The Brief

California regulators released a report this week that found Kaiser has yet to fix several “deficiencies” in behavioral health care for which it was cited years ago.

The report from the California Department of Managed Healthcare lists 20 deficiencies it found in 2022 based on state regulations, ranging from failing to provide non-urgent mental health and substance-use appointments within 10 days to not ensuring members are offered urgent care appointments within 48 hours of the request.

According to the report, Kaiser still had not corrected 19 of them.

The report comes as Kaiser mental health workers in Southern California prepare to enter the sixth month of a strike against the health care provider.

“This report shows why Kaiser Permanente mental health workers remain on strike,” Sal Rosselli, president emeritus of the National Union of Healthcare Workers, said in a statement. “Kaiser keeps saying everything is fine when its workers know that patients can’t get the care they need because Kaiser’s services are understaffed and underfunded.”

In a response included in the 88-page document, Kaiser Foundation Health Plan said it had made “substantial progress” in addressing issues brought up in the report as it “continues the transformation of its behavioral health program.”

“Despite the efforts of the National Union of Healthcare Workers to mislead the public, the Department of Managed Health Care has not identified new deficiencies in our mental health care,” Kaiser Permanente said in a statement to LAist, adding that the deficiencies in the report had not “gone unaddressed.”

The plan said all deficiencies outlined in the report had been addressed and were part of its corrective action plan to get in line with state regulations. 

What the report from state regulators found 

The strike comes more than a year after state regulators hit Kaiser with a $50 million fine for failing to provide timely access to mental health care and other problems.

As part of that settlement agreement, Kaiser committed to investing an additional $150 million over five years to expand and improve behavioral health care for members.

The report out this week from the Department of Managed Healthcare outlines 20 deficiencies that were found in Kaiser’s Northern and Southern California regions during a 2022 survey of operations and the status of the deficiency following the regulator’s review of compliance efforts.

They include:

• Failing to offer non-urgent mental health and substance use appointments within 10 days of the initial appointment request
  
• Not ensuring enrollees are offered urgent care appointments within 48 hours of the request
  
• Not enough oversight of suicide risk screenings.

“Health plans are required to provide their members with appropriate access to behavioral health care services, and the DMHC will continue to hold Kaiser Permanente accountable to these requirements in the law,” Director Mary Watanabe said in a statement.

Watanabe said Kaiser plans to remedy the deficiencies in the report through a corrective action plan required as part of the $200 million settlement agreement.

According to the report, state regulators will do a follow-up survey within 18 months to see if the issues have been corrected.

In a statement emailed to LAist, Kaiser Permanente said it was currently exceeding state requirements for timely access to care, meeting access timeframes “99.7% of the time for urgent care [and] 95% of the time for initial nonurgent care appointments.”

“The investments we’ve made over the last several years have resulted in significant improvements in access for our members,” the plan said. 

The ongoing strike 

In October, about 2,400 therapists, psychiatric nurses, psychologists and social workers represented by the union went on strike, pushing for better pay and pensions, as well as more time to conduct patient follow up.

In a statement this week, Kaiser said 60% of union-represented employees who chose not to strike or have since returned to work are continuing to serve patients, along with an outside network of “more than 13,000 providers.”

Last month, Gov Gavin Newsom urged the two groups to settle the strike through mediation, especially after the wildfires tore through Los Angeles County in January.

Newsom sent a letter to Greg Adams, CEO of Kaiser Permanente, and Sophia Mendoza, president of the National Union of Healthcare Workers, noting that Southern California residents “are grappling with extreme loss and displacement” after the fires.

Mark Ghaly, former California Secretary of Health and Human Services, and Darrell Steinberg, a former mayor of Sacramento, were tapped as mediators earlier this month, but negotiations have since stalled, according to the union.

Wednesday’s protest

More than 100 Kaiser employees and supporters rallied Wednesday outside the health provider's offices in Pasadena. Picketers held signs that read “Healthy workers equals health patients,” and “End the inequity.”

Patricia Arevalo-Porcelli, a licensed clinical psychologist, said she’s been a Kaiser employee for nearly three decades, and that some of her patients have shown up to support her on the picket lines over the course of the more than five-month strike.

Arevalo-Porcelli said she knows some mental health workers on strike are not only dealing with the financial stress of the work stoppage, but have also lost their homes in the Eaton Fire.

“The need for us to get back and be of service to the community who is truly grieving, deeply, is now more than ever,” she said.

Los Angeles’ regional homelessness agency is working to find ways to keep thousands of people in their homes, while complying with new federal funding restrictions on permanent housing.

The governing board for the L.A. Homeless Services Authority voted Monday to start the process of reallocating about $130 million in federal funding currently being spent on permanent housing to other projects meant to serve unhoused Angelenos.

Because of new funding restrictions from the U.S. Office of Housing and Urban Development, known as HUD, about 5,000 households in the county will lose their rental subsidies, according to several LAHSA officials who spoke at a commission meeting Monday.

Those changes, along with state and county funding shortfalls for homeless services, threaten to drastically worsen the region’s homelessness crisis, they said.

"The fact of the matter is there’s going to be a tremendous and terrible impact on people, on agencies, on landlords,” said Nathaniel VerGow, LAHSA’s chief program officer.

Officials said they’re scrambling to maximize federal funding under the new guidelines while also advocating against the new HUD policy.

“It is a cliff and it feels catastrophic, but I think it forces us as a region to figure out how to save ourselves,” LAHSA Commission Chair Amber Sheikh said.

The funding challenge

Most federal homelessness dollars flow into the L.A. region through the Continuum of Care program, managed by HUD.

The Los Angeles region is eligible for more than $260 million in federal funding under that program in the coming fiscal year, including $217 million for existing projects.

But no more than 30% of those funds can go toward permanent housing projects, according to a “notice of funding opportunity” HUD issued last month.

That’s a challenge for L.A. County, because 90% of regional HUD funds currently cover people’s rent, according to LASHA officials.

Instead, L.A. and other cities and counties must spend the bulk of their federal funds on other interventions, including transitional housing and street outreach.

HUD officials have said the policy is meant to encourage self-sufficiency.

At Monday’s meeting, Commissioner Justin Szlasa urged his colleagues to consider larger funding trends.

“ There's actually a 23% increase in available funding from HUD, the federal government,” he said. “It just doesn't work with the way that we normally have done things here.”

“We need to find, in this crisis, a way to be constructive about this,” Szlasa added.

HUD policy changes

HUD released its new notice of funding opportunity last month and rescinded a previous two-year funding agreement.

Opponents have concerns with the federal housing department’s move away from “housing first” approaches. They also said HUD rolled out the changes without providing enough time to prepare service providers and clients for disruptions.

Last week, 21 states, including California, sued HUD, claiming the new federal policies “essentially guarantee that tens of thousands of formerly homeless individuals and families will be evicted back into homelessness.”

This week, a group of cities and homelessness organizations also sued over the changes. Plaintiffs include the city and county of San Francisco. The Continuum of Care for San Francisco was awarded $56 million in federal funding for Fiscal Year 2024.

Approximately 91% of that funding supports permanent housing projects, according to the complaint.

What’s next?

The LAHSA Commission voted Monday to approve its request for applications for existing and new projects.

Providers must submit applications to LAHSA over the next two weeks, and LAHSA has until Jan. 14 to craft and submit a new application to HUD.

The agency is now talking with 130 contractors about the transition.

LAHSA is also working with some permanent supportive housing providers to convert their programs to transitional housing instead, officials said.

People who were in permanent housing projects aren’t eligible for transitional housing under HUD’s guidelines because they're not considered unhoused, VerGow said.

The commission also reviewed a policy for ranking project applications and prioritizing them for federal funding. Officials said that policy has to be approved at a LAHSA Commission subcommittee on Dec. 10.

Funds are expected to be awarded in May 2026.

LOS ANGELES — As the season of Advent begins, many Christians turn toward quiet reflection and preparation for Christmas. But in several Southern California congregations with large immigrant communities, that sacred anticipation is shadowed by a looming sense of fear.

For worshippers like Mike, an Iranian asylum-seeker who attends a West Los Angeles church, the weeks leading up to Christmas feel less like a spiritual refuge and more like a time of apprehension. He asked that only the anglicized version of his Farsi name be used because he fears speaking publicly could affect his immigration case. He fled Iran after converting to Christianity.

"I kept this secret, my faith as a secret, for like 12 years," he said.

Mike arrived in Los Angeles 18 months ago and says he has tried to build a life rooted in community and respect for his new home. But a series of immigration enforcement actions in the region — including the June arrests of two men outside a nearby church with a large Iranian membership — has shaken him.

"Even church is not safe because it's a public place," he said. "They can get there and catch you."

The Department of Homeland Security says enforcement actions at churches require secondary approval and are expected to be rare. Still, the concern is real inside Mike's congregation, where church leaders asked that the name of the church not be published.

A significant number of Iranian parishioners worship there, and the pastor often invites them to pray in Farsi during services. Lately, fewer take her up on the offer.

"It's part of the heartbreak of these days," the pastor said. "They feel like they have to be apprehensive about it — not even wanting to speak in their own language here."

She said the fear is especially painful during Advent, a season she describes as a time to prepare to "give thanks for this God we have who wants to be with us."

Room at the inn, despite fears

East of Los Angeles, at Baldwin Park United Methodist Church, Pastor Toña Rios unzips a red tent pitched in the middle of the sanctuary. For years, the church took in newly arrived immigrants, providing a place to sleep while they looked for work and housing.

The tent remains as a reminder of that welcome — and of the fears many congregants now carry. Rios estimates that about 80% of her church members are immigrants and says many don't have legal status.

"A lot of them say, 'Don't open the door. Just close the door,'" she said.

Rios urges a different posture, especially during Advent. She uses the tent to help her congregation imagine being the ones who offer shelter, not shut others out.

"It is very hard," she said. "But Jesus is going to be born in our heart. That's why we need to be prepared."

For longtime church member Royi Lopez, the sense of vulnerability goes beyond immigration status. Lopez is a U.S. citizen but says she often feels targeted because she is Latina. Many of her relatives are undocumented, and she worries constantly about them.

"What if on my way to church, they catch us?" she said. "On a daily basis, we're scared of going to the school, to work, to church, to even the grocery store."

Lopez says that during Advent, these fears remind her of the Christmas story itself — of Mary and Joseph searching for somewhere to stay, turned away again and again until somebody finally took them in.

"Even though so many doors were closed, somebody opened a door," she said.

That theme of welcome runs through the hymn chosen for every Sunday of Advent at Baldwin Park United Methodist Church, "All Earth is Hopeful." Its lyrics speak of a world longing for liberation, where people labor to "see how God's truth and justice set everybody free."
Copyright 2025 NPR

The Supreme Court today is hearing a billion-dollar case about whether internet providers can be liable for their users' committing copyright violations using their services.

The legal battle pits the music entertainment industry against Cox Communications, which provides internet to over 6 million residences and business.

A coalition of music labels, which represent artists such as Sabrina Carpenter, Givēon and Doechii, sued Cox alleging that company should be responsible for the copyright violations of internet users that Cox had been warned were serial copyright abusers.

The coalition argues Cox was sent numerous notices of specific IP addresses repeatedly violating music copyrights and that Cox's failure to terminate those IP addresses from internet access means that Cox should face the music.

In its briefs, the coalition argued many of Cox's anti-infringement measurements seem superficial and the company willingly overlooked violations.

The coalition points out that Cox had a 13-strike policy for potentially terminating infringing customers, under which Cox acted against a customer based on how many complaints it received about a particular user. The Cox manager who oversaw the Digital Millennium Copyright Act, the law at issue in this case, told his team to "F the dmca!!!"

"Cox made a deliberate and egregious decision to elevate its own profits over compliance with the law," the coalition asserts.

The Fourth Circuit Court of Appeals and a jury agreed with the coalition, with the jury awarding the coalition more than a billion dollars in damages.

Cox argues it should not be liable for its customers' actions as it never encouraged the copyright infringements, its terms of service prohibit illegal activities, and it does not make additional money when customers use its internet to infringe on copyrights.

In its briefs, Cox specified that less than 1% of its users infringe on music copyrights and that its internal compliance measures "got 95% of that less than 1% to stop." It asserts that if the Supreme Court does not side with them, then "that means terminating entire households, coffee shops, hospitals, universities and even regional internet service providers (ISPs) — the internet lifeline for tens of thousands of homes and businesses — merely because some unidentified person was previously alleged to have used the connection to infringe."

A decision in the case is expected this summer.

Copyright 2025 NPR