Patti LaFleur’s mother, Linda LaTurner, moved into her home after her dementia progressed and care became complicated. “My mom had always been a very happy easygoing person. But she withdrew from social situations and cried a lot,” LaFleur says.
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Courtesy of Patti LaFleur
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Topline:
A new proposal from the Centers for Medicare & Medicaid Services offers more support to people who care for frail, ill, and disabled older adults.
Why it matters: For the first time, the proposal would authorize Medicare payments to healthcare professionals to train informal caregivers who manage medications, assist loved ones with activities such as toileting and dressing, and oversee the use of medical equipment.
Why now: The proposal, which covers both individual and group training, is a long-overdue recognition of the role informal caregivers play in protecting the health and well-being of older adults.
The backstory: About 42 million Americans provided unpaid care to people 50 and older in 2020, according to a much-cited report.
What's next: If you’d like to let CMS know what you think about its caregiving training proposal, you can comment on the CMS site until 5 p.m. ET on Sept. 11.
Even with extensive caregiving experience, Patti LaFleur was unprepared for the crisis that hit in April 2021, when her mother, Linda LaTurner, fell out of a chair and broke her hip.
LaTurner, 71, had been diagnosed with early-onset dementia seven years before. For two years, she’d been living with LaFleur, who managed insulin injections for her mother’s Type 1 diabetes, helped her shower and dress, dealt with her incontinence, and made sure she was eating well.
In the hospital after her mother’s hip replacement, LaFleur was told her mother would never walk again. When LaTurner came home, two emergency medical technicians brought her on a stretcher into the living room, put her on the bed LaFleur had set up, and wished LaFleur well.
That was the extent of help LaFleur received upon her mother’s discharge.
She didn’t know how to change her mother’s diapers or dress her since at that point LaTurner could barely move. She didn’t know how to turn her mother, who was spending all day in bed, to avoid bedsores. Even after an occupational therapist visited several days later, LaFleur continued to face caretaking tasks she wasn’t sure how to handle.
“It’s already extremely challenging to be a caregiver for someone living with dementia. The lack of training in how to care for my mother just made an impossible job even more impossible,” said LaFleur, who lives in Auburn, Washington, a Seattle suburb. Her mother passed away in March 2022.
A new proposal from the Centers for Medicare & Medicaid Services addresses this often-lamented failure to support family, friends, and neighbors who care for frail, ill, and disabled older adults. For the first time, it would authorize Medicare payments to healthcare professionals to train informal caregivers who manage medications, assist loved ones with activities such as toileting and dressing, and oversee the use of medical equipment.
The proposal, which covers both individual and group training, is a long-overdue recognition of the role informal caregivers — also known as family caregivers — play in protecting the health and well-being of older adults. About 42 million Americans provided unpaid care to people 50 and older in 2020, according to a much-cited report.
“We know from our research that nearly 6 in 10 family caregivers assist with medical and nursing tasks such as injections, tube feedings, and changing catheters,” said Jason Resendez, president and CEO of the National Alliance for Caregiving. But fewer than 30% of caregivers have conversations with health professionals about how to help loved ones, he said.
Even fewer caregivers for older adults — only 7% — report receiving training related to tasks they perform, according to a June 2019 report in JAMA Internal Medicine.
Cheryl Brown’s husband, Hardy, was diagnosed with amyotrophic lateral sclerosis, also known as Lou Gehrig’s disease, in 2002. He can’t walk but he can use his arms and hands. Brown says she “never gets a break” from caregiving responsibilities.
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Van Howard
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Image Arts
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Nancy LeaMond, chief advocacy and engagement officer for AARP, experienced this gap firsthand when she spent six years at home caring for her husband, who had amyotrophic lateral sclerosis, a neurological condition also known as Lou Gehrig’s disease. Although she hired health aides, they weren’t certified to operate the feeding tube her husband needed at the end of his life and couldn’t show LeaMond how to use it. Instead, she and her sons turned to the internet and trained themselves by watching videos.
“Until very recently, there’s been very little attention to the role of family caregivers and the need to support caregivers so they can be an effective part of the health delivery system,” she told me.
Several details of CMS’ proposal have yet to be finalized. Notably, CMS has asked for public comments on who should be considered a family caregiver for the purposes of training and how often training should be delivered.
(If you’d like to let CMS know what you think about its caregiving training proposal, you can comment on the CMS site until 5 p.m. ET on Sept. 11. The expectation is that Medicare will start paying for caregiver training next year, and caregivers should start asking for it then.)
Advocates said they favor a broad definition of caregiver. Since often several people perform these tasks, training should be available to more than one person, Resendez suggested. And since people are sometimes reimbursed by family members for their assistance, being unpaid shouldn’t be a requirement, suggested Anne Tumlinson, founder and chief executive officer of ATI Advisory, a consulting firm in aging and disability policy.
As for the frequency of training, a one-size-fits-all approach isn’t appropriate given the varied needs of older adults and the varied skills of people who assist them, said Sharmila Sandhu, vice president of regulatory affairs at the American Occupational Therapy Association. Some caregivers may need a single session when a loved one is discharged from a hospital or a rehabilitation facility. Others may need ongoing training as conditions such as heart failure or dementia progress and new complications occur, said Kim Karr, who manages payment policy for AOTA.
When possible, training should be delivered in a person’s home rather than at a health care institution, suggested Donna Benton, director of the University of Southern California’s Family Caregiver Support Center and the Los Angeles Caregiver Resource Center. All too often, recommendations that caregivers get from health professionals aren’t easy to implement at home and need to be adjusted, she noted.
Nancy Gross had to perform “nursing tasks I wasn’t prepared to do” when her husband, Jim Kotcho, came home after a stem cell transplant for leukemia. “Until you’re really into caregiving, you don’t know what your issues will be,” she says.
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Courtesy of Jim Kotcho
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Nancy Gross, 72, of Mendham, New Jersey, experienced this when her husband, Jim Kotcho, 77, received a stem cell transplant for leukemia in May 2015. Once Kotcho came home, Gross was responsible for flushing the port that had been implanted in his chest, administering medications through that site, and making sure all the equipment she was using was sterile.
Although a visiting nurse came out and offered education, it wasn’t adequate for the challenges Gross confronted. “I’m not prone to crying, but when you think your loved one’s life is in your hands and you don’t know what to do, that’s unbelievably stressful,” she told me.
For her part, Cheryl Brown, 79, of San Bernardino, California — a caregiver for her husband, Hardy Brown Sr., 80, since he was diagnosed with ALS in 2002 — is skeptical about paying professionals for training. At the time of his diagnosis, doctors gave Hardy five years, at most, to live. But he didn’t accept that prognosis and ended up defying expectations.
Today, Hardy’s mind is fully intact, and he can move his hands and his arms but not the rest of his body. Looking after him is a full-time job for Cheryl, who is also chair of the executive committee of California’s Commission on Aging and a former member of the California State Assembly. She said hiring paid help isn’t an option, given the expense.
And that’s what irritates Cheryl about Medicare’s training proposal.
“What I need is someone who can come into my home and help me,” she told me. “I don’t see how someone like me, who’s been doing this a very long time, would benefit from this. We caregivers do all the work, and the professionals get the money? That makes no sense to me.”
What’s next: The temporary order expires in 14 days. The court battle will continue to play out, with further decisions by the judge expected in the coming weeks, after more arguments from both sides.
The context: In halting childcare and welfare benefits to hundreds of thousands of low-income Californians, the Trump administration wrote that “recent federal prosecutions” are driving concerns about “systemic fraud.” But an LAist review found fraud in the targeted programs appears to be a tiny fraction of the total spending. Prosecutions that have been brought around child care benefits amount to a small fraction of 1% of the federal childcare funding California has received, according to a search of all case announcements in the state. When pressed for details about what specific prosecutions justify the freeze in California, administration officials have offered few specifics.
Federal judge orders LA to pay $1.8M in settlement
Makenna Sievertson
has been covering the case and attending federal hearings in downtown L.A. since at least March 2024.
Published January 9, 2026 5:02 PM
A view of L.A. City Hall in downtown.
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Makenna Sievertson
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LAist
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Topline:
A federal judge has ordered Los Angeles to pay more than $1.8 million in attorneys’ fees and costs to the L.A. Alliance for Human Rights and other organizations that sued the city over what it deemed an inadequate response to the homelessness crisis.
The details: In addition to $1.6 million in attorneys’ fees and $5,000 in costs to L.A. Alliance, the judge awarded about $200,000 in fees and $160 in costs to the Los Angeles Catholic Worker and Los Angeles Community Action Network.
Why now: The city is appealing the decision.
Why it matters: In his order, released Tuesday, the judge compared the recent award to the millions of taxpayer dollars city officials agreed to pay an outside law firm representing L.A.in the settlement.
Read on ... for more about this week's order.
A federal judge has ordered Los Angeles to pay more than $1.8 million in attorneys’ fees and costs to the L.A. Alliance for Human Rights and other organizations that sued the city over what it deemed an inadequate response to the homelessness crisis.
The city is appealing the decision.
The details
L.A. Alliance is a group of business owners and residents who sued the city and county of Los Angeles in 2020 in an effort to push both governments to provide more shelter to unhoused people in the region.
The city of L.A. settled with the plaintiffs in 2022, and U.S. District Judge David O. Carter is overseeing the city’s progress in keeping up with the terms of that agreement. The judge found the city breached its agreement in multiple ways in a ruling last summer.
Specifically, the judge found that the city did not provide a plan for how it intends to create 12,915 shelter beds, as promised, by 2027. The court also found the city “flouted” its responsibilities by failing to provide accurate, comprehensive data when requested and did not provide evidence to support the numbers it was reporting, according to court documents.
In addition to $1.6 million in attorneys’ fees and $5,000 in costs to L.A. Alliance, Carter awarded about $200,000 in fees and $160 in costs to the Los Angeles Catholic Worker and Los Angeles Community Action Network.
The organizations are considered “intervenors” in the suit, representing people experiencing homelessness on Skid Row. Their attorneys include those from the Legal Aid Foundation of Los Angeles.
Why it matters
In his order, released Tuesday, Carter compared the recent award to the millions of taxpayer dollars city officials agreed to pay an outside law firm representing L.A. in the settlement.
“It has fallen to plaintiff, intervenors, and journalists to point out the deficiencies in the city’s reporting,” Carter wrote, referring to data the city is required to report to the court as part of the settlement.
“Plaintiff and intervenors must be compensated for this,” he said.
The city’s response
Attorneys representing the city filed a notice of appeal with the U.S. District Court in Los Angeles on Thursday.
L.A. City Attorney Hydee Feldstein-Soto’s office did not respond to LAist’s requests for comment by phone or email.
Shayla Myers, senior attorney with the Unhoused People's Justice Project at the Legal Aid Foundation of Los Angeles, told LAist the intervenors participated in the case without compensation “because it's incredibly important given what is at stake in these proceedings that unhoused folks have a voice.”
Matthew Umhofer, an attorney for L.A. Alliance, told LAist he’s thrilled the court is imposing accountability on the city, including sanctions for violating the settlement agreement. But Umhofer said he’s saddened that L.A. Alliance is going to have to keep fighting to hold the city to its promises.
“The obvious city strategy here is hire a big, good law firm to fight on absolutely every front in hopes that the plaintiffs, the intervenors or the court will ultimately give up trying to hold the city accountable,” he said.
What's next
The parties are scheduled to appear in federal court in downtown L.A. on Monday, when a hearing will resume to determine whether the judge will hold the city of Los Angeles in contempt of court.
Carter has said in documents that he’s concerned “the city has demonstrated a continuous pattern of delay” in meeting its obligations with court orders under the settlement and that the “delay continues to this day.”
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Gab Chabrán
covers what's happening in food and culture for LAist.
Published January 9, 2026 3:52 PM
Asha Stark's Hot Grease specializes in Black fish fry with a side of social justice.
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Gab Chabrán
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LAist
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Topline:
Smorgasburg L.A. reopens this Sunday with 13 new food vendors joining the downtown market's annual grand reopening at the Row.
Why now: The January grand reopening with new vendors is a longstanding tradition that kicks off the year ahead. Vendors apply through Smorgasburg's website, and the team meets with every applicant to taste their food before acceptance. Competition remains fierce, with many more applicants than available spots. This year marks the market's 10th anniversary celebration in June.
Why it matters: The new vendor class demonstrates the resilience of L.A.'s independent food scene, following a challenging year for the restaurant industry, with concepts ranging from a Grammy-nominated producer's Persian-influenced pizza to Southern fried fish honoring Black migration history.
Every January, the open-air downtown food fair reopens after its winter break and announces new additions to its carefully selected group of regular vendors.
This year’s new vendor class demonstrates the resilience of L.A.'s independent food scene, ranging from a Grammy-nominated producer's Persian-influenced pizza to Southern fried fish celebrating Black American culinary traditions, to an LAist 2025 Tournament of Cheeseburger heavyweight contender.
The reopening also marks the start of Smorgasburg LA's 10th anniversary year, and will feature 41 returning vendors, who've helped build the regular event into a fun, family-friendly opportunity to try new, often cutting-edge food you may not be familiar with.
Doors open from 10 a.m. to 4 p.m. at DTLA’s The Row, with free entry and free parking for the first two hours.
A new year
General manager Zach Brooks said this is his favorite time of year. "We add the new vendors at the beginning of the new year, everyone's excited."
Vendors apply through Smorgasburg's website, and the team meets with every applicant to taste their food before acceptance. Brooks said it's not a vetting process like "Shark Tank" but rather a matter of seeing if it's a good fit. Competition remains fierce, with many more applicants than available spots.
"I think it's just a testament to L.A. and the resilience of people who love this business and have a passion for it, and are going to continue to persevere and start their businesses and want to be out there selling food," Brooks said.
Here are a few highlights:
Viral orange chicken sandwich
Long Beach-based Terrible Burger becomes Smorgasburg's new permanent burger vendor after standout appearances at LAist's Tournament of Cheeseburgers and the market's rotating Smorgasburger Stand. The smashburger pop-up, run by husband-and-wife team Nicole and Ryan Ramirez, specializes in burgers that draw from pop culture and global influences. They've made waves with a Korean barbecue burger topped with bulgogi barbecue sauce and a viral orange chicken sandwich, previously available only at their Tuesday night residency at Long Beach's Midnight Oil, making its L.A. debut Sunday.
Terrible Burger's viral orange chicken sandwich makes its LA debut at Smorgasburg after being available only in Long Beach.
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Courtesy Terrible Burger
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"We have been big Smorgasburg fans for a really long time before we even started Terrible Burger. We would go to Smorgasburg on dates, just eat and hang out. And it was just always a little dream of, "oh, what if we ever sold food here?" Nicole Ramirez said.
Crispy fried snapper and thick-cut fries
Orange County-based Hot Grease, run by Asha Starks, is among four vendors graduating from residencies to permanent status. The Southern fried fish pop-up celebrates Black American history through food that honors Starks' family heritage.
"Folks often forget that there are Black folks in Orange County. My family came to Orange County during the second wave of the Great Migration, and they settled in Santa Ana... my food is very cultural. And the story, I feel like, is just as important to highlight," Starks said.
Hot Grease's crispy buttermilk fried snapper with thick-cut fries and "Ill Dill" tartar sauce.
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Courtesy Hot Grease
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Hot Grease serves crispy buttermilk fried snapper with thick-cut fries and small-batch sauces like "Ill Dill" tartar. Honoring the fish fry's history as a site of mutual aid, Starks directs 3% of sales to the Potlikker Line, Hot Grease's reproductive justice mutual aid fund. For January, she's added fish and grits, black-eyed peas and collard greens.
Pizza with a Persian twist
Mamani Pizza brings studio-born energy to Smorgasburg LA with pies featuring Persian-inspired creativity.
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Courtesy Mamani Pizza
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Mamani Pizza, from the Grammy-nominated producer Farsi, part of the music production team Wallis Lane, started making Neapolitan-style pizzas at his West L.A. recording studio a year ago. What began as late-night pies for friends and artists became an underground hit. Most pizzas are traditional, but Farsi adds Persian touches like The Mamani, topped with ground wagyu koobideh, roasted Anaheim chilis, Persian herbs and pomegranate molasses.
Cato Hernández
covers important issues that affect the everyday lives of Southern Californians.
Published January 9, 2026 3:48 PM
Potholes pop up after rain because water seeps into the road's crevices and weakens the foundation. Cars driving over it exacerbates the damage, leading to more cracks.
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Cato Hernández
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LAist
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Topline:
All that rain didn’t just flood L.A. County streets, it chewed up our roads. You’re likely driving over more potholes than usual, so what do you do if your car gets damaged from one? You could get the government to pay for it.
How it works: You’ll want to take pictures of the pothole and your car. Then, submit a claim form. Personal property damage claims have a six-month filing period, and you’ll have to pay out-of-pocket first.
Unincorporated L.A. County: If the damage happened in an unincorporated area, you’ll have to print and mail this claim form.
Highway/freeways in L.A. or Ventura counties: For Caltrans damage claims, follow the filing directions here.
Manage your expectations: Keep in mind, this isn’t a quick way to cash. Claims can take months. You’ll also have to prove the agency was aware of the problem before your incident, such as by looking at street maintenance records for your area. Here are tips from the now-defunct site LAPotholes.com.
What’s next: Potholes continue to plague the city of L.A., and that’s probably not ending soon. In the next budget, StreetsLA (aka Bureau of Street Services) is proposing to prioritize funding for “large asphalt repair,” which means patching over sections rather than fully repaving streets, which some argue will lead to worse roads.
