivery system on the West Coast , comprising one main hospital , multiple outpatient clinics , a specialty center , and several ancillary services distributed through the region . As the county 's medical safety - net within the area 's stratified ecology of health services , patients , providers , and staff all exhibited a high level of racial , ethnic , and linguistic diversity , with many also reporting histories of immigration . As a public institution , the organization carries a mission of serving all patients without consideration of ability to pay . Despite this stated mission and urban geographic location , the health system rarely acknowledged SGM issues within its public messaging of care for " all . " The announcement of the SOGI mandate appeared within the organization 's existing data - centered accountable care initiatives , with the data understood as a new demographic reporting requirement following growing societal awareness of gender and sexuality .