LA County pauses syringe and pipe handouts at Skid Row services hub

Los Angeles County quietly stopped handing out syringes and pipes at the county’s flagship services hub in Skid Row in August, and has now terminated the contract of the nonprofit that ran harm reduction programs there, the Department of Health Services told LAist.

The pause — which county officials said is temporary — began in August, “in part due to concerns that community stakeholders and local businesses raised to County leadership,” according to a statement provided to LAist by Thomas Lynch, a spokesperson for the county’s Department of Health Services.

The changes come amid a growing cluster of HIV cases in Skid Row and mounting pressure from the Trump administration and neighboring businesses on L.A. programs that distribute drug paraphernalia. Critics argue the programs enable drug addiction and contribute to crime in the area.

The goal of these programs is to keep people who use drugs alive and free of infections like HIV and hepatitis, while working to connect them with services including treatment.

In late August, the county Department of Public Health identified a cluster of HIV cases among people who live in and around Skid Row. As of Sunday, 15 people had been linked to it, 11 of them women, according to Becky Schlikerman, a spokesperson for that department.

In a statement, Schlikerman said both substance use and sexual transmission are being investigated as possible factors, and that the department is working with street medicine teams and harm reduction groups to expand HIV testing and prevention in the area.

“There is an active HIV outbreak in Skid Row, so reducing safe injection supplies to people who use drugs in this moment seems particularly dangerous,” said Ricky Bluthenthal, distinguished professor of population and public health sciences at USC’s Keck School of Medicine.

The Skid Row Care Campus still distributes naloxone — the opioid overdose reversal drug — wound care supplies and safe sex supplies, Lynch said, but “distribution of syringes and pipes is currently on pause.”

He also said they have not set a date for syringe services to resume, that the pause applies only at the campus, and that staff are referring people to syringe programs elsewhere.

The state lists 24 authorized syringe services programs in L.A. County, according to the California Department of Public Health. Two are based in or next to Skid Row.

Harm reduction services are provided across much of L.A. County, according to the L.A. County Department of Public Health.

Darren Willett, director of the Center for Harm Reduction in Skid Row, in September of 2021.

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Al Seib / Los Angeles Times

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Provider layoffs 

The county has also terminated its contract with Homeless Health Care Los Angeles effective Tuesday, county officials said. The county announced the change in an Aug. 28 statement, the same month the syringe and pipe pause began.

Homeless Health Care Los Angeles, one of L.A.’s best-known harm reduction providers, notified the state in September that it would permanently lay off 134 workers — including 117 employees at the Skid Row Care Campus — effective Tuesday, Nov. 3, according to state Employment Development Department records.

“Right now, HHCLA is being forced to say goodbye to some deeply valued staff and reduce services that some of LA’s most marginalized rely on every day,” the nonprofit wrote in an Instagram post in late September.

In the same post, Homeless Health Care Los Angeles said its jobs program for people in Skid Row “no longer exists.” The nonprofit said the program offered “real income, real pathways forward for people too often shut out of opportunity.”

The county is bringing in nonprofits St. Joseph Center and LA Community Health Project instead, officials said. Meanwhile, Social Model Recovery Systems will expand its existing services and Wesley Health Centers will continue providing healthcare on site.

In statements provided to LAist, L.A. County's health services and homelessness departments described the shake-up as “contractor changes” made as part of an effort to “strengthen operations.” Officials are updating campus protocols, “strengthening on-site safety” and expanding substance use treatment and healthcare, according to those statements.

County officials said they are committed to a transition that avoids disruption for people using the campus.

“Providers are hiring from within the Skid Row community and have worked hard to retain staff who were working for Homeless Health Care Los Angeles,” Lynch told LAist.

Those providers have hired more than 80 people so far, and nearly 90% previously worked for Homeless Health Care Los Angeles, according to the department.

Representatives for Homeless Health Care Los Angeles did not respond to repeated requests for interview or comment.

The nonprofit has worked in Skid Row since the 1980s and ran the campus’s harm reduction and overdose response programs. It celebrated its 40th anniversary this year.

A group of Skid Row community members and laid-off campus workers calling itself the Skid Row Coalition for Community Safety has launched a campaign saying L.A. County is “playing politics with people’s lives.”

“Supervisor Hilda Solis and LA County chose to cowardly abandon the recommendations of public health experts and the Skid Row community,” the group said in a statement on its website.

County Supervisor Hilda Solis, who represents the area and authored the 2022 motion that created the Skid Row Action Plan, told LAist in a statement that the decision to end Homeless Health Care Los Angeles’ contract was made jointly by the county’s health services and homelessness departments.

“Some services have been paused to allow the incoming provider to onboard staff and establish operations,” Solis said. “This is a necessary part of coordinating the transition.”

“I am proud of the Skid Row Action Plan and its commitment to expanding low-barrier services, health care, and pathways to housing,” Solis’ statement continued. “That commitment remains unchanged.”

Solis completes her final term next month and is on Tuesday’s ballot running for California’s 38th Congressional District, which covers parts of eastern Los Angeles and Orange counties but not Skid Row.

Los Angeles County Supervisor Hilda Solis. Solis represents Skid Row and authored a 2022 motion that created the Skid Row Action Plan.

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Samanta Helou Hernandez

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Criticism of the campus 

The Skid Row Care Campus opened in spring 2025. County officials call it the first community-designed homeless services hub in the nation.

The campus logs more than 2,700 visits a day, a count that includes repeat visitors, according to the county. It costs about $26 million a year to operate. Funding is secured through June 2027. The budget for the following fiscal year has not been finalized.

The campus in the heart of Skid Row drew scrutiny this year. In May, Fox 11 aired a segment featuring Estela Lopez, executive director of the Downtown Industrial Business Improvement District, who called the campus a “meth mansion.” L.A. Mayor Karen Bass told the TV station she was concerned about problems at the campus.

LAPD responded 693 times to the two blocks around it between January and late May, and recorded four homicides there in the first four months of 2026, according to LAPD figures first reported by Fox 11.

On Oct. 8, federal agents and LAPD officers carried out a drug sweep dubbed “Operation Save Skid Row,” centered about a block from the campus. Federal prosecutors charged 28 people and arrested 23, according to the Drug Enforcement Administration.

In July 2025, President Donald Trump signed an executive order directing agencies to stop funding “so-called ‘harm reduction’” efforts. In April, federal health officials barred grantees from using federal money for pipes and drug test strips, on top of a longstanding ban on federal funds for syringes.

L.A. County officials have not said whether federal policy played a role in the pause. The campus is funded through opioid settlement money, Medi-Cal managed care plans, the state and the county — not federal grants, according to officials.

County officials and employees have credited harm reduction programs with helping drive down overdose deaths, which fell 6% in 2025 — the third straight annual decline — according to the county Department of Public Health.

A person walks past an encampment of unhoused people in the Skid Row community. Skid Row is home to thousands of people who are either experiencing homelessness on the streets or living in shelters.

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Getty Images North America

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Harm reduction’s track record

Harm reduction programs including needle and syringe exchanges started in L.A. more than three decades ago in response to the HIV/AIDS epidemic. L.A. County declared a local public health emergency in 2000 to authorize syringe exchange under a new state law, according to a Kaiser Family Foundation report.

People who use fentanyl in L.A. have increasingly shifted from injecting it to smoking it, according to a 2025 study co-authored by Bluthenthal, with USC’s Keck School of Medicine.

Bluthenthal called the recent syringe and pipe distribution pause at the Skid Row Care Campus “obviously a setback.”

“Harm reduction programs, through providing social and material support, have been one of the most consistent pathways to treatment for people who are currently using illicitly purchased drugs,” he said.

In a statement on the pause, officials at L.A. County’s Department of Health Services said people who receive syringe services are three times more likely to reduce or stop using drugs and five times more likely to enter substance use treatment.

John Raphling, an organizer with the Los Angeles Community Action Network based in Skid Row, said his group is “extremely concerned that the county is cutting these services” and that Skid Row residents “were not at all consulted.”

“Harm reduction services, like those provided by Homeless Health Care, help save lives, prevent the spread of disease, and allow people to survive and work through their recovery,” Raphling said.

Some Skid Row residents see it differently — including Don Garza, who has lived in the neighborhood for 27 years and resides in a single-room-occupancy building there.

“It’s not helping anyone,” Garza told LAist. “It exponentially accelerates the overdose deaths.”

“The part of harm reduction that we still need is the overdose prevention, but without the pipes and the needles,” Garza said. “We still need the Narcan because Skid Row is not going anywhere, and people are still gonna OD, and they're gonna die.”