This document describes findings and recommendations from a study of health and the health care service delivery system in the District of Columbia. The goals of the study are to: (1) conduct a comprehensive health needs assessment for Washington DC; (2) assess the quality and accessibility of the District\u27s health care delivery system for individuals with urgent or emergent medical needs; and (3) use information from those assessments to identify and assess various policy options for improving the health care delivery system. Specifically, the document recommends how $135 million in funding from the tobacco settlement should be spent to strengthen the District\u27s health care system. An interim report, RAND Working Paper 534, summarizes findings related to the first two goals. This document primarily addresses the third goal