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This story is part of the Cap Times series Deadly Divide, investigating Wisconsin’s ongoing Black infant mortality crisis. The reporting is supported through a National Fellowship from the USC Annenberg Center for Health Journalism.

Click here to read highlights from the story

• Wisconsin’s Black infant mortality rate remains more than twice the rate for white infants. Nearly 850 Black babies died before their first birthdays from 2015 through 2024.
• Five women in the Wisconsin Legislative Black Caucus call the crisis deeply personal, citing their own experiences with premature births, frightening pregnancies and unequal treatment in health care. 
• Black Caucus lawmakers last session introduced a seven-bill Birth Equity Act addressing doula care, maternal mental health, dental care, postpartum support and other needs — but none of the bills received a committee hearing before the Republican-controlled Legislature adjourned.
• Republicans who control the Legislature have declined to advance similar legislation for years. 
• Black Caucus lawmakers say reducing Black infant deaths requires policy changes and greater trust in the medical system, including culturally competent care.

For decades, Wisconsin’s Black infant mortality crisis has been measured in painful numbers: babies who die before their first birthdays, families left grieving and an enormous racial disparity that never relents. 

Wisconsin regularly ranks among the worst in the nation when it comes to the rate at which Black babies die before reaching age 1. In 2024, the most recent year for which the Wisconsin Department of Health Services has publicized data, the state had an infant mortality rate of 12.5 deaths for every 1,000 live births among Black babies. For white babies, that rate was 4.8. 

Between 2015 and 2024, nearly 850 Black babies died in Wisconsin before turning 1, according to state data. Over the first half of that decade, nearly 25% of the deaths of Black infants were caused by being born into this world too early and too small to survive.

But for the five women in the Wisconsin Legislative Black Caucus who have pushed awareness of the issue year after year, the crisis is not abstract or statistical. It is personal. 

Wisconsin’s notorious peril for Black pregnancies is a fear and a pain they have known in their own bodies, and one they have returned to the Capitol session after session determined to change. 

One legislator delivered her daughter nearly eight weeks early. Another, state Rep. Margaret Arney of Wauwatosa, was born prematurely alongside her twin. State Rep. Sequanna Taylor of Milwaukee was told she was unlikely to carry her pregnancy to term, but not why. And this year, one of the lawmakers carried that same fear throughout her first pregnancy.

“Being a senator that knows all the data I think has made it more nerve-wracking,” said Sen. Dora Drake, D-Milwaukee, while holding her pregnant belly during a listening session with the Cap Times in July. Drake delivered her baby without complications in early September. 

Wisconsin continues to face one of the nation’s highest rates of Black infant mortality in the nation, a crisis these five women say cannot be separated from the lived experiences of the families and babies behind the numbers. 

But session after session, they say they have run into resistance from Republican leaders who have declined to give any one of their proposals even a committee hearing. 

“We encountered nothing but struggles in this building,” said Sen. LaTonya Johnson, D-Milwaukee. 

Last spring, Rep. Shelia Stubbs, D-Madison, worked with members of the Foundation for Black Women’s Wellness in Madison to develop the latest version of the Birth Equity Act — a package of seven bills aimed at improving birth outcomes and connecting expecting and new mothers with resources that increase their chances of carrying healthy pregnancies to term and managing the postpartum period with greater support. 

The proposals were based on what the foundation has heard from community members about what would help Black mothers, babies and families the most. 

“These bills came directly from Black women,” Stubbs said. 

• Assembly Bill 1082 would have created a sales tax exemption for breastfeeding equipment.
• Assembly Bill 1083 would have barred the state from seeking recovery or reimbursement of birth expenses from a new mom covered by the state’s Medicaid program.
• Assembly Bill 1084 would have ensured the Medicaid program covers services by a dentist or dental therapist and stipulated that pregnant patients should be able to receive timely dental care during pregnancy.
• Assembly Bill 1085 would have required Medicaid plans to cover care provided by a doula before, during and after delivery.
• Assembly Bill 1086 would have required Medicaid to cover maternal mental health screenings and required the state’s health department to develop — in consultation with advocates and providers within the Black community — a set of standards to ensure cultural competency in maternal mental health screening practices.
• Assembly Bill 1087 would have allowed for a pregnant person to enroll in a health insurance plan outside of a standard enrollment period after becoming pregnant to ensure prenatal care is covered by a health plan.
• Assembly Bill 1088 would have required hospitals to provide a postpartum home visit to a new mom and baby, if requested, within the first few weeks after giving birth. The bill also would have required health insurance plans to cover these visits. The visits could be conducted by a doula, midwife, nurse-midwife or other licensed health care provider who is certified to provide postpartum care.

But none of the bills introduced last February received a public hearing before the Republican-controlled Legislature adjourned its session early, Stubbs said. 

That included bills assigned to the committees she said were best suited to consider them, like the Assembly Committee of Health, Aging and Long-Term Care where she holds a seat. 

The proposals were aimed at shrinking disparities and improving maternal and infant health in Wisconsin through a variety of approaches ranging from insurance-covered doula care to ensuring pregnant women get adequate dental care. 

“Of all of the bills we introduced, absolutely none of them received a hearing, which is very shameful (and) unacceptable in the state of Wisconsin,” Stubbs said. “So even serving on a committee that’s most appropriate to have these bills, we still couldn’t get these bill hearings.”

Republican Rep. Clint Moses, who chairs the Assembly health committee and holds gatekeeping power over which bills receive hearings, did not respond to multiple requests for comment for this story. Committee chairs often decide which bills receive hearings in line with party leadership priorities. 

For Drake, the lack of movement comes down to a simple conclusion. 

“It’s not a priority for them, honestly, and that’s really the bottom line,” she said. 

A crisis measured in lives

Wisconsin’s Black infant mortality crisis has persisted for generations. And the women pushing for change say the disparities cannot be explained by income or individual behavior. 

Arney, a Democrat from Wauwatosa, knows that personally. 

“This is a generational issue,” Arney said. “I am a twin. My twin sister and I were born prematurely. Our lives were at risk.” 

Her mother was college-educated, she said, but that did not erase the risks associated with being a Black mother in America. 

“It’s more than just social class,” Arney said. 

Johnson, the senator from Milwaukee, said she has encountered resistance to policies specifically designed to address racial disparities based on an argument that helping Black families reduce disproportionate harm is discrimination itself. 

“A lot of the feeling in this building is that if something is targeted specifically, then it’s somehow discriminatory,”  said Johnson, the lawmaker who delivered her daughter two months early. 

But, she said, the nature of the crisis demands a targeted response. 

“It’s not discriminatory that it’s kids who look like us that are dying, but it’s discriminatory because we want to fix it?” Johnson said. 

The lawmakers pointed to policies that have passed as examples of what can happen when the Legislature works together. 

Johnson cited Act 102, signed by Gov. Tony Evers earlier this year, which extended the period of time Medicaid covers postpartum services. About 76% of Black women who give birth in Wisconsin are on Medicaid, making this law particularly important to fight to save Black babies, she said. 

“That bill will disproportionately impact Black women, which in this case is a good thing,” Johnson said. “That will be one piece of legislation that will start to uncover the core of what’s really taking place.”

But the lawmakers say broader changes — including greater access to doulas and culturally competent care — are still needed. 

“Several of us were working on trying to have that coverage provided, because the research shows that having doulas and midwives helps mitigate some of those harmful factors,” Drake said. 

Having that kind of support was important to her personally, she said, because “that was something that I really wanted to ensure I had someone I could trust.”

When the statistics become your own 

Before Johnson’s daughter was born — a few days shy of 32 weeks — a midwife recognized that Johnson and her pregnancy could be in danger. 

“My midwife went to the doctor and said ‘Look, she’s high risk. She needs another level of care other than what I can provide,’ and I didn’t get it,” Johnson said. 

Johnson spent two weeks in the hospital before her daughter was born, receiving steroid shots to help develop her baby’s lungs, she said. 

Her daughter was born on June 3 and went home on June 22, Johnson’s birthday. 

Johnson quickly returned to work, without giving herself time to recover from giving birth because she felt driven to make sure she could pay the bills as a single mother. 

“So when (my daughter) got home, she had a place to come home to,” Johnson said. 

But she later learned something about her pregnancy that she said doctors had not told her at the time: She had contracted an infection that caused premature delivery. 

“There was things I didn’t realize about my own pregnancy until I got a copy of the medical records,” Johnson said. “My experience was so horrible. I remember saying I would never have another baby.”

Her daughter survived and is now in her 20s.

“The fact that my daughter made it to her first birthday was a luxury that a lot of these Black babies are not afforded,” Johnson said. 

Rep. Taylor’s experience was different, but it left her with many of the same questions and a similar, lingering pain. 

During her pregnancy with her youngest daughter, Taylor said, her doctor told her she was unlikely to carry her baby to term. He never explained why. 

“They were so cold,” she said. “I know as doctors they can’t be emotional because they deal with so many people. But to tell me ‘There’s nothing you can do to help. This baby won’t go to term. Go home. If you start bleeding or something, come back…’’’

The interaction left Taylor feeling unable to connect to her pregnancy because she was so convinced she would lose it. 

Taylor, who is from Milwaukee, did carry her daughter to term. But after delivery she was rushed to emergency surgery because she couldn’t successfully deliver her placenta, a complication that can lead to serious infection. 

Taylor now wonders whether her medical team failed to adequately screen her for complications because they already assumed her pregnancy would fail. 

The fear of not being heard 

For the lawmakers, the problem is not only access to care. It is whether Black women are believed, listened to and treated with dignity when they seek it.

“There’s this notion of who gets to have access to health care,” Drake said, adding that she has experienced that dynamic herself. 

Two years ago, she went to a hospital in Milwaukee with a broken arm. When she told the staff she had state insurance — the coverage  provided to her as a Wisconsin legislator — the hospital assumed she meant Medicaid. 

During Stubbs’ pregnancy, a nurse mistakenly gave her the test results of another Black patient. 

“It wasn’t stressful carrying my child,” Stubbs said. “It was stressful going to the doctor.”

Arney said she has seen the same pattern play out over generations. 

Years ago, she participated in a focus group of Black women discussing their experiences giving birth. Arney said she was fortunate. Her sister, who is a doctor, was there. She had a doula, a midwife, an obstetrician and her husband supporting her. 

Nearly every other woman in the group, Arney said, described a traumatic birth experience. 

“Different years. Different times. This is what I’m talking about with the generational thing,” Arney said. “It’s like these kinds of things are not moving. This is not budging. This needs attention. It needs focus and it needs urgency.” 

A crisis of trust 

The lawmakers say those experiences have contributed to a broader lack of trust between Black women and the medical system. 

“People can go through history on how hospitals and medical professions have used Black women’s bodies for experimentation,” Drake said. “This is not hidden. This is known. This is documented.” 

One of the more egregious examples of this is by 19th-century physician James Marion Sims, the so-called “father of gynecology” who developed techniques in the field by performing dozens of experimental surgeries without anesthesia on three enslaved women without their consent. The women — Anarcha, Lucy and Betsey — have been memorialized in the Mothers of Gynecology sculpture in Montgomery, Alabama. 

That pain haunts the medical profession and is a traumatic history providers must intentionally work to move beyond, reestablishing trust among Black women, the lawmakers said. 

This work, Arney said, must go beyond individual providers. 

“I know there’s some health systems that are trying to take this on, but I hate to say it’s baked into our culture that there’s this callousness towards Black women,” Arney said. 

That distrust can make pregnancy itself more frightening, regardless of the resources you have sought for yourself. The data and statistics surrounding Black birth outcomes in Wisconsin have remained in the back of Drake’s mind throughout her pregnancy. Despite the fact that she is a college-educated professional social worker and a member of the Wisconsin Senate. “Those are still the realities we have in our state,” she said. 

Inside the Capitol

The women of Wisconsin’s Legislative Black Caucus say the political resistance to their proposals is part of the same struggle. 

Stubbs said her white Democratic colleagues have been supportive, often signing on as co-sponsors to her legislative proposals and allowing the Black Caucus to lead on issues they view as particularly tied to the Black community. 

That support matters, she said, because the Black lawmakers bring lived experience that their white colleagues don’t have in the same way. 

“It’s helpful, because nobody knows our struggle the way that we do, and they’re not going to understand,” Stubbs said. 

But there is a limit to simply standing behind the Black Caucus, she said. It’s not enough to simply sign onto legislative proposals or attend press conferences during Black History Month or in June, when Juneteenth falls.

“Sometimes it’s harmful to just be like ‘You got it,’ you know?,” Stubbs said of the type of support she gets from other Democrats.

Stubbs said she has also had conversations with white lawmakers who choose not to believe the evidence showing racial disparities in health outcomes. 

“In that building, we have many of our colleagues that don’t believe in diversity, equity or inclusion,” Stubbs said. “We have a federal government that doesn’t believe in that. So we’re fighting already systems that don’t believe in us.”

Some lawmakers, she said, see the Black Caucus’ efforts as blowing an issue out of proportion. 

“They don’t want to believe the data,” Stubbs said. “They think it’s us coming one more time with another inequity, but it’s a fact, and so it is our responsibility as a state to address this.”

The five legislators say they have heard about the pain and trauma of this crisis from constituents. They have lived it themselves; in premature births, frightening pregnancies, traumatic deliveries and the persistent pain of being made to feel less than. 

That’s why the fight is much more than a political one, they said. 

The stakes are measured in whether a baby gets to come home. 

“We have these stories,” Stubbs said, “and we are telling them because we want to save the next life.”

Erin McGroarty is a health and policy reporter for the Cap Times in Madison. She can be reached at emcgroarty@captimes.com.

How a fight to save Wisconsin’s Black babies keeps hitting a dead end is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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Wisconsin Watch has documented the deadly toll of Wisconsin’s drinking culture, from liver disease and alcohol poisoning to crashes involving impaired drivers. 

But one alcohol-related danger receives far less attention — and it doesn’t end when someone hands over the car keys: walking while intoxicated.

Police reported suspected alcohol use among nearly 1 in 5 pedestrians killed in Wisconsin crashes between 2017 and 2025. Because pedestrians are not routinely tested, researchers say the true share may be higher.

The pattern is not unique to Wisconsin. Nationwide in 2024, 27% of pedestrians killed in traffic crashes were alcohol-impaired, compared with 15% of drivers involved in fatal pedestrian crashes, according to the National Highway Traffic Safety Administration.

The figures do not make the danger of walking drunk comparable to driving drunk: An impaired driver controls a fast-moving vehicle and endangers others. But they underscore the risks intoxicated pedestrians face.

“We always hear somebody talking about having a safe plan home, have one sober driver. Maybe you should have a sober walker if you’re walking home,” said Vera Elle, a researcher at Wellbrook Recovery, a Brookfield-based alcohol and substance recovery rehabilitation center. She and her colleague Shimmy Stregosky wrote a series of reports on the topic and brought the issue to Wisconsin Watch’s attention.

Alcohol-related pedestrian crashes fall from 2019 peak

The number of annual crashes involving drunk pedestrians dropped from a 2019 peak of 126 to 101 in 2025. Annual deaths in those crashes plunged from 15 to five during the same period.

That trend coincided with lower reported binge drinking, defined as four or more drinks for women and five or more for men on a single occasion, said Maureen Busalacchi, director of the Wisconsin Alcohol Policy Project at the Medical College of Wisconsin. 

She cautioned that the data cannot establish that changing drinking habits caused fewer pedestrian crashes. Traffic volume, remote work and vehicle speeds also affect crash frequency. 

“The use of alcohol is going down, and then you start to see changes in perceived health effects. So more people are starting to see it as bad for health than they have in the past,” Busalacchi said.

Nationally, Gallup found that 54% of adults reported consuming alcohol in 2025, a record low in its polling. The share of adults ages 18 to 34 who considered moderate drinking harmful rose from 34% in 2018 to 66% in 2025.

In Wisconsin, the state’s Behavioral Risk Factor Surveillance System estimates a similar trend: The share of adults reporting binge drinking fell from 21.9% in 2019 to 19.1% in 2024.

Alcohol-related crashes span age groups

From 2017 through 2025, 16 pedestrians ages 35 to 39 were killed in Wisconsin crashes in which police suspected they consumed alcohol, according to a Wisconsin Watch analysis of Wisconsin Department of Transportation data. 

That was the highest death toll of any five-year age group. Pedestrians ages 30 to 34 had the second-highest total, with 11 deaths, followed by those ages 25 to 29 and 50 to 54, with 10 each. Overall, 78 of the 96 pedestrians killed were ages 20 to 59.

Across crashes of all injury severity, pedestrians in their 20s accounted for the most cases involving suspected alcohol use. The total was highest among those ages 20 to 24, followed by those ages 25 to 29. But the numbers remained relatively high across most age groups from 30 to 59. Most pedestrians in those crashes suffered injuries.

The data showed a stark difference in injury severity: 44.6% of pedestrians suspected of alcohol use were seriously or fatally injured, compared with 21.1% of those without suspected alcohol use. 

However, the connection does not establish that alcohol alone caused the difference. Nor can the data show how much more likely an intoxicated person is to be struck because no reliable count exists of how many intoxicated and sober people walk Wisconsin’s roads.

The figures are also likely to understate how many pedestrians involved in crashes had been drinking, said Richard Blomberg, vice president of the research firm Dunlap Research. 

His research found that police generally identified alcohol use reliably when they checked the “had been drinking” box on crash reports. But an unchecked box did not mean a pedestrian was sober because police were less likely to document alcohol use when signs were unclear.

Research shows alcohol’s role in pedestrian crashes

Adults who had been drinking, especially those doing so excessively, were heavily overrepresented among pedestrians struck by vehicles, Blomberg found in a study he designed in the 1970s. About half of the adult pedestrian victims had been drinking, and nearly one-quarter had a blood alcohol level of 0.20% or higher.

Blomberg also compared crash victims with a random sample of pedestrians walking on the street near the crash sites. The researchers assembled three control groups. Some pedestrians were sampled at the same locations, days and times as previous crashes, while others were sampled at 112 randomly selected locations across New Orleans. The comparisons allowed Blomberg to estimate the extent to which alcohol was overrepresented among crash victims.

Blomberg also found alcohol-involved victims were disproportionately middle-aged men and more likely to have arrest records. Their crashes clustered at night and on weekends. 

Blomberg cautioned that findings in one city did not represent the entire country, even if New Orleans was reasonably similar to other urban areas. Almost half a century later, he found the same demographic overrepresented in an analysis of crash data from five states from 2007 to 2017.

Later studies examined a related but different question: whether alcohol was associated with more severe injuries once a pedestrian was struck. In a study published in 1995, Dr. James Williams of Memorial Medical Center in Savannah, Georgia, reviewed autopsies of 223 pedestrian fatalities. He found that alcohol-involved pedestrians were more likely to suffer more severe injuries than sober pedestrians when struck by vehicles. Because the study included only fatalities, it did not measure whether intoxicated pedestrians were more likely to die after being struck.

A Florida analysis published a year later, however, found that pedestrians classified by police as under the influence had four to five times the adjusted odds of dying from a collision as pedestrians not classified as such. Rebecca Miles-Doan, the analysis’ author, cautioned that the finding might overestimate the association because police tend to conduct more intensive investigations into fatal cases. 

Using more recent data from 2011 to 2016, University of Tennessee researchers found that alcohol was identified in about 7% of Tennessee pedestrian crashes but in 22% of pedestrian fatalities. The researchers pointed to limitations of their study: Few crashes had BAC readings, and alcohol classifications relied heavily on police judgment.

Experts point to public health solutions

Unlike impaired driving, walking while intoxicated generally is not a crime in Wisconsin. The Legislature eliminated the crime of public intoxication in 1973, which critics said created a “revolving door” through the criminal justice system for lower-income people and did little to improve rehabilitation — and sometimes worsened it.

Experts interviewed for this story also do not view criminalization as a principal solution. 

Cities elsewhere have experimented with less punitive measures to improve safety. Baltimore launched the “Walk Smart Baltimore” campaign at the turn of the century. Blomberg participated as a researcher. 

The campaign tested measures that did not depend entirely on intoxicated pedestrians making safe decisions. The city distributed reflective hats and used television, radio, billboards and flyers to warn pedestrians of dangers.

The evaluation reported fewer pedestrian crashes in the target area, although Blomberg said the program required resources that made it difficult for other communities to replicate.

“We can wrap them in cotton and potentially keep them from being injured in a crash or in a fall, but the health effects of that excess alcohol use are still there,” Blomberg said. “If we solve the underlying alcohol problem, everything else goes away.”

Addressing excessive alcohol use is the long-term goal, Blomberg said, but communities should not wait to reduce immediate risks through other efforts including safer vehicle designs, separating pedestrians from traffic or other measures. 

If a street redesign, safer ride home or other intervention reduces alcohol-involved pedestrian crashes by even 5% or 10%, he said, “then of course we should do it.”

DataWatch: The overlooked risks of walking while intoxicated is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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Click here to read highlights from the story

• Wisconsin Watch spoke to three small business owners who put their businesses on hold to serve the community after the July 27 tornado. 
• Destiny Antuna of Fox Valley Meal Prep, Lora Glasel of the Recyclist Bicycle Co. and Shane Rosenow of Rosenow Customs talked about the support they found throughout the Fox Cities. 
• They also shared how they will continue to support relief efforts even as they turn their attention back to their businesses.

For a few weeks, countless donations piled up on Destiny Antuna’s shop floor. 

Stacks of canned food, water bottles, Band-Aids, toilet paper, paper plates, work gloves, dog food and boxes of diapers made it almost impossible to walk through the store. Her business in Kaukauna, Fox Valley Meal Prep, usually sells handmade meal kits. But last month, it became a hub for delivering care packages to neighboring Appleton, Neenah and Menasha. 

Ever since the July 27 tornado that damaged homes and businesses in the Fox Cities, community support has poured in. Classified as an EF3, the tornado caused an estimated $8.2 million in damages to over 2,300 structures. With 84 structures destroyed and 412 majorly damaged, many residents were left without shelter, transportation or basic needs.   

Emersyn Banda, a 20-year-old Menasha resident, described the experience of the tornado as life-altering.

“I remember instantly just crying when I had seen it, because I mean, houses were completely down. All of our trees are down. All of the power lines, people looking lost,” she said. “It looked like a nuke had hit our town. It was just in shambles. Everyone was on the phone trying to contact people.” 

In the chaos, community members’ overwhelming desire to help often came without knowing where to direct their efforts. That’s where small business leaders stepped in, putting their daily operations on hold and organizing large-scale efforts to direct volunteers and donation requests. Now, they’re navigating how to continue helping while keeping their businesses afloat. 

Meeting the needs of tornado victims in real time

Antuna was in Menasha during the tornado, completing renovations on a new location she had planned a grand opening for in the next week. She had to shelter in place during the storm.

“Luckily, we’re kind of tucked into a corner, so there wasn’t any major damage,” Antuna said. “It was just a lot of debris hitting that corner, but renovations were, for the most part, done there Monday while we were there, and we were hoping to do a soft opening that Sunday.” 

About an hour later, she immediately drove home to Kaukauna and made a post on Instagram letting people know she was accepting donations to distribute. A loyal customer in Menasha let Antuna turn his lawn into a hot food station and take requests for donations. 

“It was very shell-shocking to walk around and see some houses be totally fine and some others where it’s just their personal belongings just everywhere,” Antuna said. “Like, I have a little kid, that could have easily been like all of my kids’ toys.” 

Antuna and other business owners started going door to door with wagons, which she said was vital in getting the most up-to-date requests from affected residents. 

“I felt like everybody on the outside, in terms of help, was almost a day or two behind,” she said. “So by the time you would get people water, the next day there’s businesses trying to drop off pallets of water, but everybody already has enough water.” 

Lora Glasel, co-owner of Recyclist Bicycle Co. in Kaukauna, went door to door delivering food with Antuna. She soon realized that fixing up and donating used bikes would be helpful for people whose transportation had been destroyed.

“After the requests started rolling in for either people whose cars or bicycles or their kids’ bicycles were destroyed, we did not have enough bikes to accommodate the need,” Glasel said. “So we put a little bit of a call out to our community, and we’ve gotten a good amount of donations that over the next couple weeks we’ll be able to tune up and safety-check, and subsequently then deliver back to the affected area.” 

She delivered over 70 bikes to residents who needed a reliable way to work or even just to relax after a stressful day. Glasel hopes to turn it into a long-term program to help families in need, regardless of whether they were affected by the tornado. 

“To bring, maybe for some families, just a little semblance of normalcy of just being able to take their family on a bike ride in a time where their life is not normal at all is also pretty impactful,” she said. 

In addition to fulfilling specific donation requests for families, Antuna began using the Kaukauna store as a home base to create general care packages with essential household items and food. She used social media to call out for drivers to fill up their cars with 20-plus bags and drop them off one by one on people’s porches in the hardest-hit areas. 

“I will say, it definitely took over my life for the first week after (the tornado) … I do think the store got kind of neglected for the first week, so now we’re slowly trying to get back to a little bit of normalcy,” she said. 

Antuna, who also runs Bad Batch Fitness in Little Chute, struggled to find a sustainable way to run her businesses long term while coordinating the influx of donations coming in, requests from affected residents and volunteer schedules. 

“Once we started to gather a lot of volunteers and have people reach out, it made it a lot easier to delegate things and be able to give a little bit more focus to the businesses,” she said. “It’s definitely been a hard push and pull because if I could have everything run as normal and also be there, I absolutely would.” 

As Antuna moves into the next phase, Fox Valley Meal Prep is no longer accepting donations other than gift cards for gas and groceries. Her plan for the remainder of the year is to have a “meal match week” every month, donating a meal to families in need for every one purchased in-store.

Contractors volunteer to clear tons of debris, protect houses

Cleaning up the widespread destruction from July’s tornado took a legion of volunteers working tirelessly to clear streets and repair homes. Shane Rosenow, owner of the exterior remodeling company Rosenow Customs in Neenah, became an unofficial leader of the cleanup efforts. 

Rosenow said it all started with a post he made on Facebook with the office phone number and an offer to help with yard cleanup, tarping and assessing damage. 

“My phone just started ringing,” Rosenow said. “I had a band of I want to say 12 to 18 contractors that reached out and said, ‘Hey, let’s help. Let’s do this.’ And it was everything from people in the same trade that I do right now to people with heavy machinery, landscapers (and) home mold remediation people.” 

For the next two weeks, he devoted all of his time to the efforts, sleeping only a few hours each night and putting normal business operations on the back burner. He estimates they protected up to 200 homes by clearing fallen trees and setting up tarps. His team of contractors loaded and dumped over 190 tons of debris. 

“I’ve never seen anything like it before. Pictures don’t even do it justice,” he said. “I get emotional on this because Neenah’s my hometown, and Menasha’s like a sister town to us, and it’s going to take years, years (to rebuild).” 

Restoring the St. Mary Catholic Cemetery sticks out to him as the biggest miracle. He started with a small group on the Friday after the tornado, but soon, a bus drove by with about 50 volunteers from the faith-based group Risen Men. After a few hours of careful work, the cemetery curator came by.

“He goes, ‘You guys, in three hours, have done more work here than five of us in the church have done all week. What made you come here?’” Rosenow said. “And I said, ‘God, you know, he just told us, go.’”  

He also had a colleague create two Facebook groups, one for volunteers and one for donations, so Rosenow wouldn’t have to keep fielding texts and emails himself. That way, people could make a post with what they needed — for example, two or three people to help clean up their yard — and other community members could message them directly to coordinate help. 

“The goal behind that was to kind of divide and conquer and allow us to still go back to work, but still do some good in the community,” Rosenow said. “And it’s worked.”

Progress after such a large disaster isn’t always linear. Rosenow’s efforts were set back by a recent storm that blew the tarps off people’s roofs, meaning some homeowners had to start from scratch. The other contractors also needed to get back to work after the first two weeks, he said.

“Some of these guys, it’s just them,” Rosenow said. “And they’re like, ‘We don’t have any money, and we’re spending hundreds of dollars a day on fuel and maintenance on our vehicles and our equipment.’ So I said, ‘Get back to work. We will regroup.’”  

Even though he’s started being recognized as a local celebrity, he rejects that label and says nothing would be possible without God and the other community members who devoted their time.

“It’s not me. If it wasn’t for the people that stepped up behind me, we wouldn’t even be having this conversation right now,” Rosenow said.

Fox Cities businesses balance tornado relief with keeping doors open is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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• Wisconsinites have called or texted the 988 Suicide and Crisis Lifeline more than 345,000 times since it launched in July 2022. 
• States including Illinois and Minnesota have implemented telecommunications fees on phone bills that fund 988 in their states.  
• Other states have allocated long-term funding through budget appropriations or by introducing legislation to fine AI companies when their chatbots fail to refer people in crisis to mental health resources. 
• Wisconsin officials say the line’s growth surpassed all projections they had, and the organization that coordinates the service is continuously recruiting counselors. 
• Despite bipartisan support for the lifeline, lawmakers have failed to enact a permanent long-term funding mechanism for it. 

Every year, millions of people in crisis dial three numbers — not 911, but 988, the national suicide and crisis lifeline. People like Cadence Van Beek, who used the lifeline as a sophomore at Melrose-Mindoro High School in Melrose.

During a mental health crisis, Van Beek worried she would be placed on a waitlist or hurried through the process. Instead, a  counselor patiently  helped her de-escalate her feelings. At the end, she informed Van Beek about local resources in Jackson County.

“It didn’t feel rushed … She took her time with me, and she was very kind – just a kind soul,” she said.

Van Beek’s conversation is one of over 345,000 texts or calls to the state lifeline since its launch in July 2022. A recent JAMA study found that in the first two and a half years, suicides among 15- to 34-year-olds were 11% lower than expected, corresponding to nearly 4,400 fewer deaths.

Yet despite the line’s proven success and increased demand, long-term funding remains uncertain. Unlike other states, Wisconsin has not passed legislation to permanently fund the service. And Wisconsin trails most states in the share of calls answered in-state.

In May, Van Beek visited the state Capitol and presented lawmakers with a solution: Fund 988 like 911.

Since 2009, Wisconsinites have paid a telecommunications fee on their phone bills for 911, currently 75 cents per month. Twelve states, including Illinois and Minnesota, have enacted a 988 fee to fund the service.

Illinois and Minnesota had in-state response rates of 90% in July — compared with Wisconsin’s 81%. The rest of the calls are routed to a national backup center, which can mean less knowledge of local resources and longer wait times.

When Van Beek visited Madison with the Wisconsin Office of Children’s Mental Health, she set up a posterboard with her research and told legislators her peers rely on 988. 

“988 has always kind of been a given,” she told Wisconsin Watch. “We always kind of assume that it’ll be there … The possibility that there might not be enough counselors on the line because of funding for 988 and funding for those counselors just makes me a little worried.” 

State struggles to keep up with increased demand

Family Services of Northeast Wisconsin operates Wisconsin’s 988 line. Senior Vice President Tana Koss said the crisis team planned for a moderate to high level of calls when the three-digit number was launched in 2022. 

“Still, Wisconsin has blown all numbers out of the water and continues to … The demand from Wisconsinites for this service has surpassed every model of projection that was available to us,” Koss said.

Family Services is still recruiting counselors to keep up with the need. Koss attributes the increase to lingering mental health effects from the COVID-19 pandemic and the lifeline’s accessibility. She celebrates more people using the service, which she views as a reflection of reduced stigma.

Wisconsin received over 11,200 calls in July alone – and responded to just over 9,000 of them in-state. Only eight states had the same or worse in-state response than Wisconsin.

“The longer a person waits on the line, the more likely they are to disengage … When you’re in queue, our primary center gets an opportunity to answer. If we’re not able to, then our backup center gets an opportunity to answer. And then, if they’re not able to, it goes to national backup,” Koss said. “So the sooner in that process you can have the staff available, the more likely you are to engage that caller.”

Still, the state has improved its answer rate over the past few months — growing from 74% in January to 81% in July as demand increased. 

“Purely from the administration of the service … we want (the answer rate) to get to 90%, and had the growth not gone up even a little bit more than anticipated, we would have been there.” Koss said.

So, should Wisconsin officials enact a 988 fee, a recurring appropriation or even consider legislation that Ohio and Illinois lawmakers have introduced to fine AI companies for failing to address suicidal ideation? Koss doesn’t care, as long as it means Wisconsin won’t have to depend on federal funding or the state’s biennial budget cycle.  

“I’m not personally attached to any route,” she said. “I think the request that I would have and advocate for is sustainability over the long haul because what we’re projecting is this growth hasn’t stopped.”

The case for state funding

Every two years, the National Alliance on Mental Illness’s Wisconsin chapter pushes for 988 funding in the state budget, said Julia Polk, the group’s advocacy coordinator. Last year, Gov. Tony Evers’ budget recommended $12.2 million for the lifeline, but lawmakers approved $7 million.

“What we would love to see is that we can educate our legislators on why 988 is so important and why it’s important to fund it long term, and get them in the next state budget to say, ‘we’re going to permanently fund this,” Polk said.

Polk also said delays from the Trump administration in making grants available are part of why advocates want to secure reliable state funding for the lifeline. 

“It’s a lot of us and other advocates, and the 988 Lifeline and the state government having to just trust and hope that those grants will become available,” she said.

Waiting for confirmation on an anticipated federal grant last year left officials fearing the funds had disappeared. In response, state Rep. Ben Franklin, R-De Pere, and state Sen. Jesse James, R-Thorp, authored a bill that would have required the state to provide grants to agencies that administer the 988 Lifeline.

“988 has proven to be highly effective and used frequently amongst Wisconsinites and is a vital service we should be funding,” Franklin said during a committee hearing on the bill in June 2025.

However, the bill included no funding attached. It failed to pass in the Senate and did not come up for a vote in the Assembly.

The federal government announced a grant funding opportunity in January and provided Family Services about $4.5 million per year for the next three years, according to Koss. But that still leaves a gap, since the state needs $12.2 million per year to fund the service. 

Officials included  $7 million for the lifeline in the 2025-27 biennial budget, but Koss said Family Services needs the next budget to match that. She knows a $6.195 million deficit is coming in 2028.

“We didn’t slow down with recruitment, but administratively, it’s stressful when you have these delays on giant parts of the funding,” Koss said.

Franklin’s Democratic opponent in the November election, Brandy Tollefson, is a De Pere School Board member. The issue is personal to her, and not just because she hears about the youth mental health crisis from school social workers, counselors and teachers.

“I myself went through the experience of having my stepbrother die by suicide years ago, so I know what happens to a family when this happens and the impact it has on families,” Tollefson said. “I fully support working with any Democrat or Republican who wants to get this permanently funded.”

Tollefson echoed other Democrats’ criticisms that Assembly Bill 303 lacked the critical funding needed to ensure 988 would get financial support. Franklin did not respond to requests for comment in time for publication. 

“There was a lot missing from it to make it a bipartisan bill that people could get behind, because the details just weren’t there,” Tollefson said.  

Connecting with younger generations

Megan Zimmerman, NAMI Fox Valley’s outreach program director, educates local schools about mental health and promotes 988. She said many people hesitate to call 988 because they fear emergency services will get involved, but in reality, law enforcement or emergency services respond to only 0.4% of callers in Wisconsin. Counselors resolved the other 99.6% of calls by providing support, coping strategies and resources. 

“Even outside of 988, I think when someone expresses that they have suicidal ideation – like they’re having thoughts about it – I think that scares people,” Zimmerman said. “They almost immediately triage to like, ‘OK, this person needs to be hospitalized.’”

Zimmerman noted the person who calls 988 doesn’t have to be the one who is in crisis, as she often calls 988 with her clients.

“If I can get an individual to agree to have that conversation on the phone with someone, and I’m there to support them in whatever way they need, that is just as good of an outcome as telling them to go home and call it themselves, which they may or may not follow through on,” she said.

Van Beek, who always considered herself the “therapist friend,” often recommends 988 to peers who confide in her. Once, when a friend shared distressing details about her home life, Van Beek quickly realized she wasn’t equipped to handle the conversation. 

“I just realized I’m a high school kid, and I can’t take this on,” Van Beek said. “I don’t have the knowledge to help you get to where you need to be with the situation. So that’s an instance where I recommended calling or texting 988 and just going through with that. And she did.” 

The 24/7 chat feature, introduced in 2024, particularly appeals to her generation and was helpful when she had to use it.

“Gen Z in general, we’ve always been behind a screen,” Van Beek said. “988 gives youth the option to text it, and I always have liked that, because talking or maybe even going in person can be overwhelming for youth, and I can personally relate to that.” 

Amid increasing reports of generative AI enabling suicides, proposed legislation in Illinois would fine AI companies for not addressing suicidal ideation and deposit the money into a 988 trust fund. Companies under the legislation would face a penalty of up to $15,000 per day if they don’t refer users to crisis services like 988 when they express thoughts of self-harm. 

Zimmerman said the chat feature of 988 has led her to encourage students to message the lifeline instead of an AI companion. 

“Every suicide prevention presentation I give, especially in a school, I just always stress (that) I know it’s easy to bring up ChatGPT or your Claude or your Gemini or whatever it is, and start essentially texting or chatting that feature,” Zimmerman said. “But I always really encourage people to instead think about 988 … because then you’re getting a real live human being.”

Having graduated as president of her high school’s Raise Your Voice mental health advocacy club, Van Beek recently began studying psychology at the University of Wisconsin-Whitewater, where she wants to continue raising awareness about mental health. 

“The events that I participate in, whether it’s through NAMI or NAMIWalks — the mental health walk that we do — it has never felt like a chore to me,” Van Beek said. “I’ve always felt like that’s my purpose.”

This story was produced as part of the NEW (Northeast Wisconsin) News Lab, a consortium of five news outlets.

Despite bipartisan support, 988 Crisis Lifeline faces funding shortage is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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McKenna and Celia Olson expanded their family by adopting four children, completing their South Side Milwaukee home. The adoption closed a chapter in their journey as foster parents with the Wellpoint Care Network. 

McKenna and Celia, closed their foster care license in May after spending the past eight years fostering 10 children. 

In June, the couple celebrated their 6, 5, 2 and 9-month-old children with an adoption party at Milwaukee’s Humboldt Park.

“We have four kids now and they’ve been with us since birth,” McKenna said. “This is our family unit now and we’re grateful to be alongside the kids as they grow.”

Adjusting to a new parenting lifestyle

As the Olson family has grown, McKenna and Celia have adapted to new parenting routines such as staying home when a child is sick, making multiple drop-offs to daycare or extracurricular activities and more.

“As the older kids are growing up, they’re getting more involved in things,” McKenna said. “We’re being aware of what works and understanding what’s best for each kid.”

McKenna said she’s also adjusting to no longer having to follow certain policies and procedures.

Last month, McKenna and Celia took the kids on vacation without going through an approval process.

“One part of being a foster parent is you have to get approval if you want to go out of state, and sometimes you might have to share your itinerary or birth parents have to get involved,” she said. 

As they navigate new parenting routines, McKenna and Celia are excited to create memories as a family such as celebrating birthdays and capturing moments from the first and last days of school. 

“In my dream ideal world, I would love to have so many people around the table during Thanksgiving and birthdays and that would include the birth families of my kids,” McKenna said. “I really just look forward to being a family, spending quality time and having our extended family come together.”

Feeling mixed emotions

No longer foster parents, McKenna and Celia still reflect on the bittersweet moments they’ve shared with other foster children.

“The kids that have left us, we still think about them and miss them,” McKenna said. “You’re in people’s lives for a reason during certain stages of their life.”

McKenna and Celia said they were grateful to care for all 10 children over the years. 

“Every kid that came into our home, we open our hearts,” McKenna said.

Using resources to help with trauma

McKenna and Celia chose to become foster parents through Wellpoint Care Network because of its Trauma Informed Care Program, which teaches principles for responding to people who have experienced trauma.

“Children who experience trauma, their brains formulate differently than children who may have not gone through trauma,” said Emily Davis, Wellpoint foster care recruitment and retention supervisor. 

In addition to supporting foster parents, the training has helped social workers, librarians, educators, police officers and others. 

According to Julie Scott, Wellpoint director of trauma-informed strategy and practice, the organization developed the training after discovering its former residential boys group wasn’t receiving enough mental health support. 

“We found that traditional mental health services and therapies weren’t enough,” Scott said. “Because of adversity and trauma there are particular needs that aren’t always met.”

Davis said there are five levels of foster parents, all of whom are required to take the free Trauma-Informed Care training to become licensed through Wellpoint Care Network. 

“We don’t want children to be moved from home to home, and our biggest goal is to only have a child in one placement the entire time they’re in foster care,” Davis said. “Providing foster parents with the training allows them to have the knowledge and ability to be that one foster parent the child needs rather than multiple.”

The training helped McKenna and Celia understand that no parent is perfect and that they shouldn’t take a child’s response to trauma personally. 

“It’s about being aware that everyone comes with their own story and situations,” McKenna said. “It’s all a work in progress because the kids are changing and you’re changing right with them.”

Scott and the Olson family encourage foster parents to meet children where they are instead of expecting them to reach a certain development stage.

“Be compassionate, understanding and stick around a little longer,” Scott said. “A child may behave a certain way because they don’t understand their trauma.”

McKenna wants aspiring foster parents to know that the process requires them to embrace change. 

“If you’re entering a new world, you shouldn’t be going in the same person you were,” she said.

Information for new or aspiring foster parents

To become an eligible foster parent in Wisconsin applicants must meet the following requirements:

• Be at least 21 years of age.
• Pass a background check. 
• Show proof of income.
• Meet all home safety requirements.
• Have car insurance with valid license. 
• Have no past history with child welfare agency involving child neglect or abuse. 
• Be willing to work alongside the child’s biological family. 
• Demonstrate positive qualities such as patience and humor.

McKenna said she and Celia could always reopen their license if they wanted to. They are grateful for the support Wellpoint Care Network provided them as foster parents. 

“Wellpoint Care Network has been a part of our life, and because of this nonprofit, our family is the way that it is,” she said.

Milwaukee couple adopts four children after eight years as foster parents is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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Note: This is the first story in the Cap Times series Deadly Divide, investigating Wisconsin’s ongoing Black infant mortality crisis. This reporting is supported through a National Fellowship from the USC Annenberg Center for Health Journalism. 

Click here to read highlights from the story

• Wisconsin’s Black infant mortality rate was 12.5 deaths per 1,000 live births in 2024, compared with 4.8 for white babies; nearly 850 Black babies died before age 1 from 2015 through 2024.
• Preterm birth and low birth weight are the leading causes of death among Black infants, and Black mothers in Wisconsin are 50% more likely to give birth early than white mothers.
• Experts say income, education and health care access alone do not explain the disparity, pointing instead to the lasting health effects of systemic racism, chronic stress, segregation and generational trauma.
• State health leaders say improving outcomes will require support before and beyond pregnancy — including more time and trust in health care settings, culturally informed care and efforts to address housing, child care and other stressors.

For generations, Black families in Wisconsin have buried babies at rates far higher than their white neighbors — a disparity that has withstood medical advances, public health initiatives and decades of promises to close the gap.

The numbers have remained stubbornly consistent, with Wisconsin regularly ranking the worst in the nation when it comes to the rate at which Black babies die before reaching age 1. In 2024, the most recent year for which the Wisconsin Department of Health Services has publicized data, the state had an infant mortality rate of 12.5 deaths for every 1,000 live births among Black babies. For white babies, that rate was 4.8. 

Between 2015 and 2024 nearly 850 Black babies died in Wisconsin before turning 1, according to state data. Over the first half of that decade, nearly 25% of the deaths of Black infants were caused by being born into this world too early and too small to survive. 

Researchers and health experts say the crisis cannot be explained by lack of access to quality health care alone. They point to the cumulative effects of systemic racism, chronic stress and generational trauma that shape maternal health long before pregnancy begins and influence birth outcomes from one generation to the next. 

That these disparities transcend socioeconomic factors like income or level of educational attainment show the root cause lies elsewhere. Black babies are dying at higher rates even when their parents make a decent living. Black babies are dying at higher rates even when their moms are well-educated.

For Dr. Jasmine Zapata, Wisconsin’s state epidemiologist for maternal and child health and chronic diseases, the numbers have never just been numbers. 

Every chart tracking premature births, every report on infant death and every statewide trend carries the memory of her own pregnancy, when she unexpectedly delivered her daughter at just 25 weeks. 

As a second-year medical student at the time, she knew something wasn’t right when she felt sharp pain in her lower abdomen. Her due date was not until Jan. 2. It was Sept. 20. 

Zapata’s pain was repeatedly dismissed by doctors as Braxton Hicks contractions — a type of contraction that typically takes place earlier in a pregnancy and doesn’t result in cervical dilation or labor.

“I called about two, three times and I was just brushed off,” Zapata said.

But when Zapata began bleeding, she rushed to the hospital where providers found her cervix was already 10 centimeters dilated, the threshold typically required to give birth. 

“They told me ‘You’re going to meet your daughter today,’” Zapata said.

Though she was nearly 15 weeks out from her due date and her baby was barely beyond the point of viability, Zapata gave birth to her little girl. 

“When my baby came out, she was not crying. It was quiet, because her little lungs were too fragile to even breathe,” Zapata said. “I knew that complications of prematurity, this little baby fighting for her life … I was right there at the verge of being one of the infant mortality statistics.”

Zapata’s experience with preterm birth, even though her pregnancy was not categorized as high-risk, is common in Wisconsin, where Black mothers are 50% more likely to give birth before their due dates than white women. 

Preterm birth and low birth weight are the leading causes of death among Black infants, defined as younger than age 1. 

National experts on health and development say there’s a painful and deep-rooted reason these statistics persist despite medical advancements. 

‘This is the world you’ll be born into’ 

Dr. Tony Iton, a nationally recognized public health leader and advocate for health equity, has spent much of his career studying how chronic stress related to discrimination puts people’s health at risk. Iton is the CEO of The Health Trust in California.

Decades of research, he said, shows that living in a society built on a legacy of structural racism can result in consistently elevated levels of cortisol, the body’s stress hormone. Those levels increase the risk of pregnancy complications like preeclampsia (pregnancy-related high blood pressure) and early labor. 

“We don’t have a preterm crisis, we have a chronic stress crisis,” he said in an interview with the Cap Times. 

Those effects don’t disappear when a pregnancy ends. They accumulate over a lifespan and, in many cases, across generations. 

Research has shown that prolonged exposure to adversity can influence fetal development through changes in the mother’s body and health, said Nicole Bush, a clinical psychologist and director of the Division of Developmental Medicine at the University of California San Francisco. 

The science, she said, increasingly shows that a mother’s environment and experiences across her lifespan can affect a child’s health before birth, with consequences that can then extend into that child’s adulthood.

Those intergenerational effects can happen through epigenetic changes. Different from genetic mutations, epigenetic changes don’t alter core DNA sequences but instead perform like chemical switches that can turn specific genes on or off, Bush said. That switch affects how genes activate processes in someone’s body.  

“Our epigenetic marks can be influenced by nutrition. They can be influenced by sleep. They can be influenced by social experience,” Bush said. “Epigenetic changes related to experience can be stable for a long time after they’ve been changed, and so major stressors can have a long-standing impact on our bodies. They can affect our perceptions, our brain chemistry, our physiology.”

As a result, trauma and stress that someone experiences as a child can alter how their body responds later in life and, during pregnancy, influence how a fetus develops and preemptively trains an infant in utero to expect more stress in life. 

“In addition to placing the mother and her uterus and her pregnancy functions at immediate risk for challenges such as preterm birth or postpartum depression, it can also send certain chemicals and signals to the baby in utero that then program that baby to come out ready for a strong fight or flight and reactive immune system,” Bush said, “because the mom’s biology is trying to communicate to the baby ‘This is the world you’ll be born into, come out as prepared as you can.’”

Where Wisconsin stands

Nationally, the Black infant mortality rate is 11 per 1,000 live births, according to 2024 data from the National Center for Health Statistics, an agency that is part of the U.S. Centers for Disease Control and Prevention. 

The national infant mortality rate for white babies that same year was 4.4 deaths per 1,000 births. 

Also that same year, Wisconsin health data showed Black women were five times more likely than white women to die from pregnancy-related complications.

According to a 2025 study published in the Annals of Internal Medicine, Americans are living longer than ever and the difference in mortality between Black and white Americans has shrunk over the last half century, except when it comes to infants, where the disparity in mortality between Black and white babies has grown. 

That Wisconsin ranks so poorly for Black infant and maternal mortality is not new. In 2009, Black babies were almost four times more likely to die within their first year of life than white babies. 

The year before that, Dr. Richard Allan Aronson submitted a white paper to the University of Wisconsin School of Medicine and Public Health highlighting racial disparities in the state’s birth outcomes. Aronson served as medical consultant and chief medical officer for family and community health at the Wisconsin Division of Public Health from 1988 to 2002.

The Wisconsin Department of Health Services publicizes infant mortality statistics going back to 1985. In the four decades since, the mortality rate among white babies has consistently decreased in line with medical advancement. The rate among Black babies has remained largely stagnant, with the state having a higher rate of mortality among Black infants in 2023 than it did in 1991.

In his 2008 paper, Aronson identified segregation and disparate access to services as key factors in the racial gap in birth outcomes. 

“Since infant mortality is a sentinel indicator of a community’s overall well being, the factors that contribute to racial and ethnic birth outcome disparities relate to all sectors of society. The neighborhoods in Wisconsin with the highest rates of black infant mortality are characterized by hypersegregation, unemployment, economic hardship, and inadequate housing,” Aronson wrote. “Systems that serve children and families in these communities are often fragmented, burdensome, culturally and linguistically disrespectful, and deficit-based.”

Aronson’s assessment of the situation in Wisconsin is as true today as it was nearly two decades ago. And from the year he issued his report to 2024, nearly 1,500 Black babies in Wisconsin died before their first birthday, according to data from the Wisconsin health department. 

Had the rate been the same as it was for white babies, more than 970 of them would have survived.

Gaps in access to care and a lack of culturally competent medical services still play a key role in how Black Wisconsinites interact with the health care system, particularly during and after pregnancy, Zapata said. 

Wisconsin’s largest cities still carry the spectre of racial segregation and redlining, policies that separated whole populations from necessary services.

Milwaukee, Wisconsin’s largest city with the highest population of Black residents and the highest total annual number of Black infant deaths, has also been consistently ranked as one of the most segregated cities in America. 

Madison, which has a far lower population of Black residents, also faces notable racial and subsequently connected socioeconomic segregation. 

“If you were going to design a strategy to adversely impact the well-being of a population, you couldn’t come up with a better policy than racial residential segregation. It’s actually brilliantly evil in its manifestations,” Iton, with The Health Trust in California, said.

‘It shouts racism’

Poor health outcomes are often explained away by poverty or low educational achievement, Iton said. But disparities in maternal and infant health outcomes for Black women and babies are shown to transcend both of these factors. This shows that something else is at work, he said.

National data shows Black mothers with a college degree still have higher infant mortality rates than white women who drop out of high school. 

“It shouts racism,” Iton said. “If you’re not protected by income and social status from this outcome, that suggests that it’s not just material poverty or lack of resources, but it’s also your situatedness in society and what you perceive to be essentially a pervasive, large-scale devaluation of you as a human being.”

Those effects become clearer looking at data that show Black immigrants have better health outcomes when they come to the United States but exhibit poorer health outcomes the longer they are here, Iton said.

“The birth outcomes are so much better in the African immigrant women, and then as they acculturate, spend more time in America, their birth outcomes get worse,” he explained. “So the suggestion is that it’s really something in the environment in the United States.”

‘Preventing the fire in the first place’

Zapata, Wisconsin’s state specialist in child and maternal health, said she wants more focus on preventing the problems that hurt people in the first place. 

“There’s always so much focus on just when you get pregnant and right after. It’s kind of like a house is on fire and it’s burning, and then you’re always just focusing on how can the fire truck get there faster,” she said. “Let’s focus on preventing the fire in the first place.”

That means addressing stressors faced by Black Wisconsinites across their lifespan. 

“It’s like once you’re pregnant, you can qualify for all these services. But sadly, from a physiological and biological standpoint, a lot of times it’s too late,” Zapata said. “Because that birthing person — what happened to them all the way into their childhood, and even what was going on with their parents, and when they were in utero, the environment, the stress that their parents were having — that impacts them, that impacts their birth outcomes.”

Zapata said reducing Wisconsin’s Black infant mortality rate will require more than improving medical care. It will require confronting the centuries of systemic racism and inequity that have shaped Black women’s experiences with health care, government and other institutions — and rebuilding trust that has been eroded over generations.

“We’re not going to be able to undo some of the things that got us here in just five years,” she said.

She pointed to a history of exclusion and abuse that is not as distant as it can seem. Less than a century ago, Black people were barred from medical schools, she said, while unethical government and medical practices against people of color have contributed to generations of distrust.

“All of that accumulated harm plays a role into what we’re seeing today,” Zapata said.

That history is reflected in the health care system Black women encounter today, she said. Even when women have access to a doctor or hospital, that doesn’t necessarily mean they feel heard, respected or safe enough to fully engage with the system.

“We’re working within a system that’s just not designed to provide equitable care to all people in all backgrounds,” Zapata said. “We want to look around and see that it reflects the diversity of our community, or just come in and see someone that looks like me.”

Building that trust, she said, requires something the current health care system often does not give providers or patients: time.

Providers can be expected to see dozens of patients a day, while appointments designed to take an hour are squeezed into 15-minute slots. Long waitlists can make it difficult for patients to establish relationships with providers in the first place.

For Black women who already approach the health care system with distrust, those constraints can be especially consequential, Zapata said. A rushed appointment can leave a patient feeling dismissed even when the provider is not intentionally doing so.

“Patients who feel brushed off will be less likely to engage with that system again,” she said.

If something goes wrong during a pregnancy, that can mean a mother is less likely to call her doctor or seek help.

“There’s a lot of Black women that are scared to have children in our state, just because of the statistics,” Zapata said. “When we come into a provider, because of that unique background, we need more time.”

That need extends beyond the exam room. Zapata recalled treating a mother who, just 24 hours after giving birth, was pleading to leave the hospital because she had no child care. Another mother was discharged with her newborn to a homeless shelter.

“They don’t even have a place for the baby to sleep,” she said. “It is just heartbreaking.”

Those circumstances can make it difficult for a mother to focus on her own health or her baby’s health, even when medical care is available.

“Do you think they’re listening to us with their whole heart, with their full attention?” Zapata said of patients in these circumstances. “No, because their brain is thinking about how they’re going to survive.”

Doulas are one option to help bridge some of that divide, she said. Because they can provide advocacy, emotional support and culturally informed guidance, doulas can help women feel safer navigating a health care system that might not feel built for them.

For Black women, she said, that kind of support is not an extra. It is part of what they are asking for as the state tries to change outcomes that have persisted for generations.

‘Too many funerals’

Zapata’s daughter, Aameira, was in the neonatal intensive care unit for three months after she was born. She is now almost 16 years old. Her mother describes her talent for photography, her sassy personality, her beautiful singing voice — each moment of praise an appreciation for the fact that her daughter survived what many babies born that early do not.

It was the moments, days, weeks and months that followed Aameira’s birth that Zapata says shaped the trajectory of her life’s work. 

“When I walked out of the NICU with her in my arms, I made a commitment that I’m going to dedicate my career to finding ways to make sure every baby gets to walk out,” Zapata said.

That has remained a driving factor in her work as a doctor, as a state health official, as a mother and as a resident of a state where too many babies don’t make it to age 1.

“I’ve been to too many funerals of babies who didn’t make it to their first birthday. Words can’t express that. I’ve had to do CPR on a baby that came into the hospital already basically gone,” Zapata said. “When you have those types of memories, and screams of family members, and faces drilled in your mind, in your soul, it just really impacts the work that you do.”

Erin McGroarty is a health and policy reporter for the Cap Times in Madison. She can be reached at emcgroarty@captimes.com.

‘Too many funerals’: Wisconsin’s Black infant mortality crisis is harming generations is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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Bryn Schraven is no stranger to death. When Schraven was 19 years old, their dad died in a car accident in the middle of their small Wisconsin town. A mountain of paperwork soon piled up, and so did the comments from well-meaning community members.

“It was very tragic and very sudden … I had some issues feeling unheard by the funeral director and funeral company I went with,” Schraven said, “and I felt a little hurt by some of the things that people said to me at that time because people don’t know how to talk about death and dying.” 

Neighbors said things like, “At least he’s in a better place,” or asked if Schraven was wondering if he was in heaven. As Schraven sat down for breakfast on the morning before the funeral, a waitress shared her experience of seeing the accident happen in uncomfortable detail.  

“I decided at that time that I wanted to be part of the change … I have to be able to help somehow and turn this negative experience into something more positive for other people,” they said. 

Schraven started reading books about grief and death, researching what other options were out there. They discovered the term “death doula” – a trained companion who helps people through the processes of death, dying and grief. 

How it works

After spending years training with various death doulas, Schraven started a business this year called Silver Glass Deathcare to help others through the experience of loss and to change the conversation around death. They provide support in the form of death education, planning end-of-life rituals for people and their pets, and being with individuals in their final hours. 

“A lot of people seem to have this idea that talking about death is going to bring it on faster,” Schraven said. “That’s a big misconception that I see a lot, is that I’m morbid for wanting to talk about death and dying and grief, and it’s simply not true.” 

Similar to how a birth doula helps clients make a birth plan, Schraven and other death doulas will create a custom death plan for each person, allowing people to express their wants and needs for their last few hours. This could include dimming the lights, choosing what music to play and deciding who they want to take shifts at their bedside. 

Schraven, who is nonbinary, usually opts for a more gender-neutral term instead of doula: death companion or deathwalker. They created Silver Glass Deathcare with the goal of reaching out to members of the LGBTQ+ community, who can have a unique relationship to grief and death. For example, some might want a nonreligious approach to funerals or a bedside vigil that doesn’t involve a church. 

Others might not be married to their significant other, which means that legally, their family would decide what to do with their body, Schraven said. Filling out an Authorization for Final Disposition form allows people to designate someone to carry out their final wishes. 

“After you pass away, there’s a chain of custody that determines who is in charge of what happens to your body,” Schraven said. “Your spouse comes first, and if you’re not married, then it’s your family – your parents, your next of kin – and not everybody in the queer community has a great relationship with their next of kin.” 

‘It happens to all of us’

Schraven trained extensively by taking classes with death doulas across the country, including Erin Merelli’s Deathschool Evolved and La Mort’s School of Sacred Death. Merelli said Schraven stood out for their dedication to the queer community. 

“There’s always one or two students in each of the sessions that really stand out for their passion in this space, for the experience that they’ve already had in it and for the vision they have of where they want to take it and how they want to serve,” Merelli said. “And Bryn definitely showed up as that person.”

Merelli trains hundreds of death doulas throughout the country and said businesses like Silver Glass Deathcare are important to spread this type of work to different communities and regions.

“For any movement, for any type of culture shift we’re hoping to make, we need a broad range of diverse and dynamic voices,” she said. “It’s not my voice alone, and these ideas are not my ideas alone.” 

In Merelli’s classes, Schraven learned that death isn’t always a taboo subject. In some Muslim or Hindu traditions, for example, it’s common for the deceased’s family to wash and prepare the body to be buried or cremated. 

“There are a lot of cultures out there that are less shy about death than we are, and they hide it less,” Schraven said. “I think that that’s really important in as far as spending time with the person that you’ve lost after they’re gone.”

Schraven wants to let families know that this is an option and suggests a ritual that acknowledges each part of their loved one’s body, one at a time — their head, eyes, ears, hands and heart.

“It’s just a really beautiful way to say, ‘We honor your body and what you did for us while you were here, and we are giving you the opportunity to go and be at peace,’” Schraven said.

Schraven is also starting a death and grief book club at Author Apothecary & Bookstore in Oshkosh, which will meet the last Thursday of the month starting Sept. 24. The goal is to normalize the conversation around death and dying through discussing books like “Lost Souls Meet Under A Full Moon” by Mizuki Tsujimura.

“I don’t advocate for censoring death,” Schraven said. “It happens to all of us, and the more openly and freely we can talk about it, the better prepared we are for when that eventuality happens.” 

This story is part of Meet a Neighbor, an ongoing feature series focused on the people who make a difference in northeastern Wisconsin. Know someone we should spotlight? Nominate them here.

Oshkosh death companion helps LGBTQ+ community navigate death, grief is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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• Nebraska and Montana implemented the new work requirement rules for Medicaid recipients earlier this year. 
• In Nebraska, officials say there’s been confusion about basic eligibility, with some people who should have received exemptions being denied coverage due to procedural errors. 
• Montana leaders stressed the importance of communication, particularly to Native American tribes, who should be exempt from the new rules. 
• Officials in Wisconsin say they’re implementing ways to automatically determine whether someone is working or if they’re required to follow the new rules. 
• Federal officials also narrowed the definition of medical frailty, meaning that people who have Medicaid because they are too medically frail to work will be required to prove their condition and the fact that it prevents them from working.

Starting in January, some Wisconsinites must prove they meet federal work requirements to enroll in Medicaid. Around 63,000 people are at risk of losing coverage, state officials say. It’s part of an effort by the Trump administration to reduce “waste, fraud and abuse” in the program and reduce federal spending by $326 billion over 10 years. 

As Wisconsin prepares to implement the measures detailed by the One Big Beautiful Bill Act, states like Nebraska and Montana have already put work requirements into effect. How the process is unfolding offers key lessons for states like Wisconsin facing a Jan. 1 deadline. 

Who needs to meet work requirements?

The new Medicaid requirements apply to states like Nebraska and Montana that voted to expand Medicaid to families living at 138% of the poverty level — with the exception of a few states that submitted a waiver to partially expand Medicaid, like Wisconsin. 

That program, called BadgerCare Plus, applies to individuals who live at or below the federal poverty level — $33,000 annually for a family of four — as compared to the $45,540 income limit for expansion states.

Only childless adults aged 19 to 64 under the BadgerCare Plus program must meet work requirements — about 200,000 people, according to state officials. That means parents of dependent children under age 19 and people with coverage other than BadgerCare Plus, such as SSI Medicaid or home- and community-based service programs, are exempt.

Other exempt groups include Native Americans, pregnant or postpartum people, caregivers of young children or disabled individuals, veterans with a total disability rating, participants in addiction or rehab programs, and those too medically frail to work. 

Starting Jan. 1, 2027, new BadgerCare Plus applicants must show they worked, volunteered or attended school for at least 80 hours in the previous month, or prove they were exempt for that month. 

Current BadgerCare Plus members will face the requirements beginning in March 2027. They  must show they met the work requirement in any one month of the last 12, or that they are exempt. They can show they received at least $580 in income in a single month or completed combined activities adding up to 80 hours. 

In July, Wisconsin Department of Health Services Secretary Kirsten Johnson told reporters officials aim to automate the process as much as possible.

Those system changes will cost an estimated $10 million in the first year, Wisconsin Medicaid Director Amanda Dreyer confirmed, which will be split between the state and federal government. 

Nebraska’s early lesson

Nebraska became the first state to implement the new requirements on May 1. 

Officials began to disenroll Nebraskans who didn’t meet the requirements on Aug. 1. Nebraska Medicaid Director Drew Gonshorowski told Tradeoffs in July roughly 200 people could lose coverage on that day. The state Department of Health and Human Services has not released official numbers. 

The state sent more than 75,000 letters, 38,000 text messages and 10,000 emails to notify people of the change. Amy Behnke, CEO of the Health Center Association of Nebraska, told Wisconsin Watch some residents still had basic eligibility questions. 

“There’s some confusion over who the work requirements apply to and who they don’t apply to,”  Behnke said. “The communication that went out from the state was pretty lengthy. It was about four pages long and at a collegiate reading level, and so it was a lot for somebody to digest.” 

It’s also hard to know whether someone is part of the Medicaid expansion without contacting the state directly. 

“Our health centers don’t have a really good way of being able to look that up,” she said. 

Her organization supports Nebraska’s federally qualified health centers, which provide low-cost medical care and help people apply for Medicaid. 

She’s already seen patients have their Medicaid applications denied due to procedural errors. One woman was denied because she didn’t meet work requirements — even though pregnancy made her exempt.

“She was able to get her Medicaid restored,” Behnke said. “But that’s always been our fear – that somebody’s not going to know that they’ve lost their coverage until they show up to pick up a prescription or they show up for a medical appointment.” 

Residents can call the state’s Medicaid help line, but wait times have stretched as long as 90 minutes, Behnke said. She recommends states consider hiring additional caseworkers, which Nebraska has not done. 

“They are hardworking individuals (at the call center), and there is just an additional load of work and information that’s needed that comes with these requirements,” Behnke said. 

Wisconsin DHS plans to use the additional FoodShare staff secured last year to help with implementing Medicaid requirements, Johnson said, noting the increased budget will add flexibility for other staff to help Wisconsinites. 

Behnke urged Wisconsin to prioritize flexibility in implementing the program. She highlighted that Nebraska requires members to meet requirements in just one month of the last 12 and allows individuals to self-attest to medical frailty — policies Wisconsin DHS confirmed it will follow. 

A balancing act in Montana

Montana also implemented work requirements on July 1 — the first state to do so after the U.S. Centers for Medicare and Medicaid Services released stricter guidelines on medical frailty. For three months, Montana enrollees won’t be penalized if they fail to document community engagement hours. 

Dr. Aaron Wernham, CEO of the Montana Healthcare Foundation, said the effects won’t become clear until Oct. 1 – the first day the state begins to disenroll people. The foundation estimates 29,000 people could lose coverage. 

Wernham said it remains unclear how Native Americans, who are exempt  from the requirements, will be asked to document their status. The state had limited interaction with the tribes and other stakeholders on how to communicate the change, he said, and urged Wisconsin officials to engage those groups now. 

Wisconsin could improve implementation by working with partners such as Covering Wisconsin to develop forms, define medical frailty and plan outreach, Wernham said.

Montana has effectively automated systems to determine whether someone is working, Wernham said. But automatically verifying medical exemptions has been more difficult as officials struggle to access claims data, the Montana Free Press reported. 

Defining medical frailty

The challenge comes as federal officials have tightened the definition of medical frailty. Rather than automatically exempting people with certain medical conditions, the rules require people to prove their condition and show that it significantly prevents them from working. 

The tightened medical frailty definition has overshadowed concerns over Montana’s ability to automate processes, Wernham said. 

“There are many patients with cancer that may have a disease that will be lethal if not treated, and yet they might not be too sick to work,” Wernham said. “The real question is, what’s going to happen with those people who have a very serious illness, any doctor would consider them medically frail, and yet it may be hard to say they’re too sick to work?” 

For the first year, people can self-attest that they are too medically frail to work. Wisconsin  officials confirmed DHS will rely on self-attestation and existing diagnoses codes, reassuring providers they would not have to determine medical frailty. But in 2028, states will have to determine how to verify those exemptions while risking federal audits.

Montana and other states should outline their plans for monitoring who is disenrolled from Medicaid and the potential impacts, Wernham said. That’s something Wisconsin has done by  announcing that roughly 63,000 are at risk of losing Medicaid due to a lack of work history on file. 

“States aren’t always eager to share their data, especially if it doesn’t look good with the public,” Wernham said. “But the fact is that transparency with regard to data on this program leads to better government.” 

State budget woes

Medicaid funding is often the largest source of federal funds for states, so it can have a big impact on their budgets. State Medicaid budgets could be reduced by an estimated $665 billion through 2034 under the One Big Beautiful Bill Act.

This leaves officials with few choices: raise taxes, cut other programs or cut Medicaid — which would mean reducing provider rates or limiting benefits or coverage. The Congressional Budget Office estimated 10 million more people will be uninsured nationwide by 2034 as a result of the new law. 

The cuts could affect the entire health care system, even those who are insured, said Vaishu Jawahar, director of policy programs at the national health care advocacy nonprofit Protect our Care. 

Programs could be cut or premiums will increase because hospital budgets will be strained. Hospitals could face more uncompensated care as more uninsured patients seek treatment, tightening budgets and potentially increasing costs for privately insured patients. 

Jawahar said people who lose insurance may forgo preventive care until their conditions become severe enough to require emergency treatment.

“They’re still going to have to provide care to uninsured people who will come in sicker,” Jawahar said. “… And so, how do hospitals make up for that? They will have to hike costs on people with employer-based insurance.” 

Medicaid cuts are expected to hit rural hospitals hardest. A March report by Public Citizen found 446 hospitals nationwide were at risk of closing or reducing services due to cuts. Samantha Peck, rural hospitals and clinics program manager for the Wisconsin Office of Rural Health, manages funds that benefit critical access hospitals across the state. 

About 13% of patients in Wisconsin hospitals use Medicaid, but Peck said critical access hospitals in Door County, Oconto, Shawano and New London average about 48% of patients on Medicaid, leaving them particularly vulnerable if more patients lose coverage. 

Maternal and mental health programs could be among the first cut, Peck said. 

“The biggest worry is that community hospitals will start reducing service lines,” Peck said. “What we’re already seeing is a reduction in maternal care, specifically labor and delivery.”

Clinics prepare to help Wisconsinites navigate changes

NorthEast Wisconsin Community Clinic, a free and low-cost health center in Green Bay, is educating people about the new requirements with its mobile outreach vehicle. 

In 2025, 47% of the center’s clients were on Medicaid, which means it’s preparing its budget to receive less federal reimbursement next year. Executive Director Kim Franzen said the clinic will continue serving the uninsured.

“While I’m concerned, I want to make sure that as a health center, it’s our responsibility to take care of people regardless of their ability to pay,” Franzen said. 

Franzen worries people might not realize their coverage was denied before racking up medical bills. 

“If you lose your Medicaid, now a person could potentially have four therapy sessions (before realizing) that ‘Oh, I didn’t know my coverage lapsed,’ and then as an organization, we have to step back and go, ‘OK, so do we bill the person? Do you write off the expenses?’” she said. 

Adam VanSpankeren is the navigator program manager for Covering Wisconsin, which receives federal funding from the Affordable Care Act Navigator Program and responds to calls about health insurance.

Despite recent funding cuts, VanSpankeren hopes people affected by the changes call Covering Wisconsin for help.

“I don’t love that people are affected, but that means we’re going to be able to help those people,” VanSpankeren said. “It’s the people that don’t call us that I worry more about.” 

This story was produced as part of the NEW (Northeast Wisconsin) News Lab, a consortium of five news outlets.

Some states started Medicaid work requirements early. What can Wisconsin learn? is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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This story was produced in partnership with the University of Wisconsin-Madison’s Investigative Journalism class taught in the School of Journalism and Mass Communication.

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• Recent wildfires in Canada and northern Minnesota brought a wave of smoke to Wisconsin in July, raising concerns in Rock County similar to those in 2023, when Beloit was ranked the city with the worst air quality in the nation.
• Rock County faces above average asthma rates, and air pollution from wildfire smoke combined with emissions from existing polluters can worsen these health risks. 
• The county relies on a particulate matter monitor in Rockford, Illinois, to track PM2.5 levels. Local advocates and community members are pushing for a regulatory monitor in Rock County, especially as industrial emissions increase.

Pablo Toral expected another successful summer field program at the Boundary Waters, continuing a tradition that has lasted close to 70 years. Instead, he found himself evacuating by canoe after wildfires forced his team to abandon the trip. 

Students had already started arriving at the research station for the program’s mid-summer session. They were supposed to spend the next month doing hands-on field research, canoeing and camping. Then came the evacuation alert giving everyone 20 minutes to pack up and leave. Toral, the chair of environmental studies and political science at Beloit College, said it was clear conditions were unlikely to improve, leading organizers to cancel the rest of the program.

After driving through the night, Toral returned to Beloit, only to find that the wildfires had followed him in the form of thick smoke and unhealthy air quality. 

Poor air quality is a serious concern for Beloit residents who worry about the emissions from nearby power plants and now wildfire smoke. Just three years ago, under similar wildfire concerns as this summer, the city was named the worst for air pollution in the United States.

Rock County also has above average asthma rates, making the poor air quality even more troubling for residents. 

Cristine Rameker, the Wisconsin Department of Health Services’ asthma program manager, told Wisconsin Watch that the most recent estimate of asthma-related hospitalizations per 10,000 people in Rock County — between 2022 and 2024 — was 39% higher than the statewide average, with a rate of 3.2 per 10,000 people compared to 2.3.

During those years, asthma-related emergency department visits per capita in the county were 23% higher than the statewide average at 34.2 visits per 10,000 people compared with 27.8 statewide. For children ages zero through 17, the average asthma-related emergency department visit is about 9% higher than the state average. 

The county ranked sixth-highest in the state for asthma hospitalizations and eighth-highest for emergency department visit rates between 2022 and 2024. Rock County is the ninth-largest county in the state in terms of population. 

In 2024 alone, data shows there were 138 asthma-related emergency visits among children in Rock County, or one every two-and-a-half days. 

Beloit School District data shows about 11% of students — 436 children — have asthma. Of those students, 110 have inhalers at school, while 326 do not have ready access to medication. 

Brittany Keyes, clean air policy manager with Healthy Climate Wisconsin and former vice president of the Beloit City Council, recalled a moment last fall when she was riding on a bus in Waunakee with a group of third grade girls from Beloit, including her daughter, after the girls finished their first 5K for a “Girls on the Run” event.

She described how the third graders had been training for months together, and now they were laughing, exhausted and proud of their achievement on the ride home. Until one girl began struggling to breathe. 

Keyes said a teacher was frantically searching through a bag for the girl’s inhaler — pulling one out, and then another. 

“She takes out a bag — nope, it’s not hers. She takes another bag — nope, not hers, not hers, nope, not hers,” Keyes said. “There were six inhalers for a group of 22 girls. … That’s not normal, and it doesn’t have to be that way, right?”

No particulate sensors in Beloit

Fine particulate matter (PM2.5), a type of pollution that is a combination of solid and liquid particles in the air, is a key concern for residents worried about air quality and asthma rates. 

Nick Mailloux, a postdoctoral research associate at the University of Wisconsin-Madison’s Center for Sustainability and the Global Environment, said a major reason why PM2.5 raises so much concern is its extremely small size — about 1/30th of the width of a human hair. 

Particulate pollution comes from a range of different sources, including power plants, vehicle emissions and industrial facilities — which Keyes and Toral both noted can all be found in Beloit. Additionally, Mailloux noted that wildfires are increasingly becoming a source of PM2.5 across the United States.

“A particle of that size is small enough that it bypasses a lot of our natural defenses,” Mailloux said. “These are particles that are small enough where they can pass through your airways and into your lungs, where then they can get into your bloodstream and cause inflammation that leads to lots of different respiratory, cardiovascular and neurological health harms.”

PM2.5 can cause new or worsened heart and lung diseases, along with a list of health effects like coughing, shortness of breath, fatigue, asthma attacks and more. 

While Keyes was still vice president of the Beloit City Council, she had read a 2021 report from Toral that found Rock County’s CO2 emissions increased by 325% between 2010 and 2019. After discovering that the emissions in her county were much higher than in counties like Dane and Winnebago, she contacted the Wisconsin Department of Natural Resources. 

She learned the agency operated one monitor for ozone on the west side of Beloit, and only for six months out of the year. She said DNR officials recommended community sensors, such as PurpleAir monitors, if she wanted to start monitoring for herself. 

PurpleAir makes sensors that actively monitor PM2.5, temperature, humidity and pressure, collecting air quality data and making it publicly accessible. 

Keyes said different nonprofits across Beloit participated in a community project to install PurpleAir monitors in the city in late 2022, using a U.S. Environmental Protection Agency community sensor loan program. Early data raised concerns, but the DNR told her that only five months of data had been collected, which is far less than the three years needed to establish an annual standard, Keyes said. However, that’s all the EPA could lend them for their study.

The group had secured funding during their time with the EPA’s loan to install three monitors in Rock County, allowing for continuous monitoring with data collected every 10 minutes. Now, Keyes said they have been able to expand their monitoring network to more than 20 PurpleAir monitors in the county.

“Our effort has really built awareness, and even the Rock County Health Department went after a mini grant … and they were awarded it, and they got 10 sensors, and were able to put them up at schools around the county, so now it’s not just urban centers,” Keyes said. “It’s super cool if you look at PurpleAir now, how we have a better distributed geographical monitoring system.”

Then in early 2024, technology company and global leader in air quality monitoring IQAir contacted Healthy Climate Wisconsin with alarming news — Beloit was ranked the most polluted city in the United States in 2023. The company had pulled data from the PurpleAir monitors through 2023 to draw that conclusion. 

What makes Beloit ‘pollution central’

Toral pointed to numerous factors — including an unusual amount of wildfire smoke from Canada that year, regional pollution from nearby cities such as Madison, Chicago and Milwaukee, as well as transportation emissions, nearby power plants and industrial activity — that all make Beloit “pollution central.”

He said bigger cities surrounding Beloit like Chicago, Milwaukee and Madison reported very high rates of pollution that summer exacerbated by the smoke. Toral noted all of those cities closely track their air pollution data. He pointed to the sensors Beloit has compared to other surrounding areas, saying through the sensors, Beloit was able to document where the smoke from the 2023 wildfires converged. 

“Unusually, we got winds coming out of the northeast, and that brought back the smoke from the fires in Quebec,” Toral said. “Those are what led to the perfect storm — very active fire season, dry winter, slow snow precipitation in the winter, low precipitation in the spring, leading up to the fires lasting longer, being more aggressive.”

He said that while Beloit is small, its monitoring is on par with bigger cities like Chicago and Madison. So, while Beloit was ranked as most polluted, he said there’s also a lack of data from other cities in that area of the state and northern Illinois to officially confirm if it’s Beloit specifically. 

“You don’t know how polluted you are until you test, and Beloit is very unusual in the sense that it’s a very small town that actually has very good air pollution sensors,” Toral said.

Keyes said the organizations involved in Healthy Climate Wisconsin’s air monitoring effort recognized the need for more coordinated action, so they formed the Stateline Clean Air Coalition — a group of organizations and community members who meet monthly to advocate for cleaner air and healthier communities. 

She highlighted that for more than two years one of the coalition’s primary concerns had been to install a regulatory PM2.5 monitor in Rock County — specifically in Beloit. While Beloit has an ozone monitor, Keyes said it’s not ideally located and only operates for part of the year. 

“(Ozone) is a harmful air pollutant, but not the most toxic. And what we’re really concerned about is particulate matter,” Keyes said.

Community members, health care professionals and advocacy groups also have shared their concerns with the DNR, urging a regulatory PM2.5 monitor in the area. Some argued that Beloit may have some of the highest PM2.5 in the state, with some estimates from advocacy groups and community sensors exceeding standards.

The DNR relies on data from a regulatory monitor in Rockford, Illinois, rather than direct measurements from Beloit. An agency spokesperson emphasized that Wisconsin meets the current PM2.5 standard of 9.0 micrograms per cubic meter, based on 2022-24 regulatory monitor data. 

The DNR spokesperson cited the EPA, saying the three-year PM2.5 design value for Rockford from 2022 to 2024 was 8.3 micrograms per cubic meter, with an annual mean of 7.3 in 2024 — below the requirement for a regulatory-grade PM2.5 sensor.

Craig Czarnecki, the outreach coordinator of air management at the DNR, emphasized that regulatory monitors are used for official decision-making and produce the most reliable data, while community sensors like the PurpleAir monitors are better suited for general awareness.

“Data produced using low-cost sensors do not undergo the same rigorous quality assurance and are known to be biased high when compared with data produced by regulatory monitors. These limitations make low-cost sensors best suited for qualitative purposes such as making decisions on daily activities considering the current air quality,” Czarnecki said.

Despite ongoing requests from residents and advocates to install a regulatory-grade PM2.5 monitor in Beloit, particularly near known pollution sources and in heavily affected neighborhoods, the DNR has not committed to expanding its monitoring. The agency stated that the existing network meets federal requirements. 

Czarnecki also noted the department lacks funding to expand monitoring beyond federally mandated levels.

Residents also raised concerns about the estimated 2.4 million metric tons of carbon dioxide emitted in Rock County in 2022, with about 2.1 million coming from power plants. The DNR spokesperson noted that CO2 is not regulated in the same way as pollutants such as ozone or particulate matter. 

Keyes said concern over emissions increased as Beloit’s energy infrastructure began to expand. She pointed to Alliant Energy’s Riverside Energy Center and the additions of the West Riverside Energy Center, a 730 MW natural gas plant. 

Toral said emissions data showed the Riverside Energy Center produced about 2.8 million tons of CO2 emissions the last year it was required to report in 2023, surpassing plants in higher-populated areas, which Toral said shows a “disproportionate concentration of pollutants in one single point.” 

Although multiple coal plants used to be in the Rock County area, and burning coal was worse, Keyes noted that natural gas, primarily the burning of methane gas, is still very harmful for the environment and the health of communities. 

“The fossil fuel industry has marketed very hard to make us feel like natural gas isn’t harmful. But it is. It is still a fossil fuel,” she said. 

Alliant Energy has since proposed and been approved to build a liquified natural gas storage and processing facility in Rock County to meet growing demand. Taylor Adams, the senior communications specialist for Alliant Energy, said in a statement that the location was chosen for its proximity to infrastructure and customers and that the project will comply with environmental regulation. 

“Rock County serves our largest concentration of natural gas customers in Wisconsin and is located near established pipeline corridors, making it a logical location for this type of infrastructure,” Adams said. “The proposed facility would incorporate multiple design features intended to control and minimize emissions.”

Adams said air quality impacts are currently under review by the DNR and will be available for public comment. 

Who’s affected

Toral called the situation in Beloit, a low-income community of immigrants and people of color,  “a case of environmental injustice.”

Toral noted the effects of pollution often fall most heavily on vulnerable populations, including children, older adults and people with preexisting conditions. He added that noise pollution can worsen health outcomes by increasing stress, disrupting sleep and weakening the immune system. 

“If you basically are living close to traffic, a power plant, a factory, anything that generates noise — that really exacerbates people’s conditions,” Toral said. “That makes the body more vulnerable to then have to cope with the pollutants.”

Keyes highlighted that Beloit previously had lower emissions than Dane County, but as Madison was able to retire some of its natural gas and coal plants, the regional demand for electricity resulted in power plants — and emissions — expanding in Rock County. 

Keyes’ daughter was one of 15 youth plaintiffs who filed a lawsuit against the Public Service Commission and state Legislature last summer over laws that prohibit the PSC from considering air pollution when reviewing permits for new power plants, along with a failure to protect the youth from climate change.

“Dane County has made progress, but the celebration of progress is really greenwashing the fact that we are suffering,” Keyes said.

New record, new norm

Air quality records were broken across Wisconsin July 16 as wildfire smoke from northern Minnesota and Canada was carried into the Great Lakes region by winds. Much of the state experienced hazardous air conditions, with Air Quality Index levels reaching their highest points in at least 16 years. 

The smoke brought back memories of the 2023 wildfire season, when similar conditions covered much of the Midwest. 

Toral said this year’s fires are following a similar pattern to 2023. He said because the Great Lakes form a basin, smoke tends to converge there, making Wisconsin “ground zero” for this contamination. He added that the current fire season is already very active, and while the fires were more severe three years ago, this year’s fires are closer to Wisconsin. However, he said it’s still too early to know whether this year’s fire season is going to be worse than 2023. 

“We thought that the fire season we saw two years ago was one of a kind — was very unusual — and here it is again, two years later,” Toral said. “This is a very unusual pattern.”

Wildfire smoke raises air pollution concerns in Rock County, where asthma rates are among the highest in Wisconsin is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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Most of the 29 people killed in ATV/UTV crashes so far this year had never completed an off-highway vehicle safety course, according to the latest data from the Wisconsin Department of Natural Resources.

And DNR officials say that 15 of those who died were over the age of 60 — meaning they were among those who are not required to take safety courses under state law.

DNR data shows most of the people killed in off-highway vehicle incidents were not wearing seat belts or helmets, and frequently alcohol was a factor in the crashes. Those are all aspects the state’s safety courses try to explain to riders.

Jacob Holsclaw, the DNR’s off-highway vehicle administrator, said that’s a notable trend and one the state is starting to look at.

“Many of the crashes could be prevented simply by adopting a safety code of conduct,” Holsclaw said. The DNR offers tips and class information on its ATV/UTV page. 

The DNR recommends all operators to take a safety class, no matter their age.

The data for 2026 shows most people killed in ATV/UTV incidents were born before Jan. 1, 1988.

“What we’re seeing is a majority of the folks involved in these fatal or serious injury crashes were born before that date,” Holsclaw said. “So the class would have been optional.”

Under the law, riders over 38 are not required to take courses.

Only five people killed in OHV incidents were younger than 38, according to state data.

Three UTV/ATV operators were confirmed by state officials to be safety-certified at the time of the crash, according to DNR’s data for 2026. 

There are still five cases with unclear safety certification, but the DNR said their status is pending at this time.

Randy Harden, the president of the Wisconsin ATV/UTV Association, said his group has been working with the DNR to improve safety in the state’s riding population.

He says it’s often difficult to get older Wisconsinites to take protective gear seriously.

“That’s our challenge,” he said. “How do we keep communicating effectively to get the message over?”

Only three women died in UTV/ATV incidents this year. Two were over 65; the youngest was 40. All three women died on public roadways in Wisconsin.

Most of the fatalities were men, with a total of 25. The oldest was 83. One child died at 10 years old. 

And while 29 deaths this year were directly tied to crashes that happened this year, DNR officials said an additional OHV-connected fatality occured when a person died this year from injuries in a crash that occurred years ago, Holsclaw said. The medical examiner listed that death as a result of an ATV crash.

The top three kinds of fatal crashes were: rollovers, with 15 crashes; motor vehicle collisions with six; and people being ejected from the vehicle in four crashes, according to DNR data.

Harden says many riders mislead themselves into thinking they’re safe enough to ride in a machine without a helmet.

In reality, Harden says the vehicle doesn’t have air bags and riders have a real risk of being thrown out of the vehicle in a crash. 

“Even if you have your seat belt on, then your noggin is taking a beating in that roll cage,” he said. 

It’s not clear how many fatalities reflected in 2026 crash report data had alcohol in their system — but Holsclaw said it’s common in many OHV crashes.

As of Aug. 14, the DNR webpage for crash reports shows, out of 29 fatalities, 21 incidents where the BAC level is listed as “Pending.”

“It can take months for us to get alcohol or drug results back, and so that’s why we leave those open until we get that confirmation,” he said. 

But, Holsclaw said in a typical year, the department finds alcohol is a factor in between 40% and 50% of fatal crashes.

“That’s a pretty big percentage,” he said.

Five fatal crashes were confirmed to have involved alcohol, according to the DNR data. 

For comparison, Minnesota’s Department of Natural Resources says that state has had only seven fatal crashes so far this year. In 2025, MDNR recorded 22.

This story was originally published by WPR.

More than half of people killed this year in Wisconsin off-road vehicle crashes were over 60 is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 3 minutes

A measles outbreak in the southwestern corner of Wisconsin continues to grow.

As of Friday, the state Department of Health Services has identified 41 confirmed and 7 probable cases across Iowa, Lafayette and Grant counties.

All but one of the people infected with measles in Wisconsin this year have been unvaccinated, according to state data. Just over half of the cases have been in children and teens, while 44% are in adults.

State and local health officials are working to stop the highly-contagious virus from spreading further. But that work is being made more complicated by low vaccination rates in some communities.

DHS spokesperson Jennifer Miller said in an email that while the situation remains fluid, “we are seeing confirmed cases in pockets of our communities where individuals are under-vaccinated or unvaccinated.”  

“Whenever there are pockets of lower immunization coverage — whether due to geographic location, health care access, or personal reasons — highly contagious viruses can spread quickly,” Miller wrote.

Like the rest of the U.S., childhood vaccination rates have fallen in Wisconsin as parents’ uncertainty, and in some cases skepticism, around vaccines has spread in the wake of the COVID-19 pandemic. 

But state data shows some of the southwestern communities have had declining uptake of the measles, mumps and rubella vaccine series well before pandemic. 

Only 60% of two-year-olds in Lafayette County had received one or more of the shots in 2025. Grant County’s rate was just under 64%.

Iowa County, where the majority of the recent measles cases have been located, had a rate similar to the statewide average at nearly 81%. But it’s still well below the threshold needed to prevent an outbreak at 95%.

Plain community may be affected

One community in the region that may be affected by lower vaccination rates are the Amish and Mennonite faith groups. The Christian communities are collectively known as Plain people because of their selective use of modern technology and conservative style of clothes.

Wisconsin has the fourth-largest Amish population of any state in the country, with an estimated 27, 535 Amish people living in the state as of 2025. The population data from Elizabethtown College in Pennsylvania shows more than 3,000 Amish live across Grant, Lafayette and Iowa counties.

Mark Louden, a University of Wisconsin-Madison professor of Germanic linguistics, is an interpreter and cultural liaison for the state’s Plain communities. He said the Plain people in Grant and Lafayette Counties have strong family ties to Lancaster County, Pennsylvania. 

“There’s a lot of back and forth, just like people traveling back and forth, visiting and so forth, especially this time of year,” he said.

Lancaster County is home to the largest Amish settlement in the U.S. and is at the center of a major outbreak of measles that has sickened more than 300 people in Pennsylvania.

Louden said that while Amish and Mennonites have community standards for technology, health care choices are left up to individuals and their families.

“Even the most conservative or traditional groups out there do access Western healthcare,” Louden said. “While there may be some families that have their kids not vaccinated at all, that’s pretty exceptional.”

Louden characterized Plain communities as “vaccine cautious.” He said they’re more likely to choose which shots they want their children to get instead of just following a recommended vaccination schedule.

But he said their caution or even distrust of vaccines doesn’t just come from their cultural beliefs.

“(It) has been amplified by what they hear from their non-Plain neighbors, who are going down internet rabbit holes and watching certain networks,” Louden said.

Jack Sauer, chair of the Lafayette County Board of Supervisors, said like many places in the U.S., his county used to have higher rates of vaccination. But he questioned how much national rhetoric that questions childhood vaccinations, including from leaders of President Donald Trump’s administration, have had an impact.

“If you listen to anyone on the federal level, there’s a lot of going back and forth on whether the immunizations are good for you or bad for your or whatever they are,” Sauer said. “But I know when I was growing up, which was a long time ago, they were pretty well acceptable.”

Given the rapid spread of cases in neighboring Iowa County, he expects to see more cases in his county before the outbreak is over.

Iowa County Health Officer Debbie Siegenthaler said in an email that her department is working to identify cases and potential exposures and make sure people have access to testing and vaccination.

She strongly encouraged residents to check their vaccination status through the Wisconsin Immunization Registry or through their healthcare provider, especially as children head back to school.

“With increasing number of cases, we want residents to be aware of measles even if they have not been notified of a direct exposure,” Siegenthaler said in the email.

The county is holding a community vaccination clinic at the Mineral Point Rescue Squad office on Monday, Aug. 24 from 12 p.m. to 5 p.m.

This story was originally published by WPR.

Low vaccination rates drive southwest Wisconsin measles outbreak is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 7 minutes

This story is part of a collaboration between Wisconsin Watch and Door County Knock, exploring the factors that make pet ownership in Door County a pricey challenge. Read Wisconsin Watch’s story here. 

Click here to read highlights from the story

• Pet owners told Door County Knock about how they struggled to find rental properties that accept their furry friends. 
• Places that do often charge additional deposits tack on monthly charges per pet ranging from $25 to $75 or more and implement weight and breed restrictions. 
• Officials with the Wisconsin Humane Society say 24% of people who surrender a pet statewide cite housing as the reason. 
• Experts say dogs in particular can increase insurance costs, as dog bites are the number one claim under homeowner’s insurance nationwide. 
• Landlords say the extra deposit and fees help cover damage and labor costs for picking up after pets when owners fail to do so.

Owning a pet and finding rental housing can be difficult, especially in a tight rental market like Door County. As of May 2025, Sturgeon Bay’s vacancy rate — the percentage of total housing available – was less than 1%, and local housing experts say the rest of the county is similar. 

Add pet policies and extra fees, and finding affordable rental housing when you have pets is an even bigger challenge. 

Laurel Grey moved to Door County with two dogs and two cats. She had to stay in a motel while she was looking for housing, before selling her home in Onalaska. Grey said she called every place she could find and eventually got into a property in Sturgeon Bay. 

The apartment’s pet policy included an extra deposit and a $50 per animal per month fee — an extra $200 a month. Three of her pets died before apartment management changed the policy to prohibit pets, except for service animals or emotional support animals (ESAs). 

Though Grey’s remaining dog was grandfathered in and allowed to stay, she said, the monthly fee was raised to $75 per animal per month. The issue of pets and housing is one of economic inequality, she said. 

Anybody who can’t afford to own a home or chooses to rent is either not allowed to have a pet or has to pay significantly more in housing costs, according to Grey. 

“Do you realize how classist that is?… I used to be judgy of surrendering pets, but there may truly be no other option for some people,” she said.

Shelters feel the fallout

Housing insecurity and a lack of affordable pet-friendly housing are among the biggest reasons animals are surrendered to the Wisconsin Humane Society, according to Corey Viars, the organization’s media specialist for its Green Bay and Door County campuses. 

When people surrender pets to the Humane Society, they fill out an intake form that includes the reason they are doing so, Viars said, and “housing” is cited by 24% of people across the state. Of that number, almost half are related to moving, and a third are related to landlords not permitting an animal. 

“One of the most common reasons for surrender is moving and simply not being able to find pet-friendly housing,” Viars said. Pet deposits and pet rent increases add additional barriers to pet ownership, he added. 

The Door County Humane Society does not have as many animals as some of the other campuses, according to Viars, because it is one of the smallest campuses in the state. However, seven animals were adopted from Door County during the first week of August, he said. 

Strong emotions are almost always involved when people are giving up a member of their households. 

“Our intake desk is an emotional place, and those surrendering due to financial or housing reasons are no exception,” Viars said. People are “heartbroken” when they have to surrender a beloved pet because they have nowhere to go with them, he added.  

More than just a pet

Pets are more often than not a member of the family, according to Door County veterinarian Dr. Sherry Billett. 

In her practice at Peninsula Veterinary Hospital, Billett said she has seen firsthand the “substantial and oftentimes quite devastating” emotional impact of having to give up a beloved pet, but it is not a very common occurrence among her patients.

Most of the pet owners she encounters refuse to give up a pet and continue to search for housing, she said, even if it means moving out of Door County. 

“This is not hard to understand since, in the vast majority of cases, pets are members of the family, so it makes sense that the same loving dedication be extended to them as well as human family members,” Billett said in an email. 

She is aware of cases where a pet owner has to move to an assisted living or similar facility that will not allow pets, and others where individuals and families have difficulty finding any housing that will allow pets even with a deposit.  

Billett also sees the numerous benefits of caring for pets that extend beyond emotional well-being, she said. 

“Pets provide many people with the type of loving daily caretaking interactions that help prevent loneliness, that promote responsibility, that provide a reason to care for their own personal health in order to be able to take care of their pets, and that facilitate meeting other people when out on a walk or at a park,” she said. 

Officials say this is particularly important in a community with one of the largest aging populations in the state and which has identified loneliness and isolation as one of the top community health concerns. 

Aging and Disability Resource Director Jennifer Fitzgerald said she has also seen firsthand how pets help alleviate isolation and improve quality of life for both pets and the ADRC’s consumers. This becomes especially important when older adults lose a spouse, she added. 

ADRC clients encounter housing challenges involving pets, according to Fitzgerald, but the agency does not get directly involved. Rather, it provides people with a housing list as a resource, she said.

The risks landlords weigh

The Door County Economic Development Corporation keeps an inventory of available rental properties in the county, although it is not exhaustive, according to Executive Director Michelle Lawrie. However, the inventory can provide a snapshot of what pet owners encounter when looking for a place to live. 

The list contains 42 properties, and 21 of them explicitly identify themselves as pet-friendly. The rest do not specify whether they allow pets. 

Rebecca Willoughby is the property manager for SCS Sturgeon Bay Estates, a market rate housing development. All of the properties owned by SCS are pet-friendly, she said, but they have restrictions against certain breeds. 

A $250 deposit is required for pets, as well as a $50 per pet per month fee, Willoughby said. ESA and service animal owners are not charged additional fees or deposits. 

The deposit and fees are to offset the costs of pet damage, she said, such as cats or dogs urinating or defecating indoors, or scratching things. Cat urine can be especially difficult to remove, she said. Renters sometimes do not pick up after their pets outdoors, which leads to more labor for maintenance services, Willoughby added. 

The tight rental market in Door County does not factor into the policy, she said, and renter eligibility hinges on things like income qualifications and other leasing criteria. 

Dog-related liability is a real insurance concern as well, according to Andrew Franken, president of the Wisconsin Insurance Alliance. 

Insurance costs for property owners can be impacted by the presence of a dog, Franken said, and all companies handle the issue differently.

Nationally, dog bites are the number one claim under homeowner’s insurance. In Door County, there were approximately 63 dog bites reported to the Door County Department of Health and Human Services in 2025, according to data provided by county staff. 

When a dog bites someone a second time in Wisconsin, there is an automatic “double damage” law. It means the dog owner can be liable for twice the amount of damages if the owner knew about the first bite. 

Breed restrictions

Pet-friendly rental housing often specifies what types of dogs can live at a property. 

Larger dogs are disproportionately affected by restrictions, Viars said. Fifty-pound weight limits are common, and some insurers and rental companies do not allow specific breeds. Pit bull terriers, Doberman pinschers and Rottweilers are often the focus of these types of restrictions, according to rental industry sources. 

The Humane Society has stopped labeling dogs by breed, according to Viars, because breed identification can be inaccurate. 

“When we used to assign a breed, it was often a guess proven wrong by DNA tests,” Viars said. “We focus on the personality and attributes of each individual dog during adoption counseling.” 

Knock contacted Door County rental properties represented in DCEDC’s inventory to find out more pet policy details, and they ran a gamut of restrictions, with several mentioning breed and weight limits. 

What does ‘pet-friendly’ mean?

Among Door County property listings, the following pet policies were indicated: 

• no additional pet fee
• $25 per month per pet
• $45 per month per pet
• $50 per month per pet
• $75 per month per pet
• $250 deposit per pet
• half-month’s rent
• breed/weight restrictions

A renter with two dogs might be looking at an extra $100 per month in pet rent. That’s $1,200 a year before any deposit. Landlords say the fees correlate directly to expected costs brought on by animals. 

Balancing pets, people and housing 

The Humane Society said more pet-friendly affordable housing would result in fewer surrenders. The problem is not only a Door County one, according to Viars, but state and nationwide. 

Many of the people in Grey’s apartment complex are older adults — she herself is 69 — and she knows at least a dozen residents who would take a cat. One of her neighbors, who just turned 80, moved into the complex after a divorce, she said. She used to own cats and she adores them, Grey said. 

“It’s just sad. She’s someone who is lonely, who would benefit from having pets,” she said.

Emily Small is a reporter for Door County Knock and a Report for America corps member. Contact her at esmall@doorcountyknock.org.

Pets can make finding a home harder in Door County’s housing market is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 7 minutes

This story is part of a collaboration between Wisconsin Watch and Door County Knock, exploring the factors that make pet ownership in Door County a pricey challenge. Read Knock’s story here. 

Click here to read highlights from the story

• Rural residents, like those in Door County, bear the brunt of the veterinarian shortage, which leaves local clinics overbooked and unable to offer emergency services. 
• The nearest emergency veterinarian is in Appleton, though one will soon open in Bellevue. 
• The demand has placed increasing pressure on veterinary professionals, with burnout a common problem and high suicide rates among veterinarians. 
• UW-Madison’s School of Veterinary Medicine is the only training program for vets in the state. It only accepts 100 students annually due to a lack of physical space. 
• UW officials hope to renovate the vet school’s facilities to expand the class size.

Right after Wisconsin’s historic snowstorm in March, Jessica Chase’s dog started seizing on the floor of her Sturgeon Bay home. In five-minute intervals, the episodes grabbed control of Capri, a shepherd, husky and Rottweiler mix.

Panicked, Chase called the nearest emergency veterinary hospital: BluePearl in Appleton. The 24-hour vet is roughly a 90-minute drive for Chase on a good day — and likely much more that day, given more than 2 feet of snow blanketing the streets. 

Chase couldn’t fathom driving that far while her dog lay seizing in the back seat. She also didn’t know if she’d survive that long. Then, staff warned she could be waiting several more hours upon arrival, as the hospital was at full capacity. 

Less than 12 hours after her first seizure, Capri died on the kitchen floor. 

“It was the most mortifying experience ever,” Chase said. “It’s basically like my baby.”

For Door County pet owners like Chase, options are slim when crisis hits. The nearest emergency veterinarian is between one and three hours away, depending on how far north on the peninsula they reside. 

The dearth of options means residents must forgo care or make nail-biting drives with sick pets. Sometimes they arrive too late. 

Thanks to veterinarian shortages and Wisconsin’s limited capacity for training new vets, the problem is getting worse. And it’s not just an issue in emergencies: Many rural pet owners must also look far or wait long for routine vet care. 

There’s no easy solution. Existing Door County vet clinics are too overwhelmed to offer emergency services, and there are likely not enough doctors or patients to justify opening an ER facility. 

“I feel like if we had a clinic near us, even a half-hour away, it would have been much more reasonable to have someone look at her, than just having to sit there with our dog dying and there’s nothing we can do,” Chase said. “There was nobody to really call and talk to. Nobody walked us through it. No one gave us advice.”

Overwhelming demand

Peninsula Veterinary Hospital in Sturgeon Bay receives at least five calls a day from people who need emergency care. Staff work patients into the schedule if they can. But often, they’re not equipped to treat the issues, lacking the proper tools or staff.

“It’s like going to your family doctor with a broken leg,” said Amy Hults, a certified veterinary technician at the clinic. 

It was easier for residents to get by when BluePearl operated a facility in Green Bay, about 35 miles closer than Appleton. But the facility closed in early 2025. The company never offered a reason why. 

Nowadays, residents regularly complain about the issue to one another and on social media. The discourse gets louder in the summer months, when an influx of vacationers arrive, many unaware of the limited care options.

The chorus of complaints just may not be large enough. Research has shown that it takes a population of 100,000 people to have enough clients to sustain a round-the-clock facility, Door County vet Dr. Sherry Billett said. Door County is home to 30,000 year-round residents and welcomes more than 2.5 million visitors annually.

Other barriers stand in the way: Specialized equipment is pricey. The facility would need enough doctors and support staff to cover the clock — a notoriously difficult thing to find. 

Peninsula Veterinary Hospital has been trying to find a new vet for “a long time,” to no avail, Hults said. With high housing costs serving as a barrier — the average home value is nearly $440,000 according to Zillow — it’s challenging to get new hires to move to the county.

“Because of the overwhelming demand, we need to schedule appointments several weeks in advance, and sometimes even months in advance,” Billett said. “We hear from callers on a regular basis that other clinics are not taking any new patients, which adds to our case load.” 

They’ve gotten creative to fit in more patients, including overlapping bookings and having owners drop their pets off for the day, so they can work them in between appointments.

Burnout is a constant battle, Billett said. It’s stressful to juggle treating different species daily and handle the emotions of animals’ caretakers, she said. Suicide rates among veterinarians are high.

“That said, it is also an incredibly emotionally and psychologically rewarding profession for the right people,” Billett said.

Where are the vets?

So where are the right people?

There’s only one training program in the state: the University of Wisconsin-Madison’s School of Veterinary Medicine, where roughly 2,500 students vie for 100 open seats yearly. About half of the graduates will stay and practice in Wisconsin. 

The school isn’t churning out enough graduates to make a serious dent in the state’s shortage.  And its lecture halls and laboratories don’t have enough physical space to expand enrollment.

“We are capped out at the number of students we can admit because … the facilities just literally cannot fit any additional folks,” said Dr. Jonathan Levine, dean of the vet school.

“More and more people want to do this career, which is wonderful. It’s a terrific career,” he said. “The challenge is having enough spots to accommodate qualified, excellent applicants.”

To someday change that, UW-Madison is beginning to examine how it can renovate buildings and “expand our class size to meet the needs of Wisconsin and the region,” Levine said. 

Student debt also plays a role in where veterinarians choose to practice, said Dr. Jen Quammen, president of the American Veterinary Medical Association. AVMA data shows veterinarians’ average student debt upon graduation climbed to nearly $175,000 in 2025.

“Food-animal, rural and public health careers typically pay less than companion-animal practice in metro areas, so many graduates find themselves balancing where they feel called to practice with where they can realistically afford to practice,” Quammen said. 

Not all of these graduates work in emergency facilities or pet clinics. There’s demand for vets in many fields, Levine said, including research, at drug development corporations or in pathology. 

“It’s all those things that have sort of combined over the last decade to drive very high demand, and the supply of veterinarians is limited,” Levine said. “In rural communities it’s been particularly challenging, and that is not a new story. It’s … a decades-old story.” 

Solutions elusive

JoAnne Rosenfeld believes her Boston terrier, Butch, would still be alive if Door County had an emergency vet. 

In April, Butch began seizing while he slept, spinning his body in “jerky spurts” and yelping in pain. Rosenfeld and her son scooped up Butch, limp and struggling to breathe, and brought him to the car for the 90-minute haul to Appleton. 

Butch, almost 4 years old, died 18 miles from the destination. Rosenfeld pressed on, hoping CPR could save him, to no avail. 

“Heartbroken, despondent, anguished, heartsick and sad beyond belief,” Rosenfeld wrote in a letter with other local advocates, asking that county leaders and vets come together to find a solution. 

She offered one: Door County vets rotating weekends to be on-call for emergencies. 

“If there are 10 vets willing to help, their duties would be just once every 10 weeks, about five times a year, only nights and weekends, which would not interfere with daily activities,” she wrote.

Local clinic workers say such an arrangement isn’t realistic, as they’re already fighting burnout. 

“There is no way that a doctor or nurse could work their full 40- to 50-hour workweek and still be capable and fresh for after-hours or weekend emergencies,” Billett said. “This would add to the stress and the burnout that it is already a constant battle.”

While emergency care inside county limits seems unfeasible, closer help could soon be on the way. National chain Veterinary Emergency Group (VEG) will soon open a new 24-hour emergency location in Bellevue, about 40 miles closer than BluePearl in Appleton. Its website says the Brown County location is “coming soon,” and a ribbon-cutting will be hosted on Aug. 27. 

VEG’s site offers no contact information for the new branch. The company did not respond to a request for comment. 

But closer care would be a welcome relief for Sister Bay resident Nancy Treleven, who has driven a six-hour round trip to get care for her French bulldog, Winston. 

“It’s just scary when you’re in the car with a pet that’s not well,” Treleven said. “I’m focused on driving, but I’m completely stressed because I’m worrying about how my dog is doing, and if I’m gonna get there in time, and what happens if everything’s not OK, and I can’t make it back home tonight. Where am I staying? What am I doing?” 

Nationally, legislation addressing the problem is in the works. AVMA is advocating for Congress to pass the Rural Veterinary Workforce Act, which would offer $120,000 in student loan relief to veterinarians who commit to three years of service in rural shortage areas. 

Editor’s note: A caption in a previous version of this story misspelled the name of Brienna Derbique.

Miranda Dunlap reports on pathways to success in northeast Wisconsin, working in partnership with Open Campus. Find her on Instagram and Twitter, or send her an email at mdunlap@wisconsinwatch.org.

Vet shortage overwhelms clinics, leaves owners to drive hours for emergency care is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 3 minutes

Wisconsin health leaders worry future work requirements for Medicaid recipients will create both an administrative and ethical burden for doctors and other providers.

Starting next year, adults ages 19 to 64 will be required to work, go to school or volunteer for 80 hours per month to qualify for coverage under the safety-net program. 

The new rule, which was included in Republicans’ “One Big Beautiful Bill Act” last year, provides exemptions for several groups, including people who are pregnant, live with children under 19 and those with a recognized disability.

There is also an exemption for people with serious or complex medical conditions, or those considered “medically frail.”

In guidance released in June, the Centers for Medicare and Medicaid Services, or CMS, said state Medicaid programs should consider not only a person’s diagnosis or condition but also “the extent to which the condition impairs an individual’s ability” to meet the new requirements.

But Dr. Ken Schellhase, a primary care physician and member of the Wisconsin Medical Society, said making that determination is not simple, even for a doctor.

“That will require training and skills that the typical primary care doc does not have,” he said. “Honestly, that’s a big reason why most docs in primary care practices don’t do the official disability evaluations for Social Security.”

Doctors working in occupational medicine or rehabilitation are specially trained to objectively determine someone’s functional capacity, Schellhase said, but few such providers practice in those fields.

Speaking to reporters on July 30, Wisconsin Department of Health Services Secretary Kirsten Johnson said the state needs more guidance from CMS as it develops a system for verifying who qualifies for the exemption. 

She said DHS plans to use existing records like medical billing to verify that someone is unable to meet the work requirements. CMS will also allow recipients during the first year to self-attest that they are unable to work.

Scott Stewart, CEO of the Wisconsin Primary Health Care Association, said the existing system for health insurance claims is not designed to indicate a person’s level of impairment or their ability to work.

“It’s set up to say this is what a patient has, but it’s not set up to say anything more than that,” Stewart said. “You have to really also think about the privacy aspects of that. Now you’re saying that I have to potentially give a patient’s chart, which they have to sign off on in terms of HIPAA, to say that they are medically frail and meet all definitions?”

Schellhase worries that involving medical charting and billing could influence how doctors care for their patients, including how quickly they make a diagnosis. He described someone seeking for treatment of asthma symptoms.

“Not everybody who wheezes has asthma, and so sometimes we struggle with as a diagnosis code,” he said. “Do we put in just wheezing? Or have we seen it enough times, but it’s just not absolutely confirmed that yeah, this person probably has asthma? There’s a lot of gray area in that.”

He said patients with conditions not considered severe enough for exemption could see their health decline if they lose health insurance. And he worries the new process will create a conflict of interest for doctors who have a professional obligation to help, not harm, their patients.

“We’re supposed to be that patient’s advocate, to do whatever’s in our power to help them and get them the help that we think that they need,” he said. 

Stewart, whose organization represents the state’s federally supported community health centers, said increasing paperwork requirements have lead to more people losing access to care.

He’s concerned that health systems will be incentivized to help patients qualify for an exemption to keep their coverage so providers can continue to bill the program for care.

“We’ve seen issues with the Medicare Advantage program and things like that in the same way, around wanting patients to have access to these programs, but having the kind of perverse financial incentive to get them on (the program),” he said.

WPR contacted several major Wisconsin health systems for comment on the potential impact of the work requirements but received no responses. 

The Wisconsin Hospital Association, or WHA, declined WPR’s interview request. In a statement, WHA’s senior vice president for finance and payment, Christian Moran, said the association appreciates DHS’s efforts to “minimize additional regulatory burdens on hospitals and providers while helping eligible individuals maintain Medicaid coverage and reducing the risk of higher uncompensated care in Wisconsin hospitals.”

Moran wrote that WHA will continue to watch the state agency’s plans as more details become available.

This story was originally published by WPR.

Wisconsin doctors worry Medicaid work rules will create ethical, administrative burdens is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 9 minutes

Click here to read highlights from the story

• Wisconsin Watch spoke to community leaders in northeast Wisconsin to understand how support systems work, how people who are unhoused can get help in each county and who counts as homeless. 
• Officials explain how waitlists for housing programs work, how they’re funded, why people who are unhoused are more visible in cities and ways people who have housing can help. 
• The story includes links to resources and a flowchart available for free download.

An estimated 1,200 people are homeless in northeast Wisconsin — and that could be a vast undercount. Nonprofit leaders say shelters are at capacity on a regular basis and a lack of affordable housing is contributing to the problem. 

According to the National Low Income Housing Coalition, someone would have to work 112 hours per week at minimum wage to afford a modest 1-bedroom rental home in Wisconsin. Amid rising costs, Jackie Baumgart, director of youth services for Foundations Health & Wholeness, says rural counties Foundations serves have few homeless shelters.

“We need a shelter or three in every county … If there was somebody to call and get somebody in every time, we could do wonderful work, because it wouldn’t always be in crisis,” Baumgart said. 

Experts say there are misconceptions about who counts as homeless and how the homeless response system works. That prevents people from accessing resources and contributes to stigma around homelessness. 

To understand how support systems work, how to get help in each county and who counts as homeless, Wisconsin Watch put together a guide of frequently asked questions about homelessness informed by interviews with community leaders in northeast Wisconsin. 

Click here to download a free flowchart on how to access homelessness resources in northeast Wisconsin.

How many people are homeless in my region?

Homelessness is measured nationwide by a “point in time” (PIT) count — a snapshot of all the people experiencing homelessness on a single night. The federal government requires this to happen annually in January, but all counties in northeast Wisconsin conduct an additional summer count in July. 

During the PIT count in January, volunteers found 560 individuals who were living in shelters or on the street in Brown County. Other counts can be broken down into coalitions that include multiple counties. 

Northeast (Florence, Marinette, Menominee, Oconto and Shawano counties): 83 people

Lakeshore (Door, Kewaunee, Manitowoc and Sheboygan counties): 224 people

Fox Cities (Calumet, Outagamie and northern Winnebago counties): 330 people

To count someone as homeless, volunteers must speak to people who seem to be living on the streets to confirm they’re unhoused. Those who are sleeping on the couch of a friend or family member don’t count. This means many people aren’t included in the count who might be considered homeless, especially in rural areas. That’s important because the PIT count is indirectly tied to the amount of grant funding designated for each region.

Who is considered homeless?

The U.S. Department of Housing and Urban Development, or HUD, breaks its definition of homelessness into several categories. These categories determine which programs or aid you can apply for. 

Category 1: Literally Homeless

This includes who most people generally picture when they hear the word “homeless” – anyone who is unsheltered and could be sleeping outside, in a tent or in a car. It also includes people living in a temporary homeless shelter or using hotel vouchers. 

Category 2: Imminent Risk of Homelessness

This category includes individuals or families who will lose their housing within 14 days of applying for homeless assistance and who lack resources to obtain other permanent housing.

Category 3: Homeless Under Other Federal Statutes

This group includes unaccompanied youth under age 25 or families with children who don’t meet the previous definitions, but still lack permanent or stable housing, which often means living in someone else’s home due to economic hardship. Referred to as being “doubled up,” this could look like someone sleeping on a friend’s couch or staying in another family’s basement. Category 3 can also include youth who are living in motels, hotels, trailer parks or campgrounds due to lack of alternative options. 

In the 2024-25 school year, over 20,000 students in Wisconsin were homeless, including 15,400 who were “doubled up,” according to data from the Wisconsin Department of Public Instruction. Although this category is considered homeless under the federal definition, doubled up students don’t qualify for most federal homeless assistance. Instead, they are supported by the McKinney-Vento Homeless Assistance Act, which requires each school district to designate a homeless liaison and provide transportation for students experiencing homelessness.

“A majority of our students experiencing homelessness are living doubled up,” said Kristine Nadolski, state coordinator of Education for Homeless Children and Youth. “It’s a big piece kind of missing in other counts, and I do think that our students are still under-identified.”

Category 4: Fleeing/Attempting to Flee Domestic Violence

Anyone who does not have a residence due to fleeing or attempting to flee domestic violence is placed in Category 4. Specific shelters exist solely for domestic violence survivors that provide crisis intervention, counseling, support groups and legal advocacy.

Categories cover broad swath of people

Overall, these four definitions encompass a wide variety of people who aren’t usually included in the broader public perception of homelessness. Eliza Cussen is the community engagement director for Pillars, a shelter and low-income housing agency in Appleton. She said some people might not consider themselves homeless even though they fit one of these definitions.

“If you have moved in with your mom because your landlord raised your rent and you couldn’t swing it, you might not identify as homeless,” Cussen said. “So that can make people really hesitant to call for those services, or think that they are deserving.” 

How do I get help?

There are many ways to find services, including calling 211, your county Aging and Disability Resource Center or your local government. If you’re seeking shelter, you should probably access Coordinated Entry as a first step, which will place you on a list that all organizations in your area can pull from based on your eligibility. 

211: https://211wisconsin.communityos.org/, dial 211, or text your zip code to 898211.

Findhelp: https://findhelp.org/ 

Manitowoc, Sheboygan, Door, and Kewaunee counties — You are under the Lakeshore Homeless Coalition and Lakeshore CAP.

• Coordinated Entry: Lakeshore CAP 920-694-0041​
  • Lakeshore CAP Resources by County 
  • Door County Lakeshore CAP Resource Guide 
  • Door County ADRC Resource Guide 
  • Food Resources outside of Brown County  
  • Manitowoc County Lakeshore CAP Resource Guide 
  • Manitowoc and Kewaunee County ADRC Resource Guide
  • Kewaunee County Lakeshore CAP Resource Guide
  • Manitowoc Public Library Community Resources  

Brown County — You are under the Brown County Homeless and Housing Coalition.

• Coordinated Entry: House of Hope 920-884-6740, Wise Women 920-883-7202, Golden House 920-435-0100
  • Brown County Homeless and Housing Coalition Resources
  • Brown County Places to Go 
  • Brown County ADRC **Please note: Newcap is closed**

Marinette, Menominee, Oconto, Shawano Counties – You are under the Northeast Homeless Coalition.

• Coordinated Entry: Foundations Health & Wholeness 920-381-7533  
  • Shawano Area United Way Resource Guide for Shawano and Menominee counties
  • 2026 ADRC Wolf River Directory **Please note: Newcap is closed**
  • Oconto County Food Resources
  • Food Resources outside of Brown County  
  • Marinette County ADRC Resource Guide **Please note: Newcap is closed**
  • Tri County United Way Resource List

Outagamie, Calumet, northern Winnebago Counties  — You are under the Fox Cities Coalition

• Coordinated Entry: Liz Crowley, city of Appleton 920-832-6460
  • Fox Cities Housing Coalition Resources
  • Pillars Community Resources 
  • Calumet County ADRC 
  • Oshkosh / Winnebago County Housing Authority Resources
  • City of Appleton Resources 
  • Outagamie County ADRC 
  • Fox Valley Food Pantry Brochure 
  • Fox Valley Street Smart Resources 

Other resources:

• Free and low-cost medical clinics: The National Association of Free and Charitable Clinics 
• Homeless liaisons in Wisconsin schools: Wisconsin Department of Public Instruction Homeless Liaison Directory 
• Food banks: Feeding America Find Your Local Food Bank tool 
• Step-by-step guide to getting help from the National Alliance to End Homelessness
• Job Centers of Wisconsin 
• Northeastern Region Domestic Violence Services Directory from End Domestic Abuse Wisconsin

How do waitlists for housing programs work? 

Waitlists are managed through a system called Coordinated Entry, which is designed to streamline the housing application process. Rather than operating on a first-in, first-out basis, the system prioritizes people based on their level of need.

Organizations statewide can access this list and pull people who meet their requirements when a spot opens up. To be put on the Coordinated Entry list, people are asked questions about their chronic disabling conditions, medical needs, the length of their homelessness and more.

Instead of calling every housing program in your area to get on a waitlist, you will already be on a list that they can see and pull from. They can figure out your eligibility.

Who gets the highest priority depends on the different requirements of each agency. You will also be asked about things like veteran status or if you are fleeing domestic violence. Applicants are also asked which counties they would consider moving to, allowing them to access housing if a spot opens elsewhere. 

How are these programs funded? 

Regional Continuum of Care programs distribute federal funding for homelessness service organizations. Milwaukee, Dane and Racine counties have their own CoCs, while the Balance of State CoC oversees the rest of the state through regional coalitions. 

Each federal grant is designated for specific types of support, such as homeless prevention, emergency shelter — through HUD’s Emergency Solutions Grant — or the CoC’s motel vouchers, permanent supportive housing for the chronically homeless and transitional housing with the goal of helping residents achieve stable housing elsewhere

Successful applicants must meet one of HUD’s homeless definitions, in addition to other eligibility requirements. Grants are sometimes designated for specific populations like veterans, domestic violence victims, youth or individuals who are chronically homeless. Plus, anti-poverty nonprofits and homeless shelters often don’t have enough beds available for the existing homeless population, which is why people sit on waitlists for months or years. 

A recent HUD memo announced broad changes to Continuum of Care funding. Josh Benti, homeless initiative project director for the Greater Green Bay Blueprint to Prevent and End Homelessness, said CoCs across the country now must compete for 40% of HUD’s budget based on criteria like criminalizing homelessness. Previously, 10% of funds were competitive. 

This represents the Trump administration’s broader shift from the Housing First model, which prioritizes providing permanent housing for people and then addressing the root causes of their homelessness.

On Aug. 7, a district court ruled in favor of a coalition of state governments – including Wisconsin – to effectively block HUD’s 2026 notice of funding, saying HUD failed to provide the proper notice and public comment period required.

Why do I see more homeless people in cities?

Rural homelessness is usually harder to see. It’s more common for people in rural areas to live out of their cars or doubled up with a family member or friend, especially since there aren’t as many shelters. Lots of people might not even consider themselves homeless if they are sleeping on someone’s couch. 

Because rural areas are sprawling, with many people doubled up, homelessness can be harder to count. That means rural coalitions may report lower numbers in the PIT count, which indirectly reduces federal funding.

Rural areas also have fewer resources — like shelters or supportive housing — forcing more people to relocate to Green Bay or other cities.

But the solution isn’t always to move. Shawano Area Matthew 25 Executive Director Kendra Brusewitz said people used to being homeless in Shawano might struggle to adapt to living in a larger city. She sometimes encourages people to relocate, but only if they don’t have any support systems in their community. 

“Affordable housing is a challenge everywhere,” Brusewitz said. “So it’s not healthy for anybody to make all these promises, too, of like, ‘Hey, if we just get you to Green Bay, you’ll have all of these opportunities and resources,’ and then they’re in a community that still has the same issues, and then they don’t have supports there either.” 

How can people who have housing help?

Many organizations that don’t provide shelter still interact with people experiencing homelessness and can benefit from understanding how the homeless response system works. These organizations can help brainstorm community-wide solutions, Benti said.

“Housing is something that affects us all, either housed or unhoused … Our hospitals aren’t homeless providers, but they provide services to those who are experiencing homelessness,” he said. “Our employers hire and employ people who are experiencing homelessness. … So, it’s getting all these systems to work and communicate and collaborate better.” 

People who want to help can donate if they have disposable income or volunteer with organizations serving people experiencing homelessness. Volunteering can start with contacting a local shelter or attending a coalition meeting. 

Northeast Coalition (Shawano, Oconto, Marinette and Menominee counties): Contact Abby Ries at abby.ries@wibos.org

Brown County Homeless and Housing Coalition: https://bchhcwi.org/get-involved-2/ 

Fox Cities Housing Coalition: https://www.foxcitieshousing.org/calendar 

Lakeshore Coalition (Door, Kewaunee, Manitowoc and Sheboygan counties): https://lakeshorecap.org/ 

Even if you can’t donate or volunteer, you can still help fight the stigma surrounding homelessness. Brusewitz said she welcomes tours of the SAM25 shelter for greater community understanding. 

“We’re not a big city, but we do have people who are struggling,” Brusewitz said. “The stigma with homelessness, too, of like, ‘Well, they should just get a job,’ or ‘Maybe they should just quit doing drugs or drinking,’ and that’s not always the case.” 

Ryan Graham, homeless systems manager for the Wisconsin Balance of State Continuum of Care, said widespread homelessness reflects a broader affordability issue, with many people just one crisis away from losing their housing. 

“What you’ll see is we have all these people who just can’t afford basic needs or can’t afford their current housing, and they’re one bad event from becoming street homeless,” Graham said. “If we don’t have any kind of homeless prevention or diversion programming to stop that from happening, you’re just increasing the bottleneck that we have at our crisis response system, which we don’t have enough of already, right? So it’s really a tough environment across the country, but in particular in a lot of our rural counties.”

This story was updated to reflect that the Coordinated Entry system places people on waitlists for federally funded housing programs. It was also updated to correct the fact that Continuums of Care organizations distribute funding for homelessness service organizations. Wisconsin Watch regrets the errors.

How to get help: A guide to homelessness resources in northeast Wisconsin is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 6 minutes

Tom Ritter and his son, Cory, had worked together with their families every harvest season for the past 20 years.

“My daughter loved to ride in the semi during harvest with my dad,” said Cory. “I remember seeing them leave the field together, and just the time that he took and the importance that he put on spending that quality time with family.”

But last year’s harvest was different; instead of Tom and Cory working together, tragedy hit the family on Aug. 20.

“Someone drove by and saw the semi was overflowing. The corn was still coming out, but it was overflowing, and thought this isn’t good and started knocking on doors,” Cory said. “My mother’s house is just a couple of doors in town, and they knocked on her door, and she called me and had a feeling we knew what happened.”

The area around the Ritter family farm in Blue Mound, Illinois, was surrounded by neighbors, police and firefighters trying to find Tom. 

It turned out that he had gone inside the grain bin to fix a piece of equipment. While he was working on it, the grain suddenly shifted and began to move, trapping him.

“I still have the mental image of all these neighbors that just showed up. It was a hot day, sweating and scooping as hard as they could, trying to see if we could save him,” said Cory.

Tom was found against one of the walls of the grain bin. Unfortunately, he didn’t make it. 

Half of grain bin accidents are still fatal

A recent report from Purdue University shows these types of accidents are up. In 2024, 34 grain bin entrapment cases occurred compared to 27 in 2023, representing a 25% increase.

Dr. Salah Issa, an assistant professor and extension specialist at the University of Illinois, said data on grain bin accidents is hard to come by. 

“The way we collect this data is mostly through news clippings. It’s hard to put a pin on where they’re occurring exactly, like if there is a type of grain bin where they occur more frequently than others,” he said.

According to Issa, grain storage in the 1960s was very different from today’s systems. Storage facilities were generally smaller and less mechanized before the widespread use of the large steel grain bins and grain-handling equipment common on many farms today. The earliest documented grain bin entrapment case occurred in 1964.

When a farmer is trapped in a grain bin, the odds of survival are poor. Historically, 70% of accidents were fatal, Issa said.

That fatality rate has come down, but it remains high.

”Strong efforts in training for rescue personnel have contributed to the reduction of the severity,” Issa said. But he adds that about 20 to 40 people die in grain bins annually, about half of all accidents.

 “Fifty percent is pretty bad.”

Issa said weather and spoiled grain play a role in most accidents. Grain can get too wet and clump at the bottom, or crust on top — creating a false sense of security for workers who walk on the surface.

“This happened a while ago, with a father and son,” he said. “A young boy went inside a grain bin that had a crust that had formed. The kid runs across the grain bin, and nothing happens, and the farmer runs after him, and when he reaches the middle, it breaks and he falls through it and ends up losing his life.”

Grain can also build up on one side of a bin and collapse like an avalanche, burying a worker.

Young and older workers are at the highest risk; about half of accidents involve people older than 60 and younger than 21.

“In 2010, we had a really bad case where three boys under the age of 20, I think one or two of them were 14 or 15, they ended up drowning,” Issa said.

Regulatory gaps leave many farms without oversight

Grain bin safety training is offered by universities, industry groups and safety organizations across the country. Still, reaching every farming operation remains a challenge.

Farms with fewer than 10 employees are exempt from federal safety standards, and the lack of oversight also extends to young family members who help on the farm.

“It’s a devastating issue, and it should never happen,” Issa said. “Because of the frequency rate, it’s very easy to run into the thought that this is not going happen to me until it ends up happening to you.”

Aaron Lehman, president of the Iowa Farmers Union, said more regulation would help, but that added rules and costs would likely face pushback from farmers.

“Most farmers don’t appreciate a more regulatory framework, and it is difficult to implement and expensive to implement,” he said. “All the more reason before we get to that point that we expand on our efforts to educate farmers, to use voluntary incentives to put these things in place — and that really is important.”

As for Cory, he is unsure about regulation because every farm has its own unique situation.

“I don’t know if I’m for regulation because every farm is different, every situation is different,” Cory said.

For him, it’s more about slowing down and paying attention.

“Is it a dangerous job on the farm? Yes. Is it the most dangerous job on the farm? I don’t know. But it’s just, it’s all about people thinking twice, and that’s what it really takes,” he said.

New safety tools help, but prevention remains the best defense

Issa said that 95% of these incidents are preventable and that prevention starts by installing systems in or near grain bins that can safely break up clumps and address grain-flow problems from outside the bin.

An alternate solution that Issa and his team have researched is using compressed air to break up grain clumps from outside the bin, though the method can be time-consuming because it only breaks up clumps near the outlet, and the use of high-pressure compressed air requires strict safety precautions.

Issa said that as a last resort, if someone needs to enter a grain bin, all equipment should be shut off and disconnected from its power source. The equipment should also be locked and tagged so it cannot be turned on while someone is inside the bin. He added that workers should wear a harness and have a spotter outside the bin watching them.

“I have a story of three people who went into repair a grain bin, and a trucker came by not knowing they were in there and pulled out grain, and they ended up drowning,” said Issa.

California and Indiana have their own state workplace safety programs that enforce grain bin safety regulations. In California, if someone needs to enter a grain bin, written authorization from a supervisor is required, or a supervisor must be present during the entire operation. California’s regulations also require multiple safety procedures to be followed before entering the bin.

“They will have to install anchor points on the grain bin if the grain bin is older. If it’s newer, then there are anchor points there already,” said Issa. “When they’re installing the anchor points, they should work with a structural engineer so they can tell them how much weight this can support. They need an anchor point that supports at a minimum 1,000 pounds of force, but actually more is recommended.” 

In Nebraska, farmers can rent a robot called Grain Weevil that can be used while filling grain bins to help prevent fines — damaged kernels that tend to cluster in the center —  from building up and causing grain to spoil faster. The robot can also break up crusted grain while the bin is being emptied, reducing the need for farmers to enter the bin.

As for Cory Ritter, he continues honoring his dad’s legacy by prioritizing family while juggling everything else. In the middle of a day packed with work and interviews for this story, he still made time to watch his daughter compete in a high school track competition before leaving on a six-hour drive for work that stretched into the early morning hours.

“I remember what my dad told me: The job will get done. The important thing is to come home to your family every night,” said Cory. “It all starts with the personal responsibility of slowing down and thinking about what you’re doing, and that’s why I wanted to share this story, so that other people can think about that.”

And doing things even if they are hard. 

“It’s hard to drive past this (the grain bin) and still see these holes inside, but I looked at it in the fall, especially as all the harvest traffic goes by this road to our local co-op,” said Cory. “I told myself it’s a reminder for everybody how fast accidents can happen and that take time to slow down and be safe.”

This story is a product of the Mississippi River Basin Ag & Water Desk, an independent reporting network based at the University of Missouri in partnership with Report for America, with major funding from the Walton Family Foundation.

Wisconsin Watch is a member of the Ag & Water Desk network. Sign up for our newsletters to get our news straight to your inbox.

Grain bin accidents remain deadly. One farmer hopes his family’s story can help. is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 2 minutes

The Wisconsin Department of Health Services is preparing to implement new federal Medicaid work requirements that could put health insurance coverage at risk for tens of thousands of BadgerCare Plus members.

Department of Health Services Secretary Kirsten Johnson and Wisconsin Medicaid Director Amanda Dreyer answered reporters’ questions Thursday about how the state plans to implement the new requirements and what members should do now.

Here’s what you need to know.

Who is impacted

The new requirements were created under the One Big Beautiful Bill Act, which requires states to implement Medicaid work requirements for some adults.

In Wisconsin, the requirements apply to BadgerCare Plus members ages 19 to 64 who do not have a dependent child younger than 19 living with them.

About 200,000 Wisconsin adults will be subject to the new requirements. The agency estimates about 63,000 people are at immediate risk of losing their health care coverage because the state does not currently have documentation showing they meet the requirements or qualify for an exemption.

New requirements

To keep Medicaid coverage, affected members must show they completed at least 80 hours of employment, volunteer work, school, job training or another qualifying activity in a single month during the 12-month period since they were last approved for health care coverage.

Some people may qualify for exemptions, including those who are medically frail or family caregivers, but Department of Health Services leaders say they are waiting for federal guidance on what documentation will be required. 

Work requirements will take effect for new Medicaid applicants early next year. Starting in January 2027, new applicants must meet the federal work requirement in the month before they apply.

Current BadgerCare Plus members will be subject to the requirements when they renew their coverage starting in March 2027.

What you can do

State officials say the most important step is making sure the department has current contact information.

Medicaid members should keep their mailing address, phone number and email address up to date to ensure they receive important notices about the upcoming changes. Members can update their information through the ACCESS Wisconsin website or the ACCESS smartphone app.

The department also recommends keeping documentation such as pay stubs, volunteer records or school enrollment information that may be needed during the renewal process.

Where possible, the Department of Health Services plans to use existing medical records and diagnosis codes to identify people who qualify for exemptions rather than requiring new paperwork. During the program’s first year, members who believe they are medically frail may self-attest while the department obtains supporting documentation.

Resident outreach

The Department of Health Services is working with health care providers, counties and community organizations to prepare for the changes, with a particular focus on helping people experiencing homelessness and others who may have difficulty meeting the new reporting requirements. 

The department has also created a “Medicaid: New Federal Work Requirement” webpage that it will update with new information about eligibility, exemptions, reporting requirements and implementation timelines.

Johnson said the state’s goal is to ensure everyone who qualifies for Medicaid can keep their coverage despite the new federal requirements.

Department of Health Services leaders estimate the first year of implementation will cost about $10 million in system upgrades. The agency is still finalizing staffing and training costs. Officials say they will continue working with local partners to help members understand the new rules and avoid unnecessary loss of health coverage.

Jonathan Aguilar is a visual journalist at Milwaukee Neighborhood News Service who is supported through a partnership between CatchLight Local and Report for America.

New Medicaid work requirements are coming. Here’s what you need to know.  is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 5 minutes

Click here to read highlights from the story

• Business owners and individuals have mobilized to provide food, water and supplies to those impacted by Monday’s tornado and to clear fallen trees from the area.  
• Wisconsin Watch spoke to several people about why they volunteered their time and resources. 
• Waverly Beach Bar & Grille distributed 500 box lunches daily through Thursday to help affected community members, who include its own employees.  
• Organizations like Operation BBQ Relief provided food to survivors and first responders to “give them just a couple minutes reprieve from all this.”

A walk around downtown Menasha reveals the heart of devastation after an EF3 tornado surged through parts of Neenah, Appleton and Menasha on Monday at 11:56 a.m., traveling 12 miles. Ceramic roof tiles lie shattered on the sidewalk, trees bend at unnatural angles, downed power lines block streets and roofs are torn from churches and homes. 

Community members are still recovering from losing homes and businesses, and thousands of residents remain without power two days later. But the neighborhoods hit the hardest buzz with activity. Chainsaws roar on every street as volunteers clear trees to reopen roads and protect what’s left of people’s houses. 

Roy Eckberg, a meteorologist at the National Weather Service in Green Bay, told Wisconsin Watch the tornado developed quickly as two storms merged.

“Typically, most tornadoes, you probably get a few minutes to maybe 10 minutes (of warning), but in this case, the rapid development was something I’ve never seen in northeast Wisconsin,” Eckberg said. “It was that fast. It was shocking.” 

Ben Clemmer, who lives just a mile away from severely damaged businesses including Mandersfield’s Home Bakery and Tony’s Bar, was working from home when the tornado hit. 

“It was pretty crazy looking. You know, there’s that kind of freaky storm glow that people talk about. That was very real … Seeing trees bending basically all the way over to horizontal was kind of incredible,” he said. “The surprising part, I guess, to me, is that there’s any trees left.”

Since he had a generator, Clemmer set up a phone charging station outside his house Tuesday so neighbors could maintain access to critical updates and communication. Downed power lines left the entire city – about 18,000 residents – without electricity, according to the Associated Press. 

He’s one of many community members eager to help disaster survivors. Businesses and individuals have mobilized to provide food, water and supplies and to clear fallen trees.  

Helping hands reach out

Jesse Hieb, of Muskego, drove his truck around the worst-hit parts of Menasha, handing out water and Gatorade bottles from a cooler with James Enderle, outreach pastor for Living Savior Lutheran Church. Hieb has experience with disaster relief, including when a flood hit Muskego last August.

“Pop’s (Pub) down in Muskego is trying to put together supplies from that community,” Hieb said. “They were hit with a flood last year, so they’re just trying to pay it forward. So we’re gonna go down, pick those supplies up, come back up tomorrow, do the same thing. Drive around with ice cold water, trying to just help people get through the day.” 

Local business owners transformed their restaurants into food distribution sites, like Waverly Beach Bar & Grille, which planned to give out box lunches from 1 to 4 p.m. daily through Thursday. 

Even though the restaurant wasn’t hit by the tornado, Operations Director Dion Block said many employees were impacted, and residents began using the space as a temporary shelter while waiting to return to their homes. He ordered 500 box lunches per day from his supplier Monday night and mobilized his staff to hand out meals and water on Tuesday.

“We range from people who just lost something like a fence or a tree that damaged their house to … multiple employees whose families lost their home,” Block said. 

Tornado survivors with no place to stay were bused to Christ the Rock Community Church, which continues to provide overnight shelter. 

Emlyn Thomas of Operation BBQ Relief, a nonprofit disaster relief organization, gave out bratwurst at a tent just outside Christ the Rock. He was serving food at a National Night Out event in Chilton on Monday evening when he heard news of the tornado. He immediately packed the leftovers, drove to the Appleton area and served first responders. 

“Tornadoes usually are very narrow in their focus; it’s a line,” Thomas said. “This was not that narrow. This was pretty wide. I have never seen a firehouse destroyed. Station 41 was leveled. So this is in some ways unprecedented.”

Operation BBQ Relief began in 2011 after an EF5 tornado hit Joplin, Missouri, and now deploys volunteers to disasters across the country to provide barbecue meals to storm victims and first responders. Thomas said his crew will stay outside Christ the Rock until Thursday at minimum. 

“We call it the one hot meal that matters,” Thomas said. “Some of these folks, short of it being you lose a kid, this is the worst day of their life. They’ve lost everything. Your wedding pictures are in somebody’s yard 25 miles away. Every possession you had is gone. We can show up and we can give them just a couple of minutes reprieve from all this.”

Chris Ghobrial, owner of 18 Acres Food Truck, drove up about an hour and a half from Watertown and was giving out smashburgers outside of Christ the Rock on Tuesday. 

“It’s just part of our outreach program to give back to the communities that are in need, especially because we’ve been blessed with what we have and want to reciprocate the blessings,” Ghobrial said. 

‘Learning to cope’

A curfew remains in effect from 10 p.m. to 5 a.m. for the village of Fox Crossing and the city of Menasha. A boil water advisory also remains in effect for some Fox Crossing water utility customers. As of Wednesday morning, crews restored electricity to parts of Menasha, but thousands of Outagamie and Winnebago county residents still lacked power.

Two days after the tornado, Clemmer said the community is grappling with the long-term implications of rebuilding. 

“There’s lots to do, and yet sometimes it feels like there’s nothing you can do about it,” Clemmer said.

“We’ve started to transition from the initial shock of the event to now shifting more fully into a recovery mode. It’s just kind of learning to cope, I guess, with the new situation, … what do you have to do to … continue moving forward.” 

Officials are asking nonresidents to avoid traveling to Menasha and not to self-deploy to affected areas. Winnebago County officials are circulating a resource guide with information on cooling and charging sites, food, Wi-Fi centers, shelters, medical equipment and ways to donate. Volunteers can sign up to be officially deployed at Volunteer Fox Cities or in person at 1478 Midway Road.

Miranda Dunlap contributed reporting to this story.

Volunteers mobilize across Fox Cities after tornado is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 3 minutes

In Milwaukee at H.W. Longfellow School’s Community Learning Center, which is operated by the South Side nonprofit Journey House, staff are always finding new ways to immerse students in art and culture.

To help, Cherise Myers, Journey House director of community partnerships, said the nonprofit utilizes state Child Care Bridge payments to bring in instructors specializing in art, dance, digital media and more.

Now Longfellow and other Milwaukee Public Schools-based before- and after-school programs must grapple with how to continue exposing students who don’t often get exposure to art while losing thousands of dollars in stabilization payments.

“This is kind of putting the nail in the coffin,” Myers said. “Not being able to have the money to contract or work with these opportunities.”

The Child Care Bridge Payments Program was the state’s temporary solution to the federal government sunsetting Child Care Counts, a monthly federal child care stabilization program born out of the pandemic that supported nearly 1,400 child care providers in the city of Milwaukee. 

The Wisconsin Legislature budgeted for a year of Child Care Bridge payments, which ended last month. 

Journey House received over $6,300 from the state in 2026 to support the Longfellow Community Learning Center. About 90 MPS-based before- and after-school programs collectively received $1.2 million in 2025.

Activities to be cut

Milwaukee Recreation, which received Child Care Bridge funding to operate child care as part of its programming at MPS locations, has struggled to attract and retain high-quality staff with competitive wages.

The monthly Child Care Counts and later state Child Care Bridge funding were critical in raising wages and giving employee bonuses, Community Learning Center coordinator Leighton Cooper said. 

Cooper, who coordinates Community Learning Centers through Milwaukee Recreation, said the funding helped staff stay longer at their programs overall.

“It’s causing us less and less to have to go out and find and recruit more and more staff to operate our programs,” he said. 

Now that Child Care Counts and Child Care Bridge payments have ended, Cooper said Milwaukee Recreation may have to cut funding for some supplies and activities, stop giving bonuses and cut staff positions beyond the required ratios from the Wisconsin Department of Children and Families.

“Our staff wages certainly can’t be changed,” Cooper said. “Staff are paid and that’s going to help us to keep staff in spaces.”

Journey House received less funding than other Community Learning Centers, and Myers said the organization already can’t always compete with wages at other schools.  

Myers said the ended funding may not affect new employees who were hired on starting pay, but veteran employees may leave if pay drops. Many already rely on other jobs to make ends meet, she said. 

Still, Myers said the money helped Journey House bring in instructors from local colleges, universities and community organizations to lead activities because those instructors aren’t always free.

Myers said Journey House programming depends on student needs, but the organization runs chess and Lego clubs, flag football, basketball and cheerleading classes, painting and metal classes and more.

500 programs across state losing funds

Across Milwaukee, about 90 MPS-based Community Learning Centers and before- and after-school camps received $1.2 million in 2025, according to Wisconsin Department of Children and Families data. 

Randy Neve, lead of the Wisconsin Out of School Time Alliance, estimates more than 500 before- and after-school programs serving school-aged children statewide are losing monthly stabilization payments. Milwaukee’s MPS-based programs are among them.

Many of the providers who received state and federal stabilization payments were early-childhood centers serving infants and toddlers, NNS reported in June. 

But Neve said these programs, including the ones across MPS, serve thousands of 4- to 12-year-olds. The loss of stabilization payments will affect that population of children and families. 

“In the long run, the kids are the ones that lose out and are hurt,” Neve said.

Push for the state

The state budgeted for one year of Child Care Bridge payments in the biennial budget. 

Legislators including state Sen. LaTonya Johnson, who represents District 6 on Milwaukee’s North Side, proposed SB 322 to support child care providers, but the bill didn’t get a hearing, NNS reported. 

Neve said the Wisconsin Out of School Time Alliance is working with other organizations to advocate for greater funding for before- and after-school programs like the one Journey House hosts at Longfellow. He and other partners are educating policymakers about what the loss of this funding will mean for providers and families. 

Myers said many of the families at Longfellow are already struggling with the rising cost of living, and the loss of stabilization payments will ultimately hurt students and families. 

“Things are tough, and it’s sad to say that this is just going to make things tougher,” Myers said.

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Alex Klaus is the education solutions reporter for the Milwaukee Neighborhood News Service and a corps member of Report for America, a national service program that places journalists in local newsrooms to report on under-covered issues and communities. Report for America plays no role in editorial decisions in the NNS newsroom.

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Jonathan Aguilar is a visual journalist at Milwaukee Neighborhood News Service who is supported through a partnership between CatchLight Local and Report for America.

After-school programs lose thousands each month as child care stabilization funding ends is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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• UW Health leaders created a new company called WorkForward to help health care systems and state agencies nationwide create their own apprenticeship programs. 
• UW Health officials started offering apprenticeships to their employees in 2018. 
• The program has helped the company fill entry-level roles and retain existing staff while filling gaps for in-demand positions. 
• But experts say apprenticeships aren’t a silver bullet: They require clinical staff to supervise apprentices; employers have to pay staff for hours they’re in school; and each state has its own regulations for apprenticeships.

Violet LaClair was ready to leave her job. 

As a certified nursing assistant at UW Health in Madison, she used the skills she developed while caring for her dying grandmother for nine years. Her co-workers had supported her through her gender transition. She’d even won an award for providing “extraordinary” care. 

She loved her workplace, but after four years, she wanted a change.

“I felt like I’d done it all,” LaClair said. “I felt like at some point I needed to challenge myself more.” 

She thought about going back to school, but that didn’t seem doable. She was already in her 40s and didn’t have time or money to spend.

Then she learned she could get trained to be a medical assistant for free, while working, through an apprenticeship program UW Health started in 2018. She pays no school costs, and she gets paid for the time she spends in class. 

Three days a week, she works at the company’s Union Corners clinic, where she gets patients situated, takes blood pressure, flushes ears and more. 

“I can pretty much do anything the doctor asked me to,” LaClair said. Two days a week, she takes classes on pharmacology, laboratory procedures, and law and ethics.

“I think the program is great,” LaClair said. “It’s given me a whole new chapter in my life, and something to be excited about.” 

Opportunities like these are novel, but increasingly common. The idea is simple: Maybe the country’s next nurses, surgical technologists and medical assistants are already working in hospitals and clinics. The people who’ve spent years booking appointments or drawing blood might jump at the chance to train for new careers — if their employers will help them do it. 

UW Health now offers apprenticeship options for 17 professions, including surgical techs, pharmacy technicians, respiratory therapists and registered nurses. Apprentices pay nothing for their course work, and they get paid to be in class.

To date, more than 1,000 apprentices have graduated. 

Bridgett Willey, who oversaw the launch of those apprenticeships, said they’ve helped fill a critical gap. Wisconsin colleges alone just aren’t graduating enough students to meet the needs of the three major health systems in southern Wisconsin, Willey said. 

The popular programs, which attract far more applicants than they can accommodate, have helped the company fill entry-level roles and hold onto existing staff. Before it began offering apprenticeships, as many as 3 in 10 positions for medical assistants, nursing assistants and pharmacy technicians were unfilled, Willey said. Today, it’s around 1 in 10. 

“We’ve increased our supply by growing our own and training our own folks,” Willey said. 

UW Health isn’t the only health system trying this model. Apprenticeships, once a rarity in health care, have become increasingly common at hospitals and clinics nationwide.

But offering this kind of on-the-job training isn’t always easy. Now, UW Health plans to use what it’s learned to help other states overcome the financial and bureaucratic barriers that can stand in the way. In May, the health system announced it created a separate company called WorkForward to help health systems and state agencies elsewhere set up apprenticeships. Willey, who directs that new project, thinks it’s the first such initiative by a U.S. health care company.

The health care apprenticeship surge

Historically, apprenticeships have been a key on-ramp to technical trades like plumbing and carpentry, allowing trainees to earn as they learn.

Now, apprenticeships are flourishing in U.S. hospitals and clinics, too. In just five years, the number of registered apprentices in the health care field has grown by more than 40%, according to the U.S. Department of Labor, as employers have expanded existing programs and others have started new ones. 

The boom comes as demand for health care workers has shot up across the country, triggered by the growing needs of an aging population and a wave of longtime health care workers retiring. By 2038, the country will be short about 109,000 registered nurses, 61,000 physical therapists, 33,000 pharmacy technicians and 13,000 respiratory therapists, according to projections by the National Center for Health Workforce Analysis.

Meanwhile, vocational and on-the-job training is becoming increasingly popular across the board, said Susan Skillman, senior principal research scientist at the University of Washington Center for Health Workforce Studies. 

“Apprenticeships in general are growing,” Skillman said. “We’re kind of in that place in the nation where the pendulum is moving away from four-year college degrees.”

Staff seize opportunity to advance

Some health apprenticeships last months while others last years. At UW Health, apprentices training to become medical assistants finish in 10 months while future registered nurses train for four years.

No matter the length or industry, all apprenticeships involve a combination of on-the-job training and classroom instruction. In the case of Wisconsin’s registered apprentices, who are approved through the state’s Department of Workforce Development, employers must pay apprentices for the time they spend in class. In some cases, the employer pays for the apprentices’ school costs, too. 

At UW Health, the employer covers tuition. The health system’s staff also coordinate the apprentices’ work and school schedules to avoid conflicts. 

Those were big selling points for Brianna Matheson, 35, who had worked as a medical assistant for 12 years when she learned last spring that UW Health was starting a three-year surgical tech apprenticeship. She’d spent time in the operating room before, and she liked helping with clinical procedures.

“I was just ready for something more,” Matheson said. “I was in clinics for so long, doing the same thing for so long. I wanted to learn again, be a student again, and be a novice.”

When the application opened, she was the first to apply. 

“I had kind of given up on the idea of going back to school because I, like so many others, need full-time income, and I didn’t really want to give up all of my free time to work full time and go to school in the evenings and weekends,” said Matheson, who now processes and delivers supplies to the operating room at Madison’s University Hospital. 

Not only does she not pay tuition, but the Department of Workforce Development offers a stipend for scrubs, reimburses mileage to and from school, and even covers some daycare costs for apprentices with kids, Matheson said. 

The position also let Matheson keep her prior $25 hourly wage, reflecting the raises she’d earned during more than a decade on the job. When Matheson graduates in May 2028, she’ll earn surgical tech wages, which range from around $30 to $44 an hour, according to current UW Health job listings.

“I would not have been going back to school at this point in life to pursue this without the support of specifically the apprenticeship program that UW Health is offering,” Matheson said. “I wouldn’t have done it on my own.”

Apprenticeships attract new job applicants

Offering apprenticeships could help health systems draw entry-level job applicants like 25-year-old DeForest native Alex Lippman. 

Lippman trained as a certified nursing assistant in high school, then worked at a skilled nursing facility in Madison. He started college at Arizona State University with plans to become a doctor, but moved back to Wisconsin when his grandmother fell ill in his sophomore year. He wanted to continue his education but figured he’d missed his chance.

Then, in 2023, UW Health announced it was starting the state’s first apprenticeship for registered nurses. That apprenticeship, like all of UW Health’s multiyear apprenticeships that lead to degrees, are open only to employees who’ve worked for the system for at least six months. 

“I had a plan of trying to get into this program because going back to school on my own was no longer feasible,” Lippman said. He got a job as a certified nursing assistant and began the apprenticeship the next year. 

Today he takes classes at Madison College and works three night shifts a week caring for patients with brain and spine injuries in University Hospital’s neuro intensive care unit. He’s on track to graduate in 2028.

UW Health’s shorter training programs, meanwhile, are open to new applicants as well as current employees. Already, some have finished one and moved onto another, looking to advance their careers, Willey said.

“What we’re seeing is that people come in through one of our entry-level (apprenticeship) programs like medical assistant or nursing assistant, get their feet under them working in that capacity, and then now they’re applying for our degreed registered apprenticeship programs,” Willey said.

This isn’t the first time the company has built its own pipeline of health care workers. In 2013, Willey started a program called Health Occupations and Professions Exploration, or HOPE, where high school students spend a Saturday learning to do CPR, place a breathing tube in a mannequin, and more. The goal, Willey said, is to show students the range of careers available in health care. The program has trained about 6,500 students.

How much can the model grow?

Apprenticeships offer a unique way to address workforce shortages and help employees move up on the job, said Andy MacCracken, who coordinates health workforce planning for North Carolina at the NC Center on the Workforce for Health. That, he said, is one reason the number of apprentices and apprenticeships in the health care field has soared in recent years. 

Still, he said, it’s not clear exactly how much of the health worker shortage can be solved through apprenticeships. 

“We need to have a realistic view about what we’re actually aiming for when deploying apprenticeships as a solution,” MacCracken said. “I think apprenticeships are a really helpful tool in the toolbox. They’re not the only one.”

One challenge: It’s expensive to pay the clinical staff needed to supervise apprentices, so it can be hard for health system leaders to make the business case to their boards. Even health systems that embrace apprenticeships may not be able to accept as many apprentices as they’d like. 

UW Health pays for its apprenticeship program with a mix of its own funds, private donations and public funds, though Willey said the latter is usually only available for starting up a new program.  

Still, there are always far more applicants than openings. When the registered nursing apprenticeship launched in 2023, 200 employees applied for 16 slots. Last year, 70 people applied for 40 medical assistant apprenticeships.

Another challenge: Each state has its own laws about what counts as an apprenticeship and what standards an employer must meet when offering one. Likewise, the regulations for each profession may vary from state to state too. And then there are the accrediting agencies that approve educational programs, which are still getting used to the idea that students might get paid for their clinical training hours.

Willey said WorkForward will publish research on apprenticeship approaches that work, lobby for resources to support such programs and help other states identify potential funding sources. The company is a nonprofit, she said, which will apply for private and public grants. It will not receive direct funding from UW Health. 

Currently, she said, WorkForward is working in Massachusetts with Tufts Medicine and Mass General Brigham — the state’s largest health care employer — and 12 of the state’s community and technical colleges.

“It would be great if we could take the solutions that we’ve built and spread (them at) scale across the U.S. … Health care continues to be a driver of new jobs for the U.S. economy,” Willey said, “and we have an aging population who needs more care, and so we need to be addressing these things now.”

MacCracken said he hasn’t heard of another health care employer taking on this role, but he thinks it makes sense, as employers may be more willing to listen to other employers. 

In North Carolina, he said, he’s already seen how a few model programs can pave the way for others. 

“I think because of the successes of some of the early adopters who have put these programs in action, we’re seeing great results, and so that’s helping inspire more action and scalability and replication.” MacCracken said. 

Natalie Yahr reports on pathways to success statewide for Wisconsin Watch, working in partnership with Open Campus. Email her at nyahr@wisconsinwatch.org.

Can Wisconsin’s health apprenticeships become a national model? UW Health thinks so is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.