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.

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Angela Hart

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KFF Health News

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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.

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Angela Hart

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KFF Health News

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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.

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Angela Hart

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KFF Health News

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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.

Since its opening in 1919, Fosselman’s Ice Cream Co. has learned a thing or two about the art of ice cream, offering more than 50 flavors, ranging from the classics to the regionally inspired.

Co-owner John Fosselman sat down with Austin Cross, who hosts AirTalk Friday on LAist 89.3, to discuss the history of his family's business and how four generations have had a hand in keeping the business alive.

About the owners

The original concept for the ice cream venture came from Christian Fosselman, who started his business as a young man in Waverly, Iowa. While attending a bottling convention, he got his first taste of ice cream. Family lore says he was fascinated by the latest ice cream manufacturing equipment available. This led him to start a new business and move his family to Pasadena in 1924.

Fast forward to today, the business is now in the hands of the third generation of Fosselmans — Chris and John.

They currently run two brick-and-mortar locations: Fosselman's Ice Cream Co. in Alhambra, and The Ice Cream Shop in Glendora.

What goes into making their ice cream?

In the case of their "Coffee & Cookies" flavor, a lot went into perfecting it.

Freeze-dried Colombian coffee is how they capture the taste. By minimizing the amount of water used in the process, they're able to keep the ice cream quality high.

John Fosselman says they've been using this blend for 70 years.

"We've tried every other alternative — cold brew and different brewing techniques — but the best way to nail it is the freeze-dried that we use," he said.

The best way to experience Fosselman's

Photo of Fosselman's ice cream sundae

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Courtesy Grace Fosselman

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Sample all the flavors you want or ask their clerks for their favorites.

If you aren't in the mood for just ice cream, John suggests a malt, shake or even a hot fudge sundae.

Shop details:

A fleet of Fosselman's Ice Cream cars and drivers.

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Courtesy Grace Fosselman

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• Originally founded in Iowa in 1919, the family came to California’s San Gabriel Valley in 1924.
• What started as a wholesale dairy company was mostly shuttered in the 1970s when the family shifted attention to their ice cream shop in Alhambra.
• In 2019, as they reached their centennial, they opened The Ice Cream Shop in Glendora.
• John and Chris, both third-generation Fosselmans, have led the shops’ operations for 40 years.

Flavors we tried

• Fresh Peach
• Coffee & Cookies
• Cookie Monster
• Chocolate Dipped Strawberry
• Watermelon Sorbet

What should we try next?

The federal government, under a court order to immediately improve conditions at the Adelanto ICE Processing Center, said late Thursday it is working with the private contractor that runs the facility to improve conditions.

Allegations of inhumane conditions at Adelanto have been at the center of protests for months. Located 90 miles from downtown Los Angeles, the privately run detention facility in San Bernardino County is now over capacity, after being nearly empty 18 months ago.

Four people have died at Adelanto since September 2025.

On July 16, a U.S. District judge ordered federal officials to immediately improve medical care, disability accommodations and daily conditions for people held at the Adelanto.

In her order, Judge Sunshine Suzanne Sykes gave the Department of Homeland Security 14 days to submit a plan to address alleged deficiencies long term.

The government’s response, filed just ahead of Thursday’s deadline for a long-term improvement plan, was short on details and included pushback. Lawyers for the federal government notified the court they plan to appeal the order to the U.S. Court of Appeals for the Ninth Circuit, and asked the court to hold off on enforcing the July 16 order until that appeal is decided.

What we know:

• According to filings, the defendants and plaintiffs have agreed on candidates for a monitor to keep an eye on overall conditions at the facility. They have not agreed on a monitor to focus on medical conditions. The government has proposed two candidates in court filings.

• In their remediation plan, federal officials told the court that the privately run facility is already in compliance with several of the standards set in the court order, including providing timely diagnostic testing for health issues, ensuring continuous access to over-the-counter and prescribed medications and informing people held at the facility of their patients’ rights.

Immigration and Customs Enforcement officials said in their filed plan that they have been reviewing the contract with The GEO Group, which runs Adelanto, and will work to bring the facility into compliance with the full court order.

Reaction to the latest developments

A spokesperson for GEO referred LAist to ICE for comment.

In an emailed, unsigned statement, the Department of Homeland Security said claims that conditions at Adelanto are substandard are false.

“All detainees are provided with proper meals, water, medical treatment, and have opportunities to communicate with their family members and lawyers,” the statement read, in part.

Ryan Smith, an ICE assistant field office director, told the court in a declaration that the July 16 preliminary injunction “frustrates and impedes” the agency's ability to enforce immigration laws.

Smith’s declaration said the facility already complies with many of the immediate requirements of the injunction, and that other requirements would create safety risks or an “undue burden” for ICE.

Carl Bergquist is general counsel for the Coalition for Humane Immigrant Rights — known as CHIRLA — which is one of the organizations representing plaintiffs in the lawsuit. He said the plaintiffs plan to formally oppose the government’s request to stay the injunction.

He also expressed concern that other aspects of the court order — including an immediate requirement to provide 24-hour access to clean drinking water, healthy meals and hygiene products — remain unaddressed, despite the government’s claims.

“All of that was supposed to be immediate upon the order coming out,” said Bergquist. “We believe we've seen instances of some of that not happening already. So that's a problem.”

Bergquist said his organization has monitored conditions at Adelanto since the July 16 order through visits once or twice a week to the detention center. He said CHIRLA has also taken new reports from people who are detained there either through the organization's hotline or through family members.

Background on the lawsuit

Adelanto has a long history of complaints about its conditions. The facility was nearly shut down during the COVID-19 pandemic because of unsafe conditions.

A court ordered the facility to stop accepting new detainees, and the population remained relatively low, down to fewer than a handful of detainees by the end of the Biden administration.

The population climbed sharply with the start of intense ICE enforcement in the L.A. area in June 2025.

Bergquist called the rapid change from a nearly empty facility to one that is now over capacity “a recipe for what we're seeing now.”

Concerns about current conditions at Adelanto have been documented by state officials for more than a year. An amicus brief filed in June by California Attorney General Rob Bonta, whose office inspects immigration detention centers in the state, details several problems at the facility found during a July 2025 inspection.

“The Attorney General’s office found, among other things, a facility that was overwhelmed with the rapid population increase; insufficient staffing; failures to attend to urgent medical needs, to care for individuals with chronic conditions, and to ensure specialty care referrals; and use of force concerns,” according to the brief. The brief said inspectors heard reports of “murky and dirty” water and improperly cooked food.

“Almost every person interviewed complained about the quality of the food,” according to the brief.

The lawsuit that led to the July injunction was filed six months after Bonta’s inspection on behalf of four plaintiffs representing Adelanto detainees as a class.

They asked the court to “to end the unlawful and unconstitutional conditions at Adelanto, prohibit Defendants from violating their civil, constitutional, and human rights, and require Defendants to provide lawfully adequate conditions,” the complaint reads. “In other words, they ask to be treated like human beings.”

The GEO group runs Adelanto for federal officials under a contract that runs through 2029.

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David Wagner

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LAist

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Who is responsible for conditions?

In court filings, the federal government has argued it cannot be held responsible for the actions of GEO, its contractor. According to the lawsuit, ICE’s current contract with Adelanto pays GEO more than $400 million a year to run the facility. The contract was extended for five years in 2024, and is now set to expire in 2029.

While issuing the preliminary injunction, Sykes ruled that the plaintiffs demonstrated they are likely to prevail, “or at least, raise serious questions” on their claims that the facility violated their Fifth Amendment protections against inhuman conditions and will suffer “irreparable harm” if the courts don’t grant relief.

In its Thursday request to stay the injunction, the federal government reiterated its position that ICE does not “own, staff, or run” Adelanto and cannot address the conditions there on its own.

“The difficulty is not the conditions the Order describes; it is that the Order commands ICE to produce results inside a facility that The GEO Group, Inc. — a private federal contractor that is not a party in the litigation — owns, staffs, and operates every hour of every day,” the filing reads.

Bergquist said Sykes has rejected those claims.

“We argued that ICE is in charge here and those arguments are spurious. The judge agreed with that and thus moved ahead” with the preliminary injunction.

The filing states that ICE’s contract with GEO requires the facility to comply with several sets of national standards for detention and correctional health.

The government also argues several parts of the order go beyond the contractual obligations between GEO and ICE, and could be dangerous if implemented.

An independent monitor found ICE also fails to provide adequate medical care at its California City facility in Kern County.

Bergquist said lawsuits are challenging the conditions at ICE detention centers nationwide.

“I think in most of these cases that I'm aware of, including California City, the conditions are absolutely not satisfactory and injunctions are being put in place,” Bergquist said.

Details of the government's response

On July 16, a federal judge ordered the government to create a plan to improve conditions at Adelanto. The government submitted that plan on July 30.

Here’s how federal officials responded:

Medical care

The requirement: Implement “documented health intake screening” for everyone held at the facility within eight hours of arrival.

ICE response: ICE says standards at the facility already require comprehensive health screening within 12 hours. The agency says it asked GEO to comply with the standard by reducing the maximum screening time down to eight hours.

The requirement: Ensure access to “primary, secondary, and tertiary medical care” for everyone held at the facility.

ICE response: ICE says it has asked GEO to comply with this standard and are reviewing the standards set by the agency’s contract with the company.

The requirement: Ensure timely diagnostic testing and required timeframes for review and follow-up on results.

ICE response: ICE says the facility is already compliant.

The requirement: Continuous provision of ordered medications.

ICE response: ICE says the facility is already compliant.

The requirement: Make sure all patients are informed of their rights, with translations as needed.

ICE response: ICE says the facility is already compliant.

Disability Accommodations

The requirement: Implement a system to identify and track anyone with qualifying disabilities.

ICE response: ICE says the facility is already compliant, but that GEO is requesting additional staff to manage the process.

The requirement: Provide reasonable accommodations to people with disabilities.

ICE response: ICE says the facility is already compliant, but that GEO is requesting additional staff to manage the process.

The requirement: Provide materials, with translations as needed, to inform people of their rights to accommodations.

ICE response: ICE says the facility is already compliant.

Grievance system

The requirement: Ensure there is a process for people to confidentially submit complaints or comments to the independent monitors.

ICE response: ICE says it is reviewing its contract with GEO and that the company will establish a new, handwritten grievance process.

WASHINGTON (AP) — Arizona, California and Nevada would take less water from the Colorado River under a proposal announced Friday by the federal government to stave off crisis in the beleaguered waterway.

The proposal from the U.S. Bureau of Reclamation spares Colorado, Utah, New Mexico and Wyoming from facing mandatory cuts for now. But it’s a temporary fix as the states that rely on the river still fight over a long-term management plan for the dwindling resource that powers huge swaths of the Western U.S.

Under the plan, the Lower Basin states could face collective cuts up to 3 million acre-feet (130 billion cubic feet) through 2036, “subject to hydrology,” according to a press release by the Department of the Interior. That’s about enough water to serve more than 25 million people a year.

The plan would also allow annual releases between 5 million and 12 million acre-feet from Lake Powell, the basin’s second-largest reservoir. Under the 10-year federal framework, water management decisions will be made every two years.

“This framework provides the flexibility to respond to changing hydrologic conditions while preserving the opportunity for the Basin States to continue working toward durable, consensus-based solutions,” said Secretary of the Interior Doug Burgum in the press release.

The proposed cuts in the Lower Basin states of California, Arizona and Nevada would be the biggest to date and could have huge impacts across cities and farms — higher water prices, increased groundwater reliance, more agriculture out of production and conservation mandates in places where none have existed before.

The federal plan comes after years of deadlocked negotiations and a record-dry winter that tipped Colorado River reservoirs to combined record lows. Federal officials are expected to finalize the plan in the coming days.

More than 40 million people in seven U.S. states, several tribal nations and Mexico, as well as farmers, wildlife, industries and hydropower, rely on the dwindling 1,450-mile (2,334-kilometer) Colorado River. Years of overuse combined with rising temperatures and drought have severely depleted flows in the Colorado today compared with decades past.