Health information technology (HIT) is a cornerstone of health care reform, is critical for transformation of current outpatient practices to patient-centered health homes (PCHHs), and has potential to improve health outcomes. To determine the current level of electronic health record (EHR) implementation in California's outpatient safety-net, we conducted a web-based survey of the California Primary Care Association's member clinics (response rate 127/181 (70%)). Seventy-two (59%) clinics had not implemented electronic health records (EHR), 26 (21%) were all electronic, 23 (19%) were both paper and electronic, and two (2%) had no plans to implement EHR; the remaining four responses are missing. The majority of clinics allotted less than 6% of their budget to health information technology and 64% of those planning on implementing an EHR reported needing additional staff. California's safety net systems are likely to need additional support to successfully benefit from health care reform incentives.