The Brief

As AI expands into every facet of society, a California company is testing whether the technology can help improve the health of people living on the streets.

Akido Labs, a Los Angeles-based health care technology company that runs clinics and street medicine teams in California, plans to start using its AI model on homeless and housing insecure patients in the Bay Area next month. The program generates questions for outreach workers to ask patients and then suggests diagnoses, medical tests and even medication, which a human doctor then signs off on remotely. The idea is to save doctors time and allow them to see more patients.

The new model, called Scope AI, is addressing a very real problem: There aren’t nearly enough doctors visiting encampments and shelters. At the same time, homeless Californians are in much poorer health and are dying earlier than the general population.

“There are individuals who haven’t seen doctors for years. There are individuals who haven’t seen a dentist ever,” said Steve Good, president and CEO of Five Keys, which is partnering with Akido to launch the AI technology in its San Francisco homeless shelters. “There just aren’t enough resources to go in there and find out the needs these individuals have.”

Experts who research AI told CalMatters that if done right, the technology has the power to increase access to care for homeless and other marginalized communities. But while many health care providers already are using AI for administrative duties, such as transcribing patient visits, using it to help diagnose people is still a relatively new field. It brings up concerns around data privacy, biases and patient outcomes, which are particularly pressing when the technology is being used on homeless patients and other vulnerable groups.

“We don’t have perfect solutions to a lot of these challenges yet,” said Angel Hsing-Chi Hwang, an assistant professor at USC who researches human-AI interaction.

How Scope uses AI to diagnose homeless patients

Scope AI essentially allows non-medically trained outreach workers to start the intake and diagnosis process before a patient sees a doctor.

An outreach worker goes out into the field with Scope on their tablet or laptop. As they start interviewing a patient, Scope suggests questions the outreach worker should ask. Scope listens to, records and transcribes the interview, and as the interaction progresses, it suggests new questions based on what the patient says.

When it has enough information, Scope suggests diagnoses, prescriptions and follow-up tests. That information is then sent to a human doctor, who reviews it (usually the same day) and either signs off on the prescriptions, makes changes, or, if it’s a more complex case, arranges to see the patient to get additional information. The medical care is paid for by Medi-Cal through its CalAIM expansion into social services.

Dr. Rishi Patel from the Akido street medicine team checks on an unhoused man living in a vineyard in Arvin on May 28, 2024. Street medicine teams throughout California are increasingly using long-acting injectable antipsychotic medication to stabilize the mental health of people living in homeless encampments.

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Dr. Rishi Patel from the Akido street medicine team checks on an unhoused man living in a vineyard in Arvin on May 28, 2024. Street medicine teams throughout California are increasingly using long-acting injectable antipsychotic medication to stabilize the mental health of people living in homeless encampments. Photo by Larry Valenzuela, CalMatters/CatchLight Local In demonstrating the technology to CalMatters, using an imaginary 56-year-old female patient who complained of trouble breathing, Scope asked several follow-up questions to drill down on her symptoms. Then, it made suggestions that included: a diagnosis of COPD or chronic bronchitis, a chest x-ray and spirometry breathing test, and a prescription of an albuterol inhaler.

The Scope AI technology is already being used in a few target areas. Akido’s street medicine teams began using it in homeless encampments in Los Angeles County in 2023, where it has since seen more than 5,000 patients. Akido also uses AI in encampments in Kern County, clinics in California and Rhode Island, and to treat ride-share workers in New York.

Scope lands on the correct diagnoses within its top three suggestions 99% of the time, according to Akido.

Other studies have called into question the reliability of diagnoses made by artificial intelligence. A 2024 study, for example, found that AI was significantly more likely to misdiagnose breast cancer in Black women than in white women.

The infiltration of AI into homeless services has sparked concern from some critics who argue homeless patients, because of their increased vulnerability, need a human health care provider.

“We should not experiment on patients who are unhoused or have low incomes for an AI rollout,” Leah Goodridge, a tenants rights attorney and housing policy expert, and Dr. Oni Blackstock, a physician and executive director of Health Justice, wrote in a recent opinion piece for the Guardian.

Brett Feldman, director of USC Street Medicine, agrees. When someone is homeless, much of their health status is dependent on their living environment, he told CalMatters. For example, he recently treated a patient with scabies. Typically, he would prescribe a shampoo or body wash, but this patient had no access to a shower — a key detail that AI might not know to ask.

Instead, he prescribed an oral medication. The patient needed one dose right away, and another dose in a week. He had to decide whether to give the patient the second dose now and trust that it wouldn’t get lost or stolen, ask the patient to travel to a pharmacy to pick up the second dose, or try to find the patient again in a week to deliver the dose. AI couldn’t make that complex calculation, and neither could a doctor who hadn’t met the patient and seen their living situation, Feldman said.

And any missteps the AI makes could have outsized consequences when a patient is homeless, Feldman said. If the patient has an issue with the medication prescribed, they likely don’t have an easy way to contact the doctor or have a follow-up appointment.

“I would say, in general, that this would not work for this population,” Feldman said.

Akido argues the benefit of AI is clear: better efficiency and improved access to health care.

Before introducing AI, each of Akido’s street medicine doctors in LA and Kern counties could carry a case load of about 200 homeless patients at a time, said Karthik Murali, head of safety net programs for the company. Now, it’s closer to 350 patients per doctor, he said, because doctors spend less time asking routine questions and filling out paperwork.

That means more patients get access to care and medication more quickly, Murali said.

Nearly a quarter of homeless Californians surveyed by the UCSF Benioff Homelessness and Housing Initiative reported needing medical care that they couldn’t get in the six months prior to the study. Only 39% said they had a primary care provider. Nearly half of homeless Californians surveyed reported their health as poor or fair — a rate about four times higher than the general U.S. population.

Good, of Five Keys, hopes the technology also will let clinicians build trust and deeper relationships with their clients. An outreach worker using Scope will have time to form a bond with the patient and better respond to their individual needs, as opposed to a doctor who is rushing through the visit to get to the next patient, he said.

His organization hopes to roll out the technology in some of its San Francisco homeless shelters next month.

Partnerships and access

Akido also plans to work with Reimagine Freedom and the Young Women’s Freedom Center to use the AI technology at four centers — in San Francisco, Oakland, Richmond and San Jose — that serve women and girls who are or have been incarcerated. The clients they serve often had poor access to health care while in jail or prison, or had their medical concerns ignored, said Reimagine Freedom President Jessica Nowlan. Many have no trust in the medical system.

Currently, the centers offer health education. This new AI technology will allow them to provide actual medical care, Nowlan said.

“Our guess is we will see a huge increase in women being able to access health and care for themselves,” she said.

Reimagine Freedom started testing Scope AI at its Los Angeles clinic in November. So far, “it’s going really well,” Nowlan said.

Akido plans to partner with additional homeless service providers who can help it roll out its AI technology in more places throughout the Bay Area. That partnership is being spearheaded by the Future Communities Institute, which is also developing metrics to judge the effectiveness of Akido's program.

If providers who serve vulnerable patients are left out of the AI race, any benefits in the technology will go to wealthy communities instead — further widening the gap between the haves and have-nots, said Stella Tran, who researches AI companies for a California Health Care Foundation investment fund. That’s why social service providers need to be involved in testing this technology and developing the ground rules and safety checks, she said.

But that doesn’t mean Tran doesn’t have concerns. For example, AI works differently on different communities. An algorithm that produced accurate diagnoses for patients in Los Angeles might not work as well in the Bay Area, she said. And while AI has the potential to be less racially biased than human doctors, it all depends on how the algorithm is constructed.

“I think there is a potential to increase access if we do it right,” Tran said, “with the right set of guardrails and being thoughtful about safety, transparency to patients, consent, all of that.”

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

A new free record shop for survivors of last year’s Eaton and Palisades fires is celebrating with a grand opening party Saturday night.

After losing his home in the Eaton Fire, Brandon Jay founded Altadena Musicians to get instruments back into the hands of musicians who lost their gear in fires.

Now he’s doing that with vinyl records, too.

“We want to be here to help replace those items and support music in people’s lives that can’t necessarily afford it right now because they’re saving all their pennies just to live and also just to rebuild their homes,” Jay told LAist.

Jay says they’ve seen roughly 3,000 records donated so far. Now they have a dedicated space on Lincoln Avenue where fire survivors can sign up for time slots and shop for up to 10 records a month.

“It’s a really lovely distraction but it kind of keeps me going as well just to know that we’re trying to build something great for the community and keep us all moving forward,” Jay said.

The store will carry copies of the benefit album, Gimme Shelter: Songs for LA Fire Relief. The compilation features cover art by Shepard Fairey and L.A. specific tracks from artists like Elliott Smith ("Angeles" of course), Norah Jones, The Flaming Lips, as well as a cover of "Burning Down the House" by Talking Heads performed by Jay and about 50 other fire-impacted musicians.

Reggae star Ziggy Marley has spent decades carrying one of music’s most celebrated legacies. But until now, he had never written a song directly about his father, Bob Marley.

That’s changed with “Many Mourn for Bob,” a track on Marley’s ninth solo album Brightside, his first release recorded in his new studio in North Hollywood.

Marley was just 12 when his father died of cancer in 1981. Now 57, Marley says the song instinctually emerged after years of life experience and producing the biopic One Love, which revisited his father’s struggles like an assassination attempt amid political violence in Jamaica.

“He went through some things that was really tough on a human being – and just understanding him in that light is to have a little bit more emotional, deeper connection to his experience,” Marley said in an interview at his studio.

Searching for the bright side

The deeply personal track is part of a splashy return for Marley, who's touring behind Brightside and will perform at the Hollywood Bowl on June 21.

The new album blends political themes, optimism and musical experimentation.

Its lead single, “Racism Is a Killa,” featuring Big Boi, pairs the heavy topic with an upbeat groove that he hopes will make the song more accessible to young people.

“We just wanna come out straightforward, like I never want to come out tiptoeing,” Marley said. “I want to say something that can catch your ears or catch your thoughts.”

That tension between darkness and hope runs throughout Brightside. Marley described the album as a reflection on enduring difficult periods – from the pandemic to the Los Angeles wildfires – without losing sight of optimism.

“Sometimes we get lost in that so much that we don't realize that there is always a bright side,” Marley said.

The 432 Hz experiment

The album also experiments sonically: Marley recorded Brightside using 432 hertz tuning instead of the standard 440 hertz in most mainstream music. Advocates of 432 hertz believe it produces a warmer, more meditative sound better synced to the natural world. (You can hear the difference for yourself here.)

“It's a lower musical frequency, but it's a higher frequency in a next sense of your spirituality and emotion,” he said. “So even though the numbers go down, the frequency actually go up.”

Marley sees the move as part of a larger search for new creative approaches.

“I'm very open-minded and always trying to evolve and just experiment with life and music,” Marley said.

The Grammy winner, who joins James Blake and Ed O’Brien of Radiohead as the most high-profile artists to record at the lower frequency, floated the idea of a larger movement among artists.

“Let's just have a revolution in the music industry,” he said. “Let's change the frequency.”

Building a dream

Marley works out of his Rebel Lion Studio in North Hollywood, its name a nod to his 2018 album Rebellion Rises while also a play on the word “rebellion.”

He described the studio as an extension of the independent spirit his father built with Tuff Gong Studio in Jamaica.

Musicians set up for rehearsal ahead of the next leg of Ziggy Marley's tour.

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“My father had a dream, and I had a dream too,” Marley said.

Like with Tuff Gong, Marley also plans to expand the studio operation to include vinyl pressing as records continue their resurgence in the streaming era.

“There’s always gonna be a vinyl present going on,” Marley said. “A thousand years from now, people that we're still gonna need vinyl records to listen to music.”

Ziggy Marley in the hallway of his new studio in North Hollywood.

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For years, Marley said, he worked out of smaller home setups and rented facilities before deciding to build a larger permanent space in L.A.

Marley said the city has become central to his own creative evolution over the last two decades of living and working here.

Drawn initially by music, friends and the city's small but tight-knit Jamaican community, he says being surrounded by creatives from different backgrounds helped push his artistry in new directions.

“I left my safety and my community, my tribe, and come out by myself to L.A.,” he said. “But it's a great experience. It really helped my growth as a human being being here.”

What’s next

Fresh off the release of Brightside, Marley says he’s already working on another album – a notably quicker turnaround since his last album, the family-music release More Family Time in 2020,

“We're doing back to back,” he said.

Ziggy Marley will be performing at the Hollywood Bowl on June 21 as part of a tour supporting his new album Brightside.

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He’s also busy writing a children’s book based on his feel-good hit anthem “True to Myself” and eyeing opportunities in front – or behind the camera – inspired by his time working on One Love and making the video for “Racism Is A Killa.”

“Same philosophy, same message, but within visuals, you know?” Marley said excitedly. “I want to create some stories and try out. I feel it coming. I can feel it.”

A City Council committee voted Friday to shelve a proposed ballot measure aimed at cutting L.A.'s “mansion tax” nearly in half.

The ad hoc committee on Measure ULA voted 2-1 to set aside a proposal by Councilmembers John Lee and Marqueece Harris-Dawson that would have asked voters in November to reduce the ULA transfer tax rate for multifamily and mixed-use properties to somewhere between 2% and 3.5%, down from the current rate of up to 5.5%.

However, the ballot measure proposal was also referred to the City Council’s rules, elections, and intergovernmental relations committee, which could still choose to move it forward.

Instead, the ad hoc committee advanced a narrower pilot program that would reduce the property transfer tax only for newly built affordable housing projects.

The pilot program won't need voter approval in the form of a ballot measure. Committee Chair Ysabel Jurado, who introduced the substitute language, said she believes the city should avoid a ULA ballot measure because it’s still too early to evaluate the measure’s long-term effects.

“ I'm against going to the ballot, but I'm for making fixes that make this better,” Jurado said.

Voters will see a separate proposal on their ballots by the Howard Jarvis Taxpayers Association to effectively repeal Measure ULA.

If the L.A. City Council does not approve reforming the measure, the only decision on the ballot in November may be whether to keep the mansion tax in its current form or end it.

About the mansion tax

L.A. voters approved Measure ULA in 2022 to fund affordable housing and homelessness prevention. The measure taxes real estate sales over about $5 million. Since taking effect in April 2023, ULA has raised just over $1.1 billion from 1,633 real estate transactions, according to the city’s housing department.

The city projects it will generate about $500 million in the coming fiscal year — about half of what proponents initially promised. It has funded about 800 new affordable units and helped stabilize thousands of renters facing eviction, according to the housing department.

But critics say the tax has suppressed housing development. Several studies link the tax to a slowdown in apartment construction in Los Angeles, but ULA supporters say high interest rates and broader economic conditions are to blame.

The City Council's ad hoc committee on Measure ULA was formed earlier this year to study how the measure is working and develop potential reforms. That work took on more urgency inside L.A. city hall after the Howard Jarvis Taxpayers Association qualified a statewide ballot measure for November that would effectively repeal Measure ULA entirely.

Joe Donlin, director of the United to House LA coalition, which campaigned for the original measure, said the City Council committee made the right call by rejecting broader exemptions.

“By not taking up the extreme calls for broad, 15-year waivers that could cost the program about a third of its revenue, the committee acknowledged that ULA is working,” Donlin said in a statement.

A separate group of housing developers, union workers and advocacy groups calling itself the “Mend It, Don’t End It” coalition has been urging city hall to make changes to ULA. On Friday, the group said it supports the measure, but believes targeted reforms are still needed.

“Independent research shows that Measure ULA has slowed housing production in Los Angeles at a time when we need more housing, not less,” said Melanie Mendoza, a coalition spokesperson.

What the data show

The debate over ULA's impact played out in the committee room Friday morning. The city's chief legislative analyst reviewed seven independent studies on ULA’s impact. Three of those studies concluded ULA had suppressed housing production and reduced property tax revenues, while four found no meaningful negative impact.

Before ULA took effect, Los Angeles collected about $22 million a month in transfer tax. After that, it dropped to about $13 million. But city legislative analyst Henry Flatt told the committee a similar decline happened in cities without the tax, including Glendale, Long Beach, Pasadena and Santa Clarita.

“We are not currently convinced that Measure ULA has had an extremely negative impact on general fund revenues,” Flatt told the committee.

The county assessor's office read the same period differently. Scott Thornberry, an assistant assessor with L.A. County, told the committee that commercial and industrial property sales are falling in the city but not elsewhere in the county.

“We are seeing, we believe, a trend line of impact to property tax revenue growth in the city of L.A. specifically," Thornberry said.

What the committee did

Instead of the ballot measure, the committee voted to develop a five-year pilot program cutting the ULA tax to 1.5% for newly constructed affordable housing projects that meet specific requirements.

Lee, whose ballot measure was replaced with language advancing the pilot program, said he hadn't seen the substitute prior to Friday’s meeting and voted against it.

“This was just placed in front of me,” he said. Lee objected to a provision in the substitute recommendations calling for $30 million in new spending on homelessness support.

“Without knowing where this money's coming from, I'm going to have to vote no,” he said.

Lee told LAist he supports stronger oversight and technical improvements to Measure ULA, but believes a ballot measure is the right approach.

“Voters deserve the opportunity to consider targeted changes that would preserve the intent of the measure while addressing its unintended impacts on housing production and real estate activity in Los Angeles,” the councilmember said, in a statement.

Friday's meeting was the committee's final scheduled hearing. The committee, which is set to dissolve June 1, also voted to advance a narrower nonprofit tax refund limited to organizations that can prove all sale proceeds went directly to affordable housing.

The committee continued a separate motion on fire exemptions for Palisades fire victims, which will be heard by another council committee. A motion to loosen eligibility rules for the ULA Citizens Oversight Committee was noted and filed.

Councilmember Imelda Padilla, who introduced several of the committee's motions, said the process had been guided by a commitment to protect the measure.

"My goal has always been to listen carefully, bring people into the conversation, and protect ULA while honoring the voters' intent," she said at Friday’s meeting.

In her closing remarks, Jurado reflected on the three-member committee’s past work.

“We released $14 million in rental assistance to the most vulnerable Angelenos and $300 million for affordable housing,” she said. “We did in six or seven meetings what others couldn't do in five years.”

The ad hoc committee's recommendations now move to the full City Council.

Harris-Dawson and Lee’s ballot measure motion will be considered by the City Council’s rules committee at a later date, officials said.

Monsterpalooza, the annual movie-monster bash for horror fans, returns to the Pasadena Convention Center this weekend, starting Friday night (May 29) and lasting through Sunday.

What to expect

Now in its 18th year, devotees can rub elbows with legendary beastie creators, browse hundreds of vendors who traffic in the weird and unsettling, and marvel at practical effects that’ll make your flesh creep.

Dozens of panels and presentations are scheduled, including a deep-dive into the 95th anniversary of the Dracula and Frankenstein movies by writer Julian David Stone.

Writer Julian David Stone gives a presentation at a past Monsterpalooza event.

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Perry Shields

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Stone said that the two classic movies have left a lasting impact.

“Dracula is a movie about supernatural horror..... and Frankenstein is about technological or man-made horror," he said. "You can just trace those two themes all the way forward to this past year with Sinners and Megan 2.0."

Richard Redlefsen's Armageddon Rat at the PPI Booth at a past Monsterpalooza.

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Stone first attended the convention in 2008, returning over the years as a fan, spectator and presenter.

“It’s just a terrific convention that celebrates all things horror,” Stone said. “There’s a lot of celebrities you can meet who were in these horror films and you can get pictures with them." He added that he’ll never forget when he met Carla Laemmle in 2010 — the last living cast member of the original 1931 Dracula.

Mike Mekash and Chris Nelson re-created Twisty the Clown on Dan Gilbert at the PPI Booth at a past Monsterpalooza.

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Who's attending

If you’re jonesing to be photographed with high-profile entertainers (expect a fee for many), this year's event has a line-up that includes musician Alice Cooper, actress Lin Shaye from the Insidious movie franchise and David Howard Thornton, who plays Art the Clown in the popular Terrifier movie series.

Cosplay and crazy costumes are encouraged, although a T-shirt celebrating a classic horror movie will also do. Just come ready to adore all things that gnaw and gash.