The Brief

Here in the rugged foothills of California’s Sierra Nevada, the streets aren’t littered with needles and dealers aren’t hustling drugs on the corner.

But meth is almost as easy to come by as a hazy IPA or locally grown weed.

Quinn Coburn knows the lifestyle well. He has used meth most of his adult life, and has done five stints in jail for dealing marijuana, methamphetamine, and heroin. Now 56, Coburn wants to get sober for good, and he says an experimental program through Medi-Cal, California’s Medicaid program, which covers low-income people, is helping.

As part of an innovative approach called “contingency management,” Coburn pees in a cup and gets paid for it — as long as the sample is clean of stimulants.

In the coming fiscal year, the state is expected to allocate $61 million to the experiment, which targets addiction to stimulants such as meth and cocaine. It is part of a broader Medi-Cal initiative called CalAIM, which provides social and behavioral health services, including addiction treatment, to some of the state’s sickest and most vulnerable patients.

Since April 2023, 19 counties have enrolled a total of about 2,700 patients, including Coburn, according to the state Department of Health Care Services.

“It’s that little something that’s holding me accountable,” said Coburn, a former construction worker who has tried repeatedly to kick his habit. He is also motivated to stay clean to fight criminal charges for possession of drugs and firearms, which he vociferously denies.

Coburn received $10 for each clean urine test he provided the first week of the program. Participants get a little more money in successive weeks: $11.50 per test in week two, $13 in week three, up to $26.50 per test.

They can earn as much as $599 a year. As of mid-May, Coburn had completed 20 weeks and made $521.50.

Participants receive at least six months of additional behavioral health treatment after the urine testing ends.

The state has poured significant money and effort into curbing opioid addiction and fentanyl trafficking, but the use of stimulants is also exploding in California. According to the state Department of Health Care Services, the rate of Californians dying from them doubled from 2019 to 2023.

Although the cutting-edge treatment can work for opioids and other drugs, California has prioritized stimulants. To qualify, patients must have moderate to severe stimulant use disorder, which includes symptoms such as strong cravings for the drug and prioritizing it over personal health and well-being.

Substance use experts say incentive programs that reward participants, even in a small way, can have a powerful effect with meth users in particular, and a growing body of evidence indicates they can lead to long-term abstinence.

“The way stimulants work on the brain is different than how opiates or alcohol works on the brain,” said John Duff, lead program director at Common Goals, an outpatient drug and alcohol counseling center in Grass Valley, where Coburn receives treatment.

“The reward system in the brain is more activated with amphetamine users, so getting $10 or $20 at a time is more enticing than sitting in group therapy,” Duff said.

California is paying Medicaid enrollees who use meth, cocaine, and other amphetamines to stay sober. As part of the experiment, participants can earn up to $599 a year for submitting clean urine tests. A Nevada County nonprofit organization called Common Goals has enrolled more than a dozen people since launching its program early this year.

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Angela Hart

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KFF Health News

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Duff acknowledged he was skeptical of the multimillion-dollar price tag for an experimental program. “You’re talking about a lot of money,” he said. “It was a hard sell.”

What convinced him? “People are showing up, consistently. To get off stimulants, it’s proving to be very effective.”

California was the first state to cover this approach as a benefit in its Medicaid program, according to the Department of Health Care Services, though other states have since followed, including Montana.

Participants in Nevada County must show up twice a week to provide a urine sample, tapering to once a week for the second half of treatment. Every time the sample is free of stimulants, they get paid via a retail gift card — even if the sample is positive for other kinds of drugs, including opioids.

Though participants can collect the money after each clean test, many opt for a lump sum after completing the 24-week program, Duff said. They can choose gift cards from companies such as Walmart, Bath & Body Works, Petco, Subway, and Hotels.com.

Charlie Abernathybettis — Coburn’s substance use disorder counselor, who helps run the program for Nevada County — said not everyone consistently produces a clean urine test, and he has devised a system to stop people from rigging their results.

For example, he uses blue toilet cleaner to prevent patients from watering down their urine, and has dismantled a spigot on the bathroom faucet to keep them from using warm water for the same purpose.

If participants fail, there are no consequences. They simply don’t get paid that day, and can show up and try again.

“We aren’t going to change behavior by penalizing people for their addiction,” Abernathybettis said, noting the ultimate goal is to transition participants into long-term treatment. “Hopefully you feel comfortable here and I can convince you to sign up for outpatient treatment.”

Abernathybettis has employed a tough love approach to addiction therapy that has helped keep Coburn sober and accountable since he started in January. “It’s different this time,” Coburn said as he lit a cigarette on a sunny afternoon in April. “I have support now. I know my life is on the line.”

Growing up in the Bay Area, Coburn never quite felt like he fit in. He was adopted at an early age and dropped out of high school. His erratic home life set him on a course of hard drug use and crime, including manufacturing and selling drugs, he said.

“When I first did crank, it made me feel like I was human for the first time. All my phobias about being antisocial left me,” Coburn said, using a street name for meth.

Coburn escaped to the solitude of the mountains, trees, and rivers that define the rural landscape in Grass Valley, but the area was also rife with drugs.

Construction accidents in 2012 left him in excruciating pain — and unable to work.

Coburn fell deeper into the drug scene, as both a user and a manufacturer. “You wouldn’t believe the market up here for it — more than you can even imagine,” he said. “It’s not an excuse, but I had no way to make a living.”

Financially strapped, he rented a cheap, converted garage from another local drug dealer, he said. Law enforcement officers raided the house in October, and authorities found a gun and large amounts of fentanyl and heroin. Coburn, who faces up to 30 years in prison, vigorously defends himself, saying the drugs and weapons were not his. “All the other ones I did. Not this one,” he said.

Coburn is also in an outpatient addiction program and is active in Alcoholics Anonymous, sometimes attending multiple meetings a day.

Every week, the small payments from the Medi-Cal experiment feel like small wins, he said.

He is planning to take his $599 as a lump sum and give it to his foster parents, with whom he is living as he fights his criminal charges.

“It’s the least I can do for them letting me stay with them and get better,” Coburn said, choking back tears. “I’m not giving up.”

Every week, the small payments from the Medi-Cal experiment feel like small wins, Coburn says.

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Angela Hart

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KFF Health News

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This article is part of “Faces of Medi-Cal,” a California Healthline series exploring the impact of the state’s safety-net health program on enrollees.

A federal judge has denied an unprecedented, emergency request by the Department of Justice to segregate thousands of California ballots in the midterm elections.

The Justice Department wants California election officials to stop processing ballots pertaining to 20,000 individuals that federal officials say are "likely" noncitizens.

State and local officials in California have countered that the DOJ's list of "likely" noncitizens is unreliable, with a preliminary analysis by Los Angeles County showing that many on the list do not have active voter registrations. The officials also claim that setting aside ballots just days before Election Day, when voting and processing mailed ballots are already underway, would be unlawful and infeasible and would disenfranchise eligible voters.

In his 26-page ruling issued Wednesday evening, U.S. District Judge David Carter, a Clinton appointee, denied the Justice Department's request for a temporary restraining order to stop processing the ballots in question.

"Never before in American history has the federal government, on the eve of an election, sought to coerce a state and local government to abandon their own Constitutional elections procedures and bend to the will of the Executive Branch," he wrote.

Carter also expressed concern about taking action that could disenfranchise eligible voters and create chaos.

"Once a vote is segregated, lasting harm has occurred," Carter wrote at the conclusion of his order. "If the Executive can discount votes and threaten an ongoing election due to unproven allegations, then our democracy is in danger. This Court declines to be a party to such process."

The judge said that the federal government can address the issue by continuing to indict people for the crime of illegally voting as noncitizens. DOJ officials say in the last two months they have charged dozens of people for registering or voting without being a U.S. citizen.

The DOJ's lawsuit in California, which was filed Oct. 15, is among a flurry of unprecedented actions the department has waged in states close to Election Day, raising alarms about federal interference in state election procedures.

Like in California, on Monday federal prosecutors asked Washington state election officials to review a list of 400 registered voters the DOJ believes are likely noncitizens. And last week, the DOJ filed an unusual lawsuit in Alaska that seeks to stop the state from certifying the results in its Senate race if the Republican incumbent loses due to votes for a longshot candidate with a similar name who is accused of being a spoiler candidate.

In California's most recent motion to the court, state Attorney General Rob Bonta, a Democrat, asked the judge to take into account the circumstances of DOJ's demand. "This litigation is a precursor to further interference here in California," Bonta wrote. "The Court must not be drawn into this chilling degradation of democratic values and constitutional principles."

The Department of Justice is expected to appeal Carter's denial, and the matter could ultimately wind up before the U.S. Supreme Court.

The DOJ has argued the issue is urgent since ballots are already being processed. Once signatures are verified on returned mail ballot envelopes, the ballots are separated from their envelopes to retain voter confidentiality and it then becomes impossible to retrieve an ineligible ballot.

Federal prosecutors have argued that votes by noncitizens dilute the votes of U.S. citizens. Voting by noncitizens has been shown by audits and investigations to be extremely rare.

The accuracy of the DOJ's list of "likely" noncitizens is still an ongoing matter of dispute.

A Los Angeles County analysis of a small sample of people on the DOJ's list found that a significant portion had said in records they were born in the U.S. But U.S. Citizenship and Immigration Services senior official Nicolas Bartell contested that in recent court filings, writing that his office's review of those individuals found none were U.S.-born.

Bartell did acknowledge the review found four of those people "might have a claim to U.S. citizenship."

He also provided the court additional details about the federal government's methodology in creating the list in recent court filings.

But University of Delaware political scientist Kassra Oskooi, who has been tapped as an expert witness by voting rights groups who are intervening in the case, responded in his own declaration to the court that he believes USCIS's matching protocol "is likely to be unreliable."

California’s Public Utilities Commission will decide on Thursday whether to claw back or keep $37.5 million in grant funding meant to bring fast, reliable internet to Catalina Island.

The island is home to more than 4,000 residents, and it draws thousands of tourists each year. Its slow, unreliable internet connection affects everything from remote learning to emergency response.

Lance Ware is CEO of AVX Networks, the company awarded the grant from the CPUC in December 2025. He told LAist host Nereida Moreno that the island depends on a very limited wireless internet link.

“When the town is busy, for instance, a cruise ship comes … the internet just gets crippled along with all the telephone services,” Ware explained.

Months after AVX Networks was awarded the grant, CPUC staff accused the company in July 2026 of breaking federal spending rules, citing insufficient justification and documentation for invoices.

The proposed plan would build the fiber-optic network under the San Pedro Channel from two points on Catalina Island to landings near Huntington Beach. Those cables will then connect to the Middle Mile Broadband Network in Stanton.

Where do things stand today? 

CPUC staff allege that AVX Networks violated several program requirements, according to records.

“Since the award, AVX Networks has not shown itself to have the requisite administrative, technical, and operational capacity to deliver on its project, and AVX Networks has failed to comply with the terms and conditions of its award,” the CPUC agenda item records state.

Ware said he “vehemently disagrees” with those statements.

“There are allegations on things in there that do not make sense to us in that we've had no due process or cure and correct period to address,” Ware said.

What’s next? 

If the commission terminates the contract and pulls the funding, Ware said the project will be delayed, but not stopped.

“This is not curtains down for us,” Ware added. “It's gonna take longer, and we'll have to find some other way to finance it, but we certainly haven't given up.”

Nereida Moreno contributed to the reporting of this story.

Southern Californians are feeling squeezed by the rising costs of, well, everything. And now their local governments are asking for more money, too.

By LAist’s count, more than 30 cities or districts in Los Angeles and Orange counties are asking residents to approve tax measures on Election Day, Nov. 3, citing stagnant revenues that haven’t kept pace with the rising costs of insurance, maintenance and infrastructure projects, and employee pensions. Big cities, suburbs and small towns are all facing multimillion-dollar budget deficits and asking residents to open their wallets — or potentially see deep cuts to basic city services.

The list of local measures on ballots from Culver City to San Clemente includes sales taxes, hotel taxes, business taxes, parcel taxes and utility taxes. Some ballot measures would extend or increase existing taxes while others are brand-new.

Much of the answer to why so many tax measures are on the ballot lies in Proposition 13, which capped property taxes in 1978.

Before Prop. 13, cities and counties relied on property taxes for nearly all of their revenue. In the decades since, they’ve increasingly turned to other types of taxes. Hotel and utility taxes, for example, were essentially nonexistent before the mid-1970s, and sales taxes represented a small sliver of revenue. Even as these taxes have grown, they’ve struggled to replace property tax revenue.

State law caps the maximum combined local and county sales tax rate, and many Southern California cities are already at or near that cap, Coleman said. And sales tax isn’t as reliable as it used to be, amid the broader retail downturn and shift to a service-based economy (most services aren’t taxable in California).

All of that means cities are increasingly turning to “ticky-tacky, peculiar taxes” to come up with revenue, according to Kirk Stark, a professor of tax law and policy at UCLA.

The “conventional tax instruments” — property, income and sales taxes — are all limited by state law, Stark said. “Local governments that are hoping to satisfy demand for any kind of public expenditure have to turn to other, less conventional sources of revenue.”

This year, cities are asking Southern Californians to say yes to a wide range of taxes. Below, we look at three examples in South Gate, Orange and Diamond Bar.

South Gate: A utility users tax

South Gate is asking voters to approve something less common: a utility users tax, or UUT for short. If Measure SG is approved, the 8% tax would be added to bills for utilities such as electricity, water, natural gas, cable and phone service. The tax would bring in an estimated $10.4 million per year.

The city is facing a potential fiscal emergency and a $9.4 million budget deficit. Earlier this year, South Gate began cutting back services, including eliminating its crossing guard program and assigning fewer police officers per shift.

At a City Council meeting on the tax measure earlier this year, several residents spoke against the measure, with some calling the deficit a result of potential financial mismanagement that shouldn’t be pushed onto residents. Others said the monthly costs would simply add a new burden to already tight budgets.

“Being a homeowner here for the past 13 years, I have seen my utilities go up as well as the cost of living, my insurance for my house, and my car insurance go up. I believe there’s got to be a way to fix this problem without the UUT measure,” one resident told the City Council.

“I’m extremely frustrated that you now want to do electricity, water, sewer, cable, cell phone, gas. ... That hurts us. You’re passing that on to us, and that is absolutely not acceptable,” said another.

The only other utility users tax on the ballot in Los Angeles or Orange counties this year is in San Marino, where residents will decide whether to extend the city’s existing 5% utility users tax, which is set to expire on March 31, 2027, and increase it to 6%. Last year, the tax provided almost $2.2 million in revenue. As of 2021, a total of 162 out of 540 California cities and counties had a utility users tax, according to Coleman’s California Local Government Finance Almanac.

Orange: Hotel and sales taxes could go up 

Most people don’t book a hotel in their own city. That’s made hotel taxes an easier pill to swallow for voters, since the tax is mostly levied on visitors.

The city of Orange is asking voters to approve Measure J, which would raise the hotel tax from 10% to 14%. Orange is one of 10 cities across Los Angeles and Orange counties where voters will decide in November whether to increase or establish a local hotel tax, also known as a “transient occupancy tax.”

Orange residents will also vote on a 1-cent sales tax measure, as the city projects a $27.6 million deficit that it calls “one of the largest financial challenges in the city’s history.” The sales tax is expected to bring in $37 million annually, and the hotel tax would add $3 million.

Diamond Bar: A new 1-cent sales tax 

Diamond Bar voters will decide on Measure Q, a 1% local sales tax that would add a penny per dollar to purchases of taxable items. The city estimates the tax will bring in an additional $6 million annually, which could help plug a projected budget deficit of $5 million a year by 2030.

“The city’s challenge is simple: costs for city services are going up faster than revenues,” states Diamond Bar’s fact sheet on the measure, which cites rising public safety costs and $100 million in infrastructure and maintenance needs.

Several other cities have local sales tax measures on the ballot, including Santa Ana’s 1.5% sales tax extension and Los Angeles’ sales tax increase for the Los Angeles Fire Department, Measure FD.

“There’s a variety because circumstances among these local governments vary. The types of economies among governments vary, the local conditions, even the preferences for what type of revenue measure or tax measure might work varies,” Coleman said. “A local government that’s looking at one of these is going to look at a number of different options and consider what might be most palatable to the voters in their community.”

What’s on your ballot?

Our LAist Voter Game Plan is here to help guide you through the Nov. 3 election with guides to races across Los Angeles and Orange counties — and that long list of state propositions — to help you cast a ballot that’s in line with your own personal beliefs and values.

But the one thing we don’t do? We don’t tell you how to vote. That part is left up to you.

You can find it all at LAist.com/Vote.

Further reading

• Voter guide for parcel taxes in Culver City, Santa Monica, Las Virgenes Unified, San Marino Unified (LAist)
• City of Pasadena Measure PFD: What to know about the tax to support the Pasadena Fire Department (LAist)
• Los Angeles Measure FD: What to know about the proposed sales tax bump for the LA City Fire Department (LAist)
• Proposition 43: Making it harder to pass citizen-led local tax initiatives (LAist)

At the height of the Los Angeles fires in 2025, millions of residents were exposed in a 24-hour period to toxic lead levels from smoke that were 80 times higher than the typical background level, according to a new study.

Researchers from the California Institute of Technology compared the chemical composition of smoke from the Eaton Fire with that of a wildfire and found that the urban plume had more lead, arsenic and halogens (which include chlorine and bromine) linked to burning vehicles, building materials and electronics.

“The main, key finding is really that wildfire smoke is very different fundamentally from the urban smoke,” said Nga Lee “Sally” Ng, an author of the study published Wednesday in the journal Science Advances. With the new technology they used to measure what was in the smoke, they were able to “actually see the very detailed component of these particles that we are breathing.”

Co-author Haroula Baliaka said understanding the different chemical compositions of smoke from an urban versus a wildland fire helps bridge a missing gap in research. Wildfires are growing larger, more intense, faster-moving and more frequent largely because of drier and warmer weather associated with human-caused climate change. As urban growth and climate change push more fires into cities, researchers said monitoring and emergency response will have to adapt.

Ed Avol, professor emeritus in the Keck School of Medicine at the University of Southern California who has researched the health effects of air pollution for decades, said significant exposure to heavy metals is consistent with what he’d expect, “but certainly surprising because we haven’t been able to document this sort of thing.”

“One of the real advantages of this study is that it had the opportunity to make measurements sort of hour-by-hour across the sampling network. And typically we make measurements of airborne particulates and so forth a couple of times a week, at best,” said Avol, who wasn’t involved in the study.

Thousands of structures burned, releasing toxic chemicals

The two wind-whipped infernos in Altadena and the Pacific Palisades that ignited on Jan. 7, 2025, killed at least 31 people and destroyed more than 16,000 structures, mostly homes, and everything in them — cars, paint, furniture, chemicals under sinks and more. Millions of people were exposed to smoke, which across the entire United States has been linked to tens of thousands of deaths annually. A recent study found that metal mixtures in the leftover smoke, ash and debris from the deadly 2023 Maui wildfires were harmful to the lung health of people living nearby long after the burning ended.

During the fires, researchers measured trace elements of fine particulate matter, or PM2.5, every hour reported by instruments in the Atmospheric Science and Chemistry mEasurement NeTwork ( ASCENT ), a relatively new network of air quality monitors across the U.S. that measures the size and chemical composition of these particulates in real time. Ng said ASCENT is the U.S.'s first measurement network able to measure the chemical composition of airborne particles in real time.

Researchers were able to see what chemicals were in the smoke, track how its composition changed over the fire’s course, and distinguish emissions coming from burning structures. From there, they estimated how many people across Los Angeles were exposed to the heavy metals, particularly lead, during the fire’s first days.

They compared the typical value of lead before the fires and the chemical makeup of smoke from a 2024 fire in Riverside County that burned mostly vegetation with data from the Eaton Fire plume. Contrasted with the wildfire smoke, the plume from the LA fire contained 50 times more lead, three times more arsenic, and seven times more halogens. At the peak of burning, about 7 million people were exposed for 24 hours to lead levels more than 80 times what’s typical.

Lead is a neurotoxin that can stunt children’s development, lower IQ scores and increase blood pressure in adults. Scientists still don’t know how short-term, high exposure to lead impacts human health. Arsenic exposure is associated with various cancers.

Yaguang Wei, assistant professor in the department of environmental medicine at Icahn School of Medicine at Mount Sinai who researches the health impacts of air pollution, wildfire smoke and severe weather, said their findings reinforced some conclusions of a recent study he co-authored that found, in part, that PM2.5 from wildfire smoke was more toxic than particulates from other sources.

“I think their findings are not surprising,” said Wei, who was not involved in the study. When fires burn properties, they’re also burning “a lot of lead on your wall paint and the plastics and electronics and those are very toxic” when they burn, he said.

Monitoring, policies and emergency response need to adapt, experts say

Wei said the study has “important policy implications.” He thinks governments should take stronger actions to protect public health during these fires by investing in more wildfire monitoring and public alerts, and having more prescribed fires.

For Avol, the study is a reminder of our “strange and increasingly dangerous new world” where urban and wildland intersect — and increasingly catch fire.

“It reminds us to be cautious and be concerned and, you know, think about what we can do to minimize this. We’re not going to stop using all these materials containing metals and halogens and so forth in our homes,” he said. “How do we protect people from being exposed to that?”

The Associated Press receives support from the Walton Family Foundation for coverage of water and environmental policy. The AP is solely responsible for all content. For all of AP’s environmental coverage, visit https://apnews.com/hub/climate-and-environment