In 2009, an estimated six million caregivers in California provided care to a family member or friend with a long-term illness or disability. Of these caregivers, a significant number – 450,000 persons – were paid for the care they provided. Nearly two-thirds of these paid caregivers, or 290,000, aided a family member or friend receiving Medi-Cal (paid Medi-Cal caregivers). Many of these paid Medi-Cal caregivers more than likely worked for California’s In-Home Supportive Services (IHSS) program. Despite being compensated, paid caregivers – and paid Medi-Cal caregivers in particular – fared much worse on a number of economic security indicators.