Science
This rural hospital closed, putting lives at risk. Is it the start of a ‘tidal wave’?
WILLOWS — As hospital staff carted away medical equipment from abandoned patient rooms, Theresa McNabb, 74, roused herself and painstakingly applied make-up for the first time in weeks, finishing with a mauve lipstick that made her eyes pop.
“I feel a little anxiety,” McNabb said. She was still taking multiple intravenous antibiotics for the massive infection that had almost killed her, was unsteady on her feet and was unsure how she was going to manage shopping and cooking food for herself once she returned to her apartment after six weeks in the hospital.
But she couldn’t stay at Glenn Medical Center. It was closing.
The hospital — which for more than seven decades has treated residents of its small farm town about 75 miles north of Sacramento, along with countless victims of car crashes on nearby Interstate 5 and a surprising number of crop-duster pilots wounded in accidents — shut its doors on Oct. 21.
McNabb was the last patient.
Registered nurse Ronald Loewen, 74, checks on one of the last few patients. Loewen, a resident of Glenn County and a former Mennonite school teacher, said the hospital closing is “a piece of our history gone.”
Nurses and other hospital workers gathered at her room to ceremonially push her wheelchair outside and into the doors of a medical transport van. Then they stood on the lawn, looking bereft.
They had all just lost their jobs. Their town had just lost one of its largest employers. And the residents — many of whom are poor— had lost their access to emergency medical care. What would happen to all of them now? Would local residents’ health grow worse? Would some of them die preventable deaths?
These are questions that elected officials and policymakers may soon be confronting in rural communities across California and the nation. Cuts to Medicaid funding and the Affordable Care Act are likely rolling down from Washington, D.C., and hitting small hospitals already teetering at the brink of financial collapse. Even before these cuts hit, a 2022 study found that half of the hospitals in California were operating in the red. Already this fall: Palo Verde Hospital in Blythe filed for bankruptcy and Southern Inyo Hospital in Lone Pine sought emergency funds.
But things could get far worse: A June analysis released by four Democrats in the U.S. Senate found that many more hospitals in California could be at risk of closure in the face of federal healthcare cuts.
“It’s like the beginning of a tidal wave,” said Peggy Wheeler, vice president of policy of the California Hospital Assn. “I’m concerned we will lose a number of rural hospitals, and then the whole system may be at risk.”
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1. Medical assistant Kylee Lutz, 26, right, hugs activities coordinator Rita Robledo on closing day. Lutz, who will continue to work in the clinic that remains open, said through tears, “It’s not going to be the same without you ladies.” 2. Rose Mary Wampler, 88, sees physician assistant Chris Pilaczynski at the clinic. Wampler, who lives alone across the street from Glenn Medical Center, said, “Old people can’t drive far away. I’m all by myself, I would just dial 9-1-1.”
Glenn Medical’s financing did not collapse because of the new federal cuts. Rather, the hospital was done in by a federal decision this year to strip the hospital’s “critical access” designation, which enabled it to receive increased federal reimbursement. The hospital, the only one in Glenn County, is just 32 miles from the nearest neighboring hospital under a route mapped by federal officials — less than the 35 miles required under the law. Though that distance hasn’t changed, the federal government has now decided to enforce its rules.
Local elected officials and hospital administrators fought for months to convince the federal government to grant them an exception. Now, with the doors closed, policy experts and residents of Willows said they are terrified by the potential consequences.
“People are going to die,” predicted Glenn County Supervisor Monica Rossman. She said she feared that older people in her community without access to transportation will put off seeking care until it is too late, while people of all ages facing emergency situations won’t be able to get help in time.
Kellie Amaru, a licensed vocational nurse who has worked at Glenn Medical Center for four years, reacts after watching a co-worker leave after working their final shift at the hospital.
But even for people who don’t face a life-or-death consequence, the hospital’s closure is still a body blow, said Willows Vice Mayor Rick Thomas. He and others predicted many people will put off routine medical care, worsening their health. And then there’s the economic health of the town.
Willows, which sits just east of I-5 in the center of the Sacramento Valley, has a proud history stretching back nearly 150 years in a farm region that now grows rice, almonds and walnuts. About 6,000 people live in the town, which has an economic development webpage featuring images of a tractor, a duck and a pair of hunters standing in the tall grass.
“We’ve lost 150 jobs already from the hospital [closing],” Thomas said. “I’m very worried about what it means. A hospital is good for new business. And it’s been hard enough to attract new business to the town.”
Dismantling ‘a legacy of rural healthcare’
From the day it started taking patients on Nov. 21,1950, Glenn General Hospital (as it was then called) was celebrated not just for its role in bringing medical care to the little farm town, but also for its role in helping Willows grow and prosper.
“It was quite state-of-the-art back in 1950,” said Lauren Still, the hospital’s chief administrative officer.
When the hospital’s first baby was born a few days later — little Glenda May Nieheus clocked in at a robust 8 pounds, 11 ounces — the arrival was celebrated on the front page of the Willows Daily Journal.
But as a small hospital in a small town, the institution struggled almost immediately. Within a few years, according to a 1957 story in the local newspaper, the hospital was already grappling with the problem of nurses leaving in droves for higher-paying positions elsewhere. A story the following year revealed that hospital administrators were forcing a maintenance worker to step in as an ambulance driver on weekends — without the requisite chauffeur’s license — to save money.
In a sign of how small the town is, that driver was Still’s boyfriend’s grandfather.
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1. A customer walks into Willows Hardware store. 2. Cheerleaders perform during Willows High School’s Homecoming JV football game against Durham at Willows High School. 3. The press box at Willows High School’s football field is decorated with previous Northern Section CIF Championship wins.
Still, the institution endured, its grassy campus and low-slung wings perched proudly on the east end of town. Generations of the town’s babies were born there. As they grew up, they went into the emergency room for X-rays, stitches and treatment for fevers and infections. Their parents and grandparents convalesced there and sometimes died there, cared for by nurses who were part of the community.
“They saved my brother’s life. They saved my dad’s life,” said Keith Long, 34, who works at Red 88, an Asian fusion restaurant in downtown Willows that is a popular lunch spot for hospital staff.
Glenn Medical’s finances, however, often faltered. Experts in healthcare economics say rural hospitals like Glenn Medical generally have fewer patients than suburban and urban communities, and those patients tend to be older and sicker, meaning they are more expensive to treat. What’s more, a higher share of those patients are low-income and enrolled in Medi-Cal and Medicare, which generally has lower reimbursement rates than private insurance. Smaller hospitals also cannot take advantage of economies of scale the way bigger institutions can, nor can they bring the same muscle to negotiations for higher rates with private insurance companies.
For more than two decades across California, rural hospitals have been running out of money and closing their doors.
T-Ann Pearce, who has worked at Glenn Medical Center for six years, sits in the medical surgical unit during one of her last shifts with only a few remaining patients left to care.
In 2000, Glenn Medical went bankrupt, but was saved when it was awarded the “critical access” designation by the federal government that allowed it to receive higher reimbursement rates, Still said.
But by late 2017, the hospital was in trouble again.
A private for-profit company, American Advanced Management, swooped in to rescue Glenn Medical and a nearby hospital in Colusa County, buying them and keeping them open. The Modesto-based company specializes in buying distressed rural hospitals and now operates 14 hospitals in California, Utah and Texas.
The hospital set about building back its staff and improving its reputation for patient care in the community, which had been tarnished in part by the 2013 death of a young mother and her unborn baby.
“We’ve been on an upswing,” Still said, noting that indicators of quality of care and patient satisfaction have risen dramatically in recent years.
Then came the letter from the federal Centers for Medicare & Medicaid Services. On April 23, the federal agency wrote Glenn Medical’s management company with bad news: A recent review had found that Glenn Medical was “in noncompliance” with “distance requirements.” In plain English, federal officials had looked at a map and determined that Glenn Medical was not 35 miles from the nearest hospital by so-called main roads as required by law — it was just 32. Nor was it 15 miles by secondary roads. The hospital was going to lose its critical access designation. The hit to the hospital’s budget would be about 40% of its $28 million in net revenue. It could not survive that cut.
At first, hospital officials said they weren’t too worried.
“We thought, there’s no way they’re going to close down hospitals” over a few miles of road, Still, the hospital’s chief executive, said.
Especially, Still said, because it appeared there were numerous California hospitals in the same pickle. A 2013 federal inspector general’s report found that a majority of the 1,300 critical access hospitals in the country do not meet the distance requirement. That includes dozens in California.
Still and other hospital officials flew to Washington to make their case, sure that when they explained that one of the so-called main roads that connects Glenn Medical to its nearest hospital wasn’t actually one at all, and often flooded in the winter, the problem would be solved. The route everyone actually used, she said, was 35.7 miles.
“No roads have changed. No facilities have moved,” administrators wrote to federal officials. “And yet this CMS decision now threatens to dismantle a legacy of rural health care stability.”
Without it, the administrator wrote, “lives will be lost for certain.”
But, Still said, their protestations fell on deaf ears.
In August came the final blow: Glenn Medical would lose its critical access funding by April 2026.
The news set off a panic not just in Glenn County but at hospitals around the state.
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1. A bicyclist passes by Glenn Medical Center. First opened to patients on November 21, 1950, the center was called Glenn General Hospital then. 2. A member of the staff signs a farewell board on closing day at Glenn Medical Center on October 21, 2025.
At least three other hospitals got letters from the Centers for Medicare & Medicaid saying their status was under review, Wheeler said: Bear Valley Community Hospital in Big Bear Lake, George L. Mee Memorial in Monterey County and Santa Ynez Valley Cottage Hospital in Solvang. The hospitals in Monterey and Big Bear Lake provided data demonstrating they met the requirements for the critical access status.
Cottage Hospital, however, did not, despite showing that access in and out of the area where the hospital is located was sometimes blocked by wildfires or rockslides.
Cottage Hospital officials did not respond to questions about what that might mean for their facility.
Asked about these situations, officials at the Centers for Medicare & Medicaid said the law does not give the agency flexibility to consider factors such as weather, for example, in designating a critical assess hospital. They added the hospital must demonstrate there is no driving route that would make it ineligible based on driving distances included in the statute.
Jeff Griffiths, a county supervisor in Inyo County who is also the president of the California Assn. of Counties, said he has been following the grim hospital financing news around the state with mounting worry.
The hospital in his county, Southern Inyo, came close to running out of money earlier this year, he said, and with more federal cuts looming, “I don’t know how you can expect these hospitals to survive.”
“It’s terrifying for our area,” Griffiths said, noting that Inyo County, which sits on the eastern side of the Sierra, has no easy access to any medical care on the other side of the giant mountain peaks.
‘This is the final call’
In Willows, once word got out that the hospital would lose its funding, nurses began looking for new jobs.
By late summer, so many people had left that administrators realized they had no choice but to shutter the emergency room, which closed Sept. 30.
Helena Griffith, 62, one of the last patients, waves goodbye as patient transport Jolene Guerra pushes her wheelchair down the hallway on October 20, 2025.
Through it all, McNabb, the 74-year-old patient receiving intravenous antibiotics, remained in her bed, getting to know the nurses who buzzed around her.
She became aware that when they weren’t caring for her, many of them were trying to figure out what they would do with their lives once they lost their jobs.
On the hospital’s last day, nurse Amanda Shelton gifted McNabb a new sweater to wear home.
When McNabb gushed over the sweetness of the gesture, Shelton teared up. “It’s not every day that it will be the last patient I’ll ever have,” she told her.
As McNabb continued to gather her things, Shelton retreated to the hospital’s recreation room, where patients used to gather for games or conversation.
With all the patients save McNabb gone, Shelton and some other hospital staff took up a game of dominoes, the trash talk of the game peppered with bittersweet remembrances of their time working in the creaky old building.
Registered nurse Ronald Loewen, 74, looks out the window on closing day at Glenn Medical Center on October 21, 2025. Loewen, who grew up and attended school in Willows, had four children delivered at Glenn Medical, two of them survived, and took care of former classmates at this hospital, says the hospital closing is, “a piece of our history gone.”
Shelton said she is not sure what is next for her. She loved Glenn Medical, she said, because of its community feel. Many people came for long stays or were frequent patients, and the staff was able to get to know them — and to feel like they were healing them.
“You got to know people. You got to know their family, or if they didn’t have any family,” you knew that too, she said. She added that in many hospitals, being a nurse can feel like being an extension of a computer. But at Glenn Medical, she said, “you actually got to look in someone’s eyes.”
The building itself was in dire shape, she noted. Nothing was up to modern code. It didn’t have central air conditioning, and it was heated by an old-fashioned boiler. “I mean, I have never even heard of a boiler room” before coming to work there, she said.
And yet within the walls, she said, “It’s community.”
Bradley Ford, the emergency room manager, said he felt the same way and was determined to pay tribute to all the people who had made it so.
At 7 p.m. on the emergency room’s last night of service, Ford picked up his microphone and beamed his voice out to the hospital and to all the ambulances, fire trucks and others tuned to the signal.
He had practiced his speech enough times that he thought he could get through it without crying — although during his rehearsals he had never yet managed it.
“This is the final call,” Ford said. “‘After 76 years of dedicated service, the doors are closing. Service is ending. On behalf of all the physicians, nurses and staff who have walked these halls, it is with heavy hearts that we mark the end of this chapter.”
Nurses and other staff members recorded a video of Ford making his announcement, and passed it among themselves, tearing up every time they listened to it.
In an interview after the hospital had closed, Ford said he was one of the lucky ones: He had found a new job.
It was close enough to his home in Willows that he could commute — although Ford said he wasn’t sure how long he would remain in his beloved little town without access to emergency medical care there.
Rose Mary Wampler, 88, waits to have blood drawn at the lab beside a cordoning off, signaling the closure of the hospital side of Glenn Medical Center, on October 22, 2025. Wampler lives alone across the street from the hospital.
Rose Mary Wampler, 88, has lived in Willows since 1954 and now resides in a little house across the street from the hospital. Her three children were born at Glenn Medical, and Wampler herself was a patient there for two months last year when she was stricken with pneumonia and internal bleeding. She said she was fearful of the idea of driving more than 30 miles for healthcare elsewhere.
She looked out her window on a recent afternoon at the now-shuttered hospital.
“It looks like somebody just shut off the whole city, there’s nowhere to go get help,” she said.
Glenn Medical Center patient Richard Putnam, 86, closes the window in his hospital room. A month shy of it’s 75th year, the hospital closed on Oct 21, 2025.
(Christina House/Los Angeles Times)
Times photographer Christina House contributed to this report.
A respiratory virus that doesn’t have a vaccine or a specific treatment regimen is spreading in some parts of California — but there’s no need to sound the alarm just yet, public health officials say.
A majority of Northern California communities have seen high concentrations of human metapneumovirus, or HMPV, detected in their wastewater, according to data from the WastewaterScan Dashboard, a public database that monitors sewage to track the presence of infectious diseases.
A Los Angeles Times data analysis found the communities of Merced in the San Joaquin Valley, and Novato and Sunnyvale in the San Francisco Bay Area have seen increases in HMPV levels in their wastewater between mid-December and the end of February.
HMPV has also been detected in L.A. County, though at levels considered low to moderate at this point, data show.
While HMPV may not necessarily ring a bell, it isn’t a new virus. Its typical pattern of seasonal spread was upended by the COVID-19 pandemic, and its resurgence could signal a return to a more typical pre-coronavirus respiratory disease landscape.
Here’s what you need to know.
What is HMPV?
HMPV was first detected in 2001, according to the U.S. Centers for Disease Control and Prevention. It’s transmitted by close contact with someone who is infected or by touching a contaminated surface, said Dr. Neha Nanda, chief of infectious diseases and hospital epidemiologist for Keck Medicine of USC.
Like other respiratory illnesses, such as influenza, HMPV spreads and is more durable in colder temperatures, infectious-disease experts say.
Human metapneumovirus cases commonly start showing up in January before peaking in March or April and then tailing off in June, said Dr. Jessica August, chief of infectious diseases at Kaiser Permanente Santa Rosa.
However, as was the case with many respiratory viruses, COVID disrupted that seasonal trend.
Why are we talking about HMPV now?
Before the pandemic hit in 2020, Americans were regularly exposed to seasonal viruses like HMPV and developed a degree of natural immunity, August said.
That protection waned during the pandemic, as people stayed home or kept their distance from others. So when people resumed normal activities, they were more vulnerable to the virus. Unlike other viruses, there isn’t a vaccine for human metapneumovirus.
“That’s why after the pandemic we saw record-breaking childhood viral illnesses because we lacked the usual immunity that we had, just from lack of exposure,” August said. “All of that also led to longer viral seasons, more severe illness. But all of these things have settled down in many respects.”
In 2024, the national test positivity for HMPV peaked at 11.7% at the end of March, according to the National Respiratory and Enteric Virus Surveillance System. The following year’s peak was 7.15% in late April.
So far this year, the highest test positivity rate documented was 6.1%, reported on Feb. 21 — the most recent date for which complete data are available.
While the seasonal spread of viruses like HMPV is nothing new, people became more aware of infectious diseases and how to prevent them during the pandemic, and they’ve remained part of the public consciousness in the years since, August and Nanda said.
What are the symptoms of HMPV?
Most people won’t go to the doctor if they have HMPV because it typically causes mild, cold-like symptoms that include cough, fever, nasal congestion and sore throat.
HMPV infection can progress to:
- An asthma attack and reactive airway disease (wheezing and difficulty breathing)
- Middle ear infections behind the ear drum
- Croup, also known as “barking” cough — an infection of the vocal cords, windpipe and sometimes the larger airways in the lungs
- Bronchitis
- Fever
Anyone can contract human metapneumovirus, but those who are immunocompromised or have other underlying medical conditions are at particular risk of developing severe disease — including pneumonia. Young children and older adults are also considered higher-risk groups, Nanda said.
What is the treatment for HMPV?
There is no specified treatment protocol or antiviral medication for HMPV. However, it’s common for an infection to clear up on its own and treatment is mostly geared toward soothing symptoms, according to the American Lung Assn.
A doctor will likely send you home and tell you to rest and drink plenty of fluids, Nanda said.
If symptoms worsen, experts say you should contact your healthcare provider.
How to avoid contracting HMPV
Infectious-disease experts said the best way to avoid contracting HMPV is similar to preventing other respiratory illnesses.
The American Lung Assn.’s recommendations include:
- Wash your hands often with soap and water. If that’s not available, clean your hands with an alcohol-based hand sanitizer.
- Clean frequently touched surfaces.
- Crack open a window to improve air flow in crowded spaces.
- Avoid being around sick people if you can.
- Avoid touching your eyes, nose and mouth.
Assistant data and graphics editor Vanessa Martínez contributed to this report.
Science
After rash of overdose deaths, L.A. banned sales of kratom. Some say they lost lifeline for pain and opioid withdrawal
Nearly four months ago, Los Angeles County banned the sale of kratom, as well as 7-OH, the synthetic version of the alkaloid that is its active ingredient. The idea was to put an end to what at the time seemed like a rash of overdose deaths related to the drug.
It’s too soon to tell whether kratom-related deaths have dissipated as a result — or, really, whether there was ever actually an epidemic to begin with. But many L.A. residents had become reliant on kratom as something of a panacea for debilitating pain and opioid withdrawal symptoms, and the new rules have made it harder for them to find what they say has been a lifesaving drug.
Robert Wallace started using kratom a few years ago for his knees. For decades he had been in pain, which he says stems from his days as a physical education teacher for the Glendale Unified School District between 1989 and 1998, when he and his students primarily exercised on asphalt.
In 2004, he had arthroscopic surgery on his right knee, followed by varicose vein surgery on both legs. Over the next couple of decades, he saw pain-management specialists regularly. But the primary outcome was a growing dependence on opioid-based painkillers. “I found myself seeking doctors who would prescribe it,” he said.
He leaned on opioids when he could get them and alcohol when he couldn’t, resulting in a strain on his marriage.
When Wallace was scheduled for his first knee replacement in 2021 (he had his other knee replaced a few years later), his brother recommended he take kratom for the post-surgery pain.
It seemed to work: Wallace said he takes a quarter of a teaspoon of powdered kratom twice a day, and it lets him take charge of managing his pain without prescription painkillers and eases harsh opiate-withdrawal symptoms.
He’s one of many Angelenos frustrated by recent efforts by the county health department to limit access to the drug. “Kratom has impacted my life in only positive ways,” Wallace told The Times.
For now, Wallace is still able to get his kratom powder, called Red Bali, by ordering from a company in Florida.
However, advocates say that the county crackdown on kratom could significantly affect the ability of many Angelenos to access what they say is an affordable, safer alternative to prescription painkillers.
Kratom comes from the leaves of a tree native to Southeast Asia called Mitragyna speciosa. It has been used for hundreds of years to treat chronic pain, coughing and diarrhea as well as to boost energy — in low doses, kratom appears to act as a stimulant, though in higher doses, it can have effects more like opioids.
Though advocates note that kratom has been used in the U.S. for more than 50 years for all sorts of health applications, there is limited research that suggests kratom could have therapeutic value, and there is no scientific consensus.
Then there’s 7-OH, or 7-Hydroxymitragynine, a synthetic alkaloid derived from kratom that has similar effects and has been on the U.S. market for only about three years. However, because of its ability to bind to opioid receptors in the body, it has a higher potential for abuse than kratom.
Public health officials and advocates are divided on kratom. Some say it should be heavily regulated — and 7-OH banned altogether — while others say both should be accessible, as long as there are age limitations and proper labeling, such as with alcohol or cannabis.
In the U.S., kratom and 7-OH can be found in all sorts of forms, including powder, capsules and liquids — though it depends on exactly where you are in the country. Though the Food and Drug Administration has recommended that 7-OH be included as a Schedule 1 controlled substance under the Controlled Substances Act, that hasn’t been made official. And the plant itself remains unscheduled on the federal level.
That has left states, counties and cities to decide how to regulate the substances.
California failed to approve an Assembly bill in 2024 that would have required kratom products to be registered with the state, have labeling and warnings, and be prohibited from being sold to anyone younger than 21.
It would also have banned products containing synthetic versions of kratom alkaloids. The state Legislature is now considering another bill that basically does the same without banning 7-OH — while also limiting the amount of synthetic alkaloids in kratom and 7-OH products sold in the state.
“Until kratom and its pharmacologically active key ingredients mitragynine and 7-OH are approved for use, they will remain classified as adulterants in drugs, dietary supplements and foods,” a California Department of Public Health spokesperson previously told The Times.
On Tuesday, California Gov. Gavin Newsom announced that the state’s efforts to crack down on kratom products has resulted in the removal of more than 3,300 kratom and 7-OH products from retail stores. According to a news release from the governor’s office, there has been a 95% compliance rate from businesses in removing the products.
(Los Angeles Times photo illustration; source photos by Getty Images)
Newsom has equated these actions to the state’s efforts in 2024 to quash the sale of hemp products containing cannabinoids such as THC. Under emergency state regulations two years ago, California banned these specific hemp products and agents with the state Department of Alcoholic Beverage Control seized thousands of products statewide.
Since the beginning of 2026, there have been no reported violations of the ban on sales of such products.
“We’ve shown with illegal hemp products that when the state sets clear expectations and partners with businesses, compliance follows,” Newsom said in a statement. “This effort builds on that model — education first, enforcement where necessary — to protect Californians.”
Despite the state’s actions, the Los Angeles County Board of Supervisors is still considering whether to regulate kratom, or ban it altogether.
The county Public Health Department’s decision to ban the sale of kratom didn’t come out of nowhere. As Maral Farsi, deputy director of the California Department of Public Health, noted during a Feb. 18 state Senate hearing, the agency “identified 362 kratom-related overdose deaths in California between 2019 and 2023, with a steady increase from 38 in 2019 up to 92 in 2023.”
However, some experts say those numbers aren’t as clear-cut as they seem.
For example, a Los Angeles Times investigation found that in a number of recent L.A. County deaths that were initially thought to be caused by kratom or 7-OH, there wasn’t enough evidence to say those drugs alone caused the deaths; it might be the case that the danger is in mixing them with other substances.
Meanwhile, the actual application of this new policy seems to be piecemeal at best.
The county Public Health Department told The Times it conducted 2,696 kratom-related inspections between Nov. 10 and Jan. 27, and found 352 locations selling kratom products. The health department said the majority stopped selling kratom after those inspections; there were nine locations that ignored the warnings, and in those cases, inspectors impounded their kratom products.
But the reality is that people who need kratom will buy it on the black market, drive far enough so they get to where it’s sold legally or, like Wallace, order it online from a different state.
For now, retailers who sell kratom products are simply carrying on until they’re investigated by county health inspectors.
Ari Agalopol, a decorated pianist and piano teacher, saw her performances and classes abruptly come to a halt in 2012 after a car accident resulted in severe spinal and knee injuries.
“I tried my best to do traditional acupuncture, physical therapy and hydrocortisone shots in my spine and everything,” she said. “Finally, after nothing was working, I relegated myself to being a pain-management patient.”
She was prescribed oxycodone, and while on the medication, battled depression, anhedonia and suicidal ideation. She felt as though she were in a fog when taking oxycodone, and when it ran out, ”the pain would rear its ugly head.” Agalopol struggled to get out of bed daily and could manage teaching only five students a week.
Then, looking for alternatives to opioids, she found a Reddit thread in which people were talking up the benefits of kratom.
“I was kind of hesitant at first because there’re so many horror stories about 7-OH, but then I researched and I realized that the natural plant is not the same as 7-OH,” she said.
She went to a local shop, Authentic Kratom in Woodland Hills, and spoke to a sales associate who helped her decide which of the 47 strains of kratom it sold would best suit her needs.
Agalopol currently takes a 75-milligram dose of mitragynine, the primary alkaloid in kratom, when necessary. It has enabled her to get back to where she was before her injury: teaching 40 students a week and performing every weekend.
Agalopol believes the county hasn’t done its homework on kratom. “They’re just taking these actions because of public pressure, and public pressure is happening because of ignorance,” she said.
During the course of reporting this story, Authentic Kratom has shut down its three locations; it’s unclear if the closures are temporary. The owner of the business declined to comment on the matter.
When she heard the news of the recent closures, Agalopol was seething. She told The Times she has enough capsules of kratom for now, but when she runs out, her option will have to be Tylenol and ibuprofen, “which will slowly kill my liver.”
“Prohibition is not a public health strategy,” said Jackie Subeck, executive director of 7-Hope Alliance, a nonprofit that promotes safe and responsible access to 7-OH for consumers, at the Feb. 18 Senate hearing. “[It’s] only going to make things worse, likely resulting in an entirely new health crisis for Californians.”
Because of budget cuts, the Los Angeles County Department of Public Health has ended clinical services at seven of its public health clinic sites.
As of Feb. 27, the county is no longer providing services such as vaccinations, sexually transmitted infection testing and treatment, or tuberculosis diagnosis and specialty TB care at the affected locations, according to county officials and a department fact sheet.
The sites losing clinical services are Antelope Valley in Lancaster; the Center for Community Health (Leavy) in San Pedro, Curtis R. Tucker in Inglewood, Hollywood-Wilshire, Pomona, Dr. Ruth Temple in South Los Angeles, and Torrance. Services will continue to be provided by the six remaining public health clinics, and through nearby community clinics.
The changes are the result of about $50 million in funding losses, according to official county statements.
“That pushed us to make the very difficult decision to end clinical services at seven of our sites,” said Dr. Anish Mahajan, chief deputy director of the L.A. County Department of Public Health.
Mahajan said the department selected clinics with relatively lower patient volumes. Over the last month, he said, the department has sent letters to patients about the changes, and referred them to unaffected county clinics, nearby federally qualified health centers or other community providers. According to Mahajan, for tuberculosis patients, particularly those requiring directly observed therapy, public health nurses will continue visiting patients.
Public health clinics form part of the county’s healthcare safety net, serving low-income residents and those with limited access to care. Officials said that about half of the patients the county currently sees across its clinics are uninsured.
Mahajan noted that the clinics were established decades ago, before the Affordable Care Act expanded Medi-Cal coverage and increased the number of federally qualified health centers. He said that as more residents gained access to primary care, utilization at some county-run clinics declined.
“Now that we have a more sophisticated safety net, people often have another place to go for their full range of care,” he said.
Still, the closures have unsettled providers who work closely with local vulnerable populations.
“I hate to see any services that serve our at-risk and homeless community shut down,” said Mark Hood, chief executive of Union Rescue Mission in downtown Los Angeles. “There’s so much need out there, so it always is going to create hardship for the people that actually need the help the most.”
Union Rescue Mission does not receive government funding for its healthcare services, Hood said. The mission’s clinics are open not only to shelter guests, up to 1,000 people nightly, but also to people living on the streets who walk in seeking care.
Its dental clinic alone sees nearly 9,000 patients a year, Hood said.
“We haven’t seen it yet, but I expect in the coming days and weeks we’ll see more people coming through our doors looking for help,” he said. “They’re going to have to find help somewhere.” Hood said women experiencing homelessness are especially vulnerable when preventive care, including sexual and reproductive health services, becomes harder to access.
County officials said staffing impacts so far have been managed through reassignment rather than layoffs. Roughly 200 to 300 positions across the department have been eliminated amid funding cuts, officials said, though many were vacant. About 120 employees whose positions were affected have been reassigned; according to Mahajan, no one has been laid off.
The clinic closures come amid broader fiscal uncertainty. Mahajan said that due to the Trump administration’s “Big Beautiful Bill,” Los Angeles County could lose $2.4 billion over the next several years. That funding, he said, supports clinics, hospitals and community clinic partners now absorbing patients who previously went to the clinics that closed on Feb. 27.
In response, the L.A. County Board of Supervisors has backed a proposed half-cent sales tax measure that would generate hundreds of millions of dollars annually for healthcare and public health services. Voters are expected to consider the measure in June.
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