The Brief

Detranay Blankenship was 16 weeks pregnant when she found out she was expecting. The days passed quickly, and soon she was 7 centimeters dilated at Martin Luther King Jr. Community Hospital.

The 26-year-old first-time mom wasn’t sure what to expect during labor, but the team at MLK’s maternity ward soon felt like family. Every hour midwife Angela Sojobi bustled in to check on her progress and offer cheerful words of encouragement. When it was time to push, a nurse lowered the lights and flipped on the soothing sound of rain.

After 14 hours of labor, baby Myla made her appearance in the world. “That’s my grandbaby!” Latrina Jackson, Blankenship’s mother, shouted. The family’s cheers rang down the hall.

Blankenship lives just blocks away from MLK, where her labor was cozy and personalized. It was the kind of birth that many parents-to-be hope for, but a decade of widespread cutbacks to maternity care in California has made it almost a luxury. It’s available only because MLK’s leaders are fighting to keep maternity services despite steep financial losses.

Over the last decade, nearly 50 maternity wards have closed across California, with more than half shutting down in just the last four years. Seventeen of them were in Los Angeles County, where maternity ward closures have far outpaced the region’s declining birth rate.

Driving the trend in L.A. are for-profit hospitals owned by multi-state corporations. For-profit companies owned 13 of the 17 hospitals that stopped delivering babies. State data shows more than half closed at a time when the hospital was making millions of dollars for investors. Those who lost the most access were the state’s poorest patients. One hospital that serves predominantly low-income patients was earning 13 times more than the median hospital operating margin in California when it shuttered its labor and delivery ward.

In contrast, government-run and nonprofit hospitals tend to maintain labor and delivery units even if they are losing money overall, according to state data on hospital finances. State law requires nonprofit hospitals such as MLK to address community needs as part of maintaining their tax-exempt status.

Hospitals raking in profits often do so despite losing money on maternity care — the service has long been deemed a money-loser. That’s in part because Medi-Cal, California’s public insurance program which covers half of all births statewide, has had the fifth lowest reimbursement rate for obstetrics in the country, according to the Kaiser Family Foundation. Private insurance pays roughly five times more for an uncomplicated vaginal delivery. Simply put, when for-profit hospitals look at the bottom line and choose to make cuts, one of the first services to disappear is usually maternity care. No law prevents them from doing so.

In the L.A. area, these decisions disproportionately affect low-income Black and Latino communities, a CalMatters analysis found. The closures in L.A. overwhelmingly took place in hospitals where up to 80% of patients had Medi-Cal. These populations have some of the worst pregnancy-related complications and mortality outcomes in the state.

First: Angela Sojobi, the lead midwife at Martin Luther King Community Hospital in Los Angeles, checks on the dilation progress of Detranay Blankenship, who will soon give birth for the first time on March 22, 2024. Last: Latrina Jackson, the mother of Detranay Blankenship, holds her hand as she is about to give birth for the first time at Martin Luther King Community Hospital in Los Angeles, on March 22, 2024.

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Jules Hotz

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CalMatters

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The morning after giving birth, Detranay Blakenship holds her child, Myla, at Martin Luther King Community Hospital in Los Angeles, on March 23, 2024.

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“Marginalized patients, women particularly … have really observed the decline in their care even in a place like California,” said Dr. Laila Al-Marayati, division chief for obstetrics and gynecology at Keck Medicine of USC and Los Angeles General Medical Center.

This is because the state has failed to prioritize women’s health for decades, increasing Medi-Cal obstetrics rates only recently, Al-Marayati said. Hospitals with high numbers of Medi-Cal patients frequently can’t break even on labor and delivery. As a result, maternity care takes a backseat to more lucrative hospital services, leading to the wave of recent closures.

Residents in southern L.A. have been among the hardest hit. In the last few years they’ve lost two maternity wards: Centinela Hospital Medical Center and Memorial Hospital of Gardena Medical Center. Both hospitals are owned by for-profit corporations and happen to serve the highest proportion of Black Californians in the state.

Their closures mean that MLK now operates one of the last maternity wards in the area. The hospital gives patients access to a midwife-led program celebrated statewide for its healthy outcomes for both mom and baby.

It, too, is at risk.

Last year the hospital ran a $42 million deficit. A recent $20 million grant from Los Angeles County will keep it open until next summer, MLK’s chief executive Dr. Elaine Batchlor said, but it won’t fix the hospital’s primary funding problem: Medi-Cal doesn’t pay hospitals and doctors enough to keep up, she said.

Medi-Cal reimburses MLK about 71% of the cost of delivery, hospital spokesperson Gwendolyn Driscoll said. The hospital loses more than $2 million annually on its maternity ward. Despite the losses, Batchlor said the maternity ward is integral to the hospital’s mission.

“We serve a vulnerable community that has few other options,” Batchlor said. “The financial distress of our hospital threatens that mission, but we will continue to provide the care that we can as long as we’re able.”

California maternity wards closures outpace U.S. trend

Across the country, communities are scrambling to save maternity care. About 3% of U.S. hospitals, mostly in rural areas, have stopped delivering babies since 2011, according to a report by health consulting firm Chartis. California has lost an even greater share: More than 14% of the state’s 337 hospitals ended maternity services during the same period.

Baby Eren, the daughter of parents Stephanie Herrera and Guillermo Saravia, at Martin Luther King Community Hospital in Los Angeles on March 22, 2024.

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Parents Stephanie Herrera and Guillermo Saravia with Baby Eren at Martin Luther King Community Hospital in Los Angeles, on March 22, 2024.

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Some state lawmakers are trying to slow the loss of services. They’ve characterized what is happening in L.A. as “modern-day redlining” in recent legislative hearings.

“If you start looking at where these are being eliminated, I do think the local counties who are familiar with the communities are going to question why the decisions seem to be made around hospitals that are overrepresented of…people of color,” Sen. Dave Cortese, a Democrat from Campbell, told CalMatters.

Hospitals administrators say the state could make a difference by significantly increasing how much Medi-Cal pays for births to incentivize hospitals to keep these services open.

Last year lawmakers approved a rate increase that went into effect in January, bringing up pay for some obstetric services, but the state’s multibillion-dollar deficit makes further raises unlikely. Gov. Gavin Newsom has proposed canceling additional increases to address the budget gap, something that lawmakers have rejected in a counter proposal.

“I’m not sure how many more conversations we need to have about some of the crises that we have within our health care space,” Assemblymember Akilah Weber, a Democrat and an obstetrician from La Mesa said during a recent budget hearing on Medi-Cal rates. Weber said Medi-Cal rates are “embarrassingly low in the state of California.”

The California Department of Public Health in an emailed statement said it is aware of hospitals that have chosen to reduce or eliminate labor and delivery beds, but that in the last three years the total number of beds across the state has slightly increased. “CDPH is exploring any potential avenues within its authority to promote retention or further increases of these beds, in the interest of making sure maternal care across California remains protected.”

Some experts say it will take federal intervention to slow closures. On top of increasing reimbursement rates, they’ve also suggested putting policies in place that would make it harder for hospitals to close maternity services in already underserved communities.

For now, Cortese is carrying a bill to improve transparency and public notification when a hospital decides to close a maternity ward. Private hospitals aren’t currently required to disclose the reasons for eliminating services, he said. Another bill by Weber would require hospitals to notify the state a year in advance if a maternity ward is at risk of closure due to staffing or financial limitations.

Cortese and Weber say their measures would give the state and local governments information needed to intervene if there are potentially unnecessary closures.

They won’t, however, bring back services that have already been lost in communities like Blankenship’s.

Next to her delivery room, a young couple also covered by Medi-Cal rests while their newborn son sleeps in a bassinet. The mother didn’t think she would be able to deliver vaginally after a previous cesarean section, but MLK gave her the chance that other hospitals wouldn’t. At the end of the hall, a homeless woman living in a nearby shelter labors with a midwife by her side.

“If this community lost the services, I don’t know where these women would go,” midwife Sojobi said minutes after catching Blankenship’s daughter.

The insurance divide

More than 90% of the patients who go to MLK are covered by public insurance programs like Medi-Cal or Medicare. In contrast, most hospitals that still operate maternity wards rely heavily on private insurance. Patients with private insurance represent only 3% of MLK’s patient population.

Thirteen of the 17 maternity ward closures in L.A. County happened at hospitals that serve what the state calls a disproportionate share of low-income patients. Six of those closures happened in areas where shortages of medical providers make it difficult to get any type of health care, a CalMatters analysis of state and federal data shows.

Batchlor and other hospital administrators who serve mainly low-income patients say this creates a problem because public insurance reimburses far below the cost of care. The added expense of 24-hour staffing in a maternity ward makes it a loss leader for most hospitals.

Although more than 40 hospitals still deliver babies in the county, doctors say the swath of recent closures has caused care delays. The remaining maternity wards have to absorb new patients, sometimes overwhelming them, said Dr. Lisa Moore, a family medicine doctor with Venice Family Clinic, a community health center with clinics throughout the region. Since 2020, the number of babies born at L.A.’s three county-run hospitals has increased by several hundred each year, state data shows.

Medi-Cal patients often bear the brunt of delays. Appointments for pregnant Medi-Cal patients who need scheduled inductions have been increasingly postponed, and some hospitals have stopped taking all but the highest-risk Medi-Cal patients, multiple doctors interviewed for this story said.

“People are angry, and they’re scared often because we’re telling them ‘We need to induce you. It’s not safe for you to continue being pregnant.’ But then they’re also hearing ‘Not yet. There’s no appointment,’” Moore said.

Delays worsen existing maternal and infant health disparities and increase the likelihood of a pregnant patient needing a cesarean section, Moore said.

The role of for-profit hospitals

The high costs of keeping specialized staff available 24/7 combined with relatively low payment and high malpractice risk make labor and delivery particularly difficult for hospitals to maintain, but experts say hospitals can usually recoup losses on other services.

Two hospitals neighboring MLK that recently eliminated labor and delivery were high-earning for-profit facilities.

Centinela Medical Center, which is owned by national chain Prime Healthcare, averaged a 10% five-year operating margin when it stopped delivering babies in 2023. In contrast, the median five-year average operating margin for all California hospitals was 2%, according to a CalMatters analysis of hospital financial records. Prime Healthcare and its foundation have closed five maternity wards statewide since 2013, the most of any health system in California.

Elizabeth Nikels, a spokesperson for Prime Healthcare, denied that profitability or staffing shortages had anything to do with maternity ward closures at Centinela or its other four hospitals. She instead pointed to declining demand and low birth rates.

Like Centinela, many hospitals cite decreasing birth rates as a reason for eliminating labor and delivery. California’s birth rate has reached record lows and L.A. County is not immune to the trend, but maternity wards are closing faster than birth rate declines.

In 2023, 7,700 fewer babies were born in L.A. County compared to 2020. Maternity wards closed at a faster pace than that decline, forcing remaining hospitals to absorb about 3,800 additional births over three years, according to a CalMatters analysis of hospital utilization records.

“Prime Healthcare’s priority is always community need and patient care. Service line decisions are based on greatest benefit to patients with financial sustainability not a determining factor,” Nikels said in an email.

Centinela consolidated services with St. Francis Medical Center, also a Prime hospital located 10 miles away that delivers almost four times as many babies. In 2022, 732 babies were born at Centinela, state records show, roughly two per day. Another 2,762 were born at St. Francis that same year. Centinela’s consolidation with St. Francis gives patients access to “high quality care with expansive services,” Nikels said.

The other hospital near MLK that stopped delivering babies is Memorial Hospital of Gardena. Owner Pipeline Health System, another national chain, closed Memorial’s maternity ward in 2020. The hospital posted an average annual profit margin of 16% over the five years preceding its closing of labor and delivery services, state records show.

Pipeline owns four hospitals in L.A. County. Only one offers labor and delivery services. Jane Brust, a spokesperson for Pipeline Health System, said it would be “cost prohibitive” for Pipeline to implement obstetrics at its other three hospitals.

Meanwhile, nonprofit hospitals can also be part of large, well-funded systems, such as Kaiser Permanente and Sutter Health, but by law are required to assess the needs of their community and invest in those needs in exchange for their tax-exempt status. The attorney general holds additional regulatory power over nonprofit hospital acquisitions. This is not the case for transactions between for-profit systems.

“These aren’t public entities. They make the decisions in their boardroom, and nobody really knows what the basis was,” said Sen. Cortese.

That means for-profit systems tend to have more leeway in prioritizing the bottom line.

“In order to make money, you have to increase your revenue or decrease your expenses,” said Ge Bai, professor of health policy and management at Johns Hopkins University. “To decrease expenses is to cut off those unprofitable services.”

What do L.A. parents-to-be want?

Other experts say policymakers need to look beyond money.

“The bigger public policy question is, should hospital-based (obstetrics) be part of a set of services we feel everyone in California needs access to and should be a certain geographic distance from,” said Kristof Stremikis, director of markets and insights at the California Health Care Foundation.

For communities in the neighborhoods surrounding MLK, Centinela and Gardena, that’s an easy answer, said Gabrielle Brown, maternal and infant health program coordinator with Black Women for Wellness.

After Centinela ended its maternity program, Black Women for Wellness canvassed households within 10 miles of the hospital and held a community town hall to assess the impact. The verdict: Residents of Inglewood, a majority Black and Latino city, felt abandoned, Brown said.

The community was also reeling from the death of April Valentine, a young Black woman who died during childbirth at Centinela nine months before the hospital stopped labor and delivery care. Last year, state regulators fined Centinela $75,000 for lapses in care that led to the death. The hospital has previously denied allegations of improper care and racial bias.

“Instead of improving the services that they offer, they decided to remove them,” Brown said.

Prime spokesperson Nikels said Valentine’s death was not a factor in Centinela’s maternity ward closure.

If MLK were to close, patients including Blankenship and her daughter Myla would have to travel farther for delivery and postpartum services—barriers that often affect whether a pregnant patient sees a provider at all. In urban areas, the next hospital could be a few miles down the highway, but L.A.’s notorious traffic easily makes travel time untenable. They’d also lose the rare access to a midwife.

Patients and providers at MLK are acutely aware of how dangerous those barriers can be. A whiteboard in Blankenship’s room listedher birthing goals, the words “Safe Delivery” handwritten in bold. Frequently, laboring Black mothers arrive at the hospital terrified of what might happen having heard horror stories, midwife Sojobi said. Many never saw a doctor during their pregnancy.

“They look at me and go, ‘Please don’t let me die,’” Sojobi said.

Angela Sojobi, lead midwife at Martin Luther King Community Hospital in Los Angeles, on March 22, 2024.

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Next year, MLK is adding another midwife to its maternity team. A quarter of its financial loss comes from midwife salaries because Medi-Cal will not reimburse a midwife and an obstetrician working simultaneously, which is how MLK’s team works. The hospital will absorb the additional loss because midwives improve outcomes for communities of color, MLK executive Batchlor said.

For her, the decision to keep labor and delivery open no matter the cost comes down to believing patients deserve it.

“I think it’s leadership, and I think it’s values. I do,” Batchlor said.

We have another pip — the second egg in Big Bear’s famous bald eagle nest is showing signs of hatching.

The first pip, or crack, was confirmed in Jackie and Shadow’s egg no. 2 on Saturday morning, according to Friends of Big Bear Valley, the nonprofit that runs a popular YouTube livestream of the nest overlooking Big Bear Lake.

That’s about a day after the first egg started showing signs of hatching on Friday morning. The egg shell has continued to crack as the chick breaks through, revealing more of the eaglet’s fuzzy gray feathers as time goes on.

More than 38,000 people were watching the livestream shortly after the organization confirmed the second crack, compared with the more than 26,000 viewers who tuned in on Friday.

“The first egg is still in the process of hatching, it is not considered hatched until it is completely free of the egg shell. The chick has popped its head out of the shell to say a happy hatch day to mom and dad!” Friends of Big Bear Valley wrote on Facebook to more than a million followers on Saturday. “It also appears that the second egg has a pip. It is not well defined as of this morning, but we will likely see more progress throughout the day.”

Jackie and Shadow's usual incubation timeline is around 38 to 40 days, according to the nonprofit.

What’s next

With pips in place, it could take the chicks a day or two to complete the hatching process, as seen with last season’s trio.

Friends of Big Bear Valley won’t know for sure if any chicks are male or female, as the organization has said the only way to tell is with a blood test.

But once eaglets are around 9 or 10 weeks old, there should be signs that can help the nonprofit make an educated guess, including the chicks’ size, ankle thickness and vocal pitch.

Generally speaking, female bald eagles are larger than males. Female bald eagles also tend to have larger vocal organs — the syrinx — which leads to deeper, lower-pitched vocalizations, according to Friends of Big Bear Valley.

What do we call the chicks?

Historically, Jackie and Shadow’s chicks are given temporary nicknames initially, such as Chick 1 and Chick 2, or Bigger Chick and Smaller Chick (which some fans affectionately nicknamed Biggie and Smalls).

The final decision has then been left up to Big Bear Valley elementary school students. Previous chicks have been named Stormy, BBB (for Big Bear Baby), Simba and Cookie through that process.

Last year, Friends of Big Bear Valley crowdsourced more than 50,000 name choices in a week-long fundraiser, with the students voting from 30 finalists on official ballots delivered by the nonprofit.

The feathered parents’ eaglets were named Sunny and Gizmo last April.

One of last season’s three chicks didn’t survive a winter storm within weeks of hatching. Friends of Big Bear Valley named that chick “Misty” in honor of one of their late volunteers who is “still very missed,” the organization previously shared.

When Kekoa Gittens was 3, his preschool teacher told his mother he was a problem. He couldn’t sit still. He didn’t participate. When other kids learned the alphabet, he didn’t pay attention.

The next year, Kekoa’s classroom problems worsened. His mother, Sonia Gittens, took him to his pediatrician, who referred the boy to an eye doctor.

That doctor looked at the back of Kekoa’s eyes and diagnosed him with myopic degeneration, a dramatic form of nearsightedness.

“They are too little. They don’t know how to express themselves and say, ‘I cannot see it, teacher,’” said Sonia Gittens, who lives in the Marin County town of Corte Madera.

Today, Kekoa is a successful high schooler, but too many kids don’t get their eyes checked until they’re far behind in school.

Vision problems, particularly nearsightedness, have grown more common among American children. Roughly one in four school-age kids, or 25%, wear glasses or contacts, a proportion that increases as kids get older, according to 2019 federal survey data.

In California too few children on Medi-Cal like Kekoa are getting their eyes checked, and the problem is growing worse. Just 16% of school-age kids on Medi-Cal saw an eye doctor between 2022 and 2024 for first-time eye exams, continuing vision check ups or glasses, according to a report commissioned by the California Optometric Association. That’s down from 19% eight years earlier. The report, based on two years of Medi-Cal data, suggests that the state is moving in the wrong direction even as eye problems become more prevalent among kids.

Medi-Cal provides insurance for low-income Californians and those with disabilities.

“Every day when I see these children it is always a surprise to me that the kids are not getting the care they need,” said Ida Chung, a pediatric optometrist and an associate dean at Western University of Health Sciences in Pomona.

The trend indicated in the report is alarming, Chung said. In her clinic, where about half of children are on Medi-Cal, it’s common for kids with congenital vision problems to visit for the first time when they’re in first grade or later. That indicates to Chung that many kids don’t have enough access to eye care.

Though kids might be getting basic vision screenings at school or from a pediatrician, some eye problems are still overlooked. “It’s something the child had before they were born,” Chung said.

Eye exams decrease statewide

Colusa County, a rural farming region north of Sacramento, saw the sharpest drop in kids’ eye doctor appointments in the state from 20% between 2015-16 to just under 2% between 2022-24.

Nearly all counties — 47 out of 58 — performed worse on vision care than they did in the past, the report shows, with some, like Colusa, declining significantly.

Most of the severe declines happened in rural areas, although urban counties like San Francisco and Los Angeles also saw decreases. Only seven counties improved the rate of children receiving eye exams or glasses. Four counties were excluded for comparison in the report because the numbers were too small.

“The decline in performance here is so widespread that something really needs to happen,” said David Maxwell-Jolly, a health care consultant who authored the report and the former director of the Department of Health Care Services, which oversees Medi-Cal. “These numbers are way lower than what you would expect to be seeing if we’re doing a good job of detecting kids with treatable conditions.”

A spokesperson for the Department of Health Care Services said in an email the state could not confirm the accuracy of an external report, noting that vision services can be difficult to track because “not all encounters are captured in a single, comprehensive dataset.”

For example, many initial vision screenings take place in the pediatrician’s office during well-child visits, which include eye and hearing screenings as well as immunizations and developmental checks. State data shows about half of kids with Medi-Cal receive well-child visits.

Still, experts say the low numbers tell a real story: if children were reliably getting follow-up care from initial screenings, the share who get comprehensive eye exams and glasses would be closer to 25-30% — in line with the known prevalence of vision problems among kids — rather than the 16% found in the optometric association’s report.

Maxwell-Jolly said the analysis he conducted replicated an internal, unpublished department report tracking vision services between 2015 and 2016. His analysis, based on data obtained through a public records act request, updated the results for more recent years.

The state’s most recent Preventive Services Report, which measures how well Medi-Cal delivers preventive care to children, shows the rate of comprehensive eye exams for children and young adults ages 6-21 is similar to the optometric association’s analysis at 17%.

Contra Costa County experienced the third largest decline in children’s eye care in the state. A spokesperson for Contra Costa Health Plan said Medi-Cal health plans are not required by the state to track vision benefits and that it would take time to understand the data. The state, however, does track vision services internally, according to the health care services department.

A bill sponsored by the optometric association and authored by Assemblymember Patrick Ahrens, a Democrat from Cupertino, aims to require the state to establish vision benefit quality measures and report performance data publicly. The goal of the legislation is to track where kids do not have enough access to vision services and to ensure that Medi-Cal providers are improving services.

Rural challenges

Amy Turnipseed, chief strategy and government affairs officer for Partnership HealthPlan of California, said rural parts of the state struggle to find enough providers. The nonprofit health insurer provides Medi-Cal for 24 northern counties, including Colusa and Modoc.

In Modoc County, which borders Oregon and Nevada, one optometrist serves a 90-mile radius. Partnership has worked closely with that optometrist to ensure they continue accepting Medi-Cal patients, Turnipseed said.

“In rural counties with lower populations, losing even one provider can exponentially impact the access to services to families,” Turnipseed said. “In the past few years we’ve seen vision providers reduce or limit their Medi-Cal, which makes it harder for families to see providers.”

An assortment of glasses at Vision to Learn mobile optometry clinic at Esther Lindstrom Elementary School in Lakewood on March 20, 2026. Photo by Ariana Drehsler for CalMatters Modoc is one of just seven counties where more children have received vision care in recent years, according to the report.

Providers frequently cite low reimbursement rates from the state as a reason for not accepting Medi-Cal patients. The California Optometric Association estimates only about 10% of its members accept Medi-Cal. The reimbursement rate for a comprehensive eye exam is about $47, said Kristine Shultz, association executive director.

“Our reimbursement rates haven’t increased in 25 years. Imagine getting paid what you were paid 25 years ago,” Shultz said.

Schools check kids’ vision, but follow-up is spotty

State law requires schools to periodically check kids’ vision starting in kindergarten. Those screenings are a good bellwether for if a child is struggling to see in class, said Chung with Western University. The problem is getting the kids who fail the screening to an eye doctor.

Chung runs an academic optometry clinic that works with local schools in Pomona. Each year up to 35% of students fail the screening, meaning they likely have a vision problem. But based on conversations with school nurses, Chung said only about 7% of those children then go to an eye doctor and come back to school with glasses.

Chung, who chairs the children’s vision committee for the California Optometric Association, said colleagues who work with school districts around the state report similar experiences.

“If a high number of those children are not getting the follow up care, we may just be fooling ourselves and checking a box,” Chung said. “We’re in compliance with the law in California but are we really helping the children?”

For some families, the answer is no. That’s what happened to Kekoa when he was 3. The school checked his eyes and said he might have vision problems, but his mother, Gittens, waited. Her son was still learning his numbers and letters. How would he be able to read an eye chart, she reasoned. It wasn’t until his problems got worse that Gittens took Kekoa to an eye doctor.

Now, at 15, Kekoa wears contacts and likes athletics. He needs to see to compete in capoeira martial arts competitions and surf on the weekends, his mother said.

First: Dr. Kiyana Kavoussi shows letters on a monitor during Noah Mattison’s, 11, visual acuity test. Last: Optician Maya Ortega looks at Italia Martin’s, 6, eyes before she chooses new glasses inside the Vision to Learn mobile optometry clinic at Esther Lindstrom Elementary School in Lakewood on March 20, 2026. Photos by Ariana Drehsler for CalMatters Many parents lack the resources to take their kids to the doctor, or simply wait. Notes from school nurses flagging that a child failed a vision screening may also get lost in a backpack on the way home, educators say. The California Department of Education does not track the results of school vision screenings.

Vision To Learn, a nonprofit, created a mobile eye clinic to help bridge the gap between kids failing school vision screenings and getting glasses. The group brings an optometrist to campus, meaning kids that need an eye exam can get one the same day and go home having gotten a prescription and ordered glasses.

Damian Carroll, chief of staff and national director, said Vision to Learn’s numbers tell a similar story to Chung’s. About one-third of students screened are unable to read the eye chart, but very few of those kids have adequate glasses.

In the California schools where the program operates, around 70% of kids who have been prescribed glasses did not own a pair. Another 20% had glasses with outdated prescriptions, according to internal data, Carroll said.

And that gap can drastically affect learning outcomes or behavior in school.

“First and second graders who try on glasses the first time are blown away because they just thought that’s how the world looked,” Carroll said. “They can see the leaves on the trees and the math on the board, and it’s shocking to them.”

For the record: This story has been updated to reflect that Maxwell-Jolly’s study replicated the methodology of an earlier one by the Department of Health Care Services, but did not republish department findings.

Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

For more than 15 years, botanist Naomi Fraga of the California Botanic Garden has been trying to collect seeds from the rare Death Valley sage, for safekeeping in a vault of native California seeds. Each time, she's come home empty handed. But this year, with the desert in the midst of a big bloom, she's trying again.

"It's a little bit of a gamble," she says. "But, you know, the plant's having a really good year. I feel hopeful."

The plant has silvery-green pointy leaves, fuzzy buds and striking deep purple flowers. But it is challenging to study and to sample. Fraga says she often has to hike or scramble up mountainsides, or drive on backroads to find it. Very little is known about the plant's pollinator. And in exceptionally dry years, the Death Valley sage doesn't flower at all – meaning no seeds either.

The sage's habitat is mostly protected, within the boundaries of Death Valley National Park. But climate change doesn't respect park boundaries – and could push these plants that are already living on the brink into even more existential peril.

Naomi Fraga says for the first time since 2009, she found the Death Valley sage seeds. Soon, she says, she'll return with a team to make the first big harvest.

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"You can imagine that if conditions were to get more difficult with a changing climate, it's going to be harder and harder to collect seed," Fraga says.

In late March, Fraga headed into the foothills of the Nopah Range, near an abandoned mine, to check on one of the largest populations she knows of. And for the first time since 2009, she found the seeds. Soon, she says, she'll return with a team to attempt the first big harvest of Death Valley sage seeds.

A bee pollinates a Death Valley Sage in the Nopah Range near Death Valley.

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The first day of fall semester for a university freshman is often stressful. Not for Vanessa Menera, an 18-year-old who’s the first in her family to attend college.

Last year, she arrived 15 minutes early to her first fall class with an internship and campus job already in tow, plus a mental map of Cal State University Dominguez Hills, a sprawling, nearly 350-acre institution in the Los Angeles area’s South Bay.

The already confident student possessed even more motivation to make the most of her time on campus because of a program she took last summer: The First-Year Experience Summer Program.

“Everything was so easy to me, and I'm really grateful, because I know it was because of that First Year Experience that I was able to do that,” said Menera.

The summer program is one of several strategies Cal State Dominguez Hills seeks to expand as it combats a half-decade enrollment slide that’s unraveling its finances. But it’s not the only approach to fiscal right-sizing. Nor is Cal State Dominguez Hills alone in combatting large drops in its student population.

That’s because the money that the country’s largest public four-year university system needs to properly educate its students isn’t there. Now, California State University is embarking on a detailed, sweeping plan to enroll more students as part of an all-out push to bring much-needed cash to the workhorse system of 22 campuses that educates 471,000 students.

Ten campuses, including Dominguez Hills, saw double-digit enrollment declines in fall of 2025 compared to fall 2020, when the first full academic year of the COVID-19 pandemic began.

The loss of enrollment is a major driver of the financial struggles many of the system’s campuses face. The Cal State’s chancellor’s office says the system is facing a $2.3 billion budget gap in the current academic year. There’s a bright spot, though: Cal State officials say the system overall is on pace this year to beat state enrollment targets for the first time in four years.

People walk past the exterior of the Innovation & Instruction building at Cal State Dominguez Hills in Carson on Feb. 19, 2026. Photo by Zin Chiang for CalMatters Still, a key state lawmaker admonished the system’s under-enrolled campuses for missing its enrollment targets.

“I'm concerned that these campuses may be overfunded,” said Assemblymember David Alvarez, a Democrat from Chula Vista, at a December legislative hearing about Cal State’s finances. He is chairperson of the Assembly’s budget subcommittee on education and a key player in deciding how much state money universities receive. His worry? Other campuses with rising enrollments need the money to educate their ever-growing student body by hiring more professors, tutors and other staff to support students.

The state funds campuses based on how many Californians they enroll; by educating fewer students than what the state pays per student, the campuses are technically collecting more revenue than their enrollment levels would permit. That’s because the state pays schools for the number of California students they’re supposed to enroll, not how many they actually enroll.

By that measure, San Francisco State last year collected close to $50 million more in state dollars than its enrollment levels indicate it should receive — the campus enrolled about 5,300 fewer Californians than state goals stipulated in 2024. Cal State Dominguez Hills was taking about $7 million more. Conversely, Cal Poly Pomona was down about $20 million, because they enrolled 2,500 more students than the state’s target.

California is also eyeing multi-billion-dollar budget deficits, putting even more pressure on lawmakers and school systems to use money wisely.

The Legislature last year required Cal State to submit a report by March 1 detailing how campuses with enrollment struggles plan to attract new students and meet their state targets. Campuses sent their turnaround plans to the system’s chancellor’s office by December.

CalMatters conducted a dozen interviews and issued six records requests for this story.

Spotlight on Cal State Dominguez

Cal State Dominguez Hills’ enrollment is down 20% compared to 2020 and its finances have suffered. As a result, campus officials laid off 38 non-faculty staff and managers in 2025.

The school projects it will lose an additional $8 million this year, cutting deeper into its reserves, which have dwindled from $46 million in 2022 to a projected $10 million this summer.

The campus’ graduation rates fall below the systemwide average. And the campus historically has posted lower retention rates, meaning more students quit after one or two years compared to other campuses in the system. Dominguez Hill’s retention rate has grown in the last year, however.

The school enrolls the highest share of undergraduate students in the system who receive the federal Pell grant for low-income students — 69% compared to a Cal State average of 51%. Systemwide, those Pell students graduate at lower levels than students who don’t receive the grant.

Dominguez Hills’ turnaround plan includes a campus goal of enrolling about 800 more students to hit its enrollment target by 2027-28. More students plus planned systemwide tuition hikes and a new student-approved campus fee are projected to generate $25 million in additional money.

To reach its enrollment goals, the campus will lean on approaches that have demonstrated success, including the First Year Experience summer program, which Dominguez Hills started in 2022. Through the program, about a quarter of the freshman class enrolls in up to two free college courses during the summer before fall term. These are all general education courses required for graduation, with an emphasis on teaching students how to study well. The program also engenders a sense of community among students and campus staff.

Other strategies include attracting new students and keeping more of its current students. Another is to re-enroll students who’ve previously dropped out. It’s an approach that’s top of mind for campuses across the state: California is home to about 3.5 million adults with some college credit but no degree. Even a miniscule bump in the students who return to school could eradicate a campus’ enrollment woes.
Another budget-stabilizing effort may mean additional job losses. Campus professors are now meeting regularly to find ways to combine courses and run fewer sections of the same course. This helps the school average more students per course, but it’ll likely mean fewer lecturers — instructors who lack the full-time benefits and job safety of tenured professors.

Systemwide, 63 degree programs were discontinued by the Board of Trustees in 2024.

A student walks up the stairs in the Innovation and Instruction building at Cal State Dominguez Hills in Carson on Feb. 19, 2026. Photo by Zin Chiang for CalMatters Dominguez Hills in February reversed course on terminating six majors, including art history and philosophy. Student advocacy spurred the restoration. The school also determined that cutting individual programs made less sense than reviewing all majors to find other ways to integrate academic programs, said Kim Costino, the school’s interim provost, in an interview.

“Everyone is hopeful that we are going to be able to create a more economically efficient curriculum that serves students better,” said Terry McGlynn during an interview. He is a biology professor at Dominguez Hills who is chair of the academic senate, a faculty group that shapes campus academics.

But “there's clearly going to be some pain involved,” he added.

Summer session to keep students longer

The school cited in its report to the system that expanding the The First Year Experience program is one way to increase enrollment.

The campus spends $635,000 annually to run it. Almost 84% of students in the program advanced to their second year of college in fall 2024 — well above the 66% for students who didn’t sign up for the First Year Experience, according to data the campus shared. For a school desperate to undo its enrollment slide, keeping the students it has — and their tuition dollars — is a key strategy.

Any incoming freshman can enroll in the First Year Experience.

One reason Menera knew the campus so well when fall classes began? An extra-credit assignment for her environmental studies course over the summer required her to identify every vending machine on campus.

Student Vanessa Menera, 18, in the Innovation and Instruction Building at Cal State Dominguez Hills in Carson on Feb. 19, 2026. Photo by Zin Chiang for CalMatters The First Year Experience also features activities that reinforce what students learn, such as a field trip to a museum for an English course led by a guest author whose book the professor assigned to students. For her environmental studies class, Menera said that she carried a trash bag for more than a week to visualize how much waste people accumulate.

The school also awards a $150 scholarship to students who complete a summer-experience course. But for students who work over the summer or help care for family members, that amount alone may not be enough to persuade them to attend the program, said Costino. She ran the summer program until December.

The summer courses are long. Most meet twice weekly for four hours, so a student in two courses is in class for about 16 hours a week. Menera worked anyway that summer, maintaining the job she had during high school at TJ Maxx in Anaheim, some 20 miles from campus. She continues to work now, logging 17 hours a week at a campus convenience store on top of a full academic load. The summer program mentally prepared her for long school and work days, she said.

Costino thinks the program’s growth won’t be in students enrolling the summer before freshman year, but instead in students who earned a D or F in a course their first year and need to make up the class the following summer. While students can presently retake classes, they have to pay for them. Providing free make-up courses that either replace or average out a previous low grade helps the school retain more students who are on academic probation or just lost academic confidence after a bad first year, Costino said.

Re-enrolling students who dropped out

Cal State Dominguez Hills is seeking to expand its efforts to re-enroll students who’ve dropped out. Since 2021 the school has re-enrolled nearly 1,100 such students for fall term through its “Once a Toro, Always a Toro” program, named after the campus mascot.

While these students represent a tiny portion of the campus’ annual enrollment, they lead to instant revenue for the school from tuition and fees. It’s a few extra million dollars for the school, and it costs about $300,000 to $600,000 annually to maintain the re-enrollment program.

Once these students return to Dominguez Hills, most graduate. Data the campus shared with CalMatters show that earlier cohorts of the re-enrolled students have graduation rates of around 50% three years after they return. The numbers grow to about 70% after six years.

The school is now targeting any student who dropped out in the last 15 years or so, said Sabrina Sanders, the program director of Once a Toro.

She maintains a list of 10,000 formerly enrolled students. Annually, about 1,000 apply, around three-quarters are admitted, and roughly 300 to 400 enroll. Some who were admitted don’t enroll for several reasons, including prior low GPAs that make them ineligible for financial aid.

One of the students who returned is Wynette Davis. The 27-year-old is four classes away from finishing her bachelor’s degree in psychology after dropping out two years ago.

Davis transferred to the university from community college in 2022. She was on track to earn her bachelor’s in 2024 and even walked the stage during the spring graduation ceremony, needing just a few more classes that summer to finish her degree. But tragedy struck: Her daughter’s father died in spring 2024, and the shock derailed her academics. That spring and summer, she failed four classes. Davis left as a result.

She tried to re-enroll a year later, but learned she owed the university tuition money and couldn’t qualify for financial aid because her failing grades dropped her below the campus’ threshold for aid eligibility. Davis was ready to give up on earning a bachelor’s until an email from Once a Toro entered her inbox.

A staffer with the program helped Davis receive a waiver for her past-due account balance as long as she promised to pass her classes for the year, Davis said. The staffer also worked with the school financial aid office to reinstate her eligibility for financial aid for her spring classes after her grades improved.

Last fall Davis retook the classes she previously failed, passing them all this time. She’s in two classes this spring and will need two more next fall to earn her bachelor’s degree.

“If it wasn't for the Once a Toro, Always a Toro program, I probably would not have been back in school right now,” Davis said.

Another setback is the changing nature of academic requirements. Students who were gone for a decade may have pursued majors that don’t exist or were heavily altered, so the courses they took toward their majors might not satisfy new requirements. Sanders and the school’s advising teams collaborate with academic department deans to convert the re-enrolling students’ old coursework into the updated expectations for existing majors. Or re-enrolled students pursue an interdisciplinary major that combines old coursework with new.

“There's a sense of shame that comes with dropping out of college and having someone there to kind of put those thoughts and put that inner dialogue to rest” was key, said Stephanie Esquivel, a returning student who re-enrolled in 2022 after leaving the campus her freshman year in 2007.

She credited Sanders with helping her transfer her community college units to her university major. To Esquivel, a team like Once a Toro shows that the campus desires returning students and invests in the social infrastructure to help them, she said.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.