The Brief

Los Angeles officials cheered a small but significant victory recently: a 10% drop in the number of unhoused people sleeping outdoors in the city of L.A. Overall, the count in the city shows total homelessness dropped 2%, though officials said that’s within the margin of error.

This result from Los Angeles Homeless Services Authority’s annual point-in-time count, released on June 28, came after historic investment by the city in temporary shelters, long-term housing, and other services.

But while a positive step, it’s a very small one. As LAist has reported, local homelessness has, in fact, reached a plateau: As more people enter permanent housing, others continue to lose theirs.

For the region’s largest and fastest-growing unhoused population, little has changed. Latinos represent 43% of the unhoused population in the Los Angeles Continuum of Care (an integrated system of care that guides and tracks homelessness). It includes most of L.A. County save for Glendale, Pasadena and Long Beach. While LAHSA used different methodology to count Latinos this year, their share remains effectively the same as a year ago.

Homeless service providers and experts say there are unique challenges, especially for Latinos who are immigrants, and particularly for those who lack legal status. These include wage theft, a lack of available resources for undocumented immigrants, and reluctance to seek assistance.

At the same time, local shelters have been stretched this past year as newly arrived asylum seekers, some bused to Los Angeles and other cities from Texas as political pawns, have also landed on the street.

A shelter ‘greatly impacted’ as new migrants arrived

In Boyle Heights, Proyecto Pastoral’s Guadalupe Homeless Project operates two shelters that serve Spanish speakers, a 41-bed shelter for men at the Dolores Mission church, and a smaller women’s shelter a few blocks away.

At one point earlier this year, at least 90% of the residents at the men’s shelter were new asylum seekers from countries like Venezuela, Honduras and Nicaragua. Some had arrived in L.A. with nowhere to go; others had temporary housing arrangements that fell through.

“Our shelter was greatly impacted,” said Raquel Roman, executive director of Proyecto Pastoral. “But the reality is that we need to use the services we have available to serve that population, because they are in an emergency state of being unhoused. And so we can't separate the numbers.”

Staff at Proyecto Pastoral's Guadalupe Homeless Project men's shelter at Dolores Mission in Boyle Heights serve dinner to residents.

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Roman said for now, the new-migrant population at the men’s shelter has dropped to about half, but that could change, depending on circumstances at the border.

A short distance away, the 15-bed women’s shelter primarily houses a different demographic — older women, including longtime immigrants. One resident is Rosa, 67 and undocumented. Her story exemplifies the kinds of challenges immigrants struggle with in staying housed in L.A.

Job loss, wage theft, and homelessness

At the end of 2022, as Rosa relates, she was working in a small women’s clothing shop in “los callejones,” by downtown L.A.’s Santee Alley. LAist is not using Rosa’s last name due to her immigration status.

One day at work, around the holidays, she was lifting a heavy box when she felt a painful sensation.

Rosa, a resident of the Proyecto Pastoral women's shelter, says she lost her job at a clothing shop due to an injury. She went through her small savings and wound up unhoused.

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“I felt something pulling from my waist to my shoulder,” Rosa said, speaking in Spanish. An emergency room visit confirmed that she’d injured her back. She would need physical therapy and time off work — which she took, she believed, with her employer’s blessing.

But when Rosa returned to work within a couple of weeks, she received bad news: “They told me that I no longer had my job,” she said.

As a senior without legal status, Rosa faced poor work prospects. She moved from a one-bedroom unit she shared with two other people, paying $500 a month for the bedroom, to an $85-a-day motel.

She went back to her employer to ask if she could at least receive unpaid overtime she had racked up, but said she was told that if she came back again, “you’ll be met by immigration.”

Rosa had soon blown through her small savings and could no longer pay for housing. At least she had one advantage: Rosa had wound up unhoused before, several years earlier, under similar circumstances.

Back then, someone had steered her to Proyecto Pastoral, where she stayed until she could get back on her feet.

So this time, she knew where to go. She arrived at the shelter about 14 months ago.

Challenges, vulnerability

Experiences like Rosa’s are not unusual, said Roman. Undocumented immigrants are subject to wage theft and other workplace exploitation.

“That means they may not get a living wage,” Roman said, which puts these workers at risk as rent prices become untenable.

These same workers don’t qualify for affordable housing programs, Roman added. “You need a Social Security (number) and proof of income to get housing, Section 8 housing,” she said. “The housing and the work is really difficult for folks.”

Roman said in the past, she’s also encountered undocumented immigrants who’ve had trouble accessing homeless services because they’ve lacked a Social Security number. And even getting to that point can be a struggle.

Rosa and Maria, both residents of Proyecto Pastoral's women's shelter in Boyle Heights.

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“There’s a shame to being unhoused, and so a lot of times, people do not want to seek the help that they need,” Roman said. “They stay in a car, they stay in a park, they stay on a couch … and sometimes living in places that are not suitable.”

A common housing fallback in Latino communities is “doubling up” with other renters in a single unit — what Rosa was doing at the time she became injured. This was prevalent even before the economic sting of the pandemic: A UCLA study released late last year concluded that between 2016 and 2020 in L.A. County, Latinos made up 76% of those who self-identified as experiencing doubled-up homelessness.

These precarious housing situations can themselves lead to homelessness; studies have suggested that doubled-up renters who are not on the lease are more likely to become unhoused.

Takeaways from community ‘listening sessions’

Since taking office in December 2022, L.A. Mayor Karen Bass has pledged to get more Angelenos off the street, with the city investing more than $1 billion to combat homelessness.

And as the number of Latinos experiencing homelessness locally has jumped dramatically, rising by 26% just between 2020 and 2022, local officials have paid more attention.

In recent months, a new Task Force on Latinx People Experiencing Homelessness that includes LAHSA staff, service providers, and public officials has sought community input, hosting bilingual “listening sessions” in communities around the L.A. area.

The goal is to present recommendations to county officials in October, said Patricia Lally, the facilitator and consultant leading the sessions.

Lally worked with community groups in places like Lancaster, Bellflower, and downtown L.A. to draw participation from local Latino communities. While some sessions were better attended than others, people who showed up talked about feeling deeply at risk.

“They said things like this: ‘My annual rent increases at a rate that I just … can't keep up with it much longer.’ And ‘I'm going to have to live with my daughter’ or ‘I'm going to have to find something else …’” Lally said.

She said some people related having to choose between housing and sending money home to relatives out of the country: “‘I can't afford to pay rent and then also to take care of my family … I'm homeless, even though I'm working, because … I can't afford rent.”

Lally said while the task force’s recommendations aren’t ready to share, figuring out ways for people who can’t access housing resources to do so will be high on the list.

“I know the task force is going to be recommending that L.A. County and L.A. City get very clear about unrestricted resources, and that how can we funnel unrestricted resources to undocumented immigrants that might not be able to avail themselves of other housing resources,” Lally said.

Keys to housing

It’s access to housing resources that, in the end, will be leading Rosa out of the Proyecto Pastoral shelter and into a small apartment.

At the Proyecto Pastoral women's shelter, Rosa displays the keys to her future housing unit.

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With help from shelter staff, Rosa was able to qualify for a county program that provides housing for people with health problems who frequently use county health services — and for which her immigration status was not an obstacle.

One recent afternoon at the shelter, Rosa jingled her new keys proudly in the sun. She had just returned from seeing her future home, a studio unit downtown.

“I just received my keys!” she beamed. “They gave me my housing, furnished. They brought in furniture. I’m very happy. And I’m very grateful.”

The Trump administration sent shockwaves through the U.S. mental health and drug addiction system late Tuesday, sending hundreds of termination letters, effective immediately, for federal grants supporting health services.

Three sources said they believe total cuts to nonprofit groups, many providing street-level care to people experiencing addiction, homelessness and mental illness, could reach roughly $2 billion. NPR wasn't able to independently confirm the scale of the grant cancellation. The U.S. Substance Abuse and Mental Health Services Administration (SAMSHA) didn't respond to a request for clarification.

"We are definitely looking at severe loss of front-line capacity," said Andrew Kessler, head of Slingshot Solutions, a consultancy firm that works with mental health and addiction groups nationwide. "[Programs] may have to shut their doors tomorrow."

Kessler said he has reviewed numerous grant termination letters from "Salt Lake City to El Paso to Detroit, all over the country."

Ryan Hampton, the founder of Mobilize Recovery, a national advocacy nonprofit for people in and seeking recovery, told NPR his group lost roughly $500k "overnight."

"Waking up to nearly $2 billion in grant cancellations means front-line providers are forced to cease overdose prevention, naloxone distribution, and peer recovery services immediately, leaving our communities defenseless against a raging crisis," Hampton said. "This cruelty will be measured in lives lost, as recovery centers shutter and the safety net we built is slashed overnight. We are witnessing the dismantling of our recovery infrastructure in real-time, and the administration will have blood on its hands for every preventable death that follows."

Copies of the letter sent to two different organizations and reviewed by NPR signal that SAMHSA officials no longer believe the defunded programs align with the Trump administration's priorities.

The letter points to efforts to reshape the national health system in part by restructuring SAMHSA's grant program, which "includes terminating some of its … awards."

According to the letter, grants are terminated as of yesterday, Jan.13, adding that "costs resulting from financial obligations incurred after termination are not allowable."

The National Association of County Behavioral Health and Developmental Disability Directors sent a letter to members saying it believes "over 2,000 grants [nationwide] with a total of more than $2 billion" are affected. The group said it's still working to understand the "full scope" of the cuts.

This move comes on top of deep Medicaid cuts, passed last year by the Republican-controlled Congress, which affect numerous mental health and addiction care providers.

Kessler told NPR he's hearing alarm from care providers nationwide that the safety net for people experiencing an addiction or mental health crisis could unravel.

"In the short term, there's going to be severe damage. We're going to have to scramble," he said.

Regina LaBelle, a Georgetown University professor who served as acting head of the Office of National Drug Control Policy during the Biden administration, said the SAMHSA grants pay for life saving services.

"From first responders to drug courts, continued federal funding quite literally save lives," LaBelle said. "The overdose epidemic has been declared a public health emergency and overdose deaths are decreasing. This is no time to pull critical funding."

Requests for comment from SAMHSA and the Department of Health and Human Services were not immediately returned.

This is a developing story.

Copyright 2026 NPR

When the head of the nation’s largest publicly operated health plan worries about the looming federal cuts to Medicaid, it’s not just her job. It’s personal.

Martha Santana-Chin, the daughter of Mexican immigrants, grew up on Medi-Cal, California’s version of Medicaid, the government-run health care program for people with low incomes and disabilities. Today, she is CEO of L.A. Care, which runs by far the biggest Medi-Cal health plan with more than 2.2 million enrollees, exceeding the Medicaid and Children’s Health Insurance Program enrollments in 41 states.

“If it weren’t for safety nets like the Medi-Cal program, I think, many people would be stuck in poverty without an ability to get out,” she said. “For me personally, not having to worry about health care allowed me to really focus on what I needed to focus on, which was my education.”

As she begins her second year steering L.A. Care, Santana-Chin is grappling with federal and state spending cuts that complicate her task of providing health care to the poor and medically vulnerable enrollees in Medicaid. The insurer also provides Affordable Care Act marketplace plans through Covered California.

Santana-Chin warns that the GOP’s One Big Beautiful Bill Act, enacted last year and also known as HR 1, could result in 650,000 enrollees falling off L.A. Care’s Medi-Cal rolls by the end of 2028. This will strain the plan’s finances as revenues decline. The insurer had revenues of $11.7 billion in the last fiscal year.

HR 1 is expected to cut more than $900 billion from Medicaid over the next 10 years — including $30 billion or more in California, according to the Department of Health Care Services, which runs Medi-Cal.

Like other states facing big deficits, California has reduced its Medicaid spending through such steps as freezing new enrollments for immigrants without legal status and reintroducing an asset limit. And that’s before the state reckons with the spending cuts that likely will be required by the withdrawal of so many federal dollars under HR 1.

Santana-Chin oversaw Medi-Cal and Medicare operations for the for-profit insurer Health Net before taking the helm of L.A. Care in January 2025, nearly three years after state regulators fined L.A. Care $55 million over violations they said compromised the health and safety of its members. L.A. Care paid $27 million in penalties to the state and agreed to contribute $28 million to community health projects.

In a wide-ranging interview, Santana-Chin talked to KFF Health News senior correspondent Bernard J. Wolfson about the financial headwinds facing L.A. Care and why she believes health care shouldn’t be restricted based on a person’s immigration status. This interview has been edited for length and clarity.

Q: You grew up on Medicaid. How has that shaped your views now that you run one of the largest Medicaid plans in the country?

What really motivates me is knowing that many of the people that we’re serving are just like my family. They’ve struggled and have had to have their own children translate things that were very difficult to translate. I remember doing that for my own mother. You know, basic human dignity requires that you have access to health care.

Martha Santana - Chin, CEO of L.A. Care, is the daughter of Mexican immigrants and was a beneficiary of Medi - Cal throughout her childhood. Because of that experience, she says, the concerns of L.A. Care members resonate with her on a personal level.

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Q: Has anything you’ve dealt with at Health Net or L.A. Care reminded you of your childhood experiences in Medi-Cal?

Back then they didn’t cover transportation, and we didn’t have a vehicle. Today, one of the issues we’ll hear from our members is the need to make sure we have trustworthy transportation that shows up on time, where the drivers treat them with respect. Had I had that, had my mother had that, life would have been much easier.

Q: What do you think the impact of HR 1 will be?

It’s going to devastate the delivery system. The state obviously isn’t going to be able to make up for the shortfalls in federal funding, and over the course of the next several years, funding is going to be less and less, and the people we cover are going to decrease significantly. We are expecting between now and the end of 2028 that we’re going to see 650,000 people drop off the rolls. That’s just L.A. Care.

Q: That’s over a quarter of your Medi-Cal enrollment.

Yes, it’s very, very significant. The reductions in payment and the rise in uncompensated care are really going to impact our delivery system. As the delivery system gets destabilized and hospitals and other health care providers are forced to close services or reduce the number of sites they have, it’s going to impact access. And it’s not only going to impact those that lose coverage.

Q: How will L.A. Care respond?

Obviously, we’re going to see a significant drop in revenue. We’re very focused on making sure that we are operating as efficiently as we can operate. And we are looking at creative ways to use technology to empower our people to do higher-level work. Mostly supporting our call center agents with smarter technology that helps them answer questions and resolve problems more quickly. Some of it is automating processes on the claims payment side.

Q: What do you have to say to congressional Republicans who passed HR 1?

We are at a point of inflection in the health care delivery system. And we have to recognize that some of the components of HR 1 will have long-term unintended consequences — maybe they were intended; I’ve got to believe that some of these things are not. There’s probably a need to reconsider some of the things that were passed.

Q: Such as?

Work requirements are an example of something that many people did believe was the right thing to do to be good stewards of the health care dollar. It is very complex and is going to cause people to lose coverage that actually do qualify. It’s unfortunate, and that would be something that I would urge folks to reconsider.

Q: What impact do you expect from California’s decision to freeze Medi-Cal enrollment for immigrants without legal status?

It doesn’t matter what immigration status you are. If you are a human being and you need health care, you’re going to try to access health care wherever you can. That’s going to put a strain on the delivery system if you’re uninsured.

Q: What has L.A. Care done to address the state’s concerns in 2022 that it delayed authorizing care and addressing patient grievances?

There has been quite a bit of investment in the L.A. Care infrastructure over the last several years — our IT platforms, our data. There’s also quite a bit of investment in adding new capacity, adding bandwidth to many of the teams, more folks to help support the work.

Q: How have federal immigration raids in L.A. affected L.A. Care members and the broader community?

It absolutely has had a chilling effect. Families are afraid to come in. They’re not taking their children to get vaccinated. I’ve had numerous providers in emergency departments say that they have experienced a drop in the volume of individuals coming in. One of our case managers was really distraught because there was an individual that decided to forgo serious lifesaving treatment because of fear.

Take accountability and move forward.

Those were the two points Los Angeles Fire Chief Jaime Moore hit repeatedly when speaking with LAist’s Larry Mantle this week.

On taking accountability, Moore said hazardous conditions and decisions made before the Palisades Fire erupted a year ago meant “our firefighters never had a chance” to arrest the fire that killed 12 people and destroyed thousands of structures.

On moving forward, he emphasized that reform is already in the works.

“Things have changed since the Palisades Fire, and we're going to continue making big changes in the Los Angeles Fire Department,” said Moore, who was selected for the LAFD top job by Mayor Karen Bass in November.

Here are three takeaways from the interview, which aired on AirTalk on Tuesday.

1. Staffing decisions hampered fire response

The LAFD uses a so-called pre-deployment matrix to set firefighter staffing levels ahead of high-risk weather.

According to the department’s after-action report, however, staffing levels on the day the Palisades Fire began fell short of the LAFD standard for extreme weather conditions. The National Weather Service had warned of low humidity, high winds and dry vegetation, what it calls a “particularly dangerous situation.” It’s the highest level of alert the agency can give.

Despite the high risk, the LAFD report said the decision not to deploy more firefighters in advance was in part made to save money.

Moore said Monday that the department has updated its policies to increase staffing for especially hazardous conditions, but he said he doesn’t believe additional resources would have stopped a fire of the magnitude that leveled the Palisades.

To suppress that kind of fire, he said, the department would need to pre-deploy resources across the city’s vast geography — to places like Baldwin Hills, Franklin Canyon, the Hollywood Hills, the Palisades, Porter Ranch and Sunland-Tujunga.

Moore said the department has already made new policies to call for more resources when the Weather Service issues a “particularly dangerous situation” alert.

2. LAFD is mostly an urban firefighting department

Moore referenced a key finding of the after-action report regarding a lack of training in wildland firefighting, which contributed to confusion and struggles to effectively utilize resources during the fire.

Wildland fires pose a number of challenges that are different from what firefighters face in urban environments. Those include the need to coordinate a large number of resources over vast areas, all while dealing with fast-moving flames that can rapidly tear through dry plants and structures.

The department found in its report that fewer firefighters were trained in fighting these wildland fires in recent years and that “leaders struggled to comprehend their roles.”

Some leaders in the department had “limited or no experience in managing an incident of such complexity,” the report said. And some reverted to doing the work of lower positions, leaving high-level decision-making positions unfilled.

“What we're doing now is really furthering that training and reinforcing that education with our firefighters so that they could be better prepared,” Moore said on AirTalk.

3. Changes to the after-action report

Early versions of the after-action report differed from the version released to the public in October, a fact that was first reported by the Los Angeles Times. The Times also reported that Battalion Chief Kenneth Cook, who wrote the report, wouldn’t endorse the final version because of the changes.

Moore acknowledged to the L.A. Board of Fire Commissioners at a Jan. 6 meeting that the report had been watered down.

“It is now clear that multiple drafts were edited to soften language and reduce explicit criticism of department leadership in that final report,” Moore told the commissioners. “This editing occurred prior to my appointment as fire chief, and I can assure you that nothing of this sort will ever again happen while I am fire chief."

Some changes were small but telling. A section titled “Failures” later became “Primary Challenges.”

Moore told LAist that changes between versions “ made it easier for the public to understand,” but an LAist review found the edits weren’t all surface-level.

In the first version of the report, the department said the decision not to fully pre-deploy all available resources for the particularly dangerous wind event “did not align” with their guidelines for such extreme weather cases. The final version said that the initial response “lacked the appropriate resources,” removing the reference to department standards.

The department also removed some findings that had to do with communications.

One sentence from the initial version of the report said: “Most companies lacked a basic briefing, leader’s intent, communications plan, or updated fire information for more than 36 hours.” That language was removed from the final report.

LAist has asked the Fire Department for clarification about why these assertions were removed but did not receive a response before time of publication.