The Affordable Care Act has been on the books for nearly a year, but Pima County's health director says the effects on local services remain unclear.

Across the country, and particularly in Pima County, high rates of poverty are straining public health resources, which health director Francisco Garcia says, "really stresses our clinical infrastructure.

"That means that more resources are invested in trying to provide care for people who don't have those kinds of resources," Garcia adds.

Pima County is facing the additional challenges of decreasing revenue, fewer grants and the overall declining health of its citizens. It is clear the Affordable Care Act will have some impact, Garcia says, but it will not likely completely fix the problems confronting the county.

Garcia was one of 16 members of a panel advising President Barack Obama about the health care legislation.