The Brief

For four years, Shane Hutchison lived in a tent in the middle of the desert outside Lancaster, miles from the nearest grocery store. The 53-year old started each day the same way — with methamphetamine.

“It's almost like you feel you have to have it just to be able to make the seven-mile hike one-way for water,” Hutchison said. “Out there in the desert, it becomes a tool of survival.”

Last summer, an outreach worker asked Hutchison if he wanted to be a part of a new Los Angeles County program in which he could earn gift cards each week he could pass a drug test.

The program, which started last year, is one of the only treatment options available for unhoused Angelenos addicted to stimulants, including methamphetamine. While the approach has been used in drug treatment for decades, it’s now gaining traction in L.A. County. And there’s evidence to show it’s been successful.

People can be prescribed methadone to manage their addiction to heroin, fentanyl and other opioids. But experts say there are no approved medications to help people addicted to meth and other stimulants.

That makes an incentives approach even more crucial, practitioners said.

“ There aren't a whole lot of treatment options that are not just abstinence-based,” said Kim Roberts, chief program officer at shelter provider L.A. Family Housing. “Folks can be looking to change their relationship with stimulants, but maybe not ready to discontinue alcohol use or marijuana use.

“This program is really tailored to the idea that we can start to chip away at a substance use disorder and that it doesn't have to be all or nothing.”

Hutchison said he’d never seriously tried quitting before, but this time he was ready. He’d been recently diagnosed with an aggressive skin and bone cancer.

“I gave up,” he told LAist. “I threw away everything I had out there in the desert. I left there, walked away with my dog and my backpack, and here I am now.”

Hutchison completed the 13-week program in March and earned about $600 in Visa gift cards, according to county health officials. Today, he says he’s sober, living in a two-bedroom apartment in Palmdale and working full-time as a carpenter.

“If it wasn't for the program, I'd probably still be out there on meth,” he said.

About one in three homeless Californians regularly use methamphetamine, according to a UC San Francisco report released in March. Meth is a leading cause of overdose death among L.A. County’s unhoused population, according to the L.A. County Public Health Department.

California started experimenting with incentives programs in 2023, becoming the first state to get federal approval to spend Medicaid dollars on programs that essentially pay people to break their addiction to stimulants.

The concept, known to some as “contingency management,” is not yet common among L.A. County’s homeless service providers. There are more than 75,000 unhoused people in the county, but so far programs have been offered at six local homeless shelters and drop-in centers.

And it’s not without skeptics. Over the years, some clinicians and members of the public have likened the approach to bribery and expressed ethical concerns about paying people for something they should be doing anyway.

A contingency management patient checks in with county health workers before a urine analysis test.

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Thomas Lynch

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L.A. County Department of Health Services

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‘Not about a transaction’

L.A. County’s program began last spring as a collaboration between the Department of Health Services’ Housing for Health division and several homeless services providers.

It’s funded by a county grant aimed at reducing overdose deaths among the unhoused. For the fiscal year that began this month, more than $400,000 in county funds are dedicated to that grant.

The county provides money for gift cards and sends behavioral health teams trained in contingency management. Those teams work mostly out of vans equipped as mobile clinics, rotating through various locations including recent stops in North Hollywood and the San Gabriel Valley.

In May, the county launched new programs in Santa Fe Springs and Harbor City. Later this month, they’ll launch one near MacArthur Park, county officials said.

L.A. County Supervisor Lindsey Horvath supported bringing the program to a transitional shelter in Canoga Park called the Willows, where 25 residents are expected to complete their 13-week cycle later this month.

“This program is not about a transaction,” Horvath told LAist. “It's about how you develop trust and an ongoing relationship with people. So not only do they know that you are invested in their wellbeing, but they become invested in their wellbeing themselves.”

Participants in the county’s program get weekly Visa gift cards ranging from $10 to $50 for passing drug tests and also for meeting other goals like going to medical appointments, obtaining identification cards or signing up for public benefits.

The programs do not remove participants for failing drug tests.

“It's very much come as you are,” said Savann Duong, a clinical work supervisor with the county program. “There's no judgment. If you test positive, that's OK. Let's talk about it. You know, what happened this week?”

Methamphetamine can be detected in urine analysis tests up to three days after use. If participants test positive, they won’t get their weekly gift card, but they’ll still have the chance to be tested again the following week.

That’s crucial, according to Kim Roberts of L.A. Family Housing, which operates the Willows.

“We've created the space for people to come back and say, ‘Hey, this week wasn't it for me. I'm gonna try again next week,’” said Roberts. “And their housing is not dependent on it.”

To end the homelessness crisis, Horvath said the county must provide unhoused Angelenos with more than just shelter. Additional support, like drug treatment, is crucial.

“From a dollars-and-cents perspective, it's just waste if you aren't actually treating people and meeting them where they are,” Horvath said.

Not everyone completes the treatment. In the first few cycles of the county program, about three in 10 participants completed the full 13 weeks, officials said.

The incentive program uses rewards for clean drug tests to combat substance abuse and addiction.

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Mark Leong

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CalMatters

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History and evidence

Rewards programs are a new approach for L.A.’s homeless service providers, but dozens of studies have shown that positive reinforcement through small incentives is the most effective treatment available for stimulant use disorder.

Participants who received contingency management were 22% more likely to be drug-free six months after treatment than participants who received other types of treatment, like cognitive behavioral therapy, according to a recent research review.

“The one thing that we have to really significantly address stimulant use, based on 30 years of research, is contingency management,” said Thomas Freese, director of UCLA’s Integrated Substance Abuse programs.

The U.S. Department of Veterans Affairs has offered gift cards to reward people for clean drug tests since 2011. Since that time, those programs have served more than 8,000 veterans struggling with stimulant addiction, according to the VA.

The American Society of Addiction Medicine and American Academy of Addiction Psychiatry recommended this kind of treatment as the standard of care for stimulant use disorder in 2023, pointing to evidence showing it’s been more effective than anything else at helping people overcome stimulant addiction.

That same year, California became the first state to earn federal approval to use Medicaid dollars to pilot contingency management programs for Medi-Cal patients struggling with stimulant use. Earlier this year, more than 6,000 patients were enrolled in about 100 programs in the statewide pilot. About 35% of those who started the program finished, according to the UCLA researchers.

That pilot is expected to continue until at least the end of 2026.

The budget reconciliation bill signed into law by President Donald Trump this month cuts Medicaid spending in California, in part by imposing new work requirements on Medicaid recipients beginning in 2027.

Gov. Gavin Newsom said he expects the paperwork and administrative hurdles involved will result in up to 3 million California enrollees losing coverage.

The new law includes an exemption to the work requirements for people who are in treatment for substance use disorder. This should save the state’s contingency management pilot, but experts say they are waiting to see how the new rules play out in practice.

L.A. County’s program operates separately from California's Medicaid pilot. Despite some recent cuts to county homelessness funding, this particular county-led effort is funded for at least one more year, county officials said.

The fourth cycle of L.A. County’s traveling contingency management program will conclude this month at the Willows, a transitional housing site in Canoga Park.

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PracticeLA

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Battling addiction and stigma

Public programs that support people experiencing addiction often face pushback from voters and elected leaders, service providers told LAist.

Harm reduction is a public health approach that recognizes addiction is a health condition and that some people aren’t going to quit using drugs. Harm reduction interventions typically focus on minimizing the negative health effects of drug use.

In L.A. County, that includes distributing items like clean syringes, drug testing kits and doses of naloxone to treat opioid overdoses.

Many struggle to understand that approach, said L.A. Family Housing’s Roberts.

“If you talk about wearing a seatbelt when you're driving and frame that as harm reduction, people are totally fine with it,” said Roberts. “If you talk about drinking one less glass of wine as a housed person, people are totally fine with it. When you start to introduce paying people to stop meth use, all of a sudden there's a real visceral reaction that folks have, that in some way we are enabling.”

The county’s contingency management program relies on harm reduction principles, but it’s also explicitly aimed at motivating people to stop using stimulants.

Holden Bender-Bernstein, a mental health specialist at The Willows transitional shelter in Canoga Park, sees the approach as a middle ground.

"While this is a harm reduction program in some ways — in that no one's punished for coming back with a test that's positive for a stimulant, it also really relies on abstinence,” he said. “I think this is actually a good bridge for folks to understand that there's a difference between the idea of needle exchange and something like this, where they are depending on negative urine tests.”

Shane Hutchison, 53, says he used methamphetamine for nearly 20 years before getting clean last year.

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Aaron Schrank

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LAist

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Many participants stop attending treatment if they fail a drug test, even though the program encourages them to return, program managers told LAist.

“A lot of our folks, because they have that long history of feeling shame and guilt when it comes to substance use, they don't come back,” said Savann Duong. “ And that part is really hard.”

Hutchison said he saved up the gift cards he earned in his treatment program. After graduating, he bought a toaster, slow cooker and other new appliances for his apartment.

But, he said, the real reward was weekly contact with treatment providers invested in his wellbeing. His mother died four years ago, while he was incarcerated on meth-related charges.

“I don't have a family, but I had a reason to go every Thursday,” he said. “They gave me hope to be somebody. I think the reason, more than the incentive, is just having somebody there who cares.”

The newest Air Force One jet, gifted to President Donald Trump from the Qatari government, arrived ahead of schedule Friday to Joint Base Andrews in Maryland.

On Friday afternoon, Trump toured the luxury Boeing 747 plane that initially stirred controversy. The plane was one of the biggest foreign gifts ever received by the U.S. government and raised legal and ethical questions after Qatar offered to replace the presidential jet last year. Trump said last May he'd be "stupid" not to accept the offer. Industry groups originally said the plane could be worth approximately $400 million.

Trump also spoke standing in front of the plane, thanking the Emir of Qatar.

The president praised the workmanship of the plane, describing it as the "world's most luxurious plane." He also called it the "largest Air Force One ever built," adding, "It flies further and faster than any Air Force One."

"This plane was transformed into a flying White House at a level of luxury that nobody's ever seen before, probably even almost outside of an airplane," Trump said. "Nobody's ever seen anything like this, and in only 10 months, a timeframe no one thought possible."

The exterior of the jet is no longer light blue, silver and white — a fixture since the Kennedy administration. Trump unveiled the new red, white and blue color scheme.

"It was time for a change. … Everything was designed good. It was my taste," Trump said, saying that he approved the new color scheme, which reflects the American flag.

The VC-25B Bridge aircraft will now undertake its commissioning flights, what the Air Force calls a "final exam" for the plane. The plane was modified after serving the Qatari Head of State.

"Once these flights are successfully completed, the aircraft is officially 'commissioned' into the active executive airlift fleet and becomes available for presidential missions," an Air Force press release said.

The aircraft from Qatar will "serve as a bridge until the [long-term] VC-25B is delivered," according to earlier communications from the Air Force. The plane was delivered well before expectations. The Air Force originally estimated the plane would be delivered in 2028 but said by modifying requirements it could deliver the first aircraft in 2027. The modifications "were carefully crafted to prioritize mission over aesthetics, leaving much of the previous head of state interior layout minimally changed," the Air Force said.

Air Force Chief of Staff Gen. Ken Wilsbach praised the delivery.

"Many thought it could not be done, but the United States Air Force was able to execute and provide a secure, reliable airborne command post on an accelerated timeline," he said.

Vice President JD Vance has delayed his trip to Switzerland to negotiate the terms of a peace agreement with Iran on Friday.

It's unclear exactly why the talks were called off at the last minute, with hundreds of journalists already waiting in the alpine city of Lucerne.

But the delay raises questions over the sturdiness of the memorandum of understanding to end the war, signed by President Donald Trump on Wednesday.

It came as Israel continued to heavily bombard Lebanon, despite the agreement promising to end all military operations, including in Lebanon.

Lebanese media said at least 18 were killed in overnight strikes, and Israel said four of its soldiers had been killed in fighting in southern Lebanon.

Here are more details about the agreement and challenges they face in this latest effort to end the conflict:

US lifts naval blockade

There was immediate progress after the preliminary agreement to end the three-and-half month conflict that has killed thousands of people across the Middle East, rocked the global economy and pushed millions more into poverty around the world, according to the United Nations.

The United States lifted its naval blockade on Iran.

The short memorandum of understanding also promises to end military operations on all fronts and reopen the Strait of Hormuz, the crucial waterway through which much of the world's oil, gas and fertilizer must pass to reach global markets.

The agreement prompted President Trump to celebrate on Truth Social writing: "Ships of the World, start your engines. Let the oil flow!"

But there are still many potential pitfalls. Even before the agreement was signed, Trump made its fragility clear: "It's a memorandum of understanding," he said at the G7 summit in France. "If I don't like it, if they don't behave, we'll go right back to dropping bombs right smack in the middle of their head."

The document doesn't solve the underlying reason for why the United States and Israel went to war with Iran. It creates a 60-day window — extendable by mutual agreement — for the two sides to resolve the enmity that goes back many decades.

Israel remains defiant against the deal

The preliminary agreement promises to end all military operations, including in Lebanon. Israel has invaded and taken large swaths of southern Lebanon in an offensive it says is targeting the Iranian-backed militia Hezbollah, which has killed more than 3,800 people, according to Lebanon's Health Ministry.

Iranian Foreign Minister Abbas Araghchi has made clear that Iran considers Israel's withdrawal from southern Lebanon essential. "Without the withdrawal of Israeli forces from the territories they occupied during this war, the war has not fully come to an end," Araghchi said.

Israel wasn't involved in the negotiations with Iran — though Trump said at a press conference this week that he had sent Israel a copy of the document before he signed it. Israeli Prime Minister Benjamin Netanyahu has remained defiant, saying his troops will remain in southern Lebanon for as long as Israel's security requires it.

The conflict in Lebanon is causing an extraordinarily open rift between Trump and Netanyahu. "He's a very difficult guy," Trump said of the Israeli prime minister recently said to The New York Times.

On Thursday, Israel's military released a new map ⁠showing an expanded area of southern Lebanon occupied by its troops, which it describes as a buffer zone.

"Trump's agreement does not bind us," Israel's far-right national security minister, Itamar Ben-Gvir, wrote on social media on Monday. "We are not partners to this agreement that does not ensure our security."

Vice President Vance hit back at critics in the Israeli government, warning at a press conference that "Donald J. Trump is the only head of state in the entire world who is sympathetic to the nation of Israel at this moment in time."

Trump signed the deal to avoid 'economic catastrophe'

The agreement promises "the immediate and permanent termination of military operations on all fronts" — including in Lebanon, where Israel has continued its offensive. Iran and the United States also promise "not to initiate" any further war or operation against each other. Not long after Trump signed the memorandum, U.S. Central Command said Thursday it had ended its naval blockade of ships to and from Iranian ports, as promised in the agreement.

Iranian state media reported the country's national security council will suspend tolls paid by ships for 60 days, per the deal, but that ships must still request Iran's permission — through a newly established Persian Gulf Strait Authority, before passing through the Strait of Hormuz, which was once considered an international waterway.

Increased ship traffic through the strait will come as a relief to Trump, whose approval ratings have been sliding as Americans see soaring gasoline prices and spiking inflation. Last month Trump insisted he doesn't think about Americans' financial situation in his approach to Iran.

But this week he acknowledged at a news conference that he had signed this agreement because he "didn't want to see an economic catastrophe."

The memorandum gives major concessions to Iran

Trump has repeatedly called the Iran nuclear deal — formally known as the Joint Comprehensive Plan of Action (JCPOA) — presided over by President Barack Obama in 2015 the "worst deal ever," and Trump abandoned the agreement in his first term in office. But the framework agreement signed this week hands major financial concessions to Iran that could ultimately go much further than the Obama-era arrangement.

The document says the U.S. will work with regional partners to create a fund of "at least $300 billion" for Iran's reconstruction and economic development. Vice President Vance has said Gulf Arab nations would invest that amount.

It also promises that the U.S. will unfreeze Iranian funds and assets that amount potentially to tens of billions of dollars. Mohsen Rezaei, military adviser to Supreme Leader Mojtaba Khamenei, told CNN Iran wants to see the release of $24 billion.

These commitments do depend on further negotiations. But the Trump administration also plans to issue sanction waivers to allow Iran to immediately sell its oil. The waiver concedes a major point of potential leverage at the start of these 60-day talks.

And the interim deal also opens the door to ending all U.S. and international sanctions on Iran. Iran has been under a plethora of U.S. sanctions since the 1979 Revolution. The penalties have kept Iran cut off from the global economy, preventing it, for example, from accessing the international banking sector. This new pledge goes far beyond the JCPOA deal, which removed some sanctions in exchange for Iran reducing its stockpile of uranium.

The negotiation over Iran's nuclear program

President Trump has boasted he will achieve a much "better" agreement than the JCPOA. The substantive talks on this are yet to begin, but so far, the commitment Iran has made in the memorandum that it "shall not procure or develop nuclear weapons" is the same promise it has made for years, including in the 2015 nuclear accord.

The details of Iran's nuclear program are complex and technical. The JCPOA was negotiated over years by the U.S., U.K., France, Germany, Russia and China, with nuclear physicists and non-proliferation experts, and ran to 159 pages. Trump's framework was negotiated bilaterally by Steve Witkoff and Jared Kushner — a property developer and the president's son-in-law. An Iranian diplomat who spoke to NPR on condition of anonymity because they were not authorized to speak publicly told NPR they believed the last round of talks with the Trump administration did not progress because "the Americans at the table did not understand the subject."

The U.S. had been negotiating with Iran over its nuclear program before abruptly launching the bombing campaign with Israel on Tehran that began this war on Feb. 28. For this latest round of talks, Witkoff and Kushner visited the national lab in Oak Ridge, Tenn., earlier this month for consultations with a team of technical experts that could play a role in nuclear negotiations with Iran.

Has Iran come out of the war stronger?

Trump began the conflict promising to set conditions for regime change in Iran. "I say tonight that the hour of your freedom is at hand," he told Iranians in a televised address on Feb. 28. "When we are finished, take over your government. It will be yours to take."

It was a nightmare scenario for the Iranian regime, to face down the bombardment from two of the world's most powerful militaries. The war killed more than 3,300 Iranians, according to state media, including top leaders, and pounded the country's infrastructure and armed forces. But the regime's survival, and its ability to target U.S. assets in the region and control the Strait of Hormuz, empowered Iran.

The country has learned "that threatening the Strait of Hormuz works," Bill Cassidy, Republican senator from Louisiana, said in a blistering attack on the Trump administration. He called the offensive against Iran "the worst foreign policy blunder in decades."

Iran's response forced the Trump administration to set aside the goal of regime change to focus on seeking a way to reopen the vital strait.

"The only 'achievement' of the ceasefire is the likely reopening of the Strait of Hormuz — which was open before the war started. And we will apparently pay Iran to do so," Antony Blinken, who was secretary of state under former President Joe Biden, posted on X.

Trump has countered critics by saying on social media that anyone who thinks he hasn't "been tough enough on Iran," when the stock market is high and oil prices are falling, is either jealous, bad or stupid. And Vance called on critics to "have a little bit of faith in the president of the United States."

But in a hard accounting of the war, the facts are undeniable: Iran's closure of the Strait of Hormuz gave it the leverage to secure from Trump concessions that unlock vast sums of money — even more, potentially, than under Obama.

And regarding Iran's nuclear program, the Iranians so far appear not to have offered Trump any more concessions than they did at the Geneva talks two days before the U.S. and Israel launched their offensive in February.

Now new negotiations are set to begin, and the Iranians will be coming to the table having shown Trump, and the world, the power they can wield over the global economy.

The Lincoln Memorial Reflecting Pool has witnessed more than a century of American history, in all its heartbreak and majesty. Crowds have gathered around it in protest and in praise, to denounce American wars and hear great voices sing and speak.

Today, it's the center of a slimy controversy.

President Donald Trump said in April he found the water in the reflecting pool "filthy" and "disgusting." He authorized a no-bid contract to resurface the basin of the 2,000-foot long pool and paint it "American flag blue" in time for July 4th celebrations.

"I have a guy who's unbelievable at doing swimming pools," the president crowed, before the National Park Service gave out no-bid contracts for sealing and upgrades.

After weeks of renovation, the project has cost taxpayers more than $14 million and … the reflecting pool looks green. And I mean green. Like the Chicago River on St. Patrick's Day. But that river is dyed green for a day. The Lincoln Memorial Reflecting Pool is green because of algae.

Look, algae happens. It's clouded the reflecting pool since it was first filled in 1923. Algae blooms flourish when sunlight falls on warm, sluggish water — like you'd find in a shallow, still pool absorbing the glare and swelter of a Washington, D.C., summer.

But a University of Virginia satellite analysis commissioned by the Washington Post saw more algae in the Reflecting Pool this month than at any other time in the past five years.

The Interior Department says workers have deployed "a state-of-the-art ozone nanobubbler filtration system" to banish the algae.

"President Donald J. Trump is an expert builder who has fixed the reflecting pool for good," spokesperson Kate Martin said in a statement this week, "unlike the failed and extremely costly attempt by Obama and Biden."

That's a reference to a major project during President Barack Obama's first term to stop the pool from sinking and add a filtration system.

In these deeply divisive and partisan times, it's good to remind ourselves that many issues aren't just Republican red or Democratic blue. The Reflecting Pool algae doesn't care about our party lines. It's green, and it's not going anywhere.

Two smoke relief centers are now open for residents impacted by the Boyle Heights warehouse fire.

The centers in Boyle Heights and East L.A. offer resources such as masks, food, water, temporary shelter, pet assistance and information from public health and air quality officials. They’re open 24 hours a day until further notice.

The city’s Department of Recreation and Parks and Councilmember Ysabel Jurado’s office opened the Pecan Recreation Center as a smoke relief center Friday. A second center opened Saturday at City Terrace Park through the office of L.A. County Supervisor Hilda Solis. 

Here’s where they’re located: 

The fire broke out Wednesday, prompting an hours-long shelter-in-place order due to hazardous materials, including ammonia.

On Friday, a wind-driven flare-up at the site of the fire sent plumes of smoke over the city, hours after a second shelter-in-place order was lifted. Residents in the immediate area reported seeing ash on their homes and cars. On Saturday, many across Los Angeles County — from Pasadena to the West Adams neighborhood — also reported smelling smoke and experiencing poor air quality.

Two smoke relief centers are now open for residents impacted by the Boyle Heights warehouse fire.

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Courtesy City Terrace resident

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Jurado and her team were in the residential neighborhood near the fire site Friday, distributing air purifiers and masks. She said community groups, including Proyecto Pastoral, Running Mamis and Centro CSO, also went door to door distributing masks. 

Residents can contact Jurado’s office at Boyle Heights City Hall to request air purifiers and masks or to make donations at (323) 526-9332.

Los Angeles Mayor Karen Bass spoke outside the building Friday evening, praising firefighters’ efforts. She added that people in the area could expect to continue to see smoke, and she urged people and their pets to stay inside as much as possible. She asked people to wear masks when they needed to go outside.

“We know that this is concerning. This is inconvenient, but we are doing everything we can to end this as soon as possible,” she said. “And we want everyone to be safe in the meantime.”

Read more:

• What materials burned in the fire and what to know about air quality
• How to keep yourself safe from the dismal air quality driven by fires

The post Smoke relief shelters open for residents impacted by Boyle Heights warehouse fire appeared first on LA Local.