The Brief

On a brisk January morning, physician assistant Brett Feldman searched the streets of Los Angeles for patients, knocking on car windows and peering into tents. It was the day after a winter storm had doused the city, and many of the unhoused people Feldman usually treats had moved to find somewhere dry.

Feldman leads the street medicine team at the USC Keck School of Medicine, providing primary care to thousands of L.A.’s homeless individuals. Many have chronic conditions, mental health disorders, wounds or other medical issues; they need health care desperately.

But Feldman and other street medicine providers across the state are worried that changes made to Medi-Cal eligibility by President Donald Trump’s “One Big Beautiful Bill” will cause a majority of unhoused people to lose insurance, limiting their options for care.

“It’s very possible over 90% of people experiencing unsheltered homelessness will lose insurance,” Feldman said of his L.A. patients.

Medi-Cal, also known as Medicaid federally, provides health insurance for low-income people and those with disabilities. The new law requires states starting in 2027 to verify that able-bodied adults younger than 65 without dependent children are performing 80 hours or more of work each month in order to qualify for Medicaid. It also requires states to verify income and other eligibility criteria every six months as opposed to once per year.

State officials estimate up to 2 million people – about 14% of the state’s 14 million Medi-Cal recipients – will lose coverage, either because they don’t meet the work requirements or because they get overwhelmed by the paperwork.

Meeting those requirements will be particularly challenging for the state’s roughly 180,000 homeless people. They often have no phones or internet to complete a job application. They have limited access to meals, showers or clean clothes. They commonly struggle with addiction or mental health conditions and often don’t have the ability to work. Research shows that homeless individuals have far worse health outcomes and a lifespan nearly 20 years shorter than the general population.

Often those who need health care the most are the ones who are least able to work, Feldman said.

Physician’s assistant Brett Feldman checks his patient Gary Dela Cruz on the side of the road near his homeless encampment in downtown Los Angeles in November.

(

Larry Valenzuela

/

CalMatters/Catchlight Local

)

Without insurance, people who are unhoused won’t be able to pick up medications or find primary care providers. Their health conditions will worsen, and they’ll rely on emergency rooms more.

“This is going to be a huge issue for the unhoused,” said Kelly Bruno-Nelson, an executive director with CalOptima, an Orange County Medi-Cal plan that provides health insurance for an estimated 11,000 members with unstable housing.

Work exemptions

The law carves out exemptions for people who can’t work: those with substance use disorders, disabling mental health conditions, complex medical conditions and other disabilities. Children, people who are pregnant, foster youth and those with disabilities are also exempt from working, though they will be required to renew their Medi-Cal eligibility every six months.

On paper, many homeless Californians likely qualify for work exemptions. Nearly half of homeless Californians have a complex behavioral health need, including regular drug or heavy alcohol use, hallucinations or recent psychiatric hospitalization, according to recent reports from the UCSF Benioff Housing and Homelessness Initiative. About 60% report at least one chronic condition, and roughly a third have conditions that make bathing, dressing or eating difficult.

But to claim an exemption, a patient needs a doctor to certify it. Only half of insured and unhoused Californians regularly get care and only 39% have a primary care provider, Benioff data shows.

In L.A., even fewer unhoused people have a primary care provider. Just 7% of the population had seen a provider in the past year between 2022 and 2023, according to a study published by the USC Street Medicine program, meaning very few people would have medical exemptions certified under the new law.

That means many eligible people could lose Medi-Cal: people like Samantha Randolph.

The 37-year-old has lived the streets of L.A. for more than five years. She wouldn’t even know where to begin finding a job if she had to, she said. Her ID cracked in half, so she threw it away. Someone stole her phone months ago, and she has no recent work experience.

“I’m on my own. I’m doing this by myself,” Randolph said on that same January morning.

Randolph, who is seven months pregnant, would qualify for an exemption from the work requirements come 2027. Feldman’s team also checks on her regularly to monitor the baby and could certify an exemption if necessary. But even that’s no guarantee that Randolph wouldn’t inadvertently lose Medi-Cal.

Her health insurance expired six weeks prior to Feldman’s visit because the county enrollment office mailed the paperwork to an address where Randolph doesn’t live. Without Medi-Cal, which pays for maternity housing in the city, Feldman can’t get her inside.

“I’d love to get you out of here as soon as possible,” Feldman said to Randolph as he listened to her breathing and examined a bump on her head. “I’d love to get you somewhere safe and cozy.”

His benefits team has been working diligently in the background to re-enroll Randolph in Medi-Cal. Without identification and other documents, it has been a slow process.

State tries to automate eligibility checks

State Medi-Cal officials are working to launch an eligibility verification system that will automatically check for work requirement compliance and exemptions. They hope to spare the estimated 3.5 million Californians like Randolph who will need to comply with the law’s new requirements the headache of having to prove their qualifications on paper.

“This is a top priority for us in the department, really seeking to minimize the harm to members to the greatest extent that we can,” said Tyler Sadwith, state Medicaid director at the Department of Health Care Services.

The department is looking to purchase workforce data that will capture gig workers and more timely information about income than tax returns. The state already uses IRS data and information from other welfare programs like food stamps and cash assistance programs to verify Medi-Cal eligibility.

To exempt income-eligible students, the department wants to pull information from the state’s universities and colleges. And it is working to identify medical diagnosis codes that could be used to exempt people with disabilities or other qualifying conditions like mental health or substance use disorders.

If the state can link all of the data together, some qualifying and exempt Medi-Cal recipients won’t need to provide additional information.

“They won’t have to take action. They will receive a notification that they have been successfully renewed,” Sadwith said.

But there are gaps that will be difficult for the state to fill with automated data and questions left unanswered by the federal government. Evidence of volunteer work, for example, doesn’t exist in a large database, and it’s unclear if the federal government will require the medical diagnosis codes that could signal a qualifying exemption be reverified by a provider every six months. If they do, many unhoused Californians who don’t see a provider in time could still get kicked off of Medi-Cal.

Department officials also acknowledge that in states that have previously tried to implement work requirements, eligible people always fall through the cracks.

Matt Beare, a street medicine physician in Kern County, said falling through the cracks is the norm for people who are unhoused. Already, people like Randolph lose Medi-Cal all the time.

The law’s new requirements will only make that more likely.

Not even street medicine providers who work daily to find and follow up with unhoused patients can guarantee that they can locate them. Encampment sweeps, violent crime and weather force people to move frequently.

“The cost of falling through the cracks is likely human life,” Beare said.

Homeless could lose access, housing

California has invested significantly in street medicine teams over the past five years.

Street teams deliver comprehensive primary care services wherever unhoused people are: under bridges, on the side of the road, in encampments. They administer antipsychotic injections and contraceptives, provide wound care, deliver medications and help with substance use disorder treatment. Perhaps most importantly, they often travel with benefits counselors, social workers and housing specialists.

That and other Medi-Cal investments have helped the state chip away at its homelessness problem.

But with droves of patients expected to fall off of Medi-Cal, some providers predict that street medicine teams may also disappear, worsening the chance that unhoused Californians have a provider who can certify their work requirement exemptions.

“It's going to be very fiscally difficult for those programs to be able to sustain themselves,” Bruno-Nelson with CalOptima said.

Without Medi-Cal, unhoused people won’t be able to see specialists, get diagnostic testing or obtain most medications. They’ll rely more on emergency rooms. And because California policymakers have tied some housing and other social services to Medi-Cal, many experts worry members of this vulnerable population will lose their best chance at stability.

“These people are spinning through — some with 50 emergency room visits a year because they’re so sick — a vortex,” said Gray Miller, chief executive of Titanium Healthcare, a case management company that helps Medi-Cal recipients coordinate health appointments, find housing and manage chronic conditions.

Back in L.A. hours after he found Randolph again, Feldman takes a call and smiles. The county has finally approved her Medi-Cal application, which means Randolph now qualifies for maternity housing. He sends a colleague to pick her up.

“I’m so happy we got Sam inside.”

Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

In Los Angeles, the soundtrack is familiar. Car horns, the whine of leaf blowers.

But in the middle of Chinatown, another sound cuts through the din: the rhythmic hum of washers and dryers from a trailer parked outside the Alpine Recreation Center.

Chinatown hasn’t had a laundromat for as long as anyone around can remember. This mobile setup – run by the nonprofit The Laundry Truck LA – has become the neighborhood’s de facto laundromat, offering the service for free to locals, twice a week.

For 70-year-old Sam Ma, it’s been a relief.

Ma, a retired construction worker, picked up freshly-laundered items — two pairs of pants, a hat, and some socks, bundled in a white garbage bag for the bus ride home.

He usually washes his clothes by hand. But about two weeks ago, he was hit by a car. Bruises and cuts cover his hands, making it difficult to scrub heavier items.

“The things I can wash, I wash,” he said in Mandarin. “But these are too thick. It’s too hard.”

Rebel Fox of The Laundry Truck L.A. hands a garbage bag filled with newly-laundered sheets to a local.

(

Josie Huang

/

LAist

)

Nearby, Laundry Truck employee Rebel Fox checked him out with a clipboard after handing him his load.

“We help a lot of seniors out here,” Fox said. “And we offer folding services, too. It really helps people who don’t have the dexterity in their hands.”

The Laundry Truck started out in 2019 providing laundry services to people experiencing homelessness across Los Angeles and has expanded to high-need communities, like Eaton Fire survivors.

In February, the nonprofit started operating in Chinatown under a year-long contract with Council District 1, showing up every Wednesday and Thursday at 9 a.m.

A sink or bathtub

Chinatown advocates say the lack of a laundromat is especially hard on low-income tenants living in older, neglected buildings.

“These landlords aren’t doing much to keep it updated,” said Sissy Trinh, executive director of the Southeast Asian Community Alliance.

Maintaining laundry rooms may require major plumbing upgrades and hookups that many landlords avoid.

Newly-constructed residential buildings are typically being constructed with in-unit laundry.

(

Josie Huang

/

LAist

)

Advocates say in buildings that do have shared coin-operated machines, they may be broken or in constant use. Many residents decide to launder clothes by hand — in sinks or bathtubs.

“In one building, the sinks were so small, people had to cut their sheets in half just to wash them,” Trinh said. “They’d wash one half, then the other.”

A reversal of access

Those who could benefit from a laundromat include seniors on fixed incomes, and workers living paycheck to paycheck, including garment workers and home health aides.

“You’re talking about low-income, financially-stressed households,” Paul Ong said.

Ong, who studies urban inequality at UCLA, says Chinatown reflects a broader pattern: as neighborhoods change, basic services can disappear.

Each pile of dirty clothes is labeled with customers' names.

(

Josie Huang

/

LAist

)

The neighborhood’s last full-service grocery store closed in 2019 after the property was sold to a developer. Meanwhile, new market-rate housing has gone up, catering to higher-income residents with amenities like parking and in-unit laundry.

“The irony is that historically, laundry was bread and butter for the Chinese community,” Ong said.

In the late 19th and early 20th centuries, Chinese immigrants built livelihoods around laundry work — one of the few industries open to them at the time.

Nowadays, laundry options have become hard to come by.

Seeking a lasting fix

Residents without access to machines have to leave the neighborhood entirely to find a laundromat in Lincoln Heights or Echo Park, which has seen its own laundromats disappear.

Laundry can be spotted drying on balconies across Chinatown.

(

Josie Huang

/

LAist

)

“The long-term, permanent solution is that a laundry service opens up,” in the neighborhood, said Council member Eunisses Hernandez, who represents Chinatown.

Hernandez says constituents have asked for a laundromat from the time she was knocking on doors as a City Council candidate.

Hernandez, who is up for re-election this year, says the neighborhood could benefit from a community-run laundromat offering affordable services.

“If private industry is not making that investment in Chinatown then perhaps it’s up to the city – and the people of that neighborhood – to build something for them,” she said.

In the meantime, Hernandez has directed about $250,000 from her district — using TFAR payments from developers building larger projects — to cover a year of mobile laundry services.

The contract with the Laundry Truck runs through next February.

After that?

“We’ll keep filling the gap until we get to a permanent solution,” Hernandez said.

Could that solution be combined with housing?

Some community advisors to a new affordable housing project being developed on the northwestern edge of Chinatown have been pushing for a self-service laundry that would be open to other neighborhood residents, says Eugene Moy who sits on the advisory board of New High Village.

But any fix will take time. That project, Moy said, could be two years out from even breaking ground.

Taking a load off 

Back at the truck, the machines continue to spin. By mid-afternoon, nearly 18 loads of laundry are done.

The trailer for the LA Laundry Truck is set up outside the Alpine Recreation Center, across from Castelar Elementary School.

(

Josie Huang

/

LAist

)

Two months in, there are kinks to work out. How to get more residents to take advantage of the unit's capacity? Its machines can churn out 40 loads per shift.

There is also the question of whether some seniors are physically able to transport their laundry even a few blocks.

But the service is starting to get regulars. One woman on her second visit stood by the trailer, cradling just-washed clothes in her arms while clutching her daughter's teddy bear, now a sparkling white.

"If it keeps going, I'll keep coming," said the woman who gave her last name as Mo. "It's very convenient."

Her apartment building doesn’t have a laundry room. Sometimes she asks a friend next door if she can use theirs. With three children, the cost adds up quickly.

Thinking aloud, she calculated how much she saved that day.

About $8, she estimated — money she said could now spend on her kids.

At Cesar Chavez Park in Pomona, a mural depicts the now-disgraced farm worker leader from the waist-up, in a serene, almost Buddha-like pose. To his left, a lady justice figure holds the scales of justice and on the right, there are images of farm workers toiling in a field. Chavez looks like a saint.

One of five murals at Cesar Chavez Park in Pomona, painted by Paul Botello.

(

Adolfo Guzman-Lopez/LAist

)

“And that's what people thought he was,” said Pomona Mayor Tim Sandoval as he stood in front of the mural.

But after several women stepped forward accusing the late labor icon of sexual assault, that view has radically changed. Now there are calls to remove his image from public spaces, widely impacting Southern California, which has a large concentration of murals, plaques, street names, and statues dedicated to him.

But do the entire murals have to be removed, or can there be a more nuanced approach to the re-evaluation of Chavez’s legacy — a re-evaluation that doesn’t throw the baby out with the bathwater?

This week, the artist Paul Botello, Pomona Mayor Sandoval, and Pitzer College Emeritus Professor José Calderón, a former activist who was involved in getting the murals painted, met up at the park, in the shadow of the busy 57 freeway, to discuss how to go forward.

The story behind the murals

In the early 2000s violence between Black and Latino gang members gripped Pomona.

“When a young Latino was killed, we actually did a march all the way from City Hall to what is now this park,” said Calderón.

Calderon helped organize that march. He said activists were inspired by something Chavez liked to say, that when you get angry, don’t take it out on others — organize.

So they lobbied for the park, which was filled with trash and syringes, to be cleaned up and made family friendly. And because they used his quote, it was named Cesar Chavez Park.

Cesar Chavez Park in Pomona was dedicated after activists lobbied the City of Pomona to help curb gang violence.

(

Adolfo Guzman-Lopez/LAist

)

Muralist Paul Botello was chosen to create five murals at the park that depicted Chavez from youth, through his service in the U.S. Navy during World War Two, to key moments during his farm worker activism.

Today, while he feels betrayed by Chavez, he’s also keen to preserve parts of the murals which tell the bigger story of the exploitation of farm workers and the fight to improve their conditions.

While California state law says an artist must be consulted if there are any proposed changes to a mural, the ultimate decision will be made by Pomona City Council.

Sandoval said he has not received calls or emails at City Hall. But people in his various social and civic circles have told him, he says, that Chavez’s images should be removed.

Paul Botello holds mock-ups of changes he'd like to make to his murals of Cesar Chavez at a park in Pomona.

(

Adolfo Guzman-Lopez/LAist

)

Botello had brought mock-ups of the alterations he’d like to make to each mural. For the mural which depicts Chavez in a Buddha-like pose, for example, he wants to replace his face with the face of a farmworker wearing a hat.

He also wants to keep much of another mural, which depicts Chavez as a teenager in a suit surrounded by boys and girls sitting on rows of tilled soil. His one change is to turn the image of Chavez into a Zoot Suiter, a rebellious Mexican American youth from the mid 20th century.

A mural by Paul Botello depicts Cesar Chavez and children on a farm.

(

Adolfo Guzman-Lopez/LAist

)

“ 95 percent is going to be there because it just represents all the youth who also toil in the field to help their parents,” he said.

Calderon agrees with these more targeted changes. He fears painting over the murals entirely would erase the neighborhood activism that led to the creation of this park.

He’s also concerned their removal would give fuel to people who oppose Latino activism and the growing movement in public education to require the teaching of Latino history.

“The right and the white supremacists are already using it to say, ‘see this is what we told you about Cesar being anti-immigrant’”, he said. “But now they're going a little bit further and they want to wipe out ethnic studies”.

A mural at Cesar Chavez Park in Pomona.

(

Adolfo Guzman-Lopez/LAist

)

While Botello wants to keep the mural of Chavez serving in the U.S. Navy, because he believes it's important to show that Latinos have contributed to this country's military, he’s keen to make a change in the fifth mural.

It depicts a young man and woman above the phrase “Sí se puede,” the famous farmworker slogan, “yes, we can.”

The young man is clearly Chavez. Botello says he wants to replace it with the face of Dolores Huerta, the woman who led the United Farm Workers with Chavez and has accused Chavez of rape.

Mayor Sandoval says he plans to bring up Botello’s proposals at the next city council meeting.

There’s a fair amount of recreational activities Angelenos can do in and around the Los Angeles River like biking, walking, even kayaking, but did you know you can also dance in the dry river bed of a Los Angeles icon?

Adam Weiss, founder of the Gratitude Group leans over and DJs a set at his Los Angeles River dance party.

(

Michael Marshall

/

Michael Marshall

)

Dancing in the sun

Adam Weiss is the founder of the Gratitude Group, a club that hosts various events across Los Angeles like dance parties at the River, a screen-free reading club at the Central Library and meditative sound baths at Elysian Park. That’s just this weekend alone.

Weiss has been hosting the free dance parties for about two years now. The locations vary. Previously he’s held them at the Elysian Park helipad.

“Everybody wants to dance, they're just waiting to be invited to dance, and then if you're a good DJ, you just keep the floor packed,” said Weiss, who also deejays these events. Lately it's been a lot of disco, funk and soul. Weiss also likes to keep the gatherings dry, meaning no drugs or alcohol. He thinks it makes people engage with each other more.

“So the focus really is on connection and dancing,” Weiss said.

Attendees of the Los Angeles River dance party move to the music.

(

Michael Marshall

/

Michael Marshall

)

Ariana Valencia lives in Burbank and attended last month's dance party, also at the L.A. River. She says dancing in the middle of the concrete riverbed made the city feel like a playground that she could explore.

“I’d never been to the L.A. River prior to that. You think it’s just a little swampy little pond, but it was actually really full,” said Valencia. “I would have never thought that was in the middle of the city.”

Uniquely Los Angeles

Weiss says part of the appeal is not just getting people outside but to get them to experience Los Angeles differently.

At the last event, people walking or biking along the river path joined on a whim — some even brought their kids. Weiss says that’s exactly the kind of reaction he hopes for.

“ I want it to be family friendly. I want it to feel welcoming. I want it to be inclusive,” Weiss said. “My main thing is I just want people to actually dance. I think it feels good to dance.”

A woman and two children join in on the dance party.

(

Michael Marshall

/

Michael Marshall

)

For Valencia that inclusiveness is part of the draw. She says she’ll be joining again this Sunday.

“Even though it wasn’t advertised as a dry event I think the fact that it was a family friendly kind of thing was appealing to me,” said Valencia.

Join the party

After the last dance party went viral, Weiss says more than 1,500 people have RSVP-ed for tomorrow's event. This compelled him to close reservations.

Weiss plans to hold the event every other week this Spring and Summer — taking place either at the River or the Elysian Field Helipad with its amazing view of the city.

Weiss wants to start branching out too, and is eyeing the Culver City Stairs as a possible location.

“ I just wanna bring people to cool interesting places to dance,” Weiss said.

The immigration detention center closest to Los Angeles has placed dozens of people in solitary confinement each month since June, according to the most recent data from U.S. Immigration and Customs Enforcement.

In May 2025, the Adelanto ICE Processing Center had 14 people in isolation. When the Trump administration’s mass deportation effort revved up in June 2025, the number of detainees in solitary confinement there more than tripled. By July, it was 73; by August, 105.

The most recent data available shows that number went down slightly in January, to 74 people.

Ranked by percentage of the detainee population in “segregation,” as it is called at immigrant detention centers, Adelanto is among the U.S.’s top 10 facilities as of January, according to an LAist analysis of the most recent ICE data.

The data shows that of 229 ICE facilities that reported holding people since October 2024, between 50 and 60 usually reported putting at least one person in segregation in a given month. Out of the facilities that did place people in solitary confinement, Adelanto tended to do so less often than others until June 2025. (The facility held just a few people from October 2024 into January 2025.) When ICE’s presence increased in L.A. in June, the number of people sent to isolation in the facility also shot up — three to five times as many people have been isolated in Adelanto compared to the average facility that used any solitary confinement.

Since June, only two facilities have sent people to solitary confinement more times than Adelanto: one southwest of San Antonio, the other in central Pennsylvania.

Both of those facilities held twice the number of detainees as Adelanto on average from October 2024 through September 2025; but the number of people held in Adelanto since then has tripled, growing larger than either of the other facilities to hold an average of 1,800 people a day since October.

More on solitary confinement  

According to ICE, detainees may be placed in segregation for “disciplinary reasons,” or because of:

• “Serious mental or medical illness.”
• Conducting a hunger strike.
• Suicide watch.

The agency also says it might place detainees “who may be susceptible to harm [if left among the] general population due in part to how others interpret or assume their sexual orientation, or sexual presentation or expression.”

Not only is ICE holding more people in solitary confinement, but the agency's data also shows that detainees across the country are being isolated for longer periods of time. Detainees ICE considers part of the "vulnerable & special population" spent an average of about two weeks in solitary confinement each time they were isolated in 2022, when ICE first made the data available. By the end of 2025, the average stay in isolation had risen to more than seven weeks straight.

The GEO Group Inc., a private company that operates the Adelanto ICE Processing Center, has not responded to requests for comment.

How isolation can affect immigrant detainees  

UN human rights experts consider solitary confinement placements that last 15 days or more to be torture, though the U.S. Supreme Court has held that isolation doesn’t violate the Constitution.

The UN also maintains that solitary confinement should be prohibited for people “with mental or physical disabilities when their conditions would be exacerbated by such measures.”

In January, a coalition of immigrant rights groups filed a federal lawsuit on behalf of current detainees, calling for conditions at Adelanto to be improved. In addition to an unsanitary environment and a lack of healthy food and clean drinking water, detainees say solitary confinement is frequently used to punish those who speak out about conditions at the facility.

People held in immigrant detention centers are technically in “civil detention,” meaning that they are being detained to ensure their presence at hearings and compliance with immigration orders — not to serve criminal sentences.

According to the immigrant rights groups’ complaint, one detainee was placed in solitary confinement after complaining about the showers being broken. Another detainee said that, after asking a guard to “use more respectful language toward him, he was ridiculed, written up and given the middle finger by a guard who shouted, ‘Who the f--- do you think you are?’” Then, the detainee was placed in solitary confinement for 25 days.

Alvaro Huerta, the director of litigation and advocacy at the Immigrant Defenders Law Center who is representing detainees at Adelanto, told LAist that when people are placed in isolation at the facility, they’re typically in the same cell for 23 hours per day, unable to receive visits from their families.

For clients who are experiencing mental health challenges — especially those with suicidal thoughts — being placed in solitary confinement “can really exacerbate their condition,” he added.

In multiple statements to the media, ICE has said that the agency “is committed to ensuring that all those in custody reside in safe, secure and humane environments.” The agency has also said that detainees receive “comprehensive medical care” and that all detainees “receive medical, dental, and mental health intake screenings within 12 hours of arriving at each detention facility.”

Huerta called that “laughable.”

“We have countless examples of people who have said that this is not true, that they're not getting the medication that they're requesting, that they're not being seen for chronic conditions and emergency conditions,” he added. “And we know it's not true because 14 people have died in ICE custody this year alone.”