Graduation Year


Document Type




Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Dean's Office

Major Professor

Gregory Teague, Ph.D.

Committee Member

Kyaien O. Conner, Ph.D., LSW, MPH

Committee Member

Amber Gum, Ph.D.

Committee Member

Sandra Stone, Ph.D.


Delphi technique, Healthcare access, Medically underserved, Population health, Taxonomy, Uninsured


The number of medically indigent adults continues to grow in the United States, despite recent expansions in health care coverage to individuals who are non-disabled, low income, and uninsured. Indigent health care programs (IHCPs) are safety net services that are often funded and operated by local governments. These IHCPs provide access to health services at low to no-cost which protect the health and financial welfare of the individuals these programs serve and support the sustainability of the health systems that treat them. Although localities continue to expand their presence in safety net health care delivery, little is known about locally operated health service programs. The three studies that comprise this dissertation identify what local governments in Florida are doing to provide access to care for their local residents who are medically indigent, how their medical needs compare to the overall medical needs of the population in their local community, and a strategy to gather consensus about indigent health policy with community stakeholders. This collection of studies is significant for states and localities that continue to respond to the growing health needs of this population as a result of ongoing gaps in health care infrastructure. Each of the three manuscripts of this dissertation has its unique implications for indigent health care, but collectively, the strategies described provide population health researchers and health care administrations with methods that can be feasibly replicated to guide the development of local health service programs or inform more robust solutions at the state or national level.