The Brief

Inside a bright new building in the heart of Skid Row, homeless people hung out in a canopy-covered courtyard — some waiting to take a shower, do laundry, or get medication for addiction treatment. Others relaxed on shaded grass and charged their phones as an intake line for housing grew more crowded.

The Skid Row Care Campus officially opened this spring with ample offerings for people living on the streets of this historically downtrodden neighborhood. Pop-up fruit stands and tent encampments lined the sidewalks, as well as dealers peddling meth and fentanyl in open-air drug markets. Some people, sick or strung out, were passed out on sidewalks as pedestrians strolled by on a recent afternoon.

For those working toward sobriety, clinicians are on site to offer mental health and addiction treatment. Skid Row’s first methadone clinic is set to open here this year. For those not ready to quit drugs or alcohol, the campus provides clean syringes to more safely shoot up, glass pipes for smoking drugs, naloxone to prevent overdoses, and drug test strips to detect fentanyl contamination, among other supplies.

As many Americans have grown increasingly intolerant of street homelessness, cities and states have returned to tough-on-crime approaches that penalize people for living outside and for substance use disorders. But the Skid Row facility shows Los Angeles County leaders’ embrace of the principle of harm reduction, a range of more lenient strategies that can include helping people more safely use drugs, as they contend with a homeless population estimated around 75,000 — among the largest of any county in the nation. Evidence shows the approach can help individuals enter treatment, gain sobriety, and end their homelessness, while addiction experts and county health officials note it has the added benefit of improving public health.

“We get a really bad rap for this, but this is the safest way to use drugs,” said Darren Willett, director of the Center for Harm Reduction on the new Skid Row Care Campus. “It’s an overdose prevention strategy, and it prevents the spread of infectious disease.”

Despite a decline in overdose deaths, drug and alcohol use continues to be the leading cause of death among homeless people in the county. Living on the streets or in sordid encampments, homeless people saddle the health care system with high costs from uncompensated care, emergency room trips, inpatient hospitalizations, and, for many of them, their deaths. Harm reduction, its advocates say, allows homeless people the opportunity to obtain jobs, taxpayer-subsidized housing, health care, and other social services without being forced to give up drugs. Yet it’s hotly debated.

Politicians around the country, including Gov. Gavin Newsom in California, are reluctant to adopt harm reduction techniques, such as needle exchanges or supervised places to use drugs, in part because they can be seen by the public as condoning illicit behavior. Although Democrats are more supportive than Republicans, a national poll this year found lukewarm support across the political spectrum for such interventions.

Anthony Willis, who has an apartment on Skid Row, spends most of his time on the streets. He says he’s addicted to crack and alcohol.

(

Angela Hart

/

KFF Health News

)

Los Angeles is defying President Donald Trump’s agenda as he advocates for forced mental health and addiction treatment for homeless people — and locking up those who refuse. The city has also been the scene of large protests against Trump’s immigration crackdown, which the president has fought by deploying National Guard troops and Marines.

Trump’s most detailed remarks on homelessness and substance use disorder came during his campaign, when he attacked people who use drugs as criminals and said that homeless people “have no right to turn every park and sidewalk into a place for them to squat and do drugs.” Health and Human Services Secretary Robert F. Kennedy Jr. reinforced Trump’s focus on treatment.

“Secretary Kennedy stands with President Trump in prioritizing recovery-focused solutions to address addiction and homelessness,” said agency spokesperson Vianca Rodriguez Feliciano. “HHS remains focused on helping individuals recover, communities heal, and help make our cities clean, safe, and healthy once again.”

A comprehensive report led by Margot Kushel, a professor of medicine at the University of California-San Francisco, this year found that nearly half of California’s homeless population had a complex behavioral health need, defined as regular drug use, heavy drinking, hallucinations, or a recent psychiatric hospitalization.

The chaos of living outside, she said — marked by violence, sexual assault, sleeplessness, and lack of housing and health care — can make it nearly impossible to get sober.

Skid Row Care Campus

The new care campus is funded by about $26 million a year in local, state, and federal homelessness and health care money, and initial construction was completed by a Skid Row landlord, Matt Lee, who made site improvements on his own, according to Anna Gorman, chief operating officer for community programs at the Los Angeles County Department of Health Services. Operators say the campus should be able to withstand potential federal spending cuts because it is funded through a variety of sources.

Glass front doors lead to an atrium inside the yellow-and-orange complex. It was designed with input from homeless people, who advised the county not just on the layout but also on the services offered on-site. There are 22 recovery beds and 48 additional beds for mostly older homeless people, arts and wellness programs, a food pantry, and pet care. Even bunnies and snakes are allowed.

John Wright, who goes by the nickname “Slim,” works as a harm reduction specialist at the new Skid Row Care Campus, a center that provides both harm reduction services and treatment for mental illness and substance use disorder.

(

Angela Hart

/

KFF Health News

)

John Wright, 65, who goes by the nickname Slim, mingled with homeless visitors one afternoon in May, asking them what they needed to be safe and comfortable.

“Everyone thinks we’re criminals, like we’re out robbing everyone, but we aren’t,” said Wright, who is employed as a harm reduction specialist on the campus and is trying, at his own pace, to stop using fentanyl. “I’m homeless and I’m a drug addict, but I’m on methadone now so I’m working on it,” he said.

Nearby on Skid Row, Anthony Willis rested in his wheelchair while taking a toke from a crack pipe. He’d just learned about the new care campus, he said, explaining that he was homeless for roughly 20 years before getting into a taxpayer-subsidized apartment on Skid Row. He spends most of his days and nights on the streets, using drugs and alcohol.

The drugs, he said, help him stay awake so he can provide companionship and sometimes physical protection for homeless friends who don’t have housing. “It’s tough sometimes living down here; it’s pretty much why I keep relapsing,” said Willis, who at age 62 has asthma and arthritic knees. “But it’s also my community.”

Willis said the care campus could be a place to help him kick drugs, but he wasn’t sure he was ready.

Research shows harm reduction helps prevent death and can build long-term recovery for people who use substances, said Brian Hurley, an addiction psychiatrist and the medical director for the Bureau of Substance Abuse Prevention and Control at the Los Angeles County Department of Public Health. The techniques allow health care providers and social service workers to meet people when they’re ready to stop using drugs or enter treatment.

“Recovery is a learning activity, and the reality is relapse is part of recovery,” he said. “People go back and forth and sometimes get triggered or haven’t figured out how to cope with a stressor.”

Swaying public opinion

Under harm reduction principles, officials acknowledge that people will use drugs. Funded by taxpayers, the government provides services to use safely, rather than forcing people to quit or requiring abstinence in exchange for government-subsidized housing and treatment programs.

Los Angeles County is spending hundreds of millions to combat homelessness , while also launching a multiyear “ By LA for LA ” campaign to build public support, fight stigma, and encourage people to use services and seek treatment. Officials have hired a nonprofit, Vital Strategies , to conduct the campaign including social media advertising and billboards to promote the expansion of both treatment and harm reduction services for people who use drugs.

The organization led a national harm reduction campaign and is working on overdose prevention and public health campaigns in seven states using roughly $70 million donated by Michael Bloomberg, the former mayor of New York.

“We don’t believe people should die just because they use drugs, so we’re going to provide support any way that we can,” said Shoshanna Scholar, director of harm reduction at the Los Angeles County Department of Health Services. “Eventually, some people may come in for treatment but what we really want is to prevent overdose and save lives.”

Los Angeles also finds itself at odds with California’s Democratic governor. Newsom has spearheaded stricter laws targeting homelessness and addiction and has backed treatment requirements for people with mental illness or who use drugs. Last year, California voters approved Proposition 36 , which allows felony charges for some drug crimes, requires courts to warn people they could be charged with murder for selling or providing illegal drugs that kill someone, and makes it easier to order treatment for people who use drugs.

Even San Francisco approved a measure last year that requires welfare recipients to participate in treatment to continue receiving cash aid. Mayor Daniel Lurie recently ordered city officials to stop handing out free drug supplies, including pipes and foil , and instead to require participation in drug treatment to receive services. Lurie signed a recovery-first ordinance, which prioritizes “ long-term remission ” from substance use, and the city is also expanding policing while funding new sober-living sites and treatment centers for people recovering from addiction.

‘Harm encouragement’

State Sen. Roger Niello, a Republican who represents conservative suburbs outside Sacramento, says the state needs to improve the lives of homeless people through stricter drug policies. He argues that providing drug supplies or offering housing without a mandate to enter treatment enables homeless people to remain on the streets.

Proposition 36, he said, needs to be implemented forcefully, and homeless people should be required to enter treatment in exchange for housing.

“I think of it as tough love,” Niello said. “What Los Angeles is doing, I would call it harm encouragement. They’re encouraging harm by continuing to feed a habit that is, quite frankly, killing people.”

Keith Humphreys, who worked in the George W. Bush and Barack Obama administrations and pioneered harm reduction practices across the nation, said that communities should find a balance between leniency and law enforcement.

“Parents need to be able to walk their kids to the park without being traumatized. You should be able to own a business without being robbed,” he said. “Harm reduction and treatment both have a place, and we also need prevention and a focus on public safety.”

Cindy Ashley hugs her companion dog on an afternoon in late May. She lost her housing due to the hospitalization and was homeless.

(

Angela Hart

/

KFF Health News

)

Just outside the Skid Row Care Campus, Cindy Ashley organized her belongings in a cart after recently leaving a local hospital ER for a deep skin infection on her hand and arm caused by shooting heroin. She also regularly smokes crack, she said.

She was frantically searching for a home so she could heal from two surgeries for the infection. She learned about the new care campus and rushed over to get her name on the waiting list for housing.

“I’m not going to make it out here,” she said, in tears.

The Department of Justice on Thursday joined a lawsuit to block new congressional district lines approved by California voters last week through Proposition 50 .

Gov. Gavin Newsom championed the congressional maps as an attempt to help Democrats win more seats in the House of Representatives, countering Republican-led gerrymandering in states such as Texas. But California Republicans argued in a suit filed last week that the maps unfairly advantage Latino voters over other Californians.

The Trump administration joined that lawsuit, asking a judge in the Central District of California to block the new map from taking effect for the 2026 midterm elections.

“California Democrats are openly gerrymandering by race in this case,” Attorney General Pam Bondi wrote on social media platform X. “That’s immoral and illegal.”

Proposition 50 was overwhelmingly approved last week, winning support from 64% of voters. The measure sets aside political lines drawn by an independent citizens commission and enacts a map that could help Democrats flip up to five seats currently held by Republicans — and protect a handful of incumbent Democrats from competitive challenges.

The measure’s passage was a political win for Newsom and Democrats in the midst of a nationwide fight over political maps. New district lines in Texas, Missouri and North Carolina could net Republicans a handful of additional seats, while states including Virginia, Indiana and Florida are considering their redistricting plans.

The lawsuit against the Proposition 50 map argues the new lines were designed to maximize the voting power of Latino residents, thereby violating the equal protection and voting rights of non-Latino voters. The DOJ argues that it is not necessary to draw districts where a majority of voters are Latino because white California voters often prefer candidates of various races and ethnicities.

“Recent elections show that Hispanics have not struggled to elect politicians of their choice in California,” the complaint said. “That is because results in California are largely driven by party-bloc voting, not race-bloc voting.”

An analysis by the Public Policy Institute of California found that the Proposition 50 map has the same number of majority-Latino districts (16) as the maps enacted by the independent commission in 2021, which have been used in the last two congressional elections.

While the lawsuit quotes supporters of Proposition 50 touting the Latino-majority districts, Newsom and Democratic leaders in the state Legislature argued throughout the campaign that the purpose of the maps was explicitly partisan: to help Democrats retake the House. That could help the state thwart a challenge under the 14th Amendment’s Equal Protection Clause.

“These losers lost at the ballot box and soon they will also lose in court,” said Brandon Richards, a spokesman for Newsom, in a statement.

The passage of Proposition 50 has scrambled the electoral playing field ahead of California’s June primary. Sonoma State University professor David McCuan said the measure could face more legal challenges from Republicans facing political headwinds.

“You could see half a dozen to a dozen [lawsuits] … challenging both the process of how Prop. 50 got to the ballot and the constitutional legal questions related to Proposition 50 itself,” he said.

There’s a parking lot in the city of Los Angeles lined with plywood platforms where unhoused people can set up tents and access meals, bathrooms and other services — all at taxpayers’ expense.

The Lincoln Safe Sleep Village in South L.A. opened in 2022 and is one of only a handful of similar encampments around the state. Public records show it was contracted to provide space for up to 88 residents last fiscal year.

But two observers who made separate visits to the location earlier this year — one of them a commissioner with the governing body that oversees the Los Angeles Homeless Services Authority, the other a “special master” appointed by a federal judge — found the site was operating at half capacity.

Still, LAHSA paid a nonprofit organization $2.3 million to operate the site — with 88 spots — last fiscal year.

A federal judge this week described the situation as “obvious fraud.”

The nonprofit that runs the site, San Francisco-based Urban Alchemy, told LAist it reduced the site’s capacity by half in April 2024, at the request of L.A. city officials and LAHSA. The homeless services agency did not update its funding formula for the site until more than a year later.

LAHSA records show Urban Alchemy was paid in full.

The situation has emerged at a time when LAHSA is under intense scrutiny for failing to properly manage hundreds of millions of dollars in contracts with service providers, and the city of L.A. remains under a court order to provide more shelter for the city’s unhoused residents.

Federal court scrutiny

During a sometimes tense federal court hearing Wednesday, U.S. District Court Judge David O. Carter described the situation at the Lincoln Safe Sleep Village as "obvious fraud."

The hearing was the latest in a series of court appearances stemming from a settlement between the city of L.A. and a group of downtown business and property owners known as the L.A. Alliance for Human Rights.

The judge has been overseeing the settlement, specifically the city’s progress in meeting its obligations to provide housing and shelter for unhoused people. The agreement requires the city to open nearly 13,000 new shelter beds by next year.

According to testimony Wednesday, Michele Martinez — the special master Carter appointed to help enforce the terms of the settlement — visited the Safe Sleep Village on June 9. She tried to verify the number of beds available at the site with city officials, but did not get an answer, Carter said. Three weeks later, the city responded by questioning whether Martinez’s inquiry was proper.

In a June 30 email, L.A. Deputy City Attorney Jessica Mariani argued that Martinez had “no authority or basis to review or provide any assessments.” However, she added, the city was still looking into Martinez’ questions about the safe sleep site.

Carter questioned Mariani during the hearing, noting that the city (through LAHSA) continued to pay full amounts for more than 80 spots at the site and tell the court those spots existed, even though at least half appeared to not be available at the time.

"Is the City's position when the Special Master notes obvious fraud and that the documents don't match, that you are bringing forth to this Court that Ms. Martinez should disregard that and not report this to the Court when you try to curtail her monitoring activities?” the judge said, according to a transcript of the proceedings .

Carter described the city’s actions as potentially “contemptuous.”

LAist reached out to Mariani and the City Attorney’s Office, but has not yet received a response.

Weeks before the special master’s visit to the site, LAHSA Commissioner Justin Szlasa also stopped by the South L.A. campground. The 10-member LAHSA Commission makes policy and funding decisions for the regional homelessness agency.

Szlasa reported later that he noticed during his visit that half of the campground was closed down. He said budget documents sent to him for approval described the site as a “low-cost, high-impact” program serving 88 people.

“We at LAHSA must ensure that we receive what we are contracting for,” Szlasa wrote in a social media post describing his findings.

He filed a public records request with LAHSA to obtain the contracts and payment details for the Urban Alchemy campground.

“I want to understand, first and foremost, why this was misrepresented to the Commission,” Szlasa said. “Then I want to understand if Urban Alchemy was actually in compliance with the contracts.”

He continued: “I am concerned this Safe Sleep program — which I happened to arbitrarily spot-check — is not an outlier.”

A drone's view of the South LA site prior to one section closing down in 2024.

(

Jay L. Clendenin

/

Los Angeles Times via Getty Images

)

LAHSA response

LAist reached out to LAHSA for more information about its contract with Urban Alchemy and about the number of people who lived at the Lincoln Safe Sleep Village during the last fiscal year.

LAHSA authorities said the site had a 41% average “utilization rate” during the budget year that ended in June, based on capacity information Urban Alchemy provided in a database called the Homeless Management Information System.

But the agency’s calculations appear based on outdated capacity data, not on how many spaces were actually available for use.

LAHSA said it was Urban Alchemy’s responsibility to update the information in the database.

"All providers are required to record their data in HMIS; if the data is inaccurate, it would be based on that data entry,” a LAHSA spokesperson said.

LAHSA did not respond to LAist’s questions about when it learned that capacity at the site had been reduced. An agency spokesperson said LAHSA has been “engaged with” Urban Alchemy about the site since April 2024, and that the program has been “under review.”

In April, when the city of L.A. submitted its quarterly bed report to Carter, it described the South L.A. campground program as having 88 beds.

But approximately half of those beds had been unavailable for about a year, according to Urban Alchemy.

The city adjusted the count to 46 spots in its July 2025 update.

LAHSA’s troubles 

LAHSA manages more than $742 million in contracts with 121 service providers.

Over the past year, audits and reports found the agency had mismanaged hundreds of millions in contracts for homeless services, including a failure to collect accurate data on nonprofit vendors or properly track how they spent taxpayer dollars.

The South L.A. campground is the only “safe sleep” site of its kind currently in LAHSA’s portfolio, the agency told LAist. LAHSA also administers funding for about a dozen “safe parking” sites, where unhoused people can legally park and live out of vehicles they own.

LAHSA has paid it more than $12 million to operate the Lincoln Safe Sleep Village since 2021, according to the agency’s records.

Urban Alchemy told LAist it’s been following the terms of its contract, and that it followed direction from the city to close down part of the site, reducing its capacity.

The city of L.A. has not responded to questions from LAist about that claim, including whether it gave the nonprofit that direction.

"We're focused on providing the highest-level of service for our guests,” Urban Alchemy spokesperson Jess Montejano told LAist. “Given the resources provided, we're helping as many guests as we can have a safe place to sleep and get better connected to services and support."

Urban Alchemy did not clarify why it was told to close part of the campground, but property records show a South L.A. nonprofit called the Coalition for Responsible Community Development purchased the property in 2020.

It has plans to convert the property into a 60-unit affordable housing complex. Until that project is ready to start construction, the site is expected to keep operating as a safe sleeping location, according to the office of L.A. City Councilmember Curren Price, who represents the area.

“When the site first opened, beds were consistently full,” Angelina Valencia-Dumarot, Price’s communications director, told LAist Thursday. “That’s why the current occupancy rate is especially concerning.”

She said council offices are too often left out of updates by LAHSA.

“We can’t address problems quickly if we’re finding out only after numbers fall or from the press,” Valencia-Dumarot said.

A sign at the South LA campground

(

Jay L. Clendenin

/

Los Angeles Times via Getty Images

)

What should this cost? 

At full capacity, the monthly operating cost for the South LA campground would have been about $2,180 per participant.

Shayla Myers, a senior attorney with the Legal Aid Foundation of Los Angeles, said these campground sites are expensive to operate.

“They are the kinds of programs that shock the conscience of taxpayers,” Myers said, adding that they cost much more than paying rent, while keeping people unsheltered.

LAHSA staff say per-person costs for homeless programs differ based on location, hours and staffing needs.

Examples include:

• The region’s safe parking sites, which receive about $1,200 per participant per month to provide a set of similar resources to vehicle dwellers, according to LAHSA contract documents. 

• LAHSA programs that provide temporary rental assistance to families and cost about $2,000 per household per month, officials said. 

• The city of L.A.’s Inside Safe program, which moves people from encampments to hotel rooms. It costs about $6,900 per person served each month, according to a recent report by the city’s chief administrative officer.

Urban Alchemy has operated temporary campgrounds for unhoused Angelenos since 2021, including one in Virgil Village that has since closed and another in Culver City that is still operating.

In 2021, L.A.’s city administrative officer reported the Virgil Village campground cost more than $2,600 per participant per month.

Culver City opened its campground in 2023, so that the city could legally enforce a ban on camping in public approved that February. The city spent nearly $4.6 million on the campground in 2025, according to budget documents .

The Culver City site has space for 40 people, and the city says the occupancy rate is around 85% this year . That’s a cost of more than $11,000 per person served each month.

Myers said interventions like this will always cost more than moving people into homes.

“It doesn’t matter whether you're paying for a hotel room, a shelter, or in this case, lines drawn on a parking lot,”said Myers. “Continuing to provide shelter to folks who are unhoused — rather than providing permanent housing — is always going to be exponentially more expensive.”

After the city finalized its budget this June, LAHSA allocated $1.2 million to Urban Alchemy for the South L.A. campground for the current budget year, instead of $2.3 million.

LAHSA now lists the site’s capacity as 46 tent spaces, authorities said. The agency said the site now has a “utilization” rate of 70%, compared to 41% the previous fiscal year.

That’s at a cost of about $3,100 per participant per month.

Nick Gerda and Makenna Sievertson contributed to this story.

Lawyers representing victims of the Eaton Fire allege that Southern California Edison is intentionally delaying litigation and potential discussions to enter into a faster mediation process in order to increase participation in its voluntary payout program . The company denies the allegations.

In a joint case management conference statement filed Thursday afternoon, lawyers with three firms representing Eaton Fire survivors state that Edison has repeatedly delayed trial dates, as well as discussions to enter into a faster mediation process “while, at the same time, peddling their discount settlement program as ‘transparent.’”

“What is abundantly clear is that Defendants [Edison] want to waste judicial resources and subject the community they destroyed to needless delay,” the statement reads.

The lawyers argue that Edison International Chief Executive Officer Pedro Pizarro has repeatedly stated publicly that Edison’s equipment likely sparked the Eaton Fire. The filing also says, as further evidence of the company’s belief it started the fire, that Edison entered into an agreement with an undisclosed insurance company to pay them back for Eaton Fire losses.

“Despite these facts and public statements, Defendants continue to stand before this Court asserting that they cannot and will not participate in mediations because liability discovery is Incomplete,” the plaintiffs lawyers write.

Edison has settled previous wildfires lawsuits, including cases against them for causing the Thomas and Woolsey fires, through mediation, which is generally faster than litigation.

“Given these circumstances, Defendants’ plan is clear: delay litigation and refuse mediation in order to force vulnerable fire victims into accepting deeply discounted settlements,” the plaintiffs lawyers write.

Edison, however, denies the allegations, calling them “baseless” in the same court document.

“SCE has never entered into a mediation protocol this early in a wildfire litigation, and for good reason,” Edison’s lawyers write in the filing. “The Parties are still at the very early stages of developing the factual record.”

The company argued that the investigation into the cause of the Eaton Fire needs to be completed before entering into mediation and that the plaintiffs’ characterization of the delays are “misleading and misplaced.”

“To be clear, Defendants are neither supporting nor declining mediation,” Edison’s lawyers write in the filing. “It is simply too early to address these issues.”