High Desert Health System (HDHS) was initiated on July 1, 2003, with the conversion of High Desert Hospital to a Multi-Service Ambulatory Care Center (MACC). This change was one component of a comprehensive restructuring plan implemented by the Los Angeles County Department of Health Services in response to a projected budget deficit. The design of the High Desert Health System MACC was based on maintaining and expanding the outpatient services provided by High Desert Hospital and retaining the administrative, ancillary, and support services infrastructure to support the health system's network of four community-based clinics. The HDHS MACC is configured as two distinct entities. The former hospital surgical service has been restructured as an Ambulatory Surgical Center , and holds a separate license. The remainder of the MACC, including primary care and specialty services, is operated as a license-exempt primary care clinic.