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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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Every August, families in our state settle into familiar routines: filling backpacks with school supplies, scheduling sports physicals and wondering how summer disappeared so quickly. But before the first school bell rings, every family should put one more item on its checklist: making sure everyone — including children, parents and grandparents — is up to date on recommended vaccinations.

That message takes on new urgency with the recent measles outbreak in our state, and President Trump’s executive order calling for significant changes to the nation’s childhood vaccine recommendations, including splitting the combined measles, mumps and rubella (MMR) vaccine across separate visits. The order comes amid renewed claims linking childhood vaccines to autism — claims repeatedly contradicted by decades of scientific research.

As vaccine-preventable diseases resurge, Wisconsinites should follow the evidence and trusted medical expertise while making it easier — not harder — for families to protect their children.

All of this is especially fitting during National Immunization Awareness Month. Vaccines are one of the few health decisions that protect not only the individual but those around us as well. Infants, older adults, cancer patients and neighbors with weakened immune systems all benefit when more of us are protected.

Unfortunately, our state is already moving in the wrong direction. The Wisconsin Department of Health Services reports that only 66.9% of children reaching 24 months of age received the recommended routine vaccine series in 2025, down from 68.8% the year before. MMR vaccination rates among 2-year-olds have fallen below 80%, well below the approximately 95% coverage public health experts say is needed to prevent measles from spreading in a community.

This summer, the United States surpassed 2,700 measles cases, the highest total in 35 years. The overwhelming majority occurred among people who were unvaccinated, according to the U.S. Centers for Disease Control and Prevention. 

Clark and Vernon counties had kindergarten MMR vaccination rates of just 44% and 50%, respectively, creating pockets where a single imported case could quickly spark a local outbreak.

Children are only part of the story. Protection against some diseases fades over time, which is why adults also need routine vaccinations. Many adults remain behind on their recommended flu, COVID-19, Tdap, RSV, pneumococcal and hepatitis B vaccinations. Staying current helps prevent serious illness and hospitalization, particularly among older adults and people with chronic health conditions.

And vaccination isn’t a rural issue or an urban issue — it’s a Wisconsin issue.

Whether you live in Milwaukee, Madison, Green Bay, Eau Claire, Platteville, Kenosha or a small town in between, viruses don’t recognize county lines or political boundaries. An outbreak in one community can quickly spread to another, disrupting families, straining health care workers and increasing costs for everyone.

Parents and adults deserve facts — not fear. They deserve public health recommendations grounded in evidence rather than unproven claims. Decades of research have found no credible evidence that vaccines cause autism, and the combined MMR vaccine has been safely used for generations.

The federal government may be changing its approach, but states still have a critical role in protecting public health. My hope is that Wisconsin will do the right thing: follow the evidence, listen to physicians and public health experts and ensure our children continue to have access to vaccinations based on sound medical evidence.

Families should rely on conversations with trusted physicians, nurses, pharmacists and local public health professionals rather than on misinformation circulating online.

As another school year begins, make vaccinations part of your family’s back-to-school routine, and don’t forget the adults in your life. Check immunization records through the Wisconsin Immunization Registry and ask your health care provider which vaccines are recommended for every member of your family.

The healthiest thing Wisconsin students can carry into school this year isn’t in a backpack. It’s the protection that comes from a community committed to keeping one another healthy and from public health decisions grounded in science.

Rob Gundermann is president and CEO of the Coalition of Wisconsin Aging & Health Groups (CWAG).

Guest opinion: As vaccine guidance shifts, Wisconsin families should follow the evidence 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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• 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.

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Wisconsinites breathed record-breaking levels of air pollution Thursday as wildfire smoke from northern Minnesota and Canada wafted across much of the Great Lakes region and the Northeast. Many monitoring stations across the state recorded pollution considered hazardous for the first time in at least 16 years — the span covered by most monitoring stations’ records.

As of 8 a.m. on Friday, Air Quality Index, or AQI, levels in Madison had peaked above 450 — far above the AQI’s 301 threshold for “hazardous” air quality, where everyone — not just sensitive groups — should take precautions to avoid breathing dangerous air. 

Milwaukee’s AQI reached 644 earlier on Thursday — more than twice the hazardous threshold. Air quality deteriorated even further in northwestern Wisconsin, with the index reaching 967 along the Minnesota border earlier in the day. 

Many Wisconsin communities, including Milwaukee, Waukesha, Odanah and Appleton, were still observing AQI over the 301 threshold Friday morning.

The index categories typically run only from zero to 500.

Thursday’s pollution surpassed levels once considered unprecedented. Before Canadian wildfire smoke pushed the AQI to record highs across Wisconsin in July 2023, cities including Madison, Milwaukee and Waukesha had not recorded an AQI above 200 since at least 2010, according to a Wisconsin Watch analysis of historical AQI data.

But wildfire smoke has elevated air pollution in Wisconsin each summer since 2023. Major cities have periodically recorded higher AQI readings around July, though Thursday’s levels were the first to surpass those recorded in 2023.

“This is a hazardous air quality episode that we have not experienced before,” Craig Czarnecki, air management outreach coordinator for the Wisconsin Department of Natural Resources, said in an email.

DataWatch: Wisconsin air pollution reaches record highs as wildfire smoke engulfs the state 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.