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Los Angeles Times
20-07-2025
- Health
- Los Angeles Times
Federal cuts leave Los Angeles County health system in crisis
Los Angeles County's health system, which is responsible for the care of the region's poorest, is careening toward a financial crisis because of cuts from a presidential administration and Republican-led Congress looking to drastically slash the size of government. President Trump's 'Big Beautiful Bill,' which passed earlier this month, is expected to soon claw $750 million per year from the county Department of Health Services, which oversees four public hospitals and roughly two dozen clinics. In an all-staff email Friday, the agency called the bill a 'big, devastating blow to our health system' and said a hiring freeze had gone into effect, immediately. And the Trump administration's budget for the next fiscal year will likely result in a $200-million cut to the county Department of Public Health, whose responsibilities include monitoring disease outbreaks, inspecting food and providing substance use treatment. 'I'm not going to sugarcoat it. I'm not going to say we survive this,' said Barbara Ferrer, head of the public health department, in an interview. 'We can't survive this big a cut.' Both Ferrer and Department of Health Services head Christina Ghaly warned that the federal cuts will devastate their agencies — and the patients they serve — for years to come. Employee layoffs are likely. In April, the White House announced it was ending infectious disease grants worth billions of dollars, including $45 million that L.A. County was supposed to use to combat the spread of measles and bird flu. California has joined other states in a lawsuit fighting the cuts, and the court has issued a preliminary injunction suspending the cuts. This month, the county public health department lost another $16 million after Trump's bill cut funding for a program educating food stamp recipients about how to buy healthy meals. And there's more to come. The Trump administration's proposed budget for 2026 will be the biggest blow yet, Ferrer warned, yanking $200 million from her department — a 12% cut. 'I'm old. I've been around for a long time,' said Ferrer, whose work in public health dates back to the Reagan administration. 'I've never actually seen this much disdain for public health.' Ferrer said the cuts mean she no longer has enough money for the county's bioterrorism watch program, which monitors for outbreaks that might signal a biological attack. Soon, she said, county officials may have to stop testing ocean water for toxins year round, cutting back to just half the year. 'Like, you want to swim? You want to know that the water is safe where you swim, then oppose these kinds of cuts,' she said. 'That affects everybody who goes to the beach.' Layoffs are likely, said Ferrer. About 1,500 public health staffers are supported through federal grants. More than half the federal money the department receives is funneled to outside organizations, which would likely need to make cuts to stay afloat. A similarly grim cost analysis is underway at the county Department of Health Services, where executives said they expect to lose $280 million this fiscal year because of the bill. 'I can't make a promise that we will be able to avoid layoffs because of the magnitude of the challenges,' said Ghaly. Ghaly said the bill slashed the extra Medicaid money the county typically gets to cover care for low-income patients. They expect many patients might be kicked off Medicaid because of new eligibility and work requirements. The federal government is pulling back on payments for emergency services for undocumented people, meaning the county will have to foot more of the bill. The White House did not respond to a request for comment. Department of Health Services officials said they expect to lose $750 million per year by 2028. By then, the agency's budget deficit is projected to have ballooned to $1.85 billion. In an attempt to pump more cash into the system, L.A. County supervisors voted on Tuesday to increase a parcel tax first approved by voters in 2002, which is expected to raise an additional $87 million for the county's trauma care network. After a long debate Tuesday, Supervisors Holly Mitchell and Lindsey Horvath worked to direct $9 million of the parcel tax money to Martin Luther King Jr. Community Hospital, a private hospital that serves as a critical safety net for South Los Angeles residents who would otherwise find themselves in a medical desert. Without that cash infusion from the county, the cuts in Trump's bill would have put the hospital at risk of closing, since the majority of patients in its emergency room are on Medicaid, said Elaine Batchlor, Martin Luther King's chief executive officer. 'If they've lost their Medicaid coverage, we simply won't get paid for those patients,' she said. Martin Luther King replaced a county hospital that closed after losing national accreditation in 2005 because of serious medical malpractice, landing it the nickname 'Killer King.' 'The fact that that hospital closed in the first place I think is criminal, and I intend to do all I can to protect the integrity of the services,' said Mitchell, whose district includes the hospital and who pushed for it to get a cut of money from the parcel tax increase. Local health providers said that changes at the state level have created additional uncertainty. The state budget for this fiscal year freezes enrollment in Medi-Cal, California's version of Medicaid, for undocumented immigrants ages 19 and older starting in January. Medi-Cal recipients ages 19 to 59 will have to pay a $30 monthly premium beginning July 1, 2027. 'Most families [we serve] are making about $2,400 to $2,600 a month. They're going to have to choose between paying their Medi-Cal fees for a family of four — that's $120 a month — or paying rent or paying for food,' said Jim Mangia, head of St. John's Community Health, who said the cuts will disrupt care for tens of thousands of low-income residents. The St. John's clinic, which gets most of its revenue from Medi-Cal reimbursements, serves more than 120,000 patients a year, most of whom live below the federal poverty line. If the clinic doesn't find a way to replace the lost revenue, Mangia warned, services will have to be reduced. The clinic recently started treating immigrant patients in their homes after realizing they had been skipping appointments because they feared being arrested by federal immigration agents. 'Then what we're looking at is closing several health centers,' said Mangia. 'We're looking at laying off hundreds of staff.' At Venice Family Clinic, a community health center that serves nearly 45,000 patients annually, 80% of patients rely on Medi-Cal. Roughly half the clinic's revenue comes from Medi-Cal reimbursements. Dr. Mitesh Popat, a family physician and head of the clinic, said that federal policy changes — especially more frequent paperwork and added work requirements — will likely push eligible patients off of Medi-Cal. He said the clinic is exploring ways to expand support for patients to navigate the paperwork and keep their coverage. 'This puts a bunch of barriers in the way of people who already have enough challenges in life,' Popat said. 'They're trying to make it, trying to survive, trying to put food on the table.'
Yahoo
09-07-2025
- Health
- Yahoo
Homeless service veteran Sarah Mahin to lead new L.A. County homelessness agency
The Los Angeles County Board of Supervisors on Tuesday picked a director for its new homelessness agency, turning to an executive that officials praised for her two decades of experience in helping people get off the streets. In a unanimous vote, supervisors approved Sarah Mahin and a $375,000 annual salary for her to lead the Department of Homeless Services and Housing, which formally launches Jan. 1. Supervisors voted to create the new department earlier this year, stating they wanted more accountability over homelessness spending that today flows through a much criticized joint city-county authority, the Los Angeles Homeless Services Authority. Mahin currently works for the county and since 2020 has been director of the Department of Health Services' Housing for Health program, which officials see as a model for what comes next. The program, launched in 2012, focuses on housing and helping people with complex medical needs. It employs more than 600 people on an $875-million annual budget. Among the services offered are outreach, rental subsidies, interim housing beds and a wide range of medical care. Prior to serving as Housing for Health director, Mahin was director of policy and systems at LAHSA and also worked at the Department of Veterans Affairs and the Montgomery County Coalition for the Homeless, according to her LinkedIn bio. "For me, this work has always been rooted in innovation, collaboration, and accountability to the people and communities that we serve," Mahin said a statement. "I am committed to leading with those values at the forefront. " As director of the new county homelessness agency, Mahin will be tasked with overseeing a broad reorganization in how the county tackles homelessness. In April, the Board of Supervisors voted to move hundreds of millions of county dollars out of the Los Angeles Homeless Services Authority, or LAHSA, and put it into the new agency. The move followed two audits that, echoing years of criticism, found LAHSA lacked sufficient oversight of its contracts and programs, leaving them vulnerable to waste and fraud. By Jan.1, more than 700 county workers will be transferred to the new Department of Homeless Services and Housing, with hundreds more from LAHSA joining six months later. The new agency is expected to largely absorb programs for Housing for Health, which Mahin has been leading and will cease to exist as a separate division. In a statement, Supervisor Lindsey Horvath, who helped lead the push for the new department, said Mahin's experience at both LAHSA and the county is an asset as the county transitions from the old system. "She's exactly who we need, ready to hit the ground running with the urgency this moment demands," Horvath said. Sign up for Essential California for news, features and recommendations from the L.A. Times and beyond in your inbox six days a week. This story originally appeared in Los Angeles Times.
Indian Express
16-06-2025
- Politics
- Indian Express
Government must stop Manipur floods from becoming another emergency that India watches from a distance
Written by Langthianmung Vualzong The magnitude of the humanitarian crisis in Manipur is revealed by the grim statistics: 160 landslides, 35,384 damaged homes, and over 1.5 lakh people affected across the state, according to official numbers. Manipur, however, remains remote in the national psyche. A cascading ecological calamity that receives neither national empathy nor government attention is further taxing the state, already reeling from a protracted ethnic conflict that began on May 3, 2023. While central agencies like the NDRF and the armed forces have been deployed, extensive inter-ministerial cooperation is yet to be established. Although relief and medical camps have been established, the sheer number of people affected and the agricultural land lost far outweigh these efforts. Since May 30, flooding has forced hundreds of people to relocate within Senapati district. They are in constant need of relief supplies, including food, clean water, blankets, and hygiene kits. Significant infrastructure damage has resulted from landslides, cutting off important national routes, including NH-2, NH-102A, and NH-129A. Disruptions to mobile networks and power outages have further isolated many areas. Now, the threat is multiplying across the state with incessant rainfall. Due to 175 mm of rain in Kangpokpi over the past 72 hours, the Imphal river has crossed its high-flood level, triggering overflow and embankment breaches. The government has issued urgent evacuation advisories for low-lying areas in Imphal, such as Sagolband, Thangmeiband, and Kwakta, where severe waterlogging has disrupted daily life and traffic. In the districts of Senapati, Imphal East, and Imphal West, 16 Rapid Response Teams (RRTs) have been mobilised by the Department of Health Services. There is a 24-hour health helpline (104) for medical emergencies. The India Meteorological Department (IMD) has predicted that Chandel, Churachandpur, Kakching, Thoubal, and Pherzawl are expected to receive heavy rainfall. Moreh, Kamjong, Chandel, and Ukhrul recorded 102 mm, 96 mm, 76 mm, and 60.8 mm, respectively, on Thursday last week alone. The likelihood of landslides, flash floods, and infrastructure collapse has significantly increased. The public has been advised by district magistrates from Chandel, Thoubal, Bishnupur, and Tengnoupal to stay indoors, keep away from low-lying regions, and pay attention to evacuation alerts as the rains continue. Postponing fishing, farming, and non-essential travel until the weather stabilises has also been stressed in these advisories. A notice has also alerted the public to the increased risk of electrocution from water seeping into transformers and substations. Travel advisories further highlight the state's transportation vulnerability. A huge landslide at Phaibung has rendered the Ukhrul–Tadubi road inaccessible. Although NH-2 (Imphal–Senapati) is still passable, there are muddy areas between Kalapahar and Peren, and the Maram–Peren route is totally closed due to several landslides across different sections. On June 3, residents were urged by the Office of the Deputy Commissioner of Imphal East and Imphal West to formally report any damage to their respective SDOs and SDCs in a specified format. Such bureaucratic procedures, while necessary for accountability, may present challenges for persons who are already dislocated and unable to advocate for themselves. Will they receive their fair share of relief even if damage reports are filed, and if so, how? Is Direct Benefit Transfer (DBT) the solution if no third parties are involved? In Manipur, floods are a recurring problem, especially after periods of precipitation. The state saw three rounds of flooding in May 2024 alone. The current episode has revealed stark deficiencies in early warning systems, infrastructure, and disaster preparedness. Disasters exacerbate systemic negligence. Manipur's flood catastrophe is also the result of a lack of federal responsiveness and national attention. What has happened to the media, ministerial visits, parliamentary debates, relief packages, and special funds? Where is the moral urgency that accompanies floods in Gujarat, Chennai, or Mumbai? Community members were the first to respond to this emergency, supporting one another and giving impacted families food, housing, and other necessities. In addition to relief and mitigation, a comprehensive national emergency response is required in light of the June 5 status report, IMD alerts, real-time road collapses, and rising rivers. Ignoring this is not just bureaucratic indifference; it is also federal injustice and climate injustice. The government must stop this from becoming another emergency that India watches from a distance. The writer is an independent researcher from Manipur. Views are personal
Yahoo
23-05-2025
- Health
- Yahoo
FoodShare cuts would cost Wisconsin $314 million a year, state health department reports
Changes a U.S. House bill makes to the federal program known as FoodShare in Wisconsin would increase costs for the state, the state Department of Health Services (DHS) reports. (Getty Images Creative) Food and nutrition cuts in the reconciliation bill that passed the U.S. House early Thursday would cost Wisconsin taxpayers at least $314 million if they are signed into law, a state health official said Thursday. A requirement for the state to pick up some of the costs of the federal Supplemental Nutrition Assistance Program benefits, a provision penalizing the state for errors in distributing benefits, expanded work requirements for recipients and the elimination of a nutrition education program will all contribute to that cost, said Bill Hanna, Medicaid director at the Department of Health Services (DHS) in a briefing for reporters Thursday afternoon. The SNAP program is known as FoodShare in Wisconsin and administered by DHS. SNAP currently includes a work requirement for adults ages 18 to 54 without children to receive benefits. The legislation would raise the upper age to 65 and add the requirement to adults with children who are 7 or older. Wisconsin has an employment and training program to help FoodShare recipients meet the existing work requirement. With the increase in people who would have to meet the requirement, 'We estimate that would cost another $44 million a year,' Hanna said. Currently the federal government funds 100% of the food benefits under SNAP. The new bill requires states to pick up a portion of the cost, which is tied to a state's error rate, Hanna said. Errors include the payment of more benefits than a person qualifies for or the payment of fewer benefits than they qualify for. 'When errors are identified, we correct them, meaning if there was an overpayment to a member, that is recouped on future benefits, or if there's an underpayment, we fix that and back pay those payments,' Hanna said. Wisconsin's error rate is low enough to require the state to submit only a 5% match for SNAP funds under the House Republican proposal, he said. But another change — which would allow zero tolerance even for errors that in the past have not counted against state programs — would boost the state's required match to 15%. DHS estimates based on the proposed new requirements the state would have to pay about $207 million a year in benefit costs, he said. If the state is able to reduce its error rate to qualify for the 5% match, it would still need to pay $69 million a year. A higher state share of administrative costs in the bill would add $51 million to the state's costs for SNAP, Hanna said. The state would also lose the $12 million it receives for SNAP-Ed, a program that provides education to SNAP participants on healthier food choices. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Yahoo
14-04-2025
- Business
- Yahoo
Cuts to Family Care funds in state budget may mean fewer assisted living options
Unless the Wisconsin State Legislature acts to maintain funding levels of Wisconsin's Medicaid Family Care program, it's very possible the growing number of seniors in need of long-term care services like assisted living will find fewer options in their communities. Family Care is a long-term care program for older adults and adults with disabilities. Part of the program's funding is designated for assisted living facilities to help enhance caregiver wages. Without maintaining current funding levels, assisted living facilities will not be able to provide competitive wages for caregivers. In turn, that will lead to understaffed facilities and operators faced with a choice of either closing their doors or leaving the Family Care program altogether. Thankfully, there have been efforts by members of the legislature and Gov. Tony Evers to address these issues in the past, but additional attention is needed. In 2017, lawmakers created the Direct Care Workforce Funding Initiative, which provides a funding mechanism directly to caregivers to help address workforce challenges in the state. Funding through this initiative is distributed to assisted living facilities by third-party Managed Care Organizations that use industry metrics to determine funding allocations to individual facilities and ultimately to caregivers. This funding has been a lifeline to help recruit and retain caregivers during a workforce crisis. Opinion: Changes to Social Security would cost average Wisconsin resident $7,000 a year In addition, last October the Department of Health Services established a minimum fee schedule that created 'minimum rates' for assisted living facilities. This program is crucial as it also increased the average wage assumptions in the Family Care program from $13.02 per hour to $15.75 per hour. While this does not recognize the true labor market trends of caregiver starting wages, $17.75 per hour, it is a step in the right direction. We're fortunate that our state leaders have been responsive in the past to investing in programs supportive of addressing the workforce challenges affecting Wisconsin's long-term health care system. We need them to be responsive again with the next biennial budget. That's why we're requesting that current funding levels are maintained in the upcoming budget. Those funding levels include $202.7 million in state general purpose revenue over the next biennium for the 'minimum fee schedule.' It is also imperative to maintain current funding of the Direct Care Workforce Funding Initiative — $115 million in state general purpose revenue over the next biennium. Opinion: Federal government spends millions on libraries. Executive order ends that. A decrease in funding means a decrease in wages for caregivers along with rate decreases for facilities, something our industry and the state as a whole cannot afford. In order to effectively staff the anticipated increase in caregiving needs and for assisted living facilities to obtain adequate reimbursement that reflects economic realities and the true cost of care, the Family Care program needs to provide adequate reimbursement. ➤Want to contact your state legislator? Here's where you can find your representatives. Michael Pochowski is president and CEO of the Wisconsin Assisted Living Association. This article originally appeared on Milwaukee Journal Sentinel: Wisconsin budget must maintain funds for assisted living | Opinion
