The Brief

Two years ago, Gov. Gavin Newsom’s administration unveiled a new plan to help solve the homelessness crisis: It began using health care providers, funded through Medi-Cal, to help people get and stay housed.

Now, with President-Elect Donald Trump about to take office, some health care organizations, homeless service providers and other stakeholders throughout California worry the program may fall apart just as it’s starting to make a difference. It’s one of many potential shake ups they’re bracing for as they prepare for a new federal administration unlikely to see eye to eye with the Golden State on many of its social welfare policies.

“It makes us all very nervous,” said John Baackes, outgoing CEO of Medi-Cal provider L.A. Care Health Plan.

CalAIM, launched in 2022, is an expansion of Medi-Cal that allows health insurance to pay for certain things that aren’t considered traditional medical care — such as services to help homeless Californians find and keep housing. Proponents say it’s brought a much-needed infusion of money into the state’s overburdened homeless services system.

But because states aren’t typically allowed to spend Medicaid dollars on those types of services, California had to get special permission from the federal government. That permission, in the form of two waivers, expires at the end of 2026.

That means the fate of CalAIM rests in the hands of the Trump administration, which can decide whether to renew the program, scale it back or change it. Trump has yet to give any indication of what he would do (or even whether this specific California program is on his radar) and most stakeholders agree any changes he makes probably wouldn’t come until 2026. But the uncertainty is compounding the stress on already overburdened homeless service providers, who routinely receive short-term, one-time grants instead of permanent funding, making it difficult to plan for the future.

“CalAIM has been one of the most important and, I think, under-appreciated policies of the Newsom administration, to try to better connect our health system and our housing system,” said Tommy Newman, vice president of public affairs for United Way of Greater Los Angeles. “And the risk of going backwards on that is scary.”

Newsom’s administration wouldn’t specify what, if anything, it is doing to safeguard CalAIM.

“California will continue to work collaboratively with our federal partners to ensure that families in our state are healthy and our communities are vibrant places to live and work,” Anthony Cava, spokesperson for the Department of Health Care Services, said in a statement. “While we don’t typically speculate on the potential impacts of a new federal administration, we remain committed to protecting Californian’s access to the critical services and programs they need.”

What is CalAIM?

The goal of CalAIM is to address factors known as “social determinants of health” for low-income Californians. It’s hard to stay healthy when you don’t have access to basic necessities, such as housing and nutritious food, for example. Ultimately, it’s supposed to save the state and the feds money by helping people avoid expensive emergency room visits.

In 2023, more than 68,600 Californians used the three services known as the “housing trio” under CalAIM. These are services designed to help them find housing, stay housed or pay for move-in costs such as security deposits and first and last month’s rent, according to the most recent state data available. Only CalAIM’s “medically tailored meals” service (which helps people with conditions such as diabetes access food that meets their dietary needs) was nearly as popular, with nearly 62,700 users.

CalAIM provides a total of 14 of these services, or “community supports,” which also include medical respite care for people who recently left the hospital, asthma remediation — think air filters, dehumidifiers, mold removal — and sobering centers. CalAIM also provides something called “enhanced care management,” which pairs Medi-Cal members with an intensive case manager who can help them access everything from a doctor to a dentist to a social worker.

One-time grants, doled out to health plans as an incentive for them to ramp up CalAIM services, also helped fund the construction of new affordable housing.

Abode Services, a nonprofit that provides shelter, housing and other aid for unhoused people across seven Bay Area counties, serves more than 1,000 Californians through CalAIM, said CEO Vivian Wan. In Napa County, Abode uses CalAIM to provide case management services to help people move from homeless encampments into shelter and housing. In Santa Cruz County, Abode uses CalAIM funds to replace the federal COVID-19 homelessness funds that poured in during the pandemic but have since dried up.

Abode and other nonprofits also use CalAIM funds to fill an important gap often left by other grants: services for formerly homeless people living in subsidized housing. State programs such as Homekey offer money to buy or build homeless housing, and vouchers pay for tenants’ rent, but there’s often nothing left to fund the case management, counseling and more that’s crucial to help people with physical and mental health conditions, or addictions — the people Newsom has made a priority in his effort to clear encampments — hold onto their housing.

“I shudder to think what would happen if we had all of the mandates from our development side of supporting people through coordinated entry, taking really vulnerable people, and we then reduced the services down to bare bones,” Wan said.

What would Trump do to CalAIM?

It’s difficult to speculate about what the Trump administration will do with CalAIM. Celebrity physician Dr. Mehmet Oz, Trump’s pick to run the Centers for Medicare & Medicaid Services, has no prior experience with the agency and therefore no track record that could provide clues as to how he will act.

Any changes likely would be felt at the end of 2026, when California attempts to renew its CalAIM waivers. But it’s not unheard of for a president to terminate a waiver early. After President Joe Biden took office in 2021, he pulled waivers, authorized by Trump, that had allowed states to require Medicaid recipients to prove they were working or unable to work. But that was an extreme situation, as multiple courts had already shot down those waivers.

“It’s not like CalAIM is going away tomorrow, or even in January,” said Sharon Rapport, director of California state policy for the Corporation for Supportive Housing. “But after that, I think that’s where the questions are: What could happen then? And the fact that it’s California, and not Trump’s favorite state, I think makes people worried.”

Plans to expand future coverage also could be at risk. Health plans are rolling out new frameworks under CalAIM to offer health care to people in jail and prison up to 90 days before they are released. California also has applied to amend one of its federal waivers to add rental assistance to the services CalAIM offers. If that’s approved, the state would be allowed to use Medi-Cal to pay for up to six months of rent for homeless and at-risk people who are leaving settings such as jail, prison, the hospital, or an in-patient mental health or substance abuse facility.

But a recent article by conservative think tank the Manhattan Institute questions the use of health care funds to pay for social services — a potential bellwether that suggests the new administration might not be supportive of programs like CalAIM.

“Even if a social welfare program is a well-intentioned and wise idea, that does not make it health-care,” wrote Manhattan Institute senior fellow Chris Pope. “Health care costs will not be greatly reduced by expanding the meaning of health care to cover every social service; nor would doing so distribute nonmedical assistance to those who need it most.”

The Trump administration also could change the waivers before renewing them, forcing California to pare down the services CalAIM offers, or add work requirements.

Trump, as well as the Republican-controlled Congress, are likely to support requiring Medicaid recipients to prove they are either working or are unable to work. The last time he was in office, Trump approved 13 state waivers that included work requirements, before the Biden administration later withdrew them. Project 2025, a conservative governing blueprint written by the Heritage Foundation, also prioritizes work requirements.

Work requirements historically lead to people, especially low-income people and people of color, losing benefits, according to research by the progressive think tank Center on Budget and Policy Priorities. It found many recipients are working but have a hard time providing the necessary paperwork to prove it, while others can’t work due to obligations as full-time caregivers or a lack of child care.

Trump and Congress also could impose more sweeping cuts to Medicaid as a whole, which could affect California’s ability to continue programs such as CalAIM.

There are ways California could safeguard at least some of its CalAIM services, by baking them into Medi-Cal as permanent benefits, Rapport said. Her organization is pushing for the state to do that with CalAIM’s three housing services.

Staff at L.A. Care already are thinking about how they could continue offering CalAIM services to their members if the Trump administration cuts the program. It would require some significant rearranging of funds, said Chief Medical Officer Dr. Sameer Amin. His organization has nearly 16,800 people enrolled in CalAIM services to help them find and keep housing.

“My concern is that the housing crisis in LA County is not something that happened overnight, and it’s not something that can be corrected overnight,” he said. “It really requires a sustained effort over the course of years and a significant amount of investment. And if we don’t do the investment that we need to do, if we have to reprioritize away from some of these programs, my concern is that these folks are not going to get the health care that they need because they are not housed.”

After copper wire theft left the Sixth Street Bridge in darkness for years, the city of Los Angeles has hired a Pasadena-based engineering firm to restore the lighting, a move aimed at improving safety for Boyle Heights and the surrounding neighborhoods.

City officials contracted Tetra Tech to relight the bridge, which has been plagued by copper wire theft since its opening in 2022. The outages have frustrated residents and commuters who use the bridge to walk, run, bike and drive between downtown LA and the Eastside.

Aging infrastructure, copper wire theft and delayed repairs led to nearly 2,000 streetlight service requests in Boyle Heights in 2024. Nearly seven miles of copper wire have been reported stolen from the Sixth Street Bridge.

Tetra Tech began working on the project’s design in January and is scheduled to restore the wiring to all lights along the bridge, including along roadways, barriers, ramps, stairways and arches before the 2028 Olympic and Paralympic Games come to Los Angeles that summer, according to a Feb. 18 news release from Councilmember Ysabel Jurado’s office.

The firm – which was selected by the city’s Bureau of Engineering – will fortify the pull boxes, service cabinet and conduits to protect against copper wire theft. Tetra Tech will also install a security camera system to deter vandalism and theft.

“When our streets are well-lit, our neighborhoods feel safer and more connected,” Jurado said in the news release. “The Sixth Street Bridge plays a vital role in connecting Angelenos between the Eastside and the heart of the City.”

Jurado – who pledged to look into fixing the Sixth Street Bridge lights when she was elected in 2024 – said the partnership with Tetra Tech “moves us one step closer to restoring one of the City’s most iconic landmarks as a safe, welcoming public space our communities deserve.”

According to officials, the total contract value with Tetra Tech is $5.3 million, which includes work on the Sixth Street Bridge as well as the Sixth Street PARC project, which encompasses 12 acres of recreational space underneath and adjacent to the bridge.

The PARC project will make way for sports fields, fitness equipment, event spaces and a performance stage. PARC’s grand opening is anticipated later this year.

Because the work for the PARC project and the bridge is connected, the Board of Engineers recommended using the existing PARC contract with Tetra Tech to ensure completion ahead of the 2028 Games, officials said.

The cost for the design work on the bridge alone is roughly $1 million.

On Thursday, Jurado announced that her streetlight repair crew had restored lighting and strengthened infrastructure for more than 400 streetlights across her district, including Boyle Heights, Lincoln Heights, and El Sereno. Next, they plan to tackle repairs in downtown L.A.

For the last 70 years, the  27th Street Bakery hasn’t just been the go-to place for people who want to spend less time in the kitchen — it’s become a staple in South Central, providing jobs and security for people living in the neighborhood.

The bakery is Black-owned and in its third generation as a business. It’s co-owned by sisters Denise Cravin-Paschal and Olympic gold-medalist Jeanette Bolden-Pickens, as well as her husband Al Pickens.

“My grandfather employed a lot of people around here as he was growing his business and so have we,” Cravin-Paschal told the LA Local. “They feel that this is a safe place to come. We have the respect of being here for 70 years and so we enjoy it.”

The bakery sits on Central Avenue, the focal point of Black Los Angeles between the 1930s and 1960s. As segregation laws were struck down, Black people in LA began to move elsewhere and took their businesses with them. The bakery, though, is still Black-owned and operating 70 years later.

Today it is considered the largest manufacturer of sweet potato pies on the West Coast, the bakery’s website states. Last year, the city and District 9 Councilmember Curren Price Jr. presented the bakery with a plaque that reads: “A Walk Down Central Avenue — A legacy of community: powered by the people and its places.”

It hangs on the wall in the bakery’s lobby along with several other photos and recognitions they’ve received over the years.

“Our goal is to keep this legacy alive and we’re celebrating 70 years of being here in business. We are so grateful to the community,” Bolden-Pickens said.

In celebration of its anniversary, a sign in the bakery says it is offering one slice of sweet potato pie for 70 cents on Saturdays starting this weekend through Oct. 31.

The bakery was a restaurant at first bringing Southern flavor to LA

The bakery began as a restaurant in the 1930s on Central Avenue founded by Harry and Sadie Patterson, according to the family and Los Angeles Conservancy. Back then, Central Avenue was the epicenter of LA’s Black community and Patterson, who came from Shreveport, Louisiana, decided to bring his Southern recipes to life in Los Angeles.

The restaurant later became a bakery in 1956, according to the bakery’s website. Patterson’s daughter Alberta Cravin and her son Gregory Spann took over the bakery in 1980. After Spann passed away, Cravin’s daughters — the sisters who are current owners — took over the family business. Five other relatives also help them out, Cravin-Paschal said.

These days, the bakery is open Tuesday through Saturday each week and the bulk of their customers are other businesses. They serve nearly 300 vendors including convenience stores like 7-Eleven, Ralphs grocery stores, Smart & Final, ARCO gas stations, restaurants and other mom-and-pop stores. Louisiana Fried Chicken has been a customer since 1980, Cravin-Paschal said.

An average delivery today is usually 45 dozen pies and they also ship orders out of state, Cravin-Paschal said.

She also told The LA Local they have six full time employees and most of them have worked for the bakery at least 25 years.

“I like working here, I like the people,” Maximina “Maxi” Rodriguez, a longtime employee, told The LA Local. After 32 years at the bakery, she said she plans to retire in June. “I’m going to miss it.”

Rodriguez said working at the bakery is a family affair for her, too. Her sister, Guadalupe Garibaldi, has worked at the bakery for over 40 years and her niece, Yoselin Garibaldi, is now a cashier and driver.

Patterson’s lessons inspired 3 generations to keep the business running

For Bolden-Pickens and Cravin-Paschal, running the bakery is a labor of love. Both told The LA Local that their grandfather taught them to stay true to the fresh ingredients they use and not to cut corners.

These lessons helped Bolden-Pickens in her life before taking over the family business. She won a gold medal as part of the U.S. 4×100 meter relay team in track and field during the 1984 Olympics.

“What I learned from being an Olympian is that it takes a lot of hard work. I learned that from my grandfather,” she said.

Bolden-Pickens said it hasn’t been easy running the business, but they’ve been able to stay afloat because of the lessons learned from their grandfather.

“I remember during the pandemic, we actually had to go to the egg farm and stand in line for a couple of hours just to get the eggs that we needed,” Bolden-Pickens said. “We use the best spices. We make our own vanilla.”

Cravin-Paschal said after the death of their brother Gregory Spann, who was the main baker for nearly two decades, they struggled for a few years to keep the recipe and taste consistent. But eventually they figured it out.

“We had a little rough spot because we all know the recipes but you have to put it together (correctly),” Cravin-Paschal said. “Now we’re back to the original taste.”

As marijuana use among teens has grown in the past decade, researchers have been trying to better understand the health risks of the drug. Now, a new longitudinal study finds that cannabis use among adolescents increases risks of being diagnosed with bipolar and psychotic disorders, as well as anxiety and depression, years later.

"This is very, very, very worrying," says psychiatrist Dr. Ryan Sultan at Columbia University, a cannabis researcher who wasn't involved in the new study published in the latest JAMA Health Forum.

Strong study design

Researchers analyzed health data on 460,000 teenagers in the Kaiser Permanente Health System in Northern California. The teens were followed until they were 25 years old. The data included annual screenings for substance use and any mental health diagnoses from the health records. Researchers excluded the adolescents who had symptoms of mental illnesses before using cannabis.

"We looked at kids using cannabis before they had any evidence of these psychiatric conditions and then followed them to understand if they were more likely or less likely to develop them," says Dr. Lynn Silver, a pediatrician and researcher at the Public Health Institute, and an author of the new study.

They found that the teens who reported using cannabis in the past year were at a higher risk of being diagnosed with several mental health conditions a few years later, compared to teens who didn't use cannabis.

Teens who reported using cannabis had twice the risk of developing two serious mental illnesses: bipolar, which manifests as alternating episodes of depression and mania, and psychotic disorders, such as schizophrenia which involve a break with reality.

Now, only a small fraction — nearly 4,000 — of all teens in the study were diagnosed with each of these two disorders. Both bipolar and psychotic disorders are among the most serious and disabling of mental illnesses.

"Those are the scarier conditions that we worry about," says Sultan.

Silver points out these illnesses are expensive to treat and come at a high cost to society. The U.S. cannabis market is an industry with a value in the tens-of-billions — but the societal cost of schizophrenia has been calculated to be $350 billion a year.

"And if we increase the number of people who develop that condition in a way that's preventable, that can wipe out the whole value of the cannabis market," Silver says.

Depression and anxiety too

The new study also found that the risk for more common conditions like depression and anxiety was also higher among cannabis users.

"Depression alone went up by about a third," says Silver, "and anxiety went up by about a quarter."

But the link between cannabis use and depression and anxiety got weaker for teens who were older when they used cannabis. "Which really shows the sensitivity of the younger child's brain to the effects of cannabis," says Silver. "The brain is still developing. The effects of cannabis on the receptors in the brain seem to have a significant impact on their neurological development and the risk for these mental health disorders."

Silver hopes these findings will make teens more cautious about using the drug, which is not as safe as people perceive it to be.

"With legalization, we've had a tremendous wave of this perception of cannabis as a safe, natural product to treat your stress with," she says. "That is simply not true."

The new study is well designed and gets at "the chicken or the egg, order-of-operations question," says Sultan. There have been other past studies that have also found a link between cannabis use and mental health conditions, especially psychosis. But, those studies couldn't tell whether cannabis affected the likelihood of developing mental health symptoms or whether people with existing problems were more likely to use cannabis — perhaps to treat their symptoms.

But by excluding teens who were already showing mental health symptoms, the new study suggests a causal link between cannabis use and later mental health diagnoses. Additional research is needed to understand the link fully.

'Playing with fire'

Sultan, the psychiatrist and researcher at Columbia University, says the study confirms what he's seeing in his clinic — more teens using cannabis who've developed new or worsening mental health symptoms.

"It is most common around anxiety and depression, but it's also showing up in more severe conditions like bipolar disorder and psychosis," he says.

He notes that mental health disorders are complex in origin. A host of risk factors, like genetics, environment, lifestyle and life experiences all play a role. And some young people are more at risk than others.

"When someone has a psychotic episode in the context of cannabis or a manic episode in the context of cannabis, clinicians are going to say, 'Please do not do that again because you're you're you're playing with fire,'" he says.

Because the more they use the drug, he says the more likely that their symptoms will worsen over time, making recovery harder.

"What we're worried about [is if] you sort of get stuck in psychosis, it gets harder and harder to pull the person back," says Sultan. "Psychosis and severe mood disorders, particularly bipolar disorder are like seizures in your brain. They're sort of neurotoxic to your brain, and so it seems to be associated with a more rapid deterioration of the brain."

Some electric bikes in California could soon require license plates under a proposed state bill aiming to address the rise in electric bike related injuries.

AB 1942 or the E-bike Accountability Act, would apply exclusively to Class 2 and Class 3 electric bikes.

Class 2 bikes can be operated without peddling until it reaches the speed of 20 mph.

Class 3 bikes reach a max speed of 28 mph; motor assist could only kick in with peddling.

The bill would also require owners to carry proof of ownership and would direct the Department of Motor Vehicles to establish a registration process. It was introduced by Assemblymember Rebecca Bauer-Kahan of Orinda in Contra Costa County earlier this month.

E-bike injuries spiked 18-fold between 2018 and 2023, according to state traffic data.

The bill may be heard in committee March 16.