Science
Long, frustrating waits for home care persist despite California expanding program
Lyla Abuebaid needs to check on her 5-year-old son through the night to make sure he keeps breathing.
Sayfideen has a rare and serious syndrome that leaves him unable to walk. He relies on a ventilator and has to be monitored 24 hours a day, his mother said. Nurses once helped handle his care at home.
But for months now, that work has instead fallen to his mother, who is also juggling her job as a project manager.
“I’m not functioning,” the San Jose resident said. “I’m not doing well at work. I’m not doing well at home.”
Abuebaid said it feels as though she has to “beg the state for services which he absolutely deserves.”
Lyla Abuebaid has waited for months for help from the state with the care of her son. She sometimes gets help from a family friend, but 5-year-old Sayfideen needs a fulltime caregiver. (Peter DaSilva / For The Times)
She is among thousands of Californians who have been trying to get Medicaid benefits for services to help medically vulnerable people remain at home through the Home and Community-Based Alternatives waiver.
Demand for the HCBA waiver, which helps people who might otherwise have to live in nursing facilities, has far outstripped the available spots. Last summer, California stopped accepting applications for the program as it hit an enrollment cap. Amid an outcry from disability rights advocates and families, California got federal approval to gradually add 7,200 slots over four years to eventually serve more than 16,000 people at a time.
Yet thousands of Californians remain on the wait list. As of June, more than 4,900 people were waiting, according to the Department of Health Care Services — more than twice as many as last summer.
When people have to wait, either “aging adults or disabled people who need services are going without them, or family caregivers are left to fill in the gaps,” said Nicole Jorwic, chief of advocacy and campaigns for Caring Across Generations. Some could end up in nursing facilities “because there just aren’t alternatives.”
Disability rights advocates had warned the state last year that the planned increase in slots would not clear the existing wait list for years, let alone reach more Californians who might find themselves in need of care as they face unexpected illness or injury.
“I don’t know that they’ve done anything to solve the problem,” said Clovis resident Sarah Scharnick, who first spoke with The Times about the wait list last fall and is still on it. Her husband requires round-the-clock care, including being turned at night to prevent bedsores, after a bicycle crash.
Long hours of nursing care at home are not typically covered by private insurers, forcing many families to resort to placing their loved ones in nursing facilities or to shoulder their care themselves, advocates say. Abuebaid said her private insurance would not cover her son’s nursing care. He had previously gotten assistance through Medi-Cal, the California Medicaid program, then lost his coverage.
Paying for such care out of pocket “would bankrupt a millionaire,” said Katelyn Ashton, executive director of Loretta’s Little Miracles, which cares for medically fragile children. For many families unable to access the waiver, “their only option is to quit their job and provide that care themselves at home.”
State officials said that with the added slots, nearly 10,800 people could be in the program at a time this year. Despite the demand for the program, however, more than 1,500 HCBA slots remained unfilled as of June, according to the healthcare services department.
The reason: The department said it is currently releasing only about 200 slots a month. Throwing open all the slots at once, it said, “would cause administrative backlogs” for both local agencies that take applications and for the state, “due to the high number of applications to process.” The state agency said it has limited resources, “including staff, to review the existing volume of enrollment packets.”
It has seven nurses who work on reviewing the enrollment packets — only two of them doing so full time — and four other staffers who assist with the wait list, the agency said. DHCS said the process can also be delayed by scheduling difficulties at local agencies that field applications.
The lag has alarmed groups like Disability Rights California and Justice in Aging. U.S. Rep. Nanette Barragán (D-San Pedro) said she had called for Gov. Gavin Newsom “to put the resources there to make sure that they’re filling slots as quickly as they can.”
“Putting people in this program saves the state money in the long run,” she said.
Providing such care for someone at home is far less expensive than moving them into a nursing home, state figures show: The Department of Health Care Services estimated in a May report that the average nursing facility costs more than $134,000 annually, compared with roughly $53,000 for each person in the program.
“We step over a dollar to pick up a dime a lot of times,” said Jim Frazier, a former California Assembly member and director of public policy for the Arc of California, which advocates for people with intellectual and developmental disabilities. “We don’t look at the long-term cost savings.”
The healthcare department estimated 40% of people accessing the program were not coming from nursing homes, but “from the community.” Researchers have found that longer waits for such programs can prove costly even if people aren’t already living in institutions: In Iowa, older people were more likely to end up spending time in a nursing home within a few years if they had applied for such waivers when waits were long, researchers found.
The logjam has also undercut efforts to help homeless people who are medically vulnerable, advocates said. In the Bay Area, Cardea Health Chief Executive Alexis Chettiar said the unhoused clients that her nonprofit serves “are too sick to live in a home without support, they are disallowed from shelters because they may be incontinent or have malodorous wounds,” and nursing homes are often unwilling to take them.
Her nonprofit has instead worked to enroll them in the HCBA program as they are housed. The group said it has saved over $7 million annually by reducing emergency room visits, hospitalizations and other medical costs for such patients.
“It really works,” Chettiar said. “Or I should say — it was working really magnificently until we hit the cap.”
More than 90 of their clients are now on the waiting list, where some have languished over a year and a half. Cardea Health has been footing the bill for their care, but Chettiar said it cannot do so forever: It has relied on a few years of “seed funding” from local governments when it starts services at a site, but had planned to get patients onto the HCBA waiver for continued care.
As California releases slots, it has been prioritizing people under the age of 21, as well as people who have already been stuck for months in health facilities, among others. DHCS said opening up slots month by month has allowed it to continuously ensure that those applications go to the front of the line. Abuebaid said that after months of waiting, her child had recently been scheduled for an intake appointment.
For Californians who do not fit those criteria, however, the waits can be especially punishing. As of June, more than 90% of those on the HCBA wait list were not in the priority groups, according to the state.
Jenina Marik has ALS. The family applied through the state nearly a year ago for in-home care, and husband Tyler Marik worries he may have to stop working to focus on caregiving.
(Myung J. Chun / Los Angeles Times)
Among them is Jenina Marik, who was diagnosed roughly a year and a half ago with the neurodegenerative disorder ALS. Within a few years, the 40-year-old Valencia woman went from running a half marathon, operating her wedding photography business and corralling her young sons to being unable to feed or dress herself.
Her husband, Tyler Marik, turned to a caregiving service to assist her while he went to work, but “I was going broke.” After months of struggle, the family eventually got some help through a government program for in-home care, but “it’s nowhere near enough.”
Because Jenina, now quadriplegic, still needs care throughout the night, “I get maybe five hours of sleep a night. … And when I’m tired that can compromise her safety,” Tyler Marik said.
The HCBA waiver could afford them more care, but it’s been nearly a year since they applied. Marik fears he may have to stop working if nothing changes. Moving his wife into a facility “would be a nightmare,” he said.
“That would be even worse than ALS.”
Eli Marik, 7, cools off in the backyard with father Tyler, brother Owen, 4, and mother Jenina.
(Myung J. Chun / Los Angeles Times)
Science
Video: NASA Announces Artemis III Crew
new video loaded: NASA Announces Artemis III Crew
transcript
transcript
NASA Announces Artemis III Crew
NASA announced the crew of Artemis III mission, which will fly to low-Earth orbit to test rendezvous and docking maneuvers with one or two lunar landers.
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“I am excited to welcome you as the next crew in the Artemis journey to successfully return to the moon — this time to stay.” “I’m honored by the role that I’ve been given. I’m also very humbled by the task in front of us. But first and foremost, I’m grateful.” “So with that, the Artemis II crew, comrade, hands you the baton. You got the controls.” “As you know, we had a significant anomaly at our Launch Complex 36A on May 28. We’ve redoubled our efforts and are moving forward.”
By Alisa Shodiyev Kaff
June 9, 2026
Science
Santa Monica Mountains’ last steelhead trout survived the Palisades fire — and even had babies
Scientists feared the Santa Monica Mountains’ last remaining steelhead trout were dead, smothered by debris flows unleashed by the Palisades fire.
But the endangered fish surprised them: A team of biologists recently spotted 30 of the rare trout — and 21 babies — in Topanga Creek.
“There was a lot of happy dancing in the creek,” said Rosi Dagit, principal conservation biologist for the Resource Conservation District of the Santa Monica Mountains, which works with public and private landowners to conserve natural resources.
That’s because the steelhead here are endangered, at both the state and federal levels. Once, they swam in most streams of the Santa Monicas, but their numbers plummeted amid overfishing and coastal development. Increasingly frequent wildfire has further stressed their habitat. Topanga Creek, a biodiversity hot spot, is home to their last known population in the mountains that stretch from the Hollywood Hills to Point Mugu in Ventura County.
The trout that were spotted, including this one, are part of a distinct Southern California population that’s listed as endangered at the state and federal levels.
(RCDSMM Stream Team)
The California Department of Fish and Wildlife spearheaded a complex mission to rescue trout threatened by the Palisades fire that sparked in January 2025.
Time was of the essence. The fire hadn’t yet been fully contained. But rain was on the way, which would sweep massive amounts of sediment from the denuded hillsides into the water. Fish are often killed this way.
Crews stunned the fish with electricity, scooped them up in buckets, trucked them to a hatchery and ultimately moved them to Arroyo Hondo Creek in Santa Barbara County.
Within days, Topanga Creek was choked with mud. Some assumed the fish left behind were goners.
But in March, the conservation district’s team found four. The following month, when water conditions were clearer, they saw more.
“These fish continue to amaze me,” said Kyle Evans, environmental program manager for the state Department of Fish and Wildlife, who had seen the damage to the creek. “I had seen populations get wiped out in similar situations. So when I heard, I was thrilled.”
Evans surmises the fish that survived were in an area of the creek where less charred material and sediment were swept in.
“These fish likely hunkered down, were hiding under some rocks or places to try to get away from the main concentration of flow,” he said. “And luckily they weren’t buried.”
The ones that were spotted were fairly small, around 6 to 14 inches. Rainbow trout and steelhead trout are the same species, but with different lifestyles. If the fish remain in freshwater, they’ll be considered rainbows. However, they can migrate to the ocean and become steelhead, where they typically grow larger before returning to their natal waters to spawn.
Topanga Creek hasn’t fully recovered from the damage it sustained, but scientists say it’s looking better. Surveys last year were “so depressing,” Dagit said, with very few animals, and stretches that were essentially transformed into flat roads from all the sediment buildup. Some of the riparian canopy burned right down to the creek.
Then came 32 inches of rain over the last nine months, scouring out and moving sediment, creating deeper pools. Dagit said they recently found newt egg masses for the first time in years, as well as a few adult newts and many frogs. Plants that provide cover are starting to recover.
She provided photos comparing certain pools last year and this year, some dramatically transformed. In September 2025, the Shrine Pool could have been an overgrown hiking trail. This April, it was filled with shallow water.
The Shrine Pool in September 2025, left, and the same location in April 2026, right, with RCDSMM’s Isaac Yelchin donning a wetsuit.
(RCDSMM Stream Team)
Topanga Creek is home to another endangered fish, the small but hardy northern tidewater goby, often described as cute. Not long before the trout operation, Dagit led a rescue of hundreds of these fish too. Many were repatriated to the lagoon at the mouth of the creek in a moving ceremony last June.
There’s still the matter of what to do with the trout that were moved to Santa Barbara County last year. Evans would like to bring them home to the Santa Monicas at some point, but isn’t sure if it will happen. On one hand, they could bolster the small, genetically isolated surviving population. On the other, they might inadvertently bring in a disease or bacteria. There is some time to decide. Evans estimates the creek still needs to recover for two to three more years.
For now, the fish are functioning fine in their adopted creek. Experts worried the trauma wrought by the move would disrupt their spawning process, but they had babies that spring. This year, they spawned again.
Science
Pacifica pier cracks, another coastal casualty as seas continue to rise
The Pacifica Municipal Pier was shut down and taped off Thursday after city workers noticed cracks running through the landmark structure and concrete chunks falling into the ocean.
It’s just one of many coastal California structures that have recently crumbled under pressure from a rising and relentless ocean.
Officials from the small, beach city south of San Francisco said the pier was closed due to “cracking, separation, and displacement of the concrete walkway and structural elements.”
It will stay closed while structural engineers asses its safety.
Photos taken by city employees show a wide crack that runs from top to bottom and across the structure as well. Other photos show a large horizontal crack under the foundation of a small restaurant on the pier, the Chit Chat Cafe.
The cafe was also shut down.
This is not the first time the 53-year-old pier has shown signs of stress. In 2021, part of it was shut down after handrails along the edge collapsed. And in 2023, after a series of storms pummeled the Central California coast, damaging parts of the pier, the structure was partially closed for more than year.
Those same storms caused extensive damage in Aptos and Capitola, 70 miles south, where piers and waterfront infrastructure were swept away or damaged.
In 2024, a 150- to 180- foot section of the Santa Cruz wharf was ripped off by powerful waves.
At least 10 of the state’s dozens of coastal public piers were closed for part or all of 2024 due to structural damage sustained in winter storms since 2022. At least five others have longer-term upgrades planned to address structural issues.
“These things are costly to maintain,” said Zach Plopper, senior environmental director at Surfrider. “They are a part of our California coastal culture in many ways, but we’re going to need to reckon with, one, the state that they’re in, and two, the continuous and worsening threats they’re going to experience,”
He said most of the piers were constructed in the early 1900s, and they weren’t built to withstand decades of rough seas, storms and rising sea level.
“With this incoming El Niño, which is forecasted to be significant, and this marine heat wave we’re in the midst of, we’re kind of in uncharted waters as far as what this winter could bring in terms of storms and swells to the California coast, and we’re likely going to see a lot more damage,” he said. “Not just piers, but roads and other coastal infrastructure up and down the state.”
There was no storm in Pacifica earlier this week, so no single event could be blamed for the destruction.
However, a 2025 report from an outside engineering firm, GHD, found that several sections of the pier were in “poor” or “serious” condition, and they recommended closure before anticipated storms or events that could “subject the piles to high winds, swells and large waves.”
The firm found several areas of the pier where concrete was missing and rebar was exposed and corroding.
“The pier has continued to experience high winds and large waves in a harsh marine environment,” the engineers wrote in the report, noting that continuous exposure to seawater or marine spray was “detrimental” to the structure.
A 2023 city report estimated it would cost $19 million to repair.
That same year, a state law was enacted to require local governments along the California coast to plan for sea level rise in the coming decades.
Sea level has risen some 8 inches, on average, along the coast in the past 150 years, Plopper said, and researchers anticipate another foot in the next 25 years.
“We’re going to see profound shifts on our coastline, none that we have ever experienced before, and building static structures on the coast just doesn’t work all that well,” he said. “We’re going to have to make some really hard decisions.”
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