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

)

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.

This story was originally published by CalMatters. Sign up for their newsletters.

Gov. Gavin Newsom vetoed two bills that would have helped improve the insurance-claims process for consumers but signed one that also addresses claims-related issues, leaving Los Angeles County fire survivors and others wondering whether the vetoes were retaliatory.

One bill, Senate Bill 877, would have required insurance companies to explain in more detail to their customers how their claims payments are calculated. Another, SB 878, would have required insurers to pay claims within a certain amount of time, and imposed penalties for delays.

In his veto statement Sunday, the governor said the bills codified existing regulations and were “unnecessary at this time.”

But he signed SB 876, which among other things requires insurers to send their customers a status report within 15 days of assigning a new adjuster to their claims; doubles penalties during a declared emergency when insurers violate fair claims practices and settlement law; and mandates that insurers send a disaster-recovery plan to the Insurance Department.

Newsom’s office would not provide more information. Spokesperson Anthony Martinez said the governor’s veto message speaks for itself, and pointed to other legislation Newsom signed that helps survivors, such as setting new smoke-damage standards.

Martinez did not respond to a question about an accusation that the governor vetoed the two bills because they were sponsored by fire survivors and a consumer advocacy group who fought against his failed effort to reduce utilities’ liability for wildfires they cause.

Carmen Balber, executive director of Consumer Watchdog, told CalMatters that all three bills “were along the same vein, addressing claims-handling problems,” although they did not overlap. The difference, she said, was that the two bills Newsom vetoed were sponsored by her group and Every Fire Survivors Network.

“It’s a real black mark on the governor that he would throw survivors under the bus in that way for what appears to be a petty reason,” Balber said.

Democratic state Sen. Sasha Renée Pérez wrote SB 877 and 878, prompted by experiences of fire survivors she represents in Altadena. She pushed back against the governor’s veto statement, saying existing regulations have not been enough to avoid insurers’ delays and denials of survivors’ claims. As an example, she pointed to the insurance department’s findings that State Farm violated laws in its handling of L.A. fire survivors’ claims.

“I would hope (the decision) is not because of politics and petty infighting,” Pérez told CalMatters.

The senator added that her bills got bipartisan support and that the insurance industry eventually dropped their opposition to them. She noted that some survivors of the January 2025 fires are still navigating their claims. “The reality is that this decision is going to have an impact on survivors’ recovery,” she said.

Every Fire Survivors Network agreed.

“These vetoes mean more families will face what we have faced: rebuilding stalled, bills piling up, and lives on hold while waiting for insurance money they are owed,” said Joy Chen, executive director of the group, in a statement.

Pérez, Consumer Watchdog and Every Fire Survivors Network vowed to try again next session.

Insurance Commissioner Ricardo Lara was also a co-sponsor of SB 878 but had no comment on the governor’s veto, although his office issued a statement celebrating the signing of SB 876: “It holds insurers accountable when they drag their feet.”

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

Los Angeles County will begin sending mail-in ballots starting this Thursday ahead of the Nov. 3 elections. Counties across the state have until next Monday, Oct. 5, to begin mailing out ballots.

In the June primary, nearly 82% of the total ballots cast in L.A. County were through vote-by-mail ballots.

State and local officials are encouraging people to vote early.

When can I turn in my ballot?

L.A. County elections officials say voters can turn in their ballots by mail as soon as they receive them. No postage is necessary.

They can also turn them in starting this week at official dropboxes across the county, which are often found at parks, community centers or libraries.

Voters can also turn them in or vote in person at the county’s Vote Centers, which L.A. County officials say will start to open on Oct. 24. Officials say all Vote Centers will be open by Halloween.

What about in Orange County?

Orange County officials say U.S. Postal Service officials are scheduled to pick up about 1.9 million ballots from the county elections office on Saturday and start delivering them on Monday, Oct. 5.

The Trump administration has tried to restrict mail-in ballots. Will my ballot be affected?

The California Secretary of State’s office says nothing has currently changed. The U.S. Supreme Court earlier this month issued an injunction on President Trump’s executive order requiring states to turn in lists of voters and ordering the USPS to send mail-in ballots to the people on the approved lists.

"Voters will be able to cast their ballots without uncertainty, without hesitation, and without fear that their voices will be questioned or their ballots rejected," said Secretary of State Shirley Weber.

Los Angeles County is reporting the highest number of rabid bats on record, a to-date total of 69, officials said.

This year’s rabid bat count has already matched 2025’s total, according to the L.A. County Department of Public Health, which released the count Monday, marking World Rabies Day.

Health officials emphasized that rabid bats have been found all over the county "from suburban areas such as the San Fernando Valley to urban areas like downtown Los Angeles, in office buildings, parks, schools, businesses, and residential backyards."

That said, a large share of rabid bats — 68% of the 69 found so far — were in the Santa Clarita Valley, and they were mainly canyon bats, which are common in California.

When to be on high alert

Officials warned that a third of human encounters with rabid bats happened indoors, where the risk of exposure to the virus is higher.

Bat bites are small and can be hard to detect. Rabies can also be spread through scratches or other transfers of saliva.

“If you find a bat indoors or think you may have had contact with one, contact your medical provider or Public Health right away,” Dr. Muntu Davis, a Los Angeles County Health officer, said in a statement. “And remember, never touch a bat or any wild animals. Immediately report any bat found indoors, or outdoors if it appears sick, active during the day, unable to fly, or dead, to your local animal control.”

Who to call

Veterinary Public Health

Phone: 213-288-7060
Email: vet@ph.lacounty.gov
Website: publichealth.lacounty.gov/vet

*Call 211 to find your local animal control

What to know about rabies

Rabies in humans is treatable with a series of vaccines. Rabies is always fatal in animals, the county said in a release, so vaccinate your pets.

Gov. Gavin Newsom signed a law Sunday that tightens building rules for sites that store explosive chemicals, responding to an Orange County chemical incident that forced thousands of residents to evacuate Memorial Day weekend.

The law also adds the chemical methyl methacrylate to a state program that aims to prevent chemical disasters.

In May, CalMatters reported that California’s toughest accidental-release prevention rules do not cover the chemical in the tank at GKN Aerospace, a company that makes cockpits and windshields in Garden Grove. Weeks later Democratic state Sen. Tom Umberg of Santa Ana amended an existing bill with language that addressed that gap. Assembly committee and floor analyses noted CalMatters’ reporting. 

Had the chemical exploded, it “would have been perhaps the greatest catastrophe, certainly in the last several decades in California,” Umberg said at a June Assembly hearing.

Umberg’s original proposal would have set stronger standards for more types of explosive chemicals, but legislators narrowed it significantly in last-minute negotiations.

The final law bars building new facilities near homes and schools and requires backup cooling systems. It also strips an exemption from environmental review that facilities storing methyl methacrylate previously qualified for.

Garden Grove advocates call the bill a good step, but say it offers the community little immediate recourse, especially with GKN Aerospace planning to reopen by the end of September.

The law’s siting requirements apply to new facilities, not to existing ones like GKN’s Garden Grove plant.

Mai Do, research and policy manager for the Orange County advocacy group Harbor Institute for Immigrant and Economic Justice, said she hopes the state will do more to address the threat of toxic chemicals at existing facilities.

“This is a much larger fight than just what's happened in Garden Grove,” Do said. “What we see in terms of the Lineage fire and other industrial crises is that this is a problem that is affecting a lot of different communities”

In an interview with CalMatters, Umberg said the bill reflected a balancing act. “This is a net benefit for the state, a net benefit for the community,” he said.

Stronger rules for new facilities, not existing ones

Over Memorial Day weekend, residents learned of a problem with a tank storing methyl methacrylate at the GKN Aerospace facility. A crack in the tank released pressure and, along with efforts by emergency responders, averted disaster, but questions remained about what went wrong.

CalMatters reported in May that methyl methacrylate and other chemicals that could explode under certain conditions falls outside the California Accidental Release Program, which requires facilities to maintain detailed plans for preventing or responding to chemical leaks or explosions.

Rachel Tochterman, a spokesperson for Sen. Umberg, said the senator took note and initially proposed incorporating a broader category of reactive chemicals into the program.

But industry groups opposed the plan, arguing it was too broad without clearer evidence.

Dawn Koepke, a lobbyist for the California Manufacturers and Technology Association and the California Council for Environmental and Economic Balance, said she does not believe a regulatory gap exists that would justify incorporating more chemicals into the state’s accidental release regimen.

Facilities storing toxic chemicals are already heavily regulated under other federal and state laws, she said, including a requirement for plans to protect people from chemical releases.

Koepke said she worried that "jumping to conclusions and over-regulating" could affect "a wider array of facilities."

Tim Shestek, a lobbyist representing the American Chemistry Council and other groups, said in an email that Umberg’s original proposal would have affected “far more facilities, substances and sectors than were in the original scope.”

After amendments on the next-to-last day of the legislative session, nine industry groups stopped lobbying against the bill.

Most provisions of the law only apply to methyl methacrylate — the chemical involved in the Garden Grove incident. The bill adds it to the state’s accidental release program, requires facilities to maintain prevention and emergency-response plans, and closes the environmental-review exemption for new sites where the chemical is present.

Scrapped from the bill: a requirement to map reactive-chemical sites in CalEnviroScreen, a state program that identifies polluted communities.

GKN Aerospace plans to reopen 

Steve Carlin, senior vice president for GKN Aerospace programs, said the company has been working with regulators and independent experts “to safely reset the remainder of the facility with the appropriate oversight” work that has included inspections, upgrades to safety equipment, and additional monitoring. The company plans to reopen in the next few days.

The company also announced an additional $100 million program to pay residents and businesses that lost money during evacuations.

Lisa Fu, director of the California Healthy Nail Salon Collaborative, a worker-safety group, wants California to regulate hazardous chemicals more broadly.

“It's just unfortunate that it's a piecemeal thing,” said Lisa Fu, director of the California Healthy Nail Salon Collaborative. “Is it worth it to go piece by piece in terms of trying to ban certain chemicals? It makes the work harder for us, and you can see who's benefiting and who's not.”

Newsom also signed a pair of bills in response to the Lineage fire, a June cold storage fire in Los Angeles. The fire briefly prompted a shelter-in-place order over fears that toxic anhydrous ammonia had been released into the air.

The new laws raise the fines agencies can levy on companies that endanger health and safety. They also bar building permits for cold storage facilities that lack contingency funds or insurance to help communities in emergencies.

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