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California pushes to expand the universe of abortion care providers

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California pushes to expand the universe of abortion care providers


Credit: MART PRODUCTION from Pexels

California’s efforts to expand access to abortion care are enabling more types of medical practitioners to perform certain abortion procedures—potentially a boon for patients in rural areas especially, but a source of concern for doctors’ groups that have long fought efforts to expand the role of non-physicians.

The latest move is a law that enables trained physician assistants, also known as physician associates, to perform first-trimester abortions without a supervising physician present. The measure, which passed last year and took effect Jan. 1, also lets PAs who have been disciplined or convicted solely for performing an abortion in a state where the practice is restricted apply for a license in California.

Physician assistants are now on par with nurse practitioners and certified nurse midwives trained in abortion care, who in 2022 won the ability to perform abortions without a doctor present.

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The need for more abortion care practitioners is being driven by efforts in many states to gut abortion rights following the Supreme Court’s 2022 decision ending constitutional protection for the procedure. Thirty-one states have implemented abortion restrictions that range from cutting federal funding for abortion coverage to outright bans, according to the Guttmacher Institute, a research organization concerned with reproductive health.

With the new law, “there will be fewer barriers, and shorter wait times for this essential service,” said Jeremy Meis, president-elect of the California Academy of Physician Associates. While it is unclear how many of California’s 16,000 PAs will be trained in performing abortions, research shows that PAs are more likely than physicians to practice in rural areas where access to abortion is limited. More than 40% of counties in California lack clinics that provide abortion.

Comparing data from the first six months of 2020 with the same period in 2023, the number of abortions jumped from 77,030 to 92,600 a 20% increase as the state became a refuge for women seeking abortions. California has passed a suite of reproductive health laws to build in protections and increase access, and a dozen other states, including Oregon, Minnesota, and New York, have mounted similar efforts. Seventeen states, including California, now allow PAs to perform first-trimester abortions, according to the American Academy of Physician Associates.

There was little opposition to the new California law, with two physicians’ groups supporting it. But the American Medical Association, the country’s most powerful doctors’ lobby, has fought vigorously against what it calls “scope creep”—that is, changes that allow clinicians like PAs to do medical procedures independent of physicians.

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“Our policy stance is the same on scope of practice expansion regardless of procedure,” noted Kelly Jakubek, the AMA’s media relations manager. The AMA’s website points to legislative victories in 2023, including striking down “legislation allowing physician assistants to practice independently without physician oversight,” in states including Arizona and New York. The AMA did not take a formal position on the California legislation. Its local chapter, the California Medical Association, took a neutral position on the legislation.

In preparation for the new law, one physician assistant at Planned Parenthood Pasadena & San Gabriel Valley began learning how to perform aspiration abortions—a procedure also known as dilation and curettage that uses gentle suction to end a pregnancy—at the end of last year.

The PA, who requested anonymity due to concerns about safety, said that with abortion restrictions in place around the country, “I just think it’s really important to be able to provide a comfortable, safe, and very effective way to terminate a pregnancy for patients.”

She is now one of six PAs and midwives at her clinic who can offer aspiration abortions. To reach competency, she participated in 50 procedures and learned how to administer medication that eases pain and anxiety. Such conscious sedation, as it is known, is frequently used for first-trimester abortions. Now she, like any other advanced practice clinician who has obtained skills in performing abortions, can train her peers—another feature of the new law.

The length of time for training and the number of procedures to reach competency varies based on a practitioner’s previous experience.

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“It’s encouraging this cross-profession training and collaborations, which is really important when we’re looking at increasing access to essential services,” said Jessica Dieseldorff, senior program manager of abortion services at Planned Parenthood Mar Monte in Santa Cruz.

In December, California committed $18 million to help accelerate training in abortion and reproductive care for practitioners, including PAs, through the Reproductive Health Care Access Initiative.

Dieseldorff, a nurse practitioner who trains other advanced-practice clinicians in abortion care, said that rural communities, in particular, will reap the benefits since many rely solely on physician assistants and other allied clinicians.

Reflecting on her career, she said much has changed since she became a nurse 25 years ago. At that time, she worked only as support staff to doctors providing abortions.

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“When I began, medication abortions did not exist in this country,” she said, referring to the practice of using two drugs often prescribed to induce abortions. “It’s been gratifying to be able to progress and become a provider myself, provide non-stigmatizing and compassionate and safe care to patients; and now, at this stage in my career to be training others to do the same.”

2024 KFF Health News. Distributed by Tribune Content Agency, LLC.

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California

New California law extends time for renters to respond to evictions

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New California law extends time for renters to respond to evictions


SAN DIEGO (KGTV) — Starting Jan. 1, 2025, a new California law will double the response time for tenants facing eviction, offering them more opportunity to seek legal advice and adequately prepare their cases. The law extends the response period from five business days to 10 business days.

Genea Nicole Wall, a tenant from City Heights, experienced the turmoil of eviction earlier this year after failing to pay her rent on time.

“You’re trying to pack up and trying to respond. You’re just all over the place. You’re emotionally all over the place,” Wall says.

Unlike most other court summons that allow for a 30-day response period, eviction notices in California have traditionally given tenants only five business days to act. Wall described her struggle to navigate the court system under these constraints.

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“Going to court trying to get assistance… It was just a grueling task. Daunting trying to get stuff done,” she says.

The new state law is designed to provide tenants with more time to stabilize their situation and seek proper legal support.

“What do those extra five days mean for someone who was just served an eviction notice? It’s giving people more time to get your bearings, figure out what you’re going to do before it’s too late and you lose automatically and get fast-tracked to being homeless and kicked out of your home,” says Gilberto Vera, an attorney with the nonprofit Legal Aid Society.

According to Vera, 40% of tenants facing eviction in San Diego last year did not respond to their court summons, effectively forfeiting their cases.

“If they don’t respond and tell the court that the eviction was wrongful and invalid – they’ll lose automatically,” Vera says.

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Vera hopes this law will help tenants better understand their rights and prevent wrongful evictions by providing the necessary time to form a defense.

“I would be able to think — you could plan to take the time off to do what you need to do to get the assistance,” Wall says.

Wall, now living in Brea after being evicted from her City Heights apartment, believes she could have won her court case had this law been in effect.





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Federal homelessness data says California homeless population grew to 187,084 – Washington Examiner

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Federal homelessness data says California homeless population grew to 187,084 – Washington Examiner


(The Center Square) – Newly released federal data says California’s homeless population grew to 187,084 at the start of 2024, up from 181,399 in 2023, raising questions about the efficacy of the state’s tens of billions of dollars in recent homeless spending. 

Most of the state’s increase in homelessness can be attributed to growth in the state’s unsheltered homeless population, which is nearly half of the nation’s total. However, the state’s homeless population did grow much less than the national average, suggesting some of the state’s programs — albeit costly — may finally be making an impact. 

In September, California Gov. Gavin Newsom’s office brushed off a CalMatters estimate that the state’s homeless population grew to nearly 186,000, telling The Center Square the organization’s reporting was based on incomplete data that analyzed only 32 of the state’s 58 counties. 

“California and other officials use official confirmed data published by the U.S. Department of Housing and Urban Development, and not CalMatters’ estimates, which are unverified,” said a Newsom spokesperson to The Center Square in September, when CalMatters released its report.

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Now, the verified count from the U.S. Department of Housing and Urban Development recommended by Newsom’s office shows that homelessness is even higher than CalMatters estimated. This 5,685 individual increase in the state’s homeless population could suggest the state’s homelessness efforts — and tens of billions of dollars in recent state funding — have been unable to stop the growth of the state’s homeless population. 

Earlier this year a state auditor looked into $24 billion of state homelessness spending, finding “the State lacks current information on the ongoing costs and outcomes of its homelessness programs” because it has “not consistently tracked and evaluated the State’s efforts to prevent and end homelessness.”

Newsom vetoed two widely-supported bipartisan bills to better track and evaluate homelessness spending and outcomes, saying his own directives to increase accountability make the measures redundant. 

The state is now home to 123,974 unsheltered homeless individuals — up from 117,424 the year prior —  or nearly half of the nation’s total. In 2019 — before the COVID-19 era — California had 151,278 homeless individuals, 108,432 of whom were unsheltered.



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Your favorite movies starring California

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Your favorite movies starring California


Good morning, and welcome to the Essential California newsletter. Here’s what you need to know to start your weekend:

The best movies that capture the essence of California

The Essential California team this year expanded opportunities for readers to directly engage with the newsletter. Each week we ask readers to answer a question — from the best local restaurants to favorite books.

One question in particular got a lot of attention and sparked some debate: What is your favorite movie that captures the essence of California?

Below are the most mentioned movies and comments from readers about what makes these films special to California. We hope this list will help find something to watch this weekend. Enjoy!

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“Chinatown”

Adelaide writes: “It doesn’t get more iconic than a film noir that tackles tremendous geopolitical issues that still affect us to this day.”

And Jim writes: “How can you talk about movies that capture the essence of California and not mention one of the greatest movies of all time, ‘Chinatown’? Today, despite the state’s beauty and glorious climate (most of the time), it is still as corrupt and morally bankrupt as it was back in the days of stealing water from the Owens Valley.”

Paul Giamatti, left, and Thomas Haden Church in the 2004 movie “Sideways,” directed by Alexander Payne.

(Searchlight Pictures)

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“Sideways”

Raymond Ballesteros writes: “One of my all time favorite movies to see that truly captures the essence of California, hands down, is ‘Sideways.’

“Alexander Payne seizes the beauty and majesty of California’s Santa Barbara wine country, including a handful of wineries that encapsulates the hearts of fellow wine lovers across California and the country. Of course, not to be watched with a glass of Merlot!”

One man stands looking at another man who's holding a surfboard in front of him

Keanu Reeves, left, and Patrick Swayze in the 1991 film “Point Break.”

(20th Century Fox)

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“Point Break”

Fritzi Lareau write: “I am a tour guide and when touring the Golden State I show my guests ‘Point Break’ (the original with Keanu Reeves and Patrick Swayze) or ‘Hollywood Homicide’ starring Harrison Ford.”

A black-and-white film still of a man with glasses looking skeptical

Edward James Olmos stars as Garfield High School math teacher Jaime Escalante in 1988’s “Stand and Deliver.”

(Warner Bros. Pictures)

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“Stand and Deliver”

Robert Reul writes: “One great film that is 100% California is ‘Stand and Deliver,’ with Edward James Olmos and an amazing cast of young actors. I have found few, if any, films that capture the absolute magic that can happen in the community of first-generation Americans, descended from hard-working Mexican immigrants.”

Jeff Bridges takes a fighting stance in "The Big Lebowski."

Jeff Bridges as the title character in the Coen Brothers’ “The Big Lebowski.”

(Merrick Morton / Gramercy Pictures)

Honorable mentions

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“Top Gun”

“The Birds”

“The Parent Trap”

“The Big Lebowski”

“Fast Times at Ridgemont High”

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“La La Land”

Want to wade into the debate over which movie captures the essence of California? Feel free to email us at essentialcalifornia@latimes.com.

The week’s biggest stories

President-elect Donald Trump stands at a podium, American flags behind him, at his Mar-a-Lago estate in 2023.

President-elect Donald Trump, shown at his Mar-a-Lago estate in 2023, is stocking his cabinet with Floridians.

(Evan Vucci / Associated Press)

Florida is winning the political battle with California as Trump takes office

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  • Trump is stocking his cabinet with Floridians. And his plans to reverse California’s policies on the environment, crime, homelessness and education are facing far less pushback than they did during his first term.
  • Gov. Gavin Newsom has vowed to continue the fight against Trump’s policies but without what he called “a resistance brand” that defined his earlier clashes.
  • Meanwhile, healthcare is Newsom’s biggest unfinished project. Trump complicates the governor’s task.

Destructive waves keep thrashing Santa Cruz, causing millions of dollars in damage in recent years

Scientists say we are fighting H5N1 bird flu with one hand tied behind our backs

  • Scientists and health officials fear we’re on the precipice of another global pandemic as the H5N1 bird flu virus steamrolls its way across the globe. But when that could come to pass is hard to predict.
  • Just one mutation can make the bird flu a threat to humans, California researchers found.
  • L.A. County health officials are warning pet owners to avoid raw cat food after a feline died of bird flu.

California is growing again

  • The Golden State’s population grew by almost a quarter of a million residents in 2024, according to the U.S. Census Bureau, a rebound that brings California almost back to its pre-pandemic numbers.
  • While California’s population gain of 232,570 people from July 1, 2023, to July 1, 2024, represents the largest numeric population increase in the nation’s West, it lagged behind Texas, which expanded its population by 562,941, and Florida, which grew by 467,347 people.

More big stories

Get unlimited access to the Los Angeles Times. Subscribe here.

This week’s must reads

Illustration of a police search party in a snowy wooded area. Splatters of blood are seen in the snow.

(Emiliano Ponzi / For The Times)

A California inmate recruited “wives” to spread fentanyl across Alaska, federal authorities say.

The prisoner, Heraclio Sanchez Rodriguez, oversaw a sprawling drug ring that spread death and addiction to the most remote corners of Alaska, prosecutors say.

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More great reads

How can we make this newsletter more useful? Send comments to essentialcalifornia@latimes.com.

For your weekend

a man in a green tracksuit with his hands behind his head

Refresh yourself on “Squid Game” before starting Season 2 on Netflix.

(No Ju-han / Netflix)

Going out

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Staying in

How well did you follow the news this week? Take our quiz.

A collection of photos from this week's news quiz.

(Times staff and wire photos)

Which creature gets top billing in the title of the Barry Jenkins–directed “Lion King” prequel that hit theaters last week? Plus nine other questions from our weekly news quiz.

Have a great weekend, from the Essential California team

Hunter Clauss, multiplatform editor

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Check our top stories, topics and the latest articles on latimes.com.



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