MSI conducted more than 130 Key Informant interviews with California's eight Local Initiatives (LIs) and five County Organized Health Systems (COHS), which are the vehicle for the California's successful efforts to expand Medi‐Cal managed care. As part of the project, MSI identified and described promising practices to ensure language access, improve culturally competent health care, and reduce racial and ethnic disparities in health care services for the members of LIs and COHS at the plan/organizational and provider levels. MSI also estimated the level of human and budgetary resources LIs and COHS expend annually on implementing cultural and linguistic services for their members, and assessed the organizational position, degree of relevant authority and impact of staff position(s) responsible for cultural and linguistic services. Additionally, as part of this project, MSI assessed the knowledge, attitudes and commitment to cultural and linguistic services of the executive leadership of each of the LIs and COHS, including the Chief Executive Officer (or equivalent), Chief Medical Officer (or equivalent), Chief Financial Officer (or equivalent), and Culture and Language Services Coordinators (or equivalent). A critical issue in this study was the limited amount of the plan's funds dedicated to cultural and linguistic services and the impact on client recruitment, services utilization, the cost of services and treatment outcomes. MSI identified and described how the use of information and other technologies promoted the implementation of cultural and linguistic services LIs and COHS provide, and at the conclusion of the project produced a report that provides recommendations for improving cultural and linguistic services at Local Initiatives and County Organized Health Systems.