A significant part of the required plan is a needs assessment, which in addition to including county-wide figures that are readily available, also require data to be presented by planning and service delivery regions. The State is quite specific in the needs assessment requirements, asking for geographical descriptions, terrain, transportation, socioeconomic data, and information regarding Medi-Cal beneficiaries. Each county must submit their plan by July 1, 1998. ArcView has already played a major role in combining and presenting data by planning region since the original available data is either by city, census tracts or zip code.
Although San Bernardino is quite large geographically with 20,062 square miles, it can be reasonable divided into three planning areas with roughly half a million people in each region: the large expanses of the desert/mountain region, a west valley region and an east valley region.
Figure 1
In fact, if one were to drive from the populated valley regions in the south-western corner of the county, the trip to the eastern boundary of the county would be a longer drive than would a trip to the border of Mexico. One result of this proximity is that nearly 30% of the county's population is Hispanic.
Figure 2 shows the location of the 24 cities within the three planning regions. Not shown are 14 unincorporated communities The size of the circles is reflective of the 1997 estimated population. One can see that there are three major urban centers, with one predominate cluster in each region. As one would expect, when looking at nearly all the demographic/cultural data, the highest concentrations are found in these three areas. The three cluster include Victorville and Hesperia in the Desert and cities at opposite ends of the valley regions.
Figure 2 
More than 200 miles of highway separate the remote city of Needles from the urban valley. Not shown in the desert region this map are the USMC Air Ground Combat Training Center, Fort Irwin Military Reservation, and parts of the US Naval Weapons Center - China Lake, Edwards Air Force Base, Death Valley National Park and Joshua Tree National Park.
Figure 3 includes USGS contour data as its base theme. As one looks at the geography, it is clear how the valley regions obtained their names. The mountains of the San Bernardino National Forest create a physical barrier between the valley and the rest of the county. Interstate 15 which passes through Hesperia and Victorville is the only significant road connecting the desert with the valley. Although cities are spread throughout the valley, most of the population is centered around the city of San Bernardino in the East Valley and around Ontario in the West Valley.
Figure 3 
Figure 4 shows public bus routes in 1997. It can be seen that all valley cities except for Chino Hills had at least one bus route. There is no bus transportation from the desert or mountain areas into the valley. This indicates that services for the Medi-Cal population must be located in a number of cities. It is tempting to zoom in on the bus route data and see if there are particular census tracts or zip codes that are not served. This would only be a preliminary look requiring more follow-up though, since bus routes often change. Anecdotally, there are complaints about bus service. One of the facts that can't be mapped with the available data is the frequency and regularity of bus routes.
Figure 4 
Next is a density map for the nearly 293,000 Medi-Cal beneficiaries in 1997.
Figure 5 
Each dot represents 90 beneficiaries per zip code. Of course, these dots don't show the exact location of beneficiaries, the symbols are arbitrarily assigned within the boundary of each zip code.
Approximately 15,000 (5.2%) of these beneficiaries received at least one mental health service from public and/or private providers. Figure 6 displays shaded zip codes, with clear zip codes representing less than 1% utilization, the next level representing 1% to 8% utilization, and the most intense shading representing zip codes where 8% to 15% of Medi-Cal beneficiaries living within that zip code received mental health services.
Figure 6 
Also shown in the map above is the density of beneficiaries, with each dot representing 600 beneficiaries per zip code. It can be seen that there are relatively few total beneficiaries within the zip codes having the highest utilization rates. Not surprisingly, in all the demographic maps of the valley, the most dense areas are found around the two largest cities in the county: San Bernardino in the East Valley and Ontario in the West Valley.
Figure 7 shows the census tracts which had the greatest percentage of Hispanic residents in 1990. The clear census tracts have a Hispanic population of 0 to 30%, the next level of shading 30 to 60%, and the most intense shading is 60 to 90% Hispanic.
Figure 7 
Also shown is the density of Hispanic Medi-Cal beneficiaries, with each dot representing 30 Hispanic beneficiaries per zip code. In general, the zip codes with the greatest density of Hispanic Medi-Cal beneficiaries corresponds with the census tracts having a greater percent of Hispanic residents. The clear areas with a high density of beneficiaries, especially at the top and bottom of the map, may represent areas where there has been a growth in the Hispanic population between 1990 and 1997.
Finally, Figure 8 shows census tracts where individuals in 1990 greater than five years "spoke English not well/not at all." The lightly shaded areas are where 10 to 20% of the population meet that criteria, while the darker shading identifies areas where 20 to 30% of the population could not communicate well in English. Also shown are graphs indicating the percentage of white/non-white Medi-Cal beneficiaries within each zip code. The lighter color represents the percent of beneficiaries that self-identify as "white". One can see that there is a greater percentage of white beneficiaries in the mountain area at the top of the map and in a few areas along the western and southern edges of the valley.
Figure 8 
The State Department of Mental Health has determined, based on Medi-Cal beneficiary data, the languages in which each county must have linguistic capability. For San Bernardino County the required languages are Spanish and Vietnamese. In practical terms, linguistic capability means having staff/contractors who can speak the language and having certain forms translated so that counties may better serve the thousands of people speaking those languages.
It appears from Figure 8 that having a smaller percentage of white beneficiaries is not necessarily linked to having areas where communicating in English is a difficulty. More refined analysis of race and language data will allow the County to better focus its non-English linguistic resources and determine if more resources are necessary.
Maps of such geographical features as mountains, cities, roads, and bus routes can suggest access to services by certain segments of the population. Demographic data, particularly of potential clients, can allow counties to plan for services better than if only general population numbers are known. The combination of demographic and utilization data is suggestive, but requires further analysis.