Asaiah Washington died in Sacramento County Jail on July 26, 2024, and nearly two years later, his family is still calling to hold the Sacramento County Sheriff’s office accountable for his death.

On Thursday, his family and supporters gathered outside the Sacramento County Jail on what would have been Washington’s 42nd birthday. His wife Tonette Washington spoke at the rally, and said she couldn’t believe the call she received from the Sacramento County Coroner’s office.

“He’s the type of person that is not supposed to be gone. He’s the type of person that’ll go in the store and say, ‘Why are you selling water? It should be free.’” Washington said. “I just talked to him 10:07 a.m., and he died 11:30 a.m., within an hour.”

Washington said that her husband struggled for a long time with his mental health, and that she believes he wasn’t being provided with his medication. She said that when he collected his property from the jail, Washington found notes kept by her husband detailing his repeated requests for treatment.

“I’m just reading this, and it’s just giving me chills,” Washington said. “He was basically begging for his medication.”

Tonette Washington said she was worried about inmates who remain in Sacramento County Jail, and that she doesn’t believe what happened to her husband is an isolated incident. Other advocates and supporters from groups like the Anti-Police Terror Project and Decarcerate Sacramento held signs and spoke at the rally.

Christopher-Camilo Carbajal-Carbajal, an organizer with Decarcerate Sacramento, said that there has been a consistent problem with people dying in Sacramento County Jail.

“There’s not enough resources for mental health support, medical support,” Carbajal-Carbajal said. “We also know that sheriffs, from what people have told us, the sheriff deputies have been gatekeepers to medical care.”

The Sacramento County Sheriff’s office did not immediately respond to a request for comment about the rally or calls for accountability in the jail system.

Keyan Bliss (right), an organizer with the Anti-Police Terror Project reads the names of inmates who have died in Sacramento County Jail since 2018, in front of Tonette Washington(left), her family and the rally of advocates on May 28, 2026.Ruth Finch/CapRadio

Since January 2021, at least 41 people have died in Sacramento County Jail, according to reporting by the Sacramento Bee. In 2024, a lawsuit was filed against Sacramento County seeking damages for one detainee’s family after he died of septic shock and kidney failure, even though according to the lawsuit, he repeatedly requested and was denied medical assistance.

AJ Albano, another organizer with Decarcerate Sacramento, said that a number of the deaths in the jail have been drug-related.

“At least a dozen of them were related to drug overdose, like Asaiah,” Albano said. “That happens because of negligence and neglect of the staff, failure to respond to drug overdoses when they happen, and also failure to prevent drugs from getting into the jail.”

Tonette Washington said she has concerns with how an institution like the county jail could allow something like what happened to her husband to happen within its walls.

“Now we are left trying to understand how a vulnerable human being under institutional supervision lost his life,” Washington said. “Families are not seeking accountability because they hate institutions. Families seek accountability because they love the person they lost.”

On July 30th, 2025 Washington filed a lawsuit regarding the death of her husband against the County of Sacramento. Albano said that families can sometimes only find accountability in court.

“The sheriff has no structured accountability at all,” Albano said. “The only way that there is accountability is through lawsuits.”

This story was originally published by EdSource. Sign up for their daily newsletter.

Top Takeaways

• The cost of health benefits has surged nearly 500% since 2013-14, outpacing school funding growth.
• Teachers’ share of their healthcare premiums has reached $1,600 a month in some cases, fueling labor battles.
• California school districts spent 8% of their per-student funding on health benefits last school year.

Twin Rivers Unified School District teachers in Sacramento spent 12 days on strike in March, in part, because healthcare premiums for some teachers and their families had reached $1,600 a month — a growing burden now fueling labor battles in school districts across California.

Little Lake City teachers in Sante Fe Springs, Norwalk and Downey walked out of their classrooms for 10 days; Natomas Unified teachers in Sacramento for seven days; and Dublin Unified, West Contra Costa Unified and San Francisco Unified teachers for four days this school year.

All six unions ended their strikes with health coverage victories. Other unions reached agreements with their districts on improved health benefits at the bargaining table; some are still trying.

As school districts grapple with declining enrollment, expiring federal aid and rising pension costs, healthcare premiums have become one of the most contentious issues in labor negotiations. Teachers say escalating out-of-pocket costs are swallowing salary gains, while district leaders say schools can’t continue to shoulder the entire cost of employee health benefits without having to cut elsewhere.

Teachers in Modesto City Schools have been negotiating a contract with their district since the fall. The sticking point: health benefits. Teachers would like the district to pay more toward rising health benefit costs, which some of them say are now more than their mortgages, according to the Modesto Bee.

The cost of health and welfare benefits has surged nearly 500% since 2013-14, far outpacing school funding growth, according to School Services Inc., a California education consulting firm.

During the 2024-25 school year, California school districts, on average, spent 8% of their average daily attendance funding on health and welfare benefits for school employees, according to a report released recently as part of the Getting Down to Facts III collection of education research.

Health premiums outpace salary gains

The average healthcare premium for a public school employee increased 14%, while teacher salaries increased by 10% between 2018 and 2022, according to a National Council on Teacher Quality study.

Since then, insurance rates have continued to increase at a steady pace.

A July 2025 survey of nearly 2,000 California teachers found that 69% said that high, out-of-pocket costs for often inadequate healthcare benefits were eating into their paychecks.

“Health insurance premiums are rising faster than teachers’ salaries are increasing, and so this is, of course, making it harder for teachers to be able to afford to stay in the profession,” said Heather Peske, president of NCTQ.

The popular perception is that California public school teachers have generous healthcare benefits, but the reality is that some teachers pay as much as $1,600 per month in out-of-pocket costs, said California Teachers Association President David Goldberg.

Teachers feel that budgets “have basically been balanced on their backs for years,” Goldberg said during an EdSource Roundtable in February. “About a third of the association’s members report that they’re living paycheck to paycheck and are even delaying needed healthcare.”

Paul Bruno, assistant professor at the University of Illinois Urbana-Champaign, says teacher salaries have been mostly flat over the last 20 years as unions and school districts have prioritized health benefits during contract negotiations.

“Teacher compensation has gone up pretty substantially, it’s just not in salary,” said Bruno, lead author of “District Dollars 3: Recent Patterns in California School District Finances, Trends in Teacher Compensation, and Within-District, Between-School Spending.”

Higher rates are impacting district budgets

California school districts are also struggling financially. They have lost average daily attendance funding due to declining enrollment, and federal Covid dollars. At the same time, districts are paying more for pensions, healthcare, supplies and special education.

Between the 2004-05 and 2024-25 school years, healthcare costs for California districts increased 46%, or $6,345 per teacher, according to Bruno’s research. Medical benefit costs increased 52% to $18,839 per teacher, while the cost of dental and vision plans dropped slightly.

Although the cost of health benefits has increased in all industries at a faster rate than inflation most years, schools are harder hit because they generally are responsible for a larger share of their employees’ benefit costs than most other industries, according to the report.

The pain is not spread equally

Health benefits, which are collectively bargained between local districts and their teachers unions, vary greatly across the state.

About half of the state’s districts that reported data to the state during the 2024-25 school year paid between 70% and 90% of their teachers’ health benefits; about 13% of the districts paid the entire cost, according to a California Teachers Association analysis of benefits data submitted to the state by 783 school districts.

It is unclear how many California districts, if any, require teachers to pay the full cost of the insurance.

Agreeing to pay 100% of health benefits can put a district in the position of shouldering the entire cost of increases, Bruno said. It also removes incentives for employees to select less expensive health plans, he said.

Kern County is the gold standard

Kern County schools are the most generous to their teachers in terms of health benefits, with 18 of the 37 districts that reported data to the California Department of Education paying 100% of their teachers’ health premiums. Another 15 of the county’s districts reported paying between 90% and 99.58% of teachers’ health benefits.

“Not only do we have our benefits 100% paid for, we have extremely good benefits. Like we’re talking gold plan PPO benefits,” said Megan Harwell, president of the Kern County Education Association, the union for the county Office of Education.

Kern County school districts have paid a majority of teachers’ health benefits for as long as Harwell, a special education teacher, can remember. But the issue still comes up annually during contract negotiations because of rising costs, she said.

“So, it’s never been a given,” Harwell said. “It’s always been something we’ve fought very hard for.”

This year, the Kern County Office of Education paid approximately $1,700 a month for health benefits for each of their teachers and their families, Harwell said. Next year, the cost is expected to be about $2,000.

Harwell said Kern County teachers are often shocked to hear that teachers in other school districts pay between $500 and $1,700 a month for their family’s health benefits.

With healthcare costs soaring, holding the line on health insurance premiums should be a priority for teachers, even if it means accepting a smaller pay increase, Harwell said.

“Because if you open that floodgate, then when does it stop? Like, it’s $50 now, but next year it’s going to be $100, then $200, then $300 and then whatever we get in COLA (cost-of-living adjustment) will be eaten up by the amount of money we’re paying for our benefits,” she said.

Districts could share costs

Bruno said the share of health insurance costs covered by school districts declined during the early 2000s. The trend leveled off around 2012, however, as California increased state funding for education. Since then, school districts have consistently covered about 85% of employee health benefit costs, he said.

But, this school year some districts have asked teachers to pay more for their health insurance.

Peske said shifting more healthcare costs onto teachers could make it harder for districts to recruit and retain teachers, especially if benefits become less competitive. Instead, she said, district leaders should negotiate for lower-cost insurance plans, seek better rates from providers or partner with other districts to buy insurance at lower prices. The state could also help school districts improve their rates, she added.

“States are in a particularly unique and favorable position to negotiate better health insurance rates for their employees,” Peske said. “So, for example, the state of North Carolina provides state-level health insurance. So, they’re able to negotiate a plan with much better rates since they have many more employees, obviously, than a single district does.”

Peske acknowledges that a statewide program could be difficult in California, where each district has its own collective bargaining agreement with its teachers.

"We were more worried about getting crushed by slabs or getting cut with blades and stuff like that," he says, "not getting a lung disease."

He says he made some countertops out of granite, but mostly he cut "quartz," a popular composite made by factories that take bits of quartz mined from quarries and mix it with binders and pigments. Compared to granite or marble, manufactured quartz contains far more of the mineral silica — and silica dust can cause lung damage if you breathe it in.

That danger has become dramatically clear in California, where officials have been grappling with an epidemic of silicosis, an irreversible lung disease. They've tracked over 550 sickened countertop workers, almost all Hispanic men, with most of the cases emerging over the last few years. Over 30 workers have died, and more than 50 have had lung transplants, according to a public dashboard where the numbers keep going up.

On May 21, a workplace safety board in California will vote on whether the state should ban the cutting of high-silica quartz countertop material, as a group of doctors has petitioned the state to do. Those doctors say the severity of workers' disease suggests that it's caused by exposure to toxic ingredients in addition to silica, like pigments or resins.

Rebecca Shult, a lawyer for the major quartz company Cambria, said in a March hearing that her company objected to the idea that any one subset of silica-containing products was to blame. "For this reason, we take issue with the very nomenclature of 'engineered stone silicosis'" used on California's disease-tracking dashboard, she said.

Meanwhile, other states — like Hanicker's home state of Florida — haven't reported seeing large numbers of countertop workers getting sick.

"Please keep in mind, there is only a handful of silicosis cases in the other 49 states," Shult told lawmakers in Congress during a hearing earlier this year.

But David Michaels, an epidemiologist with George Washington University and an expert on workplace safety, says California is seeing a large number of sick workers because it's been actively and thoroughly looking for cases, unlike other states.

Thousands of countertop workers across the country likely have unrecognized lung damage, says Michaels.

"We could easily have 10,000 workers here with silicosis and possibly far more," he says, noting that an estimated 100,000 people work in this industry in the U.S., and studies done in Australia found lung disease in over 10% of the countertop workforce there.

"This is life-changing"

Many doctors aren't familiar with silicosis, says Michaels, and they don't always ask about a person's job. So workers who do seek medical help often get misdiagnosed.

That's what happened to Hanicker about five years ago, when he developed a knot of pain under his shoulder. He took ibuprofen and powered through. When the pain started creeping around his chest, his wife worried about his heart and insisted that he seek emergency care.

"We didn't think," he says, "that it could be, you know, work-related, from the dust."

The doctors took an X-ray, diagnosed pneumonia, and sent him home with antibiotics, which didn't help. Next, he had a CT scan. It found nodules in his lungs, and a biopsy showed silicosis. He remembers breaking down and crying with his wife.

"We realized that, hey, this is life-changing. There is no cure for this," says Hanicker, 39, who suffers from pain, weakness and shortness of breath. Doctors say he'll eventually need a lung transplant, and he also has a silica-related autoimmune disease.

"The two biggest things that hurt me is how it affects my marriage and not being able to be a father the way I want to with my kids," he says, saying he can't play sports with his young children or run along beside them to teach them to ride a bike. He's sued the makers and distributors of quartz slabs.

Quartz manufacturers like Cambria point out that breathing in dust while cutting any high-silica material — such as the natural stone quartzite — can be dangerous. They maintain that their products are safe if the fabrication workshops that cut the slabs use sufficient precautions such as vacuum systems and water sprays to control the dust.

"Workplace safety is a huge thing," says attorney Khaled Taqi-Eddin, who represents Cambria. "If you don't have good workplace safety practices, whether it's a quote-unquote 'natural' stone or whether it's a quartz stone, you are going to end up having people continuously getting sick."

Occupational health experts who have petitioned California to ban quartz, however, say this material "is too toxic to fabricate and install safely, and education and enforcement alone will not be sufficient to curtail the escalating occupational health emergency caused by this product."

A few weeks ago, in the first quartz and silicosis lawsuit to come to trial outside of California, a jury in Colorado awarded damages to an injured worker named Tyler Jordan, finding that actions by several companies led to his illnesses. 

Jordan, in an interview with NPR, said he'd started working in his family's small countertop shop as a teenager and worked full time after graduating from high school. After about a decade, he was diagnosed with silicosis. Shocked, he struggled to believe it was real.

"I felt like I was too young. It felt like there was going to be some sort of mistake. It felt wrong," says Jordan, who had hoped to take over the family business but now can't work anywhere near silica. He developed silica-related kidney failure and had to go on dialysis and have a kidney transplant from his father.

"The worst situation"

One of Jordan's doctors is Cecile Rose, an occupational pulmonologist with National Jewish Health and the University of Colorado in Denver. She was part of a team that reported on some of the first cases of severe silicosis in young U.S. countertop workers.

Back then, in 2019, she'd seen seven cases in Colorado — including a couple of women who worked as cleaners and got exposed when they swept up silica dust. The severity of the disease and the young age of the victims alarmed Rose.

Now, she and other doctors have seen about 20 cases in their state, she says. And she and her colleagues created a voluntary registry where doctors can share their experiences. 

"We have cases from Illinois, from Missouri, Montana, New Mexico, South Carolina, Wyoming," says Rose, adding that this effort is scattershot, because physicians hear about it through word of mouth.

James Nevin, an attorney whose firm represents both Jordan and Hanicker, says he and his colleagues represent other workers in about 25 states, and there are reasons why countertop laborers wouldn't want to talk to reporters, lawyers, or doctors. "They're terrified of losing their jobs, if they are still able to work. They're terrified of being deported," he says. "They're afraid to come forward."

In December, Massachusetts made headlines when that state announced its first case. Since then, state officials have found two more.

New York Department of Health officials, meanwhile, told NPR that they knew of only four cases in their state. Officials in Washington state similarly knew of four cases of silica-related lung disease that occurred across three different businesses handling quartz. At one countertop-maker in Chicago, federal inspectors found several cases.

"I'm 100% sure that there are many more cases in Florida, and New York, and probably every state in this country," says Rose.

"This is the worst situation I've seen affecting a workforce in my 35 years," says Kurt Hegmann, director of the Rocky Mountain Center for Occupational and Environmental Health in Utah.

He says sick workers have started showing up in clinics in his state and that although no one knows how many cases there are in Utah because it's not being systematically tracked, "we know that in a case of one of the fabricators, that 38% of the workforce is affected."

"I believe that California is actually leading the country, correctly, in how to address this problem," says Hegmann.

"We're probably missing 95%"

In 2023, because of concerns about silicosis in this industry, the Department of Labor's Occupational Safety and Health Administration started a targeted inspection program. Since then, its staff has inspected over 400 countertop workplaces in at least 25 states, effectively checking the worksites of more than 7,500 workers, according to a spokesperson with the Department of Labor who shared details about the program's findings.

There's a procedure for sampling airborne silica, and it turns out that about 20% of the samples taken during this inspection program were high enough to exceed the "permissible exposure limit," which is the maximum that workers can be legally exposed to, the spokesperson told NPR.

What's more, 33% of the samples collected during this program were above the "action level" for silica. That's the level that requires employers to take additional precautions like health screenings for workers and increased air testing.

But inspectors also issued over 75 citations for lack of medical surveillance of workers, according to the Department of Labor spokesperson, who added "there is evidence from publicly available research that demonstrates there is a general lack of medical surveillance occurring related to silica exposure."

Kenneth Rosenman, an expert on silicosis and workplace disease at Michigan State University, points to a recent survey showing most countertop shops don't offer medical exams to their workers.

Plus, studies have highlighted the inadequacies of the federal system for trying to collect data on nonfatal workplace accidents or illnesses, he says.

"We have a lousy system that is dependent on employer reporting," says Rosenman. "We're missing at least half of the work-related amputations in the country that occur. We're probably missing 95% of the cases of silicosis that occur in the country."

The situation in California is truly concerning, he says: "This is nothing that I've ever personally seen in my 43 years of working with silicosis."

But to know how widespread lung damage is in the U.S. countertop industry, he says, "we need somebody to go out and do a survey of fabricators in multiple states — a sample — and see how many people actually have the disease that we're not aware of."

Michaels, who used to direct the Department of Labor's Occupational Safety and Health Administration, says that this is the kind of study that a research agency called the National Institute for Occupational Safety and Health could do, but the current administration fired almost all of its staff — those positions were reinstated earlier this year — and wanted to cut its budget by about 80%, although Congress didn't go along with that.

He thinks that unless something drastic is done to reduce worker exposures, the numbers will continue to rise. That's why he favors the ban on quartz being considered in California this week.

"There is no reason," says Michaels, "to think that workers doing the same work in other states will avoid the same terrible consequences that workers in California are facing."

As Christine Ruiz sits in an exam room for some aesthetic skin treatments, she looks nervous. She's not new to injectables like Botox, but this is the first time she's received them at a Planned Parenthood clinic.

"So, I usually do the elevens and then across the forehead. I really like the little lip flip," Ruiz says to her clinician, describing what she wants done.

The Sacramento clinic is part of Planned Parenthood Mar Monte, the largest Planned Parenthood affiliate in the country, covering Northern California and parts of Nevada.

It has started offering a new set of services, ranging from Botox to IV hydration for skin rejuvenation, or for after a night of drinking, all of which patients pay for with cash. They can also request sedation for certain procedures, like the placement of an intrauterine device.

The shift comes as Planned Parenthood faces financial uncertainty after President Donald Trump and Congress stripped funding for the abortion-rights organization as part of the tax and spending package passed last year. The cuts, which prevent Planned Parenthood and other organizations that perform abortions from accepting Medicaid as payment for non-abortion services, are set to expire this summer. Congress could renew them for another year.

The affiliate says about 75 to 80% of its patients are on Medi-Cal, California's Medicaid program. Revenue from the new offerings could allow the affiliate to continue providing reproductive healthcare while it tries to fill the funding gap.

"I'm really excited by the idea of patients coming to us because it's a way they can support us financially. I think that's exciting and we get to hear their stories," says Dr. Laura Dalton, the Chief Medical Operating Officer of Planned Parenthood Mar Monte.

The affiliate has closed five clinics since the cuts.

"It is spicy," Ruiz says, trying not to flinch as the needle pokes her upper lip.

She says she relied on Planned Parenthood for access to birth control and reproductive healthcare when she was younger. She's now in her early 50s.

"I felt respected. I felt supported. I felt like the care that I got was without judgment," Ruiz says. "So, when the opportunity came up, I was like, 'Sure, why not support that?'"

Planned Parenthood charges $9 per unit of Botox, which, depending on location, could be 25 to 50% cheaper than other providers.

California Gov. Gavin Newsom, a Democrat, and state lawmakers have allocated hundreds of millions of dollars in state funding to Planned Parenthood and other organizations like it since the federal cuts, including $90 million in February.

The organization's leaders, though, say it isn't clear whether that will cover costs for core services, including cancer screenings, STI testing and contraceptive care, in the long run if Congress reinstates cuts.

That spending has sparked a backlash among politicians and groups opposing abortion rights. "We'd be shocked if California taxpayers support Gavin Newsom's $90 million 'Botox bailout' for Planned Parenthood, which happens to be a key backer of California Democrats," wrote Marjorie Dannenfelser, the president of Susan B. Anthony Pro-Life America, an anti-abortion lobbying group, in a statement to NPR.

According to Dalton, the affiliate's providers are seeing a spiked interest in aesthetic services, many for cosmetic reasons. But, she points out, Botox can also be used for migraines and gender affirming care. These aesthetic services, she says, are a way for patients to exercise bodily autonomy.

But that argument doesn't sit well with some who support the organization's overall mission.

"I'm concerned about creating a closer association between anti-aging procedures like Botox and feminism," says Jessica DeFino, a beauty critic and author of the popular Substack beauty newsletter called Flesh World.

"I think Planned Parenthood is associated, you know, rightly, in the cultural imagination with women's rights, with feminism," DeFino says. "I don't think the aesthetic use of Botox is really in line with the push for freedom from gender-based discrimination."

Planned Parenthood Mar Monte says this shift is about making sure reproductive care remains available.

While the affiliate offers Botox and IV hydration at select locations for now, it's exploring an expansion into cosmetic fillers and GLP-1 weight-loss treatments. Dalton says the new services could serve as a blueprint for other clinics trying to keep their doors open.

The Sacramento LGBT Community Center hosted a groundbreaking ceremony to launch the renovation of its historic Lavender Heights headquarters. 

A gathering of civic leaders, major donors and community partners came together to celebrate a decade-long effort to secure and transform the home for Sacramento’s LGBTQ+ community. 

From a tiny yellow house across from the Mercantile Saloon to its current, two-story 11,250 square foot building on the corner of J street and 20th, the LGBT Center’s CEO David Heitstuman said this renovation is another step to making the center a modern, permanent home for the community.

“At a time when LGBTQ communities across the country are facing renewed attacks on our rights, our health, our visibility and our dignity,” “this building stands as something very, very powerful,” Heitstuman said.

According to Heitstuman, the 100+ year old building has only been majorly renovated once. After the remodeling, it will create more space for community gathering and will expand confidential service spaces for their mental health services, sexual health services and case management.

“When this building is finally completed with the renovation, it will match the scale and dignity of the work that’s been happening in it every single day,” Heitstuman said. “Today, we’re not just breaking ground, but we’re taking the next step forward.”

When the center first opened at its current location, Heitstuman said they didn’t have the capital to get the center off the ground. With the help of former Sacramento Mayor Darrell Steinberg and current city councilmember Eric Guerra, they were able to secure a mortgage for the initial purchase of the building when they didn’t have enough for a down payment.

Guerra said that in the current political climate, increased support for the LGBTQ+ community is necessary.

“We need to stand tall, we need to be speaking up,” Guerra said. “We need to be creating a place of connection and acceptance. And not only that, but encouragement.” 

During the ceremony, Guerra joined Heitstuman, fellow councilmember Phil Pluckebaum, and other community leaders in swinging hammers painted with the colors of the pride flag into a wall that will be torn down during the renovation.

According to Shannon Cosgrove, director of annual and corporate giving at the LGBT Center, they also plan to build a commercial kitchen and to hold nutrition classes in the new center. 

“One of the things that I’m excited about is we have the beautiful farmer’s market out front,” Cosgrove said. “So the idea is that we can have people shop with their EBT or give them a budget… bring them in the kitchen and they can make a healthy meal and teaching elders and young people how to do that.”

CEO of the Sacramento Native American Health Center Britta Guerrero said her support for the LGBT Center was about just being a good neighbor. 

“Intersectionality is what brings us all together. We stand right in the middle of Midtown, the Native American Health Center and the LGBT Center, in proximity, visibility and glory,” Guerrero said. “I can’t pretend to know everything about every community, but I do know when we stand together, we’re so much more powerful.”

Through the renovation period, which is expected to last through the fall, the center has temporarily relocated all of its services around the corner to 2031 K street until construction is complete.

With his headphones on and his face inches away from an iPad, Kate Brody’s first grade son was so engrossed that he didn’t realize he had to go to the bathroom. 

He didn’t used to have accidents. But when screen time started to ramp up in his Los Angeles Unified School District classroom, that started to change. Now, Brody said, “he literally cannot tell that he has to go to the bathroom because he’s so overstimulated.” 

“It’s addictive. It’s colorful. It’s meant to appeal to kids like candy,” she said. And while her son can’t connect the dots, he does feel embarrassed when his mom picks him up, a change of clothes in hand.

While a district spokesperson said that LAUSD “prioritizes screen value” — meaning technology “supports learning rather than how long it is used” — some parents like Brody aren’t convinced. 

Brody joined Schools Beyond Screens, a coalition of LAUSD parents advocating for limits on classroom screen time, an issue expected to come before the school board in April, reflecting growing concerns about how heavy device use affects students’ learning, behavior and mental health. 

If the resolution passes, it would require officials to set daily and weekly caps, to be approved by June and implemented the following school year. 

The coalition is trying to “lobby the district to rethink some of this stuff,” Brody said, “and maybe put a tech policy in place for the first time that would outline healthy, safe, responsible use of technology so that we’re using tech in a way that’s effective — and not in a way that’s harmful and detrimental to kids’ cognitive and mental health.” 

Many teachers and parents say that the district’s cellphone ban last year has been ineffective. 

Vincent Kirk, an 11th grade English teacher at Belmont High School, asked his students, “Just for my own curiosity, how many of you have access to your phones right now?” 

“And every single student will raise their hand.” 

Students are often required to store their phones in magnetically sealed pouches, such as Yondr pouches. Kirk said students would place dummy phones inside or force the pouch open to access their devices. 

Some students also take extended bathroom breaks to use their phones, and others bypass school Wi-Fi restrictions by connecting to personal hotspots. 

Challenges in the classroom 

Katie Pace, mother of three LAUSD students, doesn’t see herself as an anti-tech parent. Her children had weathered online learning during the pandemic, but six years later, her eldest is now in the eighth grade and completes all of her assignments on a Chromebook. 

Math problems and science group projects are completed online; essays are in Google Docs and world language is on Duolingo. 

Los Angeles Unified said that while it provides Chromebooks and tablets to students, “decisions about technology use are made at the school level, allowing principals and educators to implement technology in ways that best support their students and instructional goals.” 

LAUSD says screen time is “structured and aligned with instruction,” with elementary students spending roughly 31 to 50 minutes and secondary students between 86 and 128 minutes on a screen during the school day. 

“The District provides guidance and resources to ensure technology is used intentionally, supports effective teaching, and helps students engage with digital tools safely, critically, and responsibly,” a district spokesperson said in a statement to EdSource.  

But Pace said her daughter’s in-class screen use tells another story. Her daughter streams music on Spotify and spends hours watching cat videos and makeup tutorials during class.  

For these reasons, some teachers are changing things. 

Kirk started requiring students to go 100% screen-free during class after he learned most students relied on AI for last year’s midterm papers. He said the first few months of this school year were marked by panic — and relearning basic skills, like how to write on lined paper correctly.  But over time, students’ writing grew deeper and more intentional. Class participation skyrocketed, and students seemed generally calmer. 

What Kirk has observed is consistent with research showing that writing and learning by hand lead to a student’s stronger understanding of material. 

“Teens are at such a high risk of depression and anxiety and addiction, and this is such a crucial special period for them,” Pace said. “This is when they should be talking to each other and looking at their teachers and figuring out who they are.”

Screens at home 

Los Angeles Unified claims screen time using district devices outside the school day is relatively low, averaging between nine and 15 minutes for elementary students and 24 and 44 minutes for those in middle and high school. 

But Julie Edwards, a parent of a kindergartner and fourth grader, disagrees. Her eldest became immediately hooked on screens when she brought home a Chromebook from school. 

“I just thought, ‘I can’t believe they’ve just handed me this massive problem,’ Edwards said.

She tried to hide the device, but that was short-lived because the school was mandating time on iReady. Her daughter would complete her math and then play Minecraft. 

“She comes home, and all that time is spent on a screen,” Edwards said. “And that’s the time we get to be with her.” 

Research has linked excessive screen time to negative impacts on children’s mental health, cognitive development, attention spans and academic performance. Still, LAUSD’s reported usage — in and beyond the school day — is generally consistent with guidance from experts at Children’s Hospital Los Angeles. 

Those experts recommend up to an hour of screen use per day for children age 2 to 5, ideally with an adult present to engage with. For older children and teens, parents should set limits while prioritizing sleep and at least an hour of daily physical activity. 

“Everyone should back up and really try to understand at the system level what the problem is,” said Stephen Aguilar, a professor of education at USC, who added that the challenges could be from the technology itself, or a need for additional training or the way everything is set up. 

“But without taking this exhaustive look of how things are working within a particular learning environment, I think a lot of policies fall short, because they’re not attacking the problem. They’re just attacking what they see as the visible issue.”

Over time, Edward’s daughter grew “really dysregulated,” and they eventually decided to call it quits — with both the device and with the school, transferring her to a tech-free charter school in time for fourth grade. She’s planning to transfer her youngest out of LAUSD, too. 

“Her mood is so much better. She is happy to use her imagination to figure out what to do with her time,” Edwards said, noting that she now will spend time on arts and crafts or go outside.

“She has such an awesome childhood. It’s so idyllic. It’s so much more idyllic than just sitting hunched over, scrolling.”

By Colin Lecher, CalMatters

This story was originally published by CalMatters. Sign up for their newsletters.

A Los Angeles jury has found the parent companies of YouTube and Facebook liable for a teen’s mental distress in a closely-watched trial over social media addiction. 

The jury awarded $3 million to the plaintiff, a young woman identified as KGM, and her mother, according to NPR, which noted Facebook parent company Meta would be responsible for about 70% of that amount and that the companies could face future penalties as well. The family had accused the platforms of willfully making their products addictive and targeting teens, despite internal research showing it could damage their mental health. 

The Los Angeles Superior Court decision is among the first in a wave of hundreds of suits by schools, attorneys general, and others, making personal injury claims about major tech companies’ alleged recklessness. 

A New Mexico jury recently found Meta liable on similar claims and the company was ordered to pay $375 million in damages. Meta said it would appeal that decision. Meanwhile, a case is also ongoing in a federal court based in California.

“We disagree with the verdict and plan to appeal,” José Castañeda, a Google spokesperson, said in a statement. “This case misunderstands YouTube, which is a responsibly built streaming platform, not a social media site.” 

Erin Logan, a spokesperson for Meta, said, “We respectfully disagree with the verdict and are evaluating our legal options.”

Online child safety advocates, meanwhile, immediately cheered the ruling. 

“For too many years, kids have suffered immeasurable harm from social media, while the owners of these tech companies have reaped billions in profits,” John M. Bennett, Director of the California Initiative for Technology and Democracy, said in a statement, calling the tech industry’s business model “fundamentally exploitative, addicting young children in order to create lifelong consumers, no matter the cost to their health or the damage to their lives.”

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In southwest Santa Rosa teenagers skip sports practices to avoid getting burned by the hot turf. Some will end up at the air conditioned mall. In southeast Los Angeles County people wait at unshaded bus stops, covering their faces with umbrellas and bags. 

Temperatures topped 100 degrees in some parts of the state this week — and it’s only March.

Heat doesn’t just disrupt people’s days. It’s dangerous, even fatal.

California leaders have known about the danger of extreme heat for decades, and the state has spent hundreds of millions of dollars on plans to address it. But these plans require little or nothing from state agencies or local governments, and experts say the result is a patchwork response that is leaving the most vulnerable Californians behind. 

The state has made real progress: more messaging and education campaigns, more data and tools to assess the hazard of heat, and targeted grants to local communities. But without a mandate to act, which communities are protected depends on local budgets and political will.

The state’s response remains largely organized around emergency management — mobilizing resources during crises rather than treating heat as the ongoing public health threat that researchers say it is. As climate change drives longer and stronger heat waves beyond the summer season, experts say heat must become a mainstream piece of public health work, with a focus on prevention. 

That’s hard to do. Public health departments are often stretched thin – required to  respond to competing emergencies, outbreaks and other surveillance work –  while facing funding uncertainties.

Dr. David Eisenman, a professor at the UCLA Fielding School of Public Health, said too much heat response work is run by emergency management. “This is really a well-known public health emergency that should be thought of under public health, and they should be the prime movers on this.”

A patchwork response 

Responding to extreme heat requires coordination across multiple levels of government – pulling together state and local emergency services, planning departments and public health. California has a state blueprint, and cities and counties also have plans. But it’s not clear whether any of them are making a big difference for people feeling the burden of heat.

“How we prepare for both more extreme heat and chronically higher everyday temperatures is a test of how we protect health, equity, and community in a warming world,” said Ali Frazzini, a policy director for Los Angeles County’s sustainability office.  

The human cost of the gap is already visible. For every 100,000 residents, 14.4 people visited the emergency room in 2023 for heat-related illness. The state reported 460 deaths linked to extreme heat between 2013 to 2022, although researchers say there are also the deaths that are attributed to other underlying conditions but that may have been exacerbated by heat.

A Norco High School football player takes a break from practice to cool off with ice on his head from the Inland Empire heat in Norco on Aug. 2, 2021.Terry Pierson/MediaNews Group/The Press-Enterprise via Getty Images

A state analysis of one of the most dangerous heat waves in recent years – in September of 2022 – showed a 5% increase in overall deaths during that 10-day period, or 395 more deaths than expected.

Katherine Pocock, a physician assistant and researcher with Healthcare in Action said heat waves add another layer to the many struggles unhoused people already face. During heat waves in Boyle Heights, near downtown, she would make street medicine rounds. When she came across people clearly struggling with an altered state of mind, she would have to figure out if it was a consequence of heat or substance use. 

What homeless patients need most is simple: water and ice. 

“A lot of conversations so far have been around frameworks and strategies,” Pocock said. But she wants actionable steps. “What do I need to do to really be prepared to help support folks?” 

Street medicine providers say they have to fundraise privately to buy patients water.

Hundreds of millions, no mandate

In 2022, Gov. Gavin Newsom announced a commitment to spend $800 million to support programs that protect people from heat along with the state’s overarching heat action plan. The state clawed back part of that, and a large portion of what remains – $351 million – is tied to a 2024 climate bond that hasn’t been fully spent. 

The California Natural Resources Agency, the Strategic Growth Council and the Office of Land Use and Climate Innovation distribute one-time funding to nonprofits and local governments as small one-time grants for projects that align with the state’s four goals: building public awareness, strengthening community services, improving indoor infrastructure and using nature-based solutions to reduce risks outdoors. 

This year, the governor has proposed another $241 million in spending from the bond for heat programs, including $50 million for local heat action plans, $700,000 for green space and $55 million for community resilience centers.

The state points to tangible progress toward its heat response – updated building codes, a real-time dashboard showing community vulnerability and cooling centers, and a second iteration of its plan is in development. 

But the limits of that progress are evident in the details. One law passed last year enshrined into state law residents’ right to a cool living space. But while the state Housing and Community Development Department recommended the state set a maximum indoor temperature standard of 82 degrees for all homes, the law set no requirements for landlords to keep their tenants cool. 

The state’s plan doesn’t direct local governments on specific action because every region has unique challenges. Amanda Hansen, deputy secretary for climate change with the state Natural Resources Agency, said that’s by design.

“I don’t think that the state would ever put forward ‘this is what all local extreme heat action plans should look like or should contain,’ because it’s going to be really different depending on their needs and their challenges,” Hansen said. 

Local organizers say they appreciate the state’s financial support, but they want something more lasting. The grants the state distributes – for hydration stations, building shade structures and promoting heat safety education to outdoor workers – help, but they aren’t guidance to local governments or a statewide strategy. 

“If we’re really going to protect our communities from the rising threat of heat, we need to come up with an integrated model,” said Enrique Huerta of Climate Resolve, a group that is working alongside Los Angeles County in one of the state-funded projects.  

Counties and cities don’t just need some guidance, says Agustin Cabrera, Deputy Director of Programs and Policy for the nonprofit Strategic Concepts in Organizing and Policy Education. They need funding.

“Not all of them are resourced enough to develop a heat action plan,” he said.

Local governments fill the void

Local governments are stepping up on heat resilience, but uncertain state and federal support constrain even the most committed cities and counties. 

Los Angeles County has gone further than most. It has approved a policy to require that landlords maintain homes in unincorporated areas at or below 82 degrees starting in 2027 – which goes a step further than the state.  As part of its heat action plan published recently, county officials are also surveying nonprofits about serving as cooling centers and helping cities develop their own cool housing policies.

The city of Los Angeles is exploring a similar policy. But its budget problems are undermining its ambitions. Mayor Karen Bass recently proposed cutting the city’s Office of Climate Emergency Mobilization, led by the first chief heat officer in the city, Marta Segura. Segura’s office received $750,000 from the state to develop a heat action plan. Advocates pushed back, and the city changed course, but Segura’s role was ultimately moved to the city’s Emergency Management Department.

Some communities with longer experience managing extreme heat have developed more robust systems. Fresno makes public transit free during heat waves, removing a barrier for residents who need to reach cooling centers. The county also coordinates with social service providers to reach vulnerable clients — including people with disabilities — when temperatures spike.

Heat doesn’t have a home 

The structural problem, researchers say, is that no one single agency owns the issue – and that’s true around the country.

In Arizona, Maricopa County and Phoenix treat heat as a seasonal chronic health hazard, and the state has a heat officer – located in the health services department. In New Jersey, the state resilience officer handles heat as a health problem – within its environment department. And while the city of Miami has a heat officer, the state of Florida has banned cities and counties from establishing heat protections for workers. 

In California, the state Department of Public Health collects data and offers guidance to counties and cities, but hands out no funding for the extreme heat action plan. 

Local public health departments have largely focused on managing heat crises — surveillance systems, advisories, educational campaigns — rather than building long-term resilience. That’s left to land use and urban planning departments.

“Very, very few public health departments are engaged in more long term resilience, sustainability efforts,” said Kelly Turner, Associate Director at the UCLA Luskin Center for Innovation. WIth tight budgets and competing demands that’s unlikely to change on its own. 

According to a national survey of public health professionals last month, extreme heat is a growing concern – but states are generally unprepared or underresourced to address its threats. More than half of local public health associations said barriers to addressing heat included a lack of understanding of heat-related solutions, competing priorities and funding.

“It’s not like the Department of Heat, right?” said Turner. “Heat doesn’t have a home.”

Supported by the California Health Care Foundation (CHCF), which works to ensure that people have access to the care they need, when they need it, at a price they can afford. Visit www.chcf.org to learn more.

This story was originally published by CalMatters. Sign up for their newsletters.

A booming industry that charges veterans for help in obtaining the benefits they earned through military service must shut down or dramatically change its business model in California by the end of the year under a new law Gov. Gavin Newsom signed today.

The law prohibits unaccredited private companies from billing former military service members for help with their Department of Veterans Affairs claims.

Technically, it was already illegal under federal law to charge veterans for that work, but Congress 20 years ago removed criminal penalties for violations, and scores of private companies emerged, offering to speed up and maximize benefit claims. 

“We owe our veteran community a debt of gratitude — for their years of service and sacrifice,” Newsom said in a written statement. “By signing this bill into law, we are ensuring veterans and service members get to keep more money in their pockets, and not line the coffers of predatory actors. We are closing this federal fraud loophole for good.”

Critics call the private companies “claim sharks” because their fees are often five times the monthly benefit increase veterans obtain after using their services. CalMatters in September, for instance, interviewed a Vietnam-era veteran who was billed $5,500 after receiving benefits that would pay him $1,100 a month.

Depending on a disability rating, a claim consulting fee under that model could easily hit $10,000 or more.

“We owe it to our veterans to stand with them and to protect them from being taken advantage of while navigating the benefits they’ve earned,” said Sen. Bob Archuleta, a Democrat representing Norwalk. Archuleta, a former Army officer, carried the legislation. “This is not about politics; it’s about doing what’s right. Making millions of dollars on the back of our veterans is wrong. They’ve earned their benefits. They deserve their benefits.”

California’s new law is part of a tug-of-war over how to regulate claims consulting companies. Congress for several years has been at a stalemate on whether to ban them outright, allow them to operate as they are or regulate them in some other way.

California is among 11 states that have moved to put the companies out of business, while another group of mostly Republican-led states has legalized them, according to reporting by the veteran news organization The War Horse. 

That split in some ways reflects the different ways veterans themselves view the companies. The bill had overwhelming support from organizations that help veterans file benefits claims at no cost, such as the American Legion and Veterans of Foreign Wars, as well as from Democratic Party leaders, including former House Speaker Nancy Pelosi of San Francisco.

But the VA’s claims process can take months and sow uncertainty among applicants. Several of the claims consulting companies say they have helped tens of thousands of veterans across the country, and that they have hundreds of employees.

Those trends led some lawmakers to vote against the measure, including Democrats with military backgrounds.

“We’re going to say to you, ‘Veteran, you know what, I don’t know if you are too stupid or too vulnerable or your judgment is so poor you can’t choose yourself,” said Sen. Tom Umberg, a Democrat and former Army colonel, during a debate over the measure last month, 

The new law was such a close call for lawmakers that nine of 40 senators did not vote on it when it passed that chamber last month, which counts the same as a “no” vote but avoids offending a constituency that the lawmaker wants to keep.

It was also one of the 10 most-debated measures to go before the Legislature last year, according to the CalMatters Digital Democracy database. Lawmakers spent 4 hours and 39 minutes on the bill at public hearings in 2025 and heard testimony from 99 speakers. 

Two claims consulting companies spent significant sums hiring lobbyists as they fought the bill, according to state records. They were Veterans Guardian, a North Carolina-based company that spent $150,000 on California lobbyists over the past two years; and Veterans Benefit Guide, a Nevada-based company that spent $371,821 lobbying on Archuleta’s bill and a similar measure that failed in 2024.

Those companies view laws like California’s as an existential threat. Both have founders with military backgrounds. Veterans Benefit Guide sued to block New Jersey’s law prohibiting fees for veterans claim consulting, and a federal appeals court sided with the company last year.

“This was the hardest bill I’ve had to work on since I’ve been in the Legislature,” said Assemblymember Pilar Schiavo, a Santa Clarita Democrat who supported the law. “We know why that is, because there was so much money on the other side.”

Charlotte Autolino, who organizes job fairs for former military service members as the chairperson of the Veterans Employment Committee of San Diego, criticized Newsom’s decision to sign the law. She spoke to CalMatters on behalf of Veterans Benefit Guide.

“The veterans lose,” she said. They lose the option. You’re taking an option away from them and you’re putting all of the veterans into one box, and that to me is wrong.”

But David West, a Marine veteran who is Nevada County’s veterans service officer, commended Newsom. West was one of the main advocates for the new law.

“The veterans of California are going to know that when (Newsom) says he’s taking care of everybody, he’s including us; that he values those 18- and 19-year-olds who are raising their hands, writing a blank check in the form of their lives; to then ensure that they aren’t writing checks to access their benefits,” West said.

By KAITLYN HUAMANI and BARBARA ORTUTAY, Associated Press

LOS ANGELES (AP) — Comparing social media platforms to casinos and addictive drugs, lawyer Mark Lanier delivered opening statements Monday in a landmark trial in Los Angeles that seeks to hold Instagram owner Meta and Google's YouTube responsible for harms to children who use their products.

Instagram's parent company Meta and Google's YouTube face claims that their platforms addict children through deliberate design choices that keep kids glued to their screens. TikTok and Snap, which were originally named in the lawsuit, settled for undisclosed sums.

Jurors got their first glimpse into what will be a lengthy trial characterized by dueling narratives from the plaintiffs and the two remaining defendants.

Meta lawyer Paul Schmidt spoke of the disagreement within the scientific community over social media addiction, with some researchers believing it doesn’t exist, or that addiction is not the most appropriate way to describe heavy social media use.

Lawyers representing YouTube will begin their opening statement on Tuesday.

‘Addicting the brains of children’

Lanier, the plaintiff's lawyer, delivered lively first remarks where he said the case will be as “easy as ABC” — which stands for “addicting the brains of children.” He said Meta and Google, “two of the richest corporations in history,” have “engineered addiction in children’s brains.”

He presented jurors with a slew of internal emails, documents and studies conducted by Meta and YouTube, as well as YouTube’s parent company, Google. He emphasized the findings of a study Meta conducted called “Project Myst” in which they surveyed 1,000 teens and their parents about their social media use. The two major findings, Lanier said, were that Meta knew children who experienced “adverse events” like trauma and stress were particularly vulnerable for addiction; and that parental supervision and controls made little impact.

He also highlighted internal Google documents that likened some company products to a casino, and internal communication between Meta employees in which one person said Instagram is “like a drug” and they are “basically pushers.”

At the core of the Los Angeles case is a 20-year-old identified only by the initials “KGM,” whose case could determine how thousands of other, similar lawsuits against social media companies will play out. She and two other plaintiffs have been selected for bellwether trials — essentially test cases for both sides to see how their arguments play out before a jury.

Plaintiff grew up using YouTube, Instagram

KGM made a brief appearance after a break during Lanier’s statement and she will return to testify later in the trial. Lanier spent time describing KGM's childhood, focusing particularly on what her personality was like before she began using social media. She started using YouTube at age 6 and Instagram at age 9, Lanier said. Before she graduated elementary school, she had posted 284 videos on YouTube.

The outcome of the trial could have profound effects on the companies' businesses and how they will handle children using their platforms.

Lanier said the companies’ lawyers will “try to blame the little girl and her parents for the trap they built,” referencing the plaintiff. She was a minor when she said she became addicted to social media, which she claims had a detrimental impact on her mental health.

Lanier said that despite the public position of Meta and YouTube being that they work to protect children, their internal documents show an entirely different position, with explicit references to young children being listed as their target audiences.

The attorney also drew comparisons between the social media companies and tobacco firms, citing internal communication between Meta employees who were concerned about the company’s lack of proactive action about the potential harm their platforms can have on children and teens.

“For a teenager, social validation is survival,” Lanier said. The defendants “engineered a feature that caters to a minor’s craving for social validation,” he added, speaking about “like” buttons and similar features.

Meta pushes back

In his opening statement representing Meta, Schmidt said the core question in the case is whether the platforms were a substantial factor in KGM’s mental health struggles. He spent much of his time going through the plaintiff’s health records, emphasizing that she had experienced many difficult circumstances in her childhood, including emotional abuse, body image issues and bullying.

Schmidt presented a clip from a video deposition from one of KGM‘s mental health providers, Dr. Thomas Suberman, who said social media was “not the through-line of what I recall being her main issues,” adding that her struggles seemed to largely stem from interpersonal conflicts and relationships. He painted a picture — with KGM’s own text messages and testimony pointing to a volatile home life — of a particularly troubled relationship with her mother.

Schmidt acknowledged that many mental health professionals do believe social media addiction can exist, but said three of KGM’s providers — all of whom believe in the form of addiction — have never diagnosed her with it, or treated her for it.

Schmidt emphasized to the jurors that the case is not about whether social media is a good thing or whether teens spend too much time on their phones or whether the jurors like or dislike Meta, but whether social media was a substantial factor in KGM’s mental health struggles.

A reckoning for social media and youth harms

A slew of trials beginning this year seek to hold social media companies responsible for harming children's mental well-being. Executives, including Meta CEO Mark Zuckerberg, are expected to testify at the Los Angeles trial, which will last six to eight weeks. Experts have drawn similarities to the Big Tobacco trials that led to a 1998 settlement requiring cigarette companies to pay billions in health care costs and restrict marketing targeting minors.

A separate trial in New Mexico, meanwhile, also kicked off with opening statements on Monday. In that trial, Meta is accused of failing to protect young users from sexual exploitation, following an undercover online investigation. Attorney General Raúl Torrez in late 2023 sued Meta and Zuckerberg, who was later dropped from the suit.

A federal bellwether trial beginning in June in Oakland, California, will be the first to represent school districts that have sued social media platforms over harms to children.

In addition, more than 40 state attorneys general have filed lawsuits against Meta, claiming it is harming young people and contributing to the youth mental health crisis by deliberately designing features on Instagram and Facebook that addict children to its platforms. The majority of cases filed their lawsuits in federal court, but some sued in their respective states.

TikTok also faces similar lawsuits in more than a dozen states.

Ortutay reported from Oakland, California. Associated Press Writer Morgan Lee in Santa Fe, New Mexico, contributed to this story.

Lydia Romero strained to hear her husband’s feeble voice through the phone.

A week earlier, immigration agents had grabbed Julio César Peña from his front yard in Glendale, California. Now, he was in a hospital after suffering a ministroke. He was shackled to the bed by his hand and foot, he told Romero, and agents were in the room, listening to the call. He was scared he would die and wanted his wife there.

“What hospital are you at?” Romero asked.

“I can’t tell you,” he replied.

Viridiana Chabolla, Peña’s attorney, couldn’t get an answer to that question, either. Peña’s deportation officer and the medical contractor at the Adelanto ICE Processing Center refused to tell her. Exasperated, she tried calling a nearby hospital, Providence St. Mary Medical Center.

“They said even if they had a person in ICE custody under their care, they wouldn’t be able to confirm whether he’s there or not, that only ICE can give me the information,” Chabolla said. The hospital confirmed this policy to KFF Health News.

Family members and attorneys for patients hospitalized after being detained by federal immigration officials said they are facing extreme difficulty trying to locate patients, get information about their well-being, and provide them emotional and legal support. They say many hospitals refuse to provide information or allow contact with these patients. Instead, hospitals allow immigration officers to call the shots on how much — if any — contact is allowed, which can deprive patients of their constitutional right to seek legal advice and leave them vulnerable to abuse, attorneys said.

Hospitals say they are trying to protect the safety and privacy of patients, staff, and law enforcement officials, even while hospital employees in Los Angeles, Minneapolis, and Portland, Ore., cities where Immigration and Customs Enforcement has conducted immigration raids, say it’s made their jobs difficult. Hospitals have used what are sometimes called blackout procedures, which can include registering a patient under a pseudonym, removing their name from the hospital directory, or prohibiting staff from even confirming that a patient is in the hospital.

“We’ve heard incidences of this blackout process being used at multiple hospitals across the state, and it’s very concerning,” said Shiu-Ming Cheer, the deputy director of immigrant and racial justice at the California Immigrant Policy Center, an advocacy group.

Some Democratic-led states, including California, Colorado, and Maryland, have enacted legislation that seeks to protect patients from immigration enforcement in hospitals. However, those policies do not address protections for people already in ICE custody.

More Detainees Hospitalized

Peña is among more than 350,000 people arrested by federal immigration authorities since President Donald Trump returned to the White House. As arrests and detentions have climbed, so too have reports of people taken to hospitals by immigration agents because of illness or injury — due to preexisting conditions or problems stemming from their arrest or detention.

ICE has faced criticism for using aggressive and deadly tactics, as well as for reports of mistreatment and inadequate medical care at its facilities. Sen. Adam Schiff (D-Calif.) told reporters at a Jan. 20 news conference outside a detention center he visited in California City that he spoke to a diabetic woman held there who had not received treatment in two months.

While there are no publicly available statistics on the number of people sick or injured in ICE detention, the agency’s news releases point to 32 people who died in immigration custody in 2025. Six more have died this year.

The Department of Homeland Security, which oversees ICE, did not respond to a request for information about its policies or Peña’s case.

According to ICE’s guidelines, people in custody should be given access to a telephone, visits from family and friends, and private consultation with legal counsel. The agency can make administrative decisions, including about visitation, when a patient is in the hospital, but should defer to hospital policies on contacting next of kin when a patient is seriously ill, the guidelines state.

Asked in detail about hospital practices related to patients in immigration custody and whether there are best practices that hospitals should follow, Ben Teicher, a spokesperson for the American Hospital Association, declined to comment.

David Simon, a spokesperson for the California Hospital Association, said that “there are times when hospitals will — at the request of law enforcement — maintain confidentiality of patients’ names and other identifying characteristics.”

Although policies vary, members of the public can typically call a hospital and ask for a patient by name to find out whether they’re there, and often be transferred to the patient’s room, said William Weber, an emergency physician in Minneapolis and medical director for the Medical Justice Alliance, which advocates for the medical needs of people in law enforcement custody. Family members and others authorized by the patient can visit. And medical staff routinely call relatives to let them know a loved one is in the hospital, or to ask for information that could help with their care.

But when a patient is in law enforcement custody, hospitals frequently agree to restrict this kind of information sharing and access, Weber said. The rationale is that these measures prevent unauthorized outsiders from threatening the patient or law enforcement personnel, given that hospitals lack the security infrastructure of a prison or detention center. High-profile patients such as celebrities sometimes also request this type of protection.

Several attorneys and health care providers questioned the need for such restrictions. Immigration detention is civil, not criminal, detention. The Trump administration says it’s focused on arresting and deporting criminals, yet most of those arrested have no criminal conviction, according to data compiled by the Transactional Records Access Clearinghouse and several news outlets.

Julio Cesar Peña, who has terminal kidney disease, sits on his bike in the backyard of his home in Glendale, California. His family had a hard time locating him when he was hospitalized after being detained by Immigration and Customs Enforcement.Courtesy of the Peña Family

Taken Outside His Home

According to Peña’s wife, Romero, he has no criminal record. Peña came to the United States from Mexico in sixth grade and has an adult son in the U.S. military. The 43-year-old has terminal kidney disease and survived a heart attack in November. He has trouble walking and is partially blind, his wife said. He was detained Dec. 8 while resting outside after coming home from dialysis treatment.

Initially, Romero was able to find her husband through the ICE Online Detainee Locator System. She visited him at a temporary holding facility in downtown Los Angeles, bringing him his medicines and a sweater. She then saw he’d been moved to the Adelanto detention center. But the locator did not show where he was after he was hospitalized.

When she and other relatives drove to the detention facility to find him, they were turned away, she said. Romero received occasional calls from her husband in the hospital but said they were less than 10 minutes long and took place under ICE surveillance. She wanted to know where he was so she could be at the hospital to hold his hand, make sure he was well cared for, and encourage him to stay strong, she said.

Shackling him and preventing him from seeing his family was unfair and unnecessary, she said.

“He’s weak,” Romero said. “It’s not like he’s going to run away.”

ICE guidelines say contact and visits from family and friends should be allowed “within security and operational constraints.” Detainees have a constitutional right to speak confidentially with an attorney. Weber said immigration authorities should tell attorneys where their clients are and allow them to talk in person or use an unmonitored phone line.

Hospitals, though, fall into a gray area on enforcing these rights, since they are primarily focused on treating medical needs, Weber said. Still, he added, hospitals should ensure their policies align with the law.

Family Denied Access

Numerous immigration attorneys have spent weeks trying to locate clients detained by ICE, with their efforts sometimes thwarted by hospitals.

Nicolas Thompson-Lleras, a Los Angeles attorney who counsels immigrants facing deportation, said two of his clients were registered under aliases at different hospitals in Los Angeles County last year. Initially, the hospitals denied the clients were there and refused to let Thompson-Lleras meet with them, he said. Family members were also denied access, he said.

One of his clients was Bayron Rovidio Marin, a car wash worker injured during a raid in August. Immigration agents surveilled him for over a month at Harbor-UCLA Medical Center, a county-run facility, without charging him.

In November, the Los Angeles County Board of Supervisors voted to curb the use of blackout policies for patients under civil immigration custody at county-run hospitals. In a statement, Arun Patel, the chief patient safety and clinical risk management officer for the Los Angeles County Department of Health Services, said the policies are designed to reduce safety risks for patients, doctors, nurses, and custody officers.

“In some situations, there may be concerns about threats to the patient, attempts to interfere with medical care, unauthorized visitors, or the introduction of contraband,” Patel said. “Our goal is not to restrict care but to allow care to happen safely and without disruption.”

Leaving Patients Vulnerable

Thompson-Lleras said he’s concerned that hospitals are cooperating with federal immigration authorities at the expense of patients and their families and leaving patients vulnerable to abuse.

“It allows people to be treated suboptimally,” Thompson-Lleras said. “It allows people to be treated on abbreviated timelines, without supervision, without family intervention or advocacy. These people are alone, disoriented, being interrogated, at least in Bayron’s case, under pain and influence of medication.”

Such incidents are alarming to hospital workers. In Los Angeles, two health care professionals who asked not to be identified by KFF Health News, out of concern for their livelihoods, said that ICE and hospital administrators, at public and private hospitals, frequently block staff from contacting family members for people in custody, even to find out about their health conditions or what medications they’re on. That violates medical ethics, they said.

Blackout procedures are another concern.

“They help facilitate, whether intentionally or not, the disappearance of patients,” said one worker, a physician for the county’s Department of Health Services and part of a coalition of concerned health workers from across the region.

At Legacy Emanuel Medical Center in Portland, nurses publicly expressed outrage over what they saw as hospital cooperation with ICE and the flouting of patient rights. Legacy Health has sent a cease and desist letter to the nurses’ union, accusing it of making “false or misleading statements.”

“I was really disgusted,” said Blaire Glennon, a nurse who quit her job at the hospital in December. She said numerous patients were brought to the hospital by ICE with serious injuries they sustained while being detained. “I felt like Legacy was doing massive human rights violations.”

Handcuffed While Unconscious

Two days before Christmas, Chabolla, Peña’s attorney, received a call from ICE with the answer she and Romero had been waiting for. Peña was at Victor Valley Global Medical Center, about 10 miles from Adelanto, and about to be released.

Excited, Romero and her family made the two-hour-plus drive from Glendale to the hospital to take him home.

When they got there, they found Peña intubated and unconscious, his arm and leg still handcuffed to the hospital bed. He’d had a severe seizure on Dec. 20, but no one had told his family or legal team, his attorney said.

Tim Lineberger, a spokesperson for Victor Valley Global Medical Center’s parent company, KPC Health, said he could not comment on specific patient cases, because of privacy protections. He said the hospital’s policies on patient information disclosure comply with state and federal law.

Peña was finally cleared to go home on Jan. 5. No court date has been set, and his family is filing a petition to adjust his legal status based on his son’s military service. For now, he still faces deportation proceedings.

At 5 a.m. California time, when it is still dark outside, a member of the state's Department of Public Health gets on a weekly call.

The topic? Health emergencies all over the world.

For years, the U.S. federal government participated in these calls, which are organized by the World Health Organization. Now, as the Trump administration says it has withdrawn from WHO over its handling of COVID, among other things, California is stepping in.

It is the first state to join WHO's Global Outbreak Alert & Response Network, also known as GOARN. Dr. Erica Pan, director of the California Department of Public Health, says she's been in touch with other states hoping to follow suit. Illinois, in a press release, said it's "making preparations" to join.

"The Trump administration's withdrawal from WHO is a reckless decision that will hurt all Californians and Americans," said California Gov. Gavin Newsom in a statement. "California will not bear witness to the chaos this decision will bring."

This move by states to take things into their own hands is part of a broader trend, according to Dr. Gavin Yamey, a professor of global health and public policy at Duke University.

"I think this is a very smart and savvy play," says Yamey. "The federal government has reneged on its public health protection responsibilities, and you're seeing states taking steps so they still are part of the international response to outbreaks and emerging threats."

Not quite a member but still a participant

That doesn't mean California, for example, could become a full-fledged WHO member. Many forums and meetings hosted by WHO are limited to member states — meaning national governments. But some parts of WHO, like GOARN, are open to a broader array of groups, including nonprofit and multinational organizations, academic centers and different levels of governments. Like American states. 

GOARN is made up of over 350 such groups that work together to detect and respond to infectious disease outbreaks and public health emergencies. The network was created in 2000 after leaders realized that a lack of coordination was hindering outbreak response. Since its creation, GOARN has helped organize, analyze and respond to emergencies like SARS, Ebola and mpox.

Members of GOARN participate in weekly calls, get regular outbreak updates and also get access to WHO Epidemic Intelligence from Open Sources platform, which "is continuously scanning global open sources for signals of outbreaks and health events," says Pan. "We're just now getting training and onboarding."

Pan says participating in the network and platform brings better awareness of global health threats — and lets the state respond accordingly. "[It] helps us anticipate threats earlier," says Pan, noting a drop-off in federal health guidance, including the lack of a national flu vaccination campaign this flu season.

Indeed, the U.S. federal government has said it does not plan to continue participating in groups like GOARN. In a statement sent to NPR earlier this month, the U.S. State Department wrote: "The United States will not be participating in regular WHO-led or managed events."

"Charting its own course"

Instead, the U.S. is taking a different approach, pursuing health and aid agreements directly with individual countries. These agreements often include sharing disease outbreak information.

"The United States is charting its own course on global health engagement, grounded in accountability, transparency, and the expertise of America's public health institutions," said a statement from the U.S. Department of Health and Human Services to NPR. "States do not set U.S. foreign policy."

Not everyone agrees with this stance.

Some conservative voices have urged the U.S. to continue participating in certain WHO forums, particularly those that provide information, data and assessments for emerging infectious disease outbreaks. For example, Brett Schaefer — a senior fellow at the right-leaning thinktank the American Enterprise Institute — said, even as the U.S. withdraws from WHO, the U.S. should continue to participate in initiatives like the Epidemic Intelligence from Open Sources platform "to make sure that you have full, robust access to the information."

This type of international platform would be "a very difficult thing for the U.S. to replicate or to try and build outside of the World Health Organization — also [it'd be] somewhat inefficient," says Schaefer.

However, he said over email that the jury is still out on California's decision to join GOARN. "It's interesting but unclear at this point," he wrote, noting that WHO has not clarified California's status. He added: "It also could just be a PR stunt by Newsom."

WHO did not respond to NPR's requests for comment on California's participation in GOARN or any other parts of WHO as well as on other states that have reached out to join.

This new model does have a potential downside — a split between states that join part of WHO and states that don't, says Yamey: "You could end up having this awful, tragic divide" where some state leaders have access to better, more up-to-date outbreak information for making public health decisions than leaders in other states, he says.

Pan says California is hoping to partner with other states that don't join GOARN. "Our intent is really to — acknowledging that we are the biggest state with the largest state health department — step up and provide some leadership."

BATON ROUGE, La. (AP) — Louisiana pushed Tuesday to extradite a California doctor accused of mailing abortion pills, setting up a likely test of laws designed to protect telehealth providers who ship abortion pills nationwide.

This is the second time Louisiana has pursued an out-of-state doctor under its abortion restrictions, with Republican Gov. Jeff Landry saying on social media that he wants to bring the abortion provider “to justice.” The two criminal cases pit Louisiana, which has some of the strictest abortion laws in the country, against jurisdictions that have enacted what are known as shield laws for providers who facilitate abortions from afar in states with bans.

“Louisiana has a zero tolerance policy for those who subvert our laws, seek to hurt women, and promote abortion,” Landry said in a post X announcing he'd sent the extradition paperwork. California Gov. Gavin Newsom’s office did not immediately respond to an email seeking comment

Remy Coeytaux, a physician in the San Francisco Bay Area, faces a criminal charge of abortion by means of abortion-inducing drugs, Louisiana Attorney General Liz Murrill announced Tuesday. If convicted, the doctor could face up to 50 years in jail and fines, Murrill said.

An email and a telephone message seeking comment were left for Coeytaux.

According to court documents, he is accused of mailing mifepristone and misoprostol in 2023 to a Louisiana woman who sought the medication through Aid Access, a European online telemedicine service. The woman took the pills in combination to end her pregnancy, investigators wrote in the indictment, which says authorities confirmed Coeytaux as the sender.

Murrill told The Associated Press she believes this “is not the only time he sent abortion pills into our state” and that “it probably won't be the last time we will indict him.”

The Center for Reproductive Rights, a legal advocacy group that is representing Coeytaux against civil charges, stressed that the criminal charge in Louisiana is an allegation.

“While we can’t comment on this matter itself, one thing is clear — the state of Louisiana is going after doctors for allegedly harming women, yet they are enforcing an abortion ban that puts women’s lives at risk every day,” Nancy Northup, president of the group, said in a written statement.

Coeytaux is also the subject of a separate federal lawsuit filed in July in Texas, where a man alleges the doctor illegally provided abortion medication to his girlfriend.

Medication abortion has been approved by the Food and Drug Administration since 2000. Louisiana bans abortion at all stages of pregnancy with no exceptions for rape or incest. Physicians convicted of providing abortions face up to 15 years in prison and $200,000 in fines. Last year, state lawmakers passed additional restrictions targeting out-of-state prescribers and reclassified mifepristone and misoprostol as controlled dangerous substances.

The law came after an arrest warrant was issued in Louisiana in a separate case for a New York doctor accused of mailing abortion pills to a pregnant minor. In that case, officials said the minor’s mother ordered the medication online and directed her daughter to take it. The mother was later arrested, pleaded not guilty and was released on bond.

That case appeared to be the first of its kind since the U.S. Supreme Court overturned Roe v. Wade.

Louisiana also sought that doctor’s extradition, but New York Gov. Kathy Hochul refused, saying her state’s shield laws were designed to protect providers who offer abortion care to patients in states with bans or where telehealth prescribing is restricted. New York and California are among eight states with such protections, according to the Guttmacher Institute, a research organization that supports abortion rights.

By Christine Mai-Duc and Claudia Boyd-Barrett, KFF Health News

In 2013, before the Affordable Care Act helped millions get health insurance, California’s Placer County provided limited health care to some 3,400 uninsured residents who couldn’t afford to see a doctor.

For several years, that number has been zero in the predominantly white, largely rural county stretching from Sacramento’s eastern suburbs to the shores of Lake Tahoe.

The trend could be short-lived.

County health officials there and across the country are bracing for an estimated 10 million newly uninsured patients over the next decade in the wake of Republicans’ One Big Beautiful Bill Act. The act, which President Donald Trump signed into law this past summer, is also expected to reduce Medicaid spending by more than $900 billion over that period.

“This is the moment where a lot of hard decisions have to be made about who gets care and who doesn’t,” said Nadereh Pourat, director of the Health Economics and Evaluation Research Program at UCLA. “The number of people who are going to lose coverage is large, and a lot of the systems that were in place to provide care to those individuals have either gone away or diminished.”

It’s an especially thorny challenge for states like California and New Mexico where counties are legally required to help their poorest residents through what are known as indigent care programs. Under Obamacare, both states were able to expand Medicaid to include more low-income residents, alleviating counties of patient loads and redirecting much of their funding for the patchwork of local programs that provided bare-bones services.

Placer County, which estimates that 16,000 residents could lose health care coverage by 2028, quit operating its own clinics nearly a decade ago.

“Most of the infrastructure that we had to meet those needs is gone,” said Rob Oldham, Placer County’s director of health and human services. “This is a much bigger problem than it was a decade ago and much more costly.”

In December, county officials asked to join a statewide association that provides care to mostly small, rural counties, citing an expected rise in the number of uninsured residents.

New Mexico’s second-most-populous county, Doña Ana, added dental care for seniors and behavioral health benefits after many of its poorest residents qualified for Medicaid. Now, federal cuts could force the county to reconsider, said Jamie Michael, Doña Ana’s health and human services director.

“At some point we’re going to have to look at either allocating more money or reducing the benefits,” Michael said.

Straining State Budgets

Some states, such as Idaho and Colorado, abandoned laws that required counties to be providers of last resort for their residents. In other states, uninsured patients often delay care or receive it at hospital emergency rooms or community clinics. Those clinics are often supported by a mix of federal, state, and local funds, according to the National Association of Community Health Centers.

Even in states like Texas, which opted not to expand its Medicaid program and continued to rely on counties to care for many of its uninsured, rising health care costs are straining local budgets.

“As we have more growth, more people coming in, it’s harder and harder to fund things that are required by the state legislature, and this isn’t one we can decrease,” said Windy Johnson, program manager with the Texas Indigent Health Care Association. “It is a fiscal issue.”

California lawmakers face a nearly $18 billion budget deficit in the 2026-27 fiscal year, according to the latest estimates by the state’s nonpartisan Legislative Analyst’s Office. Gov. Gavin Newsom, who has acknowledged he is mulling a White House run, has rebuffed several efforts to significantly raise taxes on the ultra-wealthy. Despite blasting the bill passed by Republicans in Congress as a “complete moral failure” that guts health care programs, in 2025 the Democrat rolled back state Medi-Cal benefits for seniors and for immigrants without legal status after rising costs forced the program to borrow $4.4 billion from the state’s general fund.

H.D. Palmer, a spokesperson for the state’s Department of Finance, said that the Newsom administration is still refining its fiscal projections and that it would be “premature” to discuss potential budget solutions.

Newsom will unveil his initial budget proposal in January. State officials have said California could lose $30 billion a year in federal funding for Medi-Cal under the new law, as much as 15% of the state program’s entire budget.

“Local governments don’t really have much capacity to raise revenue,” said Scott Graves, a director at the independent California Budget & Policy Center with a focus on state budgets. “State leaders, if they choose to prioritize it, need to decide where they’re going to find the funding that would be needed to help those who are going to lose health care as a result of these federal funding and policy cuts.”

Reviving county-based programs in the near term would require “considerable fiscal restructuring” through the state budget, the Legislative Analyst’s Office said in an October report.

No Easy Fixes

It’s not clear how many people are currently enrolled in California’s county indigent programs, because the state doesn’t track enrollment and utilization. But enrollment in county health safety net programs dropped dramatically in the first full year of ACA implementation, going from about 858,000 people statewide in 2013 to roughly 176,000 by the end of 2014, according to a survey at the time by Health Access California.

“We’re going to need state investment,” said Michelle Gibbons, executive director of the County Health Executives Association of California. “After the Affordable Care Act and as folks got coverage, we didn’t imagine a moment like this where potentially that progress would be unwound and folks would be falling back into indigent care.”

In November, voters in affluent Santa Clara County approved a sales tax increase, in part to backfill the loss of federal funds. But even in the home of Silicon Valley, where the median household income is about 1.7 times the statewide average, that is expected to cover only a third of the $1 billion a year the county stands to lose.

Health advocates fear that, absent major state investments, Californians could see a return to the previous patchwork of county-run programs, with local governments choosing whom and what they cover and for how long.

In many cases, indigent programs didn’t include specialty care, behavioral health, or regular access to primary care. Counties can also exclude people based on immigration status or income. Before the ACA, many uninsured people who needed care didn’t get it, which could lead to them winding up in ERs with untreated health conditions or even dying, said Kiran Savage-Sangwan, executive director of the California Pan-Ethnic Health Network.

Rachel Linn Gish, interim deputy director of Health Access California, a consumer advocacy group, said that “it created a very unequal, maldistributed program throughout the state.”

“Many of us,” she said. “including counties, are reeling trying to figure out: What are those downstream impacts?”