The Brief

Fortina Hernández is called “the one who knows it all.”

For more than two decades, the community health worker has supported hundreds of families throughout southeast Los Angeles by helping them sign up for food assistance, sharing information about affordable health coverage, and managing medications for their chronic illnesses. She’s guided by the expression “an ounce of prevention is worth a pound of cure.”

But she makes only around $20 an hour from a community health organization and must hold down a second job to make ends meet. “They pay us very little and expect too much,” she said in Spanish. "We build trust. We offer support. We’re the shoulder people rely on, but we don't get fair wages."

California looked to professionalize thousands of community health workers such as Hernández to improve the health of immigrant populations, particularly Hispanic residents, who often experience higher rates of chronic diseases, are more likely to be uninsured, and face more cultural and linguistic barriers when trying to access services. Studies show their work may reduce hospitalizations as well as emergency room and urgent care visits.

The state hewed closely to a series of expert recommendations put out in 2019 to standardize training and certification, integrate these workers into the health care workforce, and provide fair wages, including reimbursements through Medi-Cal, the state’s Medicaid health insurance program, to compensate for work that traditionally has been done on a volunteer basis or for low pay. But six years in, California has backed out of many of those initiatives.

The state has eliminated a certification program and rolled back nearly all funding to train and expand this workforce even though it set a goal of 25,000 workers by this year. Although Medi-Cal began covering their services, participating health plans set uneven billing requirements, making it difficult for workers to get reimbursed. And the state didn’t follow through on a planned pay raise.

With federal funding cuts just passed and President Donald Trump targeting immigrants for deportation — even sharing personal Medicaid data with the Department of Homeland Security — advocates fear California is abandoning its health equity initiative for immigrants, people of color, and people with low incomes when they say that effort is needed most.

“We're in a very dire situation right now,” said Cary Sanders, senior policy director for the California Pan-Ethnic Health Network, a statewide health equity advocacy group.

A spokesperson for Gov. Gavin Newsom, Elana Ross, said “the state has taken difficult but necessary steps to ensure fiscal stability” and that the administration continues to have a dialogue with community health workers. Ross added that the Democratic governor, a potential presidential candidate, remains committed to defending immigrants being targeted by the Trump administration.

‘Our office is on the street’

Lourdes Bernis (left) chats with a resident about Latino health issues. Bernis is a community health worker, or promotora, who helps people manage chronic illnesses, connects them to social services, and promotes healthy lifestyles.

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There are more than 60,000 community health workers nationwide, including roughly 9,200 in California, and this workforce is projected to grow 13% over the next decade, three times as fast as for all occupations, according to 2024 data from the U.S Bureau of Labor Statistics. But experts say these numbers are an undercount given the various titles community health workers hold and that many work outside of health care and governmental institutions.

Community health worker is an umbrella term that includes peer supporters and community health representatives. These workers, often known as promotores, tend to be women who work in clinics, hospitals, public health departments, and local nonprofits, places where they are trusted and have a grasp of their community’s most pressing health needs.

Besides helping people manage chronic illnesses such as heart disease and diabetes, they promote reproductive health, children’s health, and oral hygiene, and they help seniors with dementia prevent injuries and review medications. They can make people feel safe when reporting domestic violence and other abuses. They also connect people to housing and food assistance. "The community health worker is not sitting at a desk," Hernández said. "Our office is on the street."

Back in 2019, the California Future Health Workforce Commission recommended integrating community health workers into the health care system, and in 2022, the state authorized $281 million over three years for the California Department of Health Care Access and Information, which oversees health care workforce development, to recruit, train, and certify them.

The agency sought to standardize training and certification, but some community groups feared that would create barriers to entry by not giving enough credit for lived experiences and cultural competency. But just as the agency offered more flexibility and allowed community-based training, the state slashed $250 million in funding last year due to budget constraints. This year, the certification program was officially eliminated.

Spokesperson Andrew DiLuccia said the agency is now considering a program to accredit community organizations rather than individual workers and plans to spend its remaining $12 million on technical assistance, workforce development, and salaries for those working with immigrant communities.

According to the National Academy for State Health Policy, 32 other states offer a voluntary or mandatory community health worker certification program.

Some community health advocates say California’s missing an opportunity to carve a career path for this workforce. Currently, some courses offered by nonprofits, counties, and colleges require a fee, a degree, English fluency, or prior experience. Most are concentrated in the San Francisco or Los Angeles area, leaving training deserts in much of the state.

Lourdes Bernis received training that allowed her to move into a full-time role with the Los Angeles County Department of Mental Health. She says many community health workers remain stuck in low-paying positions and can’t afford training to advance.

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Elisa Ferrari for KFF Health News

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Lourdes Bernis, a dentist from Ecuador, is a model for how community health workers could be integrated into the health care system. She began as a volunteer promotora more than a decade ago and in 2019 received free training from Los Angeles County, allowing her to move into a full-time job with benefits for the county’s Department of Mental Health to help Spanish-speaking women manage depression and anxiety as they recover from drug use.

Bernis now plans to become a peer-to-peer support specialist inside hospitals and clinics. Meanwhile, many of her colleagues with decades of experience remain stuck in low-paying roles and can’t afford training to advance. “There are promotoras who have 20 to 25 years of experience, but they are still volunteering,” Bernis said in Spanish.

Medi-Cal's role

To pay community health workers, Medi-Cal began covering their services in July 2022, but California suspended a planned pay increase for them after voters approved Proposition 35, which hiked the pay of physicians, hospitals, community clinics, and other providers instead. Since then, the state has yet to establish a uniform system for how health plans should contract with organizations that employ community health workers.

“We have to jump through hoops,” said Maria Lemus, executive director at Visión y Compromiso, a Los Angeles-based nonprofit representing community health workers. “It just causes havoc, because each plan could have different requirements.”

Lemus said it took the organization nearly six months to establish payment with one health plan.

And though Medi-Cal reimbursements are tied to individual tasks, ranging from $9.46 to $27.54 for 30 minutes of work, advocates say they aren’t fully compensated for the time they spend building trust and following up with patients. Advocates say these workers should earn at least $30 a visit, with benefits, but many earn about $21 an hour, often without benefits.

Advocates say they’re surprised by how infrequently these services are used in a program with 15 million Californians. More than 16,000 Medi-Cal enrollees used these services in the first year, rising to 68,000 last year, according to state data. “I don't think it's reached the potential that the governor talked about, and that we all imagined that it could possibly achieve,” Sanders said.

Griselda Melgoza, a spokesperson for the California Department of Health Care Services, said the agency, which administers Medi-Cal, has seen “a steady, upward trend” and believes the data underestimates utilization because the benefit is sometimes bundled with other services.

A proposal to assess whether Medi-Cal managed care plans are doing enough outreach and education to enrollees about community health services died this year.

More crucial than ever

With health funding cuts from the Trump administration and passage of the GOP’s tax and spending legislation, advocates fear there will be even less funding and support for community health worker positions, shrinking a workforce tackling health disparities. Already, Fresno County’s Department of Public Health said it has cut its community health workers by more than half, from 49 positions to 20.

Yet, outreach is more crucial than ever. As the Trump administration continues immigration raids, which appear to have targeted at least one health clinic in the state, advocates and policy researchers say community health workers could act as intermediaries for immigrant patients afraid to seek medical care in hospitals and clinics.

Without a state certification program, no raises, and dwindling training funds, the path to professionalizing community health workers is unclear, leaving workers feeling left behind.

"The community trusts me,” said Hernández, the veteran community health worker, “but at the government level, there’s still a long way to go before this work is valued and fairly compensated."

This article was produced by KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism. KFF Health News is the publisher of California Healthline, an editorially independent service of the California Health Care Foundation.

A record number of people are expected to travel within the U.S. for Thanksgiving, be it plane, train or automobile.

Nearly 82 million are projected to travel at least 50 miles from Nov. 25 to Dec. 1, an increase of 1.6 million people compared to last year's holiday, according to an AAA report released on Monday.

Most of them will be hitting the road in a car, with about 73.2 million people expected to drive, AAA said. That's 1.8% more car travelers compared to the 2024 holiday period.

AAA projected 6 million people to travel by plane within the country for the holiday, a 2% increase from last year. Due to concerns over recent flight delays and cancellations, however, AAA also said that number could end up dropping slightly if travelers make last-minute arrangements to use other forms of transportation. Staffing shortages during the prolonged government shutdown earlier this month resulted in mass flight disruptions.

The FAA lifted its directive that called for an emergency reduction in flights, allowing airlines to return to operating normally. Aviation experts warned it could take some time before flights return to normal, but industry leaders appeared confident that airline operations would return to normal pre-shutdown levels in time for the Thanksgiving travel frenzy. Weather forecast to bookend the holiday in some parts of the country could cause flight disruptions and delays.

The Federal Aviation Administration (FAA) said Friday it expected the upcoming holiday rush to be the busiest Thanksgiving travel time for air travel in 15 years, with Tuesday being the busiest flying day.

Travel across other transport modes — bus, train and cruise — was forecast to increase 8.5% this year, with a likely uptick in last-minute bus and train bookings

"People are willing to brave the crowds and make last-minute adjustments to their plans to make lifelong memories, whether it's visiting extended family or meeting up with friends," Stacey Barber, vice president of AAA Travel said in a statement on Monday.

Here is what else to know:

Driving in the afternoon? Think again

Tuesday and Wednesday afternoon are expected to be the most congested times for drivers in major metro areas, according to INRIX, a transportation analytics firm.

If driving, the best times to hit the road for the holiday will be before noon on Tuesday and 11 a.m. on Wednesday to avoid backups, according to the firm. Thanksgiving Day will have minimal road traffic impacts.

When returning home after the holiday, travelers are advised to start driving before noon on any day except Monday. The Sunday after Thanksgiving will likely have heavy traffic most of the day and the best time to travel Monday will be after 8:00 p.m., INRIX said.

Weather could be messy, but should clear up for your trip back

During peak travel times, from Monday through Wednesday, rain extending from Southern Texas up to Minnesota will move across the country to the east, according to the National Weather Service (NWS).

"Monday into Tuesday will probably be a little problematic anywhere from Texas, eastern Oklahoma, into Arkansas and northwestern Louisiana," Bob Oravec, lead forecaster for the NWS, told NPR.

By Thanksgiving Day, things will be a little drier across the U.S. Temperatures will be colder than average for a majority of the country on Thanksgiving morning, with central parts of the U.S. seeing temperatures in the teens. On Black Friday, there will be warmer than average temperatures from the Great Plains to the West Coast, with places like Denver, Colo., seeing temperatures in the mid-50s, Oravec said.

Some of the worst weather will be across much of the central and eastern U.S. where there will be lake-effect snow showers coming off the Great Lakes, Oravec said.

For holiday travelers returning home on Friday and Saturday, the weather should be decent for a large portion of the country, he said. But a storm system is expected to develop over the weekend.

On Saturday and Sunday, the system could bring heavy snow across western Nebraska, South Dakota and North Dakota as well as parts of Minnesota into Wisconsin, according to Oravec. On Sunday, from Texas up into Missouri and Illinois, chances of rain are forecast to increase.

Copyright 2025 NPR

A new electric streetcar service connecting Garden Grove and Santa Ana is currently undergoing testing. If all goes as planned, the new service will be in operation starting next summer.

The nearly $650 million project — funded through a combination of state, federal and local funds — was originally set to begin service in 2021, but has been beset by rising costs and delays.

A train operator sits inside one of the OCTAs OC Streetcars for safety testing.

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Back on track

Darrell E. Johnson, Orange County Transportation Authority's CEO, told LAist that the service is 95% complete. The current testing phase could take anywhere between six and 12 months.

That means testing the train pulls out of the platform properly, control systems are operating properly, and that the train system interfaces with the street signal system along its route.

All aboard

Each car is over 90 feet long and has the capacity to carry up to 211 passengers.

“The fleet itself is eight vehicles. The service that we plan to run will take six of them every day.” Johnson said.

The new service will travel across some of densest areas of Orange County, ferrying an expected 5,000 passengers a day across the route's 10 stops.

The eastern side of the route starts at Santa Ana Regional Transportation Center, where over 50 Amtrak and Metrolink trains pass through daily.

The Civic Center for the county — which houses state, federal and county courthouses as well as Santa Ana City Hall — is in the middle of the route.

The service will end at the Harbor Boulevard — a heavily used bus route that sees more than 10,000 passengers a day.

The front view of an OC Streetcar on tracks.

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Transportation future

OCTA says it plans to charge the exact same amount as their bus system to ride the streetcar service — $2 one way or $5 for a day pass.

The service is slated to run every day from 6 a.m. to 11 p.m., with extended hours on weekends.

Officials are hoping for an Aug. 1 launch next year. And they don't anticipate stopping there.

“This is the beginning of something, whether we go north on Harbor Boulevard or South on Bristol Street or we continue westerly towards Artesia, Cerritos and LAX,” Johnson said. “That’s probably a decision that will be discussed in the next two to five years.”

Some of the red ink in California’s budget deficit is coming from unplanned spending in state prisons, according to a new report from the Legislative Analyst’s Office.

The California Department of Corrections and Rehabilitation is on track to exceed its budget by roughly $850 million over three years despite recent cuts that include four prison closures and some labor concessions that trimmed payroll expenses. The state budget included $17.5 billion for prisons this year.

The office attributed the corrections department’s shortfall to both preexisting and ongoing imbalances in its budget. The analyst’s annual fiscal outlook projected a nearly $18 billion deficit for the coming year, which follows spending cuts in the current budget.

The corrections department last year ran out of money to pay its bills. In May, it received a one-time allocation of $357 million from the general fund to cover needs including workers’ compensation, food for incarcerated people and overtime.

Democratic Sen. Scott Wiener of San Francisco in a June 17 letter to the Department of Finance said he was “shocked and disappointed that (the corrections department) overspent its budget by such a significant amount” while the state faced a $12 billion general fund shortfall that resulted in cuts to key health care and social service programs.

“These were dollars that could have been used to provide basic services to some of our most underserved communities,” wrote Wiener. “While this year’s budget included measures requiring departments to ‘tighten their belts’ and reduce state operating expenses by up to 7.95%, (the corrections department) did the opposite, and overspent by nearly three percent.”

Without having any new dedicated funding to align its actual costs with its budget, Wiener warned, deficits “will likely persist” and put additional pressure on the general fund in years to come.

That’s despite Gov. Gavin Newsom’s attempts to save the state money through prison closures. Newsom in May moved to close the state prison in Norco in Riverside County next year, the fifth prison closure under his tenure.

Newsom’s administration estimates it saves about $150 million a year for each prison closure, which lawmakers and advocates regard as the only way to significantly bring down corrections spending. A spokesperson for Newsom’s Finance Department declined to comment on the analyst’s projection. Newsom will release his next budget proposal in January.

“We are allowing wasteful prison spending to continue while Californians are being told to tighten their belts and brace for deep federal cuts to core programs,” said Brian Kaneda, deputy director for the statewide coalition Californians United for a Responsible Budget in a statement to CalMatters. “We are spending millions on prisons that could be safely closed. That is government waste, not public safety.”

I wasn’t expecting the internet’s biggest Chinese rapper to make his Southern California debut (we are not counting the earlier San Diego show) at a sprawling, sterile business park in Santa Ana.

But there I was Wednesday night along with hundreds of people at the Observatory to watch the viral sensation perform his brand of hip-hop blending Memphis trap with lyrics rooted in Cantonese folk and everyday culture across southeastern China.

You may not know the name, SKAI Isyourgod, but if you have been on Instagram or TikTok in the last couple years, you can’t escape the sound — or the memes.

" He's really famous on Instagram," said Julie Sun, who came to the gig from Irvine. " He popped up a lot throughout all different kinds of video content."

That’s how I learned of his music — through a reel that had nothing to do with his music. But it was grabby from the first note, opening as it did by sampling a vintage Cantonese opera. That inventive touch sent me searching for the whole song, “Blueprint Supreme,” which turned out to be a kind of tongue-in-cheek send up on the nouveau riche.

It’s a theme the 27-year-old from Guangdong Province goes back to with humor and deft wordplay in the track “Stacked On All Sides.”

Throughout the night, the crowd yelled out the name of that tune. When it was finally performed, all the phones were raised.

“His lyrics [are] mostly very positive and kind of give the good fortune to people,” Sun said.

Like Sun, the vast majority of the audience were Chinese.

"Where’s everyone from?" SKAI asked during one of his interludes, and the crowd shouted back: "Dongbei…. Fushan…."

But there were also plenty of non-Chinese speaking fans at the club, a testament to the rapper’s global virility.

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Fiona Ng

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LAist

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SKAI Isyourgod performs in Santa Ana in 2025.

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Noah Rosen lives in Santa Ana, but he first learned about SKAI two years ago through friends and people he worked with at the company he cofounded, which has a satellite office in China.

"We blasted [it] in carpool karaoke and stuff like that," said Rosen, who doesn’t speak Chinese.

"There's something so catchy and so inventive, and it's a fantastic melody," he continued. "Which is why they're so good on TikTok and Instagram and everything. Doesn't matter if you understand the lyrics or not."