When pressed by reporters, Executive Director of Covered California Peter Lee quipped that exactly two people will purchase coverage on the state exchange program come October 1. His off-the-cuff joke is seen as a sign that official projections for the first-day of enrollment are low.

While the state is adjusting its expectations in order to mitigate reality come Tuesday, counties across the Golden State are busily preparing to assist their residents in securing coverage.

The state exchange programs across the U.S. anticipate providing coverage for 7 million people next year. Covered California seeks to enroll 1 to 1.4 million of that total.

California has been ahead of the curve in implementing the Affordable Care Act (ACA). In 2010, California made extensive changes to its Medi-Cal services, expanding coverage and rewriting qualification rules to align with those of the ACA. These changes are part of a program known as the “Bridge to Reform” and will make it easier for counties to transfer patients into the expanded Medi-Cal program when January 1, 2014 rolls around.

47 counties are already participating in the Bridge to Reform program (or Path2Health as it is known in California’s smaller counties). For every dollar a county invests in the program, the federal government matches 50-cents. A report earlier this year found that almost 500,000 Californians had been registered by the flagship program.

Despite these efforts, California maintains one of the highest rates of uninsured residents in the nation, clocking in around 20%. Because of this, Covered California has issued over $37 million in grants to almost 50 community groups and agencies across the state.

Several county programs and affiliates have received that money, in addition to federal grants and subsidies. How they are choosing to implement enrollment efforts varies widely across the state.

PublicCEO has compiled a list of recent headlines that yield insight into the various ways that counties across California are reaching out to their communities.

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Earlier this month, the Sonoma County Board of Supervisors was awarded a $100,000 grant from the Blue Shield of California Foundation in order to improve the enrollment process launched by the County’s Health and Human Services Department.

Meanwhile, clinics in the Inland Empire have won a nearly-$1 million grant in order to conduct outreach programs.

On Tuesday, the San Diego County Board of Supervisors voted to add over 350 new positions to its Health and Human Services Agency in order to assist with the implementation of the Affordable Care Act. The move will cost the county more than $10.5 for FY 2013-14.

Santa Barbara County is hiring 53 full-time staff members to assist with the transition, paid for by a combination of federal and state tax dollars. They hope to enroll between 30,000-40,000 individuals under the Medi-Cal expansion. To accomplish this, staff will be sent to “outstation sites” in order to more effectively target the uninsured.

Last weekend, Alameda County Supervisor Keith Carson partnered with local health agencies to host a free informative event called “Take Charge of Your Health.”

“In addition to the new construction, our hospitals and clinics are adjusting to changes that come with health care reform and the County is engaged in an unprecedented outreach effort to enroll nearly 200,000 previously uninsured Alameda County residents,” Supervisor Carson remarked at the kickoff.

A proposed clinic in South Hayward will also help lessen the burden of newly-insured patients within Alameda County.

Imperial County is also hosting workshops, in addition to establishing three information hotlines. Clinics in the community have also switched to electronic medical records in preparation of the ACA.

Merced County also rolled out its own regional ACA call center this week.

In an effort to assist the business community, Butte County has included an Affordable Care Act Business Toolkit on its website. Resources include fact sheets, explanations of the services Covered California offers as well as a comprehensive list of all available workshops and seminars within the county.

Employees at community clinics across Los Angeles County are bracing for an onslaught of new patients under the ACA.

Calaveras County is worried about the impact the ACA will have on its rural residents.

According to Monterey County officials, the state has “lagged in public outreach, staff training, policy development and the automated systems essential to managing the workload.” The County’s worries are further complicated by the exit of Blue Shield as a health network provider.

Riverside County has just shelled out $1 million to a consulting firm to help get the troubled finances of its hospital back on track in preparation for the ACA.

Fresno County is facing a substantial budget blow—to the tune of $7 million this year—as the implementation of ACA nears. It is seeking help from the state as up to 135,700 residents of the Central Valley—45,000 in Fresno County alone—could be eligible for coverage under the ACA.