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.

A divided Los Angeles Unified School District Board voted 4-3 Tuesday to issue preliminary layoff notices to more than 3,000 employees, as part of a reduction-in-force plan to reduce the budget after several years of spending more money than it brings in.

Even as California is poised to fund schools at record-high levels, Los Angeles Unified and other districts have grappled with increased costs. For example, LAUSD hired more staff to support students during the pandemic, and now the federal relief dollars that initially funded those positions are gone.

For the past two years, the district has relied on reserves to backfill a multi-billion-dollar deficit. The district projects a deficit of $877 million next school year, about 14% of the 2026-2027 budget.

Who’s being cut?

LAUSD staff estimate the proposed cuts impact less than 1% of the district’s more than 83,000 member workforce.

Notices would go out to:

• 2,600 certificated and classified contract management employees and certificated administrators. 
• 657 central office and centrally funded classified positions. More than a third of these are IT technicians, by far the largest group.
• The plan also calls for reduced hours and pay for several dozen positions.

District leaders have emphasized that an employee who receives a RIF notice will not necessarily be cut.

What's next?

The reduction in force vote is the first step in a monthslong process that could result in layoffs for a still-to-be-determined number of positions because impacted employees may be moved to other positions. Staff said the board would vote to finalize any un-rescinded layoff notices in May or June.

This is a developing story and will be updated.

About 15% of California households lack access to high-speed internet, according to the latest report from UC Riverside. Researchers pointed to affordability as one of the biggest barriers to closing the persistent digital divide.

Edward Helderop, associate director at UCR’s Center for Geospatial Sciences and report author, told LAist that the findings weren't surprising.

“A lot of American households and California households don't have high-speed internet available at home,” Helderop said. “It's sort of just an unfortunate reality that that's the case for the state of California.”

What does the report say? 

Nearly one in seven households in California doesn’t have reliable internet access, according to the report. The biggest barrier continues to be affordability. Even in urban areas, like Los Angeles, where broadband internet is more widely available, the average monthly cost can range from $70 to $80 per month.

But in rural areas, broadband internet is still widely unavailable because of a lack of infrastructure investments from private companies. Only two-thirds of rural households have broadband access at home.

“This digital divide represents not just a technological failure, but a profound barrier to economic opportunity, educational advancement, and civic participation that undermines California’s potential for shared prosperity,” the report states.

Experts also call for mandatory broadband data transparency — internet providers should be required to publicly disclose their service speeds, pricing, reliability metrics and coverage areas.

“Private telecom companies administering the service, they're under no obligation to maintain publicly available data sets in the same way that you might get with other utilities,” Helderop said. “There are issues with the fact that the advertised speeds don't really match up with the actual speeds that people experience at home.”

Researchers also recommend that broadband providers be regulated as utilities, like water and power, monitoring rates, quality and service obligations.

“When we regulate something like a utility, it comes with a few regulations that we take for granted,” Helderop said. “Something like a universal service obligation, in which the utility … their primary motive is to provide universal service, so to provide the service to every household in California.”

As a public utility, officials could ensure that providers are offering the same type of service to every household in the state, as well as regulate rates.

Why it matters 

Norma Fernandez, CEO at Everyone On, said access to affordable, high-speed internet is a basic necessity.

"Still, too many families, particularly those in under-resourced communities, predominantly of color, are still left out,” Fernandez said. “Expanding reliable connectivity means addressing affordability, investing in community-centered solutions, and ensuring that digital access is part of every policy conversation."

Digital equity advocates say they see the need from local families every day, but available data doesn’t reflect that.

“On the maps, families appear to live in ‘connected’ neighborhoods, but in reality, they still can’t afford to get online because the monopoly provider’s plans are unaffordable,” Natalie Gonzalez, director at Digital Equity Los Angeles. “The provider-reported broadband maps don’t match what residents experience on the ground, and that gap has real consequences.”

In L.A., for example, hundreds of thousands of households lack reliable internet, but only a fraction qualify for public funding because available data says they’re already served, Gonzalez added.

“Public investment alone doesn’t guarantee equity if the underlying data is flawed,” Gonzalez said. “When the only data regulators have come from the providers themselves, the providers end up defining reality. Communities are then forced to prove they’re disconnected, without access to the same information the companies use to claim coverage.”

Cristal Mojica, digital equity expert at the Michelson Center for Public Policy, said pricing data is intentionally obscured.

“It makes it harder for people to shop around between internet plans,” Mojica told LAist. “It makes it really challenging for our state legislators to be effective and make effective decisions around affordability when they have to try to dig around for that information themselves.”

What’s next? 

California has already invested $6 billion for broadband –called the “Middle-Mile” project –through Senate Bill 156. The 2021 law is the largest state investment in broadband in U.S. history to get more people online.

Helderop explained that broadband investments are typically made possible through grants or loans to private telecom companies, making the state’s investment critical.

“It's the first time that any state, or any government in the United States, is taking it upon themselves to build and then own the infrastructure at the end of it,” Helderop said. “I would say that's probably the primary reason that we don't have universal broadband available to households in the United States right now.”

When completed, the “Middle-Mile” project will open markets to new providers and reduce monopolies, Helderop added.

Playboy founder Hugh Hefner’s widow, Crystal Hefner, is raising the alarm over her late husband’s foundation collecting about 3,000 of his personal scrapbooks and his diary, which she says contain thousands of nude images of women, some of whom might have been minors at the time the photos were taken.

In a press conference Tuesday, Hefner and her attorney, Gloria Allred, announced they’ve filed regulatory complaints with California and Illinois attorneys general, asking them to investigate the foundation’s handling of the scrapbooks. The complaints were filed to both attorneys general because the foundation is registered to do business in California but incorporated in Illinois.

“I believe they include women and possibly girls who never agreed to lifelong possession of their naked images and who have no transparency into where their photos are, how they’re being stored or what will happen to them next,” Hefner said.

She added the diary includes names of women he slept with, notes of sexual acts and other explicit details.

Hefner said she was asked to resign from her position as CEO and president of the Hugh M. Hefner Foundation on Monday after raising concerns about the materials. She said after she declined to resign, she was removed from her role.

She said she was told the scrapbooks may be in a storage facility in California. Allred says they were informed that the foundation plans to digitize them, but it’s unclear what it plans to do with them.

“This is not archival preservation. This is not history. This is control. I am deeply worried about these images getting out,” Hefner said. “Artificial intelligence, deepfakes, digital scanning, online marketplaces and data breaches means that once images leave secure custody, the harm is irreversible. A single security failure could devastate thousands of lives.”

In addition to asking for an investigation into the foundation’s handling of the materials, it also asks the attorneys general to take appropriate actions to secure those images.

LAist has reached out to the Hugh M. Hefner Foundation for comment.