In 10 California counties, low-income uninsured residents — especially those with complex chronic conditions — are beginning to benefit from innovations aimed at expanding access to care and redesigning systems for improved efficiency. The innovations are supported by the Health Care Coverage Initiative (CI) component of California's Medicaid hospital financing waiver.

This issue brief describes the CI counties' experiences, and highlights common strategies and challenges that they faced in moving toward effective, financially sustainable systems.

In view of the upcoming renewal of the state's hospital waiver, all California counties will need to:

• Look for opportunities to maximize available funding;
• Get clear guidance from the federal government;
• Participate in a strong partnership with the state; and
• Acquire enhanced information technology.

The complete issue brief is available under Document Downloads.