Children at The Playing Field, a Madison child care center that participates in the federal Head Start program. (Courtesy of The Playing Field)

Federal payments to Wisconsin’s Head Start programs in the first three and a half months of 2025 are half what they were a year ago, exacerbating worries about the future of the program that provides child care and early education to low-income families.

The Office of Head Start’s payments to Wisconsin program operators from Jan. 1 through April 15 of this year were down by $35 million from the same period in 2024, Sen. Tammy Baldwin (D-Wisconsin) said this week.

Nationwide, Head Start program operators have received $943 million less during that period this year compared with the period a year ago, according to Sen. Patty Murray (D-Washington), who published a table of calculations comparing disbursements for every state in a press release. The table shows Wisconsin disbursements of $34.5 million as of April 15, compared with $69.5 million in the 2024 period.

Baldwin contrasted the potential impact with the pledge by the White House and the Republican majority in Congress to extend tax cuts enacted in 2017 during Trump’s first term.

“The idea that the president is actively working to give the biggest corporations and wealthiest Wall Street guys a new tax break while taking away preschool and child care from Wisconsinites is beyond the pale,” said Baldwin, vowing to fight actions of President Donald Trump she described as “defunding Head Start.”

The calculations in Murray’s table are based on Head Start disbursement data that Senate Democrats pulled from the Tracking Accountability in Government Grants System (TAGGS) website at the U.S. Department of Health and Human Services (HHS).

While most states in Murray’s table had lower disbursements compared with a year ago, Alabama, Delaware, New Jersey, Rhode Island and the District of Columbia all showed increases.

The calculations put the big-picture numbers on funding disruptions that Head Start providers have been experiencing in the last three months, said Jennie Mauer, executive director of the Wisconsin Head Start Association.

Those disruptions first surfaced after Trump took office, with delays of up to two weeks in late January and early February for Head Start programs seeking authorized payment for their expenses.

More recently, the disruptions have continued as providers who have submitted the required documents for payment have been confronted with unexpected demands for “more information” Mauer said Friday.

“The [federal] administration is really messing around, pulling out the foundational blocks of grant operation,” Mauer said.

In order to get approved for a grant, recipients must provide a detailed accounting of how it will be spent, she said. To get payment, providers must submit detailed documentation that the expense it covers has already been incurred. 

“This is a highly regulated system,” Mauer said. “There’s a very rigorous initial grant application process, and then on an ongoing basis grantees are demonstrating, ‘We told you what we’re going to spend the money on. Now based on what I told you, I’m asking for that money.’”

The disclosure of the drop in Head Start funding comes a week after a published report raised the possibility that Head Start will be zeroed out of the next federal budget.

It also comes as some providers wait for information about their upcoming grant replenishments, Mauer said.

Head Start grants are provided under multi-year contracts signed with providers. The money itself, however, does not come to providers in large lump sums but in smaller amounts paid upon the submission of documented expenses, Mauer said.

Every six months, an allotment from the provider’s grant is made available, she said. Those funds are not paid directly to the provider, however. The money is set aside for the provider to draw on after submitting expense documents through the federal online payment system.

Providers’ grant cycles start on the first of the month. In Wisconsin, providers whose grant cycle started Nov. 1 have now received confirmation of their next grant allotment for the six months starting May 1, Mauer said Friday.

But with the previous funding access problems and then the sudden closing three weeks ago of half of Head Start’s national offices, including the Chicago Region 5 office that served Wisconsin and five other states, providers were apprehensive.

“The level of uncertainty and chaos is so dramatic,” Mauer said — in contrast not only to the Biden administration, but also the previous Trump administration. Until this year, “these kinds of questions and uncertainties didn’t exist.”

Three providers whose grant cycle started Dec. 1 are waiting to learn whether their next allotment will become available starting June 1 as scheduled.

Mauer said the Senate Democrats’ calculations appear to be “showing the cumulative effect” of the access to HHS funding streams by the team working for DOGE, an agency directed by billionaire and Trump ally Elon Musk.

DOGE is the acronym for the Department of Government Efficiency, although the office is not a cabinet department, and many of its claims of government savings have been questioned.

The hold-up on information is having “a tremendous negative effect on our programs and it’s alarming,” Mauer said. “When we think of what are the impacts of Region 5 closing and that we continue to have very, very minimal and slow communication from the Office of Head Start — they need to start communicating with grantees in a much more substantive way.”

The Wisconsin Examiner contacted the federal Department of Health and Human Services using the HHS website for journalists’ inquiries and has not yet received a response. This report will be updated when a response is received.

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Mural depicting workers painted on windows of the Madison-Kipp Corp. by Goodman Community Center students and Madison-Kipp employees with Dane Arts Mural Arts. (Photo by Erik Gunn /Wisconsin Examiner)

The economic uncertainty that has sent the stock market and consumer confidence plummeting in the last month hasn’t yet affected employment in Wisconsin, according to the state’s chief economist.

Wisconsin’s job numbers reached another record high in March, and unemployment, although up slightly, is still close to an all-time low, the Department of Workforce Development (DWD) reported Thursday.

Uncertainty over the impact of tariffs imposed by the Trump administration has contributed to falling consumer confidence as well as business confidence, said Dennis Winters, DWD’s chief economist. So far that hasn’t affected the state’s job market, however, he said.

Based on a monthly federal survey of employers, DWD projected Wisconsin had 3.055 million nonfarm jobs in March — an increase of 10,000 from February and 15,000 from a year ago.

From a separate household survey, the department projected Wisconsin’s March unemployment rate at 3.2%. That’s even with February, but a slight increase from the 2.9% calculated for March of 2024.

The job growth was greatest in service industries, which added more than 21,000 jobs over the last 12 months.

Manufacturing jobs have fallen by 7,000 since March 2024 — all of that in durable goods. Winters said that reflects longstanding challenges in the sector more than specific recent developments. 

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Child care providers, parents and advocates arrive at the state Capitol Wednesday, April 16, 2025, for a rally in support of child care funding. (Photo by Erik Gunn/Wisconsin Examiner)

Hundreds of child care providers and parents rallied outside the state Capitol Wednesday, then headed inside to buttonhole lawmakers of both parties, urging support for a $480 million provision in the next state budget for Wisconsin’s child care providers.

“Child care is not a luxury, it’s not a nice-to-have,” said Claire Lindstrom, an Eau Claire parent who addressed the rally. “It is infrastructure.”

“We’re here today because the people who are doing this very important work can no longer afford to hold up a broken system,” said Toshiba Adams, an instructor and instructional chair in early childhood education at Milwaukee Area Technical College.

The rally and afternoon visit with legislators followed a morning gathering of the participants at the nearby Concourse Hotel that included talks by lawmakers, parents and providers. At noon 350 or more people — the largest action by child care advocates in recent memory — marched from the hotel to the rally, with chants of “Kids first, families first, invest in child care now.”

The crowd massed on the Capitol building’s west steps for a half hour of speeches.

Lindstrom broke down the average cost for child care. A single parent paid the minimum wage, $7.25 an hour, “would have to work 43 full-time weeks just to cover one year of infant care,” she said. A family making the median income in Wisconsin — about $75,000 a year — will probably spend 20% of their earnings on care for a single child.

“If they have two kids, an infant and a 4-year-old, they’re spending over a third of their income just to go to work,” Lindstrom said. “This is not a personal budgeting issue. That’s a broken system.”

Gov. Tony Evers has proposed $480 million in the state’s 2025-27 budget that would go to licensed child care providers, replenishing the state’s Child Care Counts program funded from federal pandemic relief. Without that, Child Care Counts will expire for good in June.

At its height between 2021 and 2023, Child Care Counts was credited with stabilizing Wisconsin’s providers, who shared in payments totaling $20 million a month. Providers reported that with the money they were able to raise wages for child care workers while holding down increases in the fees that parents paid.

“Our early childhood educators are trained in how to support brain development, emotional regulation, and school readiness,” Lindstrom said. “We expect them to do this important work and yet we pay them less than workers at Kwik Trip and Culver’s.”

Evers, a Democrat, was unable to persuade the Legislature’s Republican majority to extend the program in the state’s 2023-25 budget. He repurposed other federal funds, and the total payment was reduced to $10 million a month. That will run out in June.

Providers, advocates and early childhood education experts have argued that only with an ongoing investment like Child Care Counts can providers pay child care workers adequately without pricing care out of reach for the average family.

“We need child care for our communities to function,” Lindstrom said. “We can no longer afford to treat this like a personal problem. It’s a public domain. And the solution is clear. We need to fund child care.”

A survey report released April 10 found that up to 25% of Wisconsin providers said they might close without continued support along the lines of Child Care Counts. More than one-third said they might have to reduce the number of children then could serve for lack of staff.

Large majorities said they might have to cut pay and that they expect to have more difficulty recruiting workers. More than half said they expect some employees to quit and that providing high quality care would become more difficult.

“We will see dramatically less care available in virtually every single county in the state,” Ruth Schmidt, executive director of the Wisconsin Early Childhood Association, told the crowd. “Is that acceptable?”

“No!” the crowd roared back in reply.

“Is it acceptable that moms will have to consider leaving the workforce in record numbers because you cannot work if you cannot afford or find child care? Is it acceptable that stressed out parents doing the best they can will have no support from the state to ensure that they can work and contribute to our tax base?”

With each question the rallygoers responded with resounding shouts of “No!”

Sachin Shivaram, CEO of Wisconsin Aluminum Foundry in Manitowoc, told the crowd that businesses should support state funding for child care.

His company pays employees with young children $400 a month toward their child care costs, he said. When the crowd applauded, he thanked them, then added, “but I also feel very embarrassed. … That’s so little, and the cost of child care is, you know, several thousand dollars a month, and this is just barely scratching the surface.”

Shivaram pointed out the state manufacturing tax credit that his company receives, along with all Wisconsin manufacturers.

“And guess what? We have to do absolutely nothing to get that tax credit,” he said. “We don’t have to invest in any capital equipment, we don’t have to train any workers, we don’t have to give back to the community, nothing. You know, how about we make that tax credit contingent on helping the child care situation?”

In an interview after the legislative visits Schmidt of WECA said the hundreds who took part went to almost every state Senate office and about 90% of the Assembly members’ offices as well. WECA organized the event along with Wisconsin Head Start Association and Raising Wisconsin — an advocacy campaign that WECA and allied groups launched in 2022.

“We really wanted this to be nonpartisan,” Schmidt said — “just an opportunity to tell stories and share, from a real perspective, from the heart what’s going on with this industry.”

Some of those conversations — with leaders in the Legislature who advocates have already spoken to about the budget request — were “not necessarily a surprise,” she acknowledged.  

With other lawmakers, she added, including some of the 30 first-term Assembly members elected in November as well as others who have not served on committees where child care has been an agenda item, “there was a lot of interest in just learning,”

The visits were an opportunity for personal testimony to reach lawmakers and their staff, Schmidt said. “The power of having parents tell their stories, and the power of having educators tell their stories about how they’ve been using the public funding when it’s available — it was very compelling.”

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Democratic U.S. Rep. Mark Pocan speaks with reporters Wednesday in his Madison office. (Photo by Erik Gunn/Wisconsin Examiner)

House Democrats think their most likely strategy to prevent major cuts to Medicaid or other popular federal programs in the current budget reconciliation process will be to win over a few House Republicans.

“We just need three Republicans, basically nationwide, to say no to something,” said U.S. Rep. Mark Pocan (D-Black Earth) at a Q-and-A session with reporters Wednesday in his Madison office.

The Republican majorities in both houses of Congress are using the complicated budget reconciliation process to pass a spending plan that will allow them to extend tax cuts enacted in 2017 during President Donald Trump’s first term.

As part of that, House Republicans passed a blueprint calling for $880 billion in cuts to programs overseen by the House Energy and Commerce Committee. Medicaid represents the largest expense item in the committee’s purview, and analysts have said Congress could only hit that target by making Medicaid cuts.

Pocan said estimates of the cost of preserving the tax cuts have risen in Washington, from $4.5 trillion in the original House proposal to “more like $7 trillion in tax cuts” in the current proposal combined from House and Senate alternatives.

The objective for House Democrats currently is to make cuts to Medicaid harder for GOP members to go along with, Pocan said. In Wisconsin, about 1.3 million residents are enrolled in Medicaid, including one third of the children in the state and 55% of seniors in nursing homes.

“You know, the more they hear that, at some point they may listen,” Pocan said of Republican members who won swing districts by narrow margins — and, he argues, they could push back against those sorts of cuts.

“I don’t expect them to maybe say it publicly and maybe to hold a town hall and say it, but if they say it privately in their caucus, that’s good enough, as long as three people won’t support something,” Pocan said. “That’s enough to kill something, right? So that’s kind of my goal is to keep facilitating that.”

The focus, though, is not on stopping the tax cuts, but stopping the cuts to Medicaid, SNAP and other federal programs.

“If we could stop that, and we could stop, maybe, some of the education cuts that might otherwise come … funds for low-income [districts], funds for special ed, I think they’re still going to move forward with their tax cut bill,” Pocan said.

He speculated that under those circumstances, the GOP majority would pay for the tax cut with a deficit increase. 

“Is that a good answer? No,” Pocan said. “But is it better than seeing people lose their health care right now or their food assistance through Supplemental Nutrition Assistance Program? Yeah. So you know my job is to wake up in the morning and get excited about bad choices rather than the worst choices.”

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Sandra Lomeli testifies at a public hearing April 10, 2025, against a bill imposing new restrictions on the process for confirming eligibility for Medicaid. (Wisconsin Examiner photo)

Legislation that would add new restrictions to the process of qualifying for Medicaid is on hold in the Wisconsin Capitol after meeting with resounding opposition at an Assembly hearing less than a week ago.

At a meeting Tuesday to vote on two other bills, State Rep. Dan Knodl (R-Germantown) told the Assembly Committee on Public Benefit Reform that he chairs that the Medicaid measure “has some work to be done yet.”

The bill’s author, Rep. William Penterman (R-Columbus), told the Wisconsin Examiner in an email message Tuesday that the legislation “is still in the Assembly Committee on Public Benefit Reform. The conversation on how to improve the bill is ongoing.”

An opponent of the measure, however, suggested that opposition testimony had prevailed in keeping it from moving forward.

“I think you all realized how terrible and harmful that legislation was,” said committee member Rep. Ryan Clancy (D-Milwaukee), directing his comment at his four Republican colleagues. “We heard two and a half hours of testimony overwhelmingly against that [bill].”

Clancy spoke before voting against two other bills that the committee passed 4-2 along party lines — one making sweeping revisions to Wisconsin’s unemployment insurance (UI) system, and the other barring local governments from instituting guaranteed basic income programs using tax dollars. 

Recipients marshal opposition to Medicaid measure

Medicaid covers acute and long-term medical care for low-income people as well as people with disabilities. It’s funded jointly with federal and state money and managed by the state under federal rules and guidelines.

With some exceptions, recipients must have incomes at or below the federal poverty guideline. Most Medicaid recipients must be reviewed once a year to confirm they are still eligible for the program.

AB 163 would direct the Wisconsin Department of Health Services (DHS) to conduct eligibility reviews every six months.

It also would add restrictions on the verification process — forbidding the state from automatically renewing Medicaid beneficiaries, forbidding the state from automatically filling in electronic forms with the recipient’s information except for their name and address, and cutting off a person’s ability to enroll in Medicaid for six months for failing to report a change that might make them ineligible.

Penterman, the only witness who testified at the bill’s April 10 public hearing, highlighted the statistic that 20% of Wisconsin residents are on Medicaid. 

He described the legislation as an effort to “reassess and restore integrity to the system by ensuring that only those who are truly needy and truly qualified for this coverage receive benefits.”

But the recurring message from a stream of hearing witnesses — the vast majority of them people with disabilities who rely on Medicaid for long-term health care in their homes or in the community or their family caregivers — was that the current eligibility requirements are already burdensome, and strict enough to keep out people who aren’t eligible.

“We heard from so many people who do a tremendous amount of work to prove to the state that they have low enough income, low enough assets, that they are who they say they are, that they meet the functional screen and all of the other requirements that the department has [for them] to be able to get in or stay in the program,” said Tamara Jackson, legislative policy representative for the Wisconsin Board of People with Developmental Disabilities, in an interview Tuesday.

The hearing came just two days after the bill was introduced April 8. Its fast track prompted an overnight opposition campaign by Medicaid recipients.

“We heard from people across the state who had said that they had contacted their state lawmakers about this particular bill and had really used it as an opportunity to tell them what they do to be allowed in the Medicaid program,” Jackson said.

Federal Medicaid debate draws attention

Recent Congressional action on federal legislation to extend tax cuts enacted in 2017 has included spending targets that would appear to make Medicaid reductions inevitable. Medicaid recipients have been following those debates and making public appeals to oppose cuts in the program — priming them to oppose the state proposal as well.

“I think that people are paying attention, and the reason there were so many contacts is because Medicaid is so important to folks and they’re willing to show up and talk about it,” Jackson said.

At the very start of the April 10 hearing, Penterman alluded to communications he had already received from advocates and said he planned an amendment to exempt people with developmental disabilities from some of the bill’s restrictions. He introduced the amendment later that day.

Several witnesses, however, criticized limiting the amendment to people with developmental disabilities, arguing that the bill’s requirements would be needlessly onerous for many other people.

Sandra Lomeli of Pewaukee was one of the hearing witnesses against the Medicaid bill. She is the mother of two adult children with severe disabilities who are able to get long-term care through Medicaid. One requires 24-hour care as a sexual assault survivor, she said.

Lomeli is also covered by BadgerCare Plus, the Wisconsin Medicaid plan for primary and specialty health care and hospitalization, because being her children’s family caregiver limits her working hours to a part-time nonprofit position.

She told the committee that she fills both sides of a ream’s worth of forms each year to confirm her children’s Medicaid eligibility. She said she spends 54 hours completing those forms and 10 hours confirming her own eligibility each year.

In her testimony Lomeli challenged lawmakers to enlist Medicaid participants and advocates if they wanted to write legislation to improve the program.

It appeared to Lomeli that her suggestion “took people by surprise that we would even be at the table,” she said in an interview Tuesday. “I don’t think they valued that we could add value — because if they did, somebody would have reached out.”

She said she doesn’t consider the legislation dead, however, which concerns her.

“The issue is not off the table yet,” Lomeli said. “They’re just going to reword it. We have won the battle now. We haven’t won the war.

UI change, basic-income ban, both pass on party lines

While setting the Medicaid bill aside Tuesday, the Committee on Public Benefit Reform advanced two others with only Republican votes.

AB 164 would rename Wisconsin’s unemployment insurance system as a “re-employment assistance” program with new requirements for workers and for the state agency that administers it.

Those include requiring recipients, who must currently make four work searches a week, to make two of those in the form of direct contacts with prospective employers. It also adds a variety of additional counseling procedures and requirements for people who receive unemployment benefits.

Department of Workforce Development Secretary-designee Amy Pechacek submitted written testimony expressing “concerns about this proposal due to the anticipated reporting burden for employers, potential costs, bureaucratic requirements, and lack of sustainable funding.”

Gov. Tony Evers vetoed similar legislation in 2023, citing similar complaints as well as the fact that it did not go through the state’s joint labor-management unemployment advisory council.

AB 165 would bar local governments from using tax dollars to create guaranteed income programs without a work or training requirement. Evers vetoed a similar bill to that one in 2023 as well, on the grounds it usurped local control. 

Rep. Christian Phelps (D-Eau Claire) made the same argument against the current legislation.

Knodl defended the both bills as helping to “protect the integrity of these systems, and that’s important if we want them to be sustainable in the future.”

Clancy argued that both should have been put on pause along with the Medicaid bill.

“But all three of those . . . bills are fundamentally the same,” Clancy said. “They are kicking people when they are down. They are hitting people at their most vulnerable, and frankly, in 2025, when national and state Republican policies have meant that people have more needs. We should not be attacking those social safety nets.”

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Children outside with a child care teacher at The Playing Field, a Madison child care center that participates in the federal Head Start program. (Courtesy of The Playing Field)

A news report that the Trump administration is considering ending the federal government’s Head Start program has alarmed providers and parents who rely on the child care and early education program.

“It would be absolutely devastating,” said Jen Bailey, executive director of Reach Dane, which operates 14 Head Start centers in Dane and Green counties. “The children and families we work with are some of the most vulnerable folks in our communities. The parents in those communities rely on the care we provide to stay employed.”

USA Today reported Friday that the Trump administration “is considering a budget proposal that would zero out funding for Head Start.” The news report quoted an anonymous administration official who said the White House funding blueprint for the 2026 fiscal year doesn’t allocate money for Head Start.

The president’s budget is a wish list, and Congress decides how to appropriate federal funds. An Office of Management and Budget spokesperson told USA Today that “no final funding decisions have been made.”

Project 2025, the agenda drafted by Russell Vought prior to his confirmation as OMB director, calls for eliminating Head Start.

Responding to the report Monday, Sen. Tammy Baldwin (D-Wis.) tied the proposal to President Donald Trump’s goal of extending the 2017 tax cuts enacted in his first term.

“Shutting down Head Start — taking care away from kids, firing teachers, and making child care even more expensive for parents — all so President Trump can hand out new tax breaks for the wealthy and well-connected is flat out wrong and you can be sure I will fight this proposal at every turn,” Baldwin said.

Head Start was founded in 1966, part of the War on Poverty undertaken by President Lyndon Johnson. It provides child care and preschool for families with incomes up to the federal poverty guideline. Children living in foster homes are also eligible for Head Start.

In Wisconsin more than 15,000 children are enrolled in more than 300 Head Start child care centers across the state, according to the Wisconsin Head Start Association. With more than 4,300 employees, Head Start ranks in the top 100 employers in Wisconsin, said Jennie Mauer, the association’s executive director.

“At least 70% of our families have a parent who is either working or in school full time,” Mauer said Monday. The remaining families include grandparents who are retired but full-time caregivers for their grandchildren as well as families unable to work due to disabilities or who “are working through some very, very significant challenges.”

She predicted that the impact from ending the program wouldn’t stop with the families who rely on Head Start.

“If Head Start isn’t there, if this program were to shut down, surely there’ll be tremendous cascading economic impacts in our communities,”  Mauer said. “I think for most of the families, it would create a huge labor disruption. With no safe place to have your kids while you’re at work, it’ll create a disaster.

Child care already a crisis

Fears for the survival of Head Start are escalating as the state’s overall child care sector is increasingly under strain. As many as 25% of child care centers in a survey released April 10 said they could close without continuing support in the next state budget.

April Mullins-Datko is Head Start director for ADVOCAP, a social service agency serving Fond du Lac, Winnebago and Green Lake counties. She said that the agency’s four Head Start centers would likely not survive the loss of federal support.

“We would lose services for the 202 children we serve,” Mullins-Datko said. “It would exacerbate the child care crisis we have in our communities, which then has negative impacts on our available workforce.”

ADVOCAP’s centers include three in Fond du Lac County and one in Green Lake County, with 193 families relying on the program for the care and early education of their children.

“Ninety-three percent of my families are working or going to school full time,” Mullins-Datko said.

The agency’s Head Start federal contract is supposed to be good through Dec. 31, 2028, Mullins-Datko said, but with reports of defunding she fears that won’t be honored: “There just doesn’t seem to be any kind of adherence to law and contracts.”

Western Dairyland Economic Opportunity Council provides social services in Buffalo, Jackson, Trempealeau and Eau Claire counties in West Central Wisconsin. The agency’s programs include nine Head Start centers enrolling 442 children. Of those, 382 children are in preschool and 60 are in Early Head Start, for children from birth to age 3, said Thanh Bui-Duquette, Western Dairyland’s Head Start director.

Three centers are in cities — two in Eau Claire and one in Altoona — but the rest are in rural communities.

“We meet the needs of each individual community,” Bui-Duquette said. “The needs of the urban Eau Claire area look very different from rural Trempealeau County.”

Even with jobs, 96% of the families with children in Western Dairyland’s program have incomes below the federal poverty guideline. For children from those families, she said, Head Start has been demonstrated to improve long-term outcomes — increasing the chances of graduating from high school and going on to higher education, and reducing the chances of ending up in the criminal justice system.

“It’s important to have that solid foundation early on, especially for children from disadvantaged families,” Bui-Duquette said.

Payments delayed, offices closed

The news that Head Start is in the crosshairs of budget-writers in the Trump administration follows other jolts to the program in the last two months.

In late January and early February, Head Start operators reported widespread problems in their efforts to collect standard payments from the federal government. Under Head Start contracts, programs incur an expense then submit documentation through a federal online portal to get reimbursed. Head Start programs reported that payments stalled, for nearly two weeks in some cases, without explanation.

Payments have since resumed, but Mauer said directors are reporting demands for more information holding up payments.

“They’re getting substantial delays for things that are accepted expenses, which is concerning,” she said.

On April 1, Head Start operators learned that the program’s five regional offices across the country were closed without any advance notice, including the Chicago office that serves Wisconsin and five other states in the Upper Midwest.

Those events and the report that the program could be defunded have rattled Head Start employees and the parents who have counted on the program, operators say.

“Families and staff are both really scared and concerned,” said Bailey, the Reach Dane director. “Families are reaching out, worried the program is going to close, asking, ‘Is my child still going to be able to go to school?’”

Reach Dane’s human resources staff has been interviewing applicants for teaching jobs in the coming school year, and applicants are nervous about whether the job will exist, she added.

Bailey said the program is trying to be transparent with employees and families about the uncertainty and fight for the program’s survival, all without sparking panic.

“Trying to figure out how to navigate and inform folks when there’s no communication is a hard place to be,” she said.

This report has been updated.

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In a new survey of Wisconsin child care providers, 25% said they could close without renewed state support. Corrine Hendrickson, shown here at a 2023 event to support the child care sector, said her New Glarus family care will likely have to raise fees. (Photo by Erik Gunn/Wisconsin Examiner)

One in four Wisconsin child care providers could close their doors if the state’s ongoing support isn’t replaced after it ends in June, according to a state-commissioned report released Thursday.

More than one in three providers expect to reduce their capacity for children or the hours they operate, or both, according to the report, based on a survey of most of the state’s licensed child care providers.

The report was commissioned by the state Department of Children and Families (DCF) and produced by the Institute for Research on Poverty at the University of Wisconsin-Madison.

It was released by the office of Gov. Tony Evers to support $480 million for child care providers in his 2025-27 proposed budget — a successor to the state’s Child Care Counts program that was funded with federal pandemic relief money. 

“It underscores what those of us in the field have known for a long time — that is, the need for public investment in order to stave off closures and rate increases,” said Ruth Schmidt, executive director of the Wisconsin Early Childhood Association.

The association supports Evers’ $480 million budget proposal and is holding an advocacy day at the state Capitol on April 16, with plans to meet lawmakers.

In a statement announcing the survey findings, Evers underscored his proposal.

“The cost of child care is too darn high, wait lists are too long, and providers are already struggling to keep the lights on, their doors open, and meet demand for child care across our state,” Evers said.

“The results of this survey are crystal clear: if we don’t make needed investments to support our child care providers and industry, programs will close, wait lists will get even longer, providers will be forced to raise prices, and parents and loved ones who can’t afford for [their] costs to get any higher may have to leave our workforce.”

Child Care Counts has provided monthly payments to state child care providers since 2021. From November 2021 to January 2024, it was funded from Wisconsin’s share of the American Rescue Plan Act (ARPA), the federal pandemic relief legislation enacted in 2021. The program paid out more than $479 million to providers. After that money ran out, Evers directed another $170 million additional pandemic relief funds to carry the program through June 2025.

Child Care Counts paid out $20 million a month until mid-2023, when it was cut to $10 million a month, with providers getting half of what they had previously received.

The Republican majority in the state Legislature rejected Evers’ proposal to put up to $360 million in the 2023-25 budget to continue the subsidy program at its earlier monthly amount.

Providers have credited the Child Care Counts program with making it possible for them to increase pay for child care workers in the face of competition from other employers without being forced to raise the fees they charge parents.  

About 80% of the state’s more than 4,500 child care providers received and took part in the survey, which was included in providers’ November application for Child Care Counts payments.

The survey included questions about providers’ experiences before and after the Child Care Counts reduction. It also asked about their expectations after the program ends in June, as well as the potential impact of a continued program.

Two-thirds of providers surveyed reported that after the payments were reduced, they raised fees.

Responding to questions about the impact of state support ending in June, 25% or more of providers in the survey said they would be somewhat or more likely to close. Fully 10% of providers said closing their program “was very or extremely likely,” the report found.

“That’s an incredibly concerning statistic,” said Schmidt. “That’s a lot of child care programs that could be pulling up stakes. It’s going to hit rural communities super hard, but across the state we’re going to see significant closures.”

More than one-third of providers — 37% — said they were “at least somewhat likely” to close some of their classrooms or reduce the number of children they serve. Almost that many, 36%, said they were likely to reduce the number of hours they provide care.

By 59%, providers also expect their waiting lists to grow without continued state support.

Providers also expect to have a harder time hiring and keeping employees, with 66% saying that it was “at least somewhat likely” they will have to cut compensation, including their own. Fully half of providers “said this was very or extremely likely,” the report states.

More than half of providers — 56% — said it was at least somewhat likely that more employees would quit, and 46% said staff cuts were somewhat or more likely.

Of providers in the survey, 69% said “that it was at least somewhat likely” they would have a harder time hiring qualified employees.

About half of providers surveyed — 51% — said they thought it would be “at least somewhat likely” that they would find it harder to provide high quality care.

Between one-fourth and nearly half of providers said they expected to have more trouble being able to meet some parents’ specific needs. Those include providing care earlier or later in the day, serving families in the state’s Wisconsin Shares subsidy child care program for low-income families, caring for infants and toddlers or caring for children with special needs.

“With families already struggling to afford child care, respondents repeatedly described how continued funding — whether at the original or at current levels—would help prevent further tuition rate increases,” the survey report notes. Some providers said it would allow them to hold rates at their current level or reduce them, while others said it would keep the rate of tuition increases down.

Corrine Hendrickson, a New Glarus child care provider and organizer of an advocacy group for providers and families, Wisconsin Early Childhood Action Needed (WECAN), said the survey points out “the disastrous results for children and families after the initial [Child Care Counts] funding wasn’t replaced in the state budget.”

Rural areas, where families are younger and have lower incomes, may be hit the most dramatically if the child care sector contracts, Hendrickson said.

Hendrickson said she is likely to have to raise the rates she charges for her family child care center, which has a capacity of eight children. A $30 increase “will put me out of reach for too many families,” Hendrickson said. “If I lose two children and can’t replace them within a month or two, I will have to close.”

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Chad Sobieck testifies in opposition to a bill introduced in the Wisconsin Assembly that would place new limitations on the process to establish if a person is eligible for Medicaid. (Wisconsin Examiner photo)

State legislation that would require the Wisconsin health department to verify that all Medicaid recipients are eligible twice a year was met with resounding opposition at a public hearing Thursday.

The bill, AB 163, also would add restrictions on the verification process. With a few differences, the legislation echoed a bill that failed to pass two years ago.

Only one witness testified in favor of the measure: its Assembly author, state Rep. William Penterman (R-Columbus).  

“It will create a balance, an important balance, in preserving a strong safety net for our most vulnerable residents while curbing inappropriate long-term reliance on public assistance,” Penterman said.

The legislation would prohibit the Wisconsin Department of Health Services (DHS) from renewing Medicaid recipients automatically and require DHS to reconsider a person’s eligibility every six months instead of annually, the federal standard.

It would cut off eligibility for six months for Medicaid recipients who don’t report a change, such as higher income, that would make them ineligible for the program. It also prescribes additional requirements for checking databases of other agencies to confirm information about a Medicaid recipient’s qualifications.

Over the course of a 2-1/2-hour hearing, witnesses said the bill would impose significant administrative burdens on Medicaid recipients and likely lead some to be kicked off the rolls, not because they were not eligible but because of mistakes, whether made by the recipient in the process of trying to requalify or by state officials processing their paperwork.

“Its reason seems to be purposely causing difficulty for people whose lives are already a monumental struggle in an attempt to make it too difficult for them to access the services they are entitled to,” said Karel Oliveras, who has two grandchildren with Angelman syndrome, a genetic disorder that causes developmental delays and other problems.

Referring to Oliveras’ comments about the process of establishing eligibility for the program, Rep. Ryan Clancy (D-Milwaukee) asked, “Would you characterize it as too easy?”

“It’s my daughter and her husband who do that,” Oliveras said. “But the stress of that [on them] was very, very obvious.”

Both Clancy and Rep. Christian Phelps (D-Eau Claire), the committee’s two Democrats, were skeptical about the idea that there were people in Wisconsin who were on Medicaid but didn’t qualify.

In response to lawmakers who had implied that Wisconsin’s Medicaid enrollment — about 20% of the state population — was excessive, Tamara Jackson, the legislative policy representative for the Wisconsin Board for People with Developmental Disabilities, said the percentage is similar in most states.   

According to Jackson, Wisconsin’s Medicaid staff already monitors people’s eligibility rigorously. “They are really checking every application and every renewal to make sure that people meet the income, asset, and other eligibility requirements,” she said.  

Chad Sobieck, who uses a wheelchair, said he has been on Medicaid for his entire life and it has enabled him to live in the community with the help of caregivers covered by the program. When completing paperwork, he has to enlist the help of others because he cannot write due to his physical disability, he said. 

A provision in the bill banning DHS from prepopulating forms for the renewal applicant would make that even more difficult.

If he has to qualify every six months and there’s an error that kicks him off  Medicaid for six months, “that would mean that I don’t have caregivers,” Sobiek said. “If there is a gap in those services, I will not be able to remain independent and it will become a safety and health issue for me.”

Almost all the opposition testimony focused on people with disabilities. Several Wisconsin Medicaid programs enable people with disabilities to live at home or in the community, rather than in an institution, with the program covering their needs for health care and home and personal care that they cannot manage on their own.

Wisconsin patients, families are wary as Congress prepares for Medicaid surgery

Penterman said that after “conversation and collaborating with the stakeholders” he was planning to offer an amendment that would exempt people with developmental disabilities from the legislation.

Critics of the bill, however — including those speaking on behalf of people with developmental disabilities — were largely skeptical about that announcement.

“I am a little offended about the fact that the amendment offered only covers the developmentally disabled,” said Jason Glozier, executive director of the Wisconsin Coalition of Independent Living Centers, arguing that the proposal’s limits would be onerous for people with physical disabilities, too.

“To say that doubling the administrative burden would decrease waste or decrease fraud doesn’t seem to make sense when we have a system that is overburdened and unable to meet its need effectively,” Glozier said.

“Why should somebody who’s been disabled from birth, who’s been paralyzed or acquired a disability, have to consistently re-insist that they have a disability?” he added. “It’s not going to get better.”

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Some of the 40 residents of New London who came out Wednesday morning to support migrants, many of whom work at Tyson Foods across the street from where they held a rally. (Photo by Jason Kerzinkski for the Wisconsin Examiner)

In 2023 a group of Haitian immigrants began arriving in the central Wisconsin community of New London.

The Haitians were admitted to the U.S. through a humanitarian parole program in response to lawlessness and deadly violence in their homeland. The newcomers became part of the community, said immigration attorney Marc Chistopher, a New London resident whose law offices are in Appleton and Milwaukee.

“Their children go to school with our children,” Christopher told the Wisconsin Examiner Wednesday morning. “They worship in the same churches. They eat at the same restaurants. They join the same civic organizations. They’re in the gyms. They’re our friends, more importantly, and they’re our co-workers. So they’re a part of our community and part of our fabric and we welcome them.”

The legal refugee program through which they were admitted includes a work authorization. More than 100 of the new immigrants  ended up working at a Tyson Foods plant in New London, processing and packaging chicken. Others went to work at stores in the community or in other jobs.

In late March, however, the Trump administration told more than a half-million people from Haiti, Cuba, Nicaragua and Venezuela that they were no longer welcome. The order from the Department of Homeland Security, terminating humanitarian parole for about 532,000 refugees from the four nations, is one of a flurry of orders targeting millions of immigrants in the U.S. since President Donald Trump took office.

Haitians in New London were among those covered by the March 25 order. They were notified through an online account assigned to every  humanitarian parole refugee, Christopher said.

 “Your parole will terminate upon the earlier of (1) your original parole expiration date or (2) April 24, 2025,” states a Homeland Security message to one of Christopher’s clients, shared with the Wisconsin Examiner. “You should depart the United States now, but no later than the date of the termination of your parole. Failure to timely depart may have adverse immigration consequences.”

Since the notices arrived, Christopher has been scrambling, trying to help a handful of people who hope they might qualify to stay in the U.S. Other New London residents have been organizing on behalf of their new Haitian neighbors. 

On Wednesday morning Christopher and his wife, Eloise DeLeon, also an immigration attorney,  joined about 40 residents of New London gathered across the street from the local Tyson plant, carrying signs advertising their support for the Haitian workers there and hoping to send a message to the community.

“The message is intended for everyone,” said one participant, Sue Krejcarek. “There are people who maybe were Republicans, voted Republican, but don’t agree with this. It’s OK to protest against things you don’t agree with, whether you voted Republican, Democrat. When something is wrong, you stand up for it.”

Emily Tseffos helped organize  the demonstration along with a group of New London activists.

“These folks have established life here because they were expecting to be able to stay here,” Tseffos said. “They came here through legal means. And they are working and paying taxes and they are going to schools and they are dreaming of starting businesses.”

School officials have been working closely with the Haitian families, Tseffos said, and teachers who have the children of Haitian parents in their  classrooms participated in the Wednesday morning rally. Community volunteers have been offering financial help with bills and groceries as the immigrant families grapple with the sudden command to go or face deportation.

“They were not planning on having 30 days notice to leave,” Tseffos said. “And so it’s really sad to see that these folks that are doing everything right and everything they’re supposed to be doing are now facing deportation in a couple weeks here.”

In addition to the notification from the federal government, Tyson plant employees who were permitted to work under the humanitarian parole program have received letters from the company telling them that their employment authorization will expire April 23 — the day before their deadline to leave the U.S.

Christopher said that he has sought to put together applications for a small number of people for whom he could make a case for asylum.

“An asylum claim is one of the more difficult and time-consuming things I do as an attorney,” he said. Asylum claims are decided on a case-by-case basis and require extensive factual details. Claims perceived as frivolous can meet with severe penalties.

An asylum applicant cannot get a work authorization for six months, however, Christopher said. That means even if the application is granted, “if they lose their work on April 24, those families have no means for supporting themselves,” he said.

Both DeLeon and Christopher are former prosecutors, and DeLeon is a former municipal judge. “So I understand the rule of law, following rules, right?” DeLeon said. “But this [following rules] is what our clients did.”

Christopher remains outraged at the way his neighbors’ lives have been overturned. “They’ve been promised they could stay here,” he said. “They came through legally, and they’ve been vetted.”

To be suddenly ejected “is not good for them,” Christopher said. “And it’s not good for our community, either.”

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State Rep. Jerry O'Connor gives testimony in favor of a bill that would require state agencies to report on various metrics for training and workforce development programs they supervise. (Screenshot/WisEye)

Republicans in the state Legislature are taking another run at changes to unemployment insurance and workforce programs in Wisconsin that Gov. Tony Evers vetoed in August 2023.

While sponsors of the bills cited a couple of modifications in some measures, they are for the most part unchanged, they said during public hearings Wednesday for four bills in the Assembly’s labor committee.

One, AB 162, would require state agencies to compile a series of metrics on training and workforce development programs under their supervision, including the unemployment rates and median earnings of participants six months after they graduate from a program.

“We want to make certain our money’s being spent in a way that generates a positive beneficial return both for taxpayers and for the individuals participating in the programs,” said state Rep. Jerry O’Connor (R-Fond du Lac), testifying in favor of the bill. “We’d look at the percent of individuals enrolled in training programs who obtained a measurable skill gain.”

O’Connor said the bill draws its performance measures from the Workforce Innovation and Opportunity Act (WIOA), a federal workforce training law updated in 2014.

In vetoing the version of the bill that passed the last session of the Legislature, Evers said that many state programs it covered didn’t fit with WIOA’s reporting structure and “have separate requirements under current state law.”

Three other bills would impose tighter restrictions on the unemployment insurance (UI) system.

AB 167 would expand the definition of employee misconduct that would be grounds for denying an unemployment insurance claim as well as for a worker’s compensation claim. The bill would also require DWD to conduct random audits of 50% of all work searches reported by people claiming UI.

AB 168 would extend the statute of limitations for prosecuting felony fraudulent UI claims to eight years. It would also require the state Department of Workforce Development (DWD) to produce more training materials for employers and UI claimants, operate a call center and expand its hours in times of higher volume, check various state and national databases to verify that UI applicants qualify, and implement “identity-proofing” measures.

AB 169 would penalize UI recipients who do not show up for a job interview they have been granted or a job they’ve been offered — “commonly referred to as ghosting,” said state Rep. Dan Knodl (R-Germantown), the bill’s author.

A UI recipient who fails to respond to an interview request or job offer, fails to report for a scheduled job interview or who is not available to return to work at their previous job would lose unemployment benefits for the week in which that occurred. The bill does not impose the penalty for the first offense.

State Rep. Joan Fitzgerald (D-Fort Atkinson) asked Knodl whether the bill had gone through the state’s Unemployment Insurance Advisory Council. The joint labor-management body revises the state’s UI law every two years. In the past Evers has vetoed UI proposals for not going through the council. 

“This is one of those that they’re not going to visit,” Knodl said. “So that’s why we’re here as a stand-alone bill.”

Nobody testified against the bills Wednesday, but Victor Forberger, a Madison attorney who represents people with UI claims, sent the committee a four-page memo opposing them. He wrote that DWD already does most of what AB 168 would require, and that it would “hamstring” the department “when new practices and resources emerge.”

The measures “will do nothing to make unemployment more useful and efficient for Wisconsin workers and employers,” Forberger wrote.

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A sign at an SEIU Wisconsin rally for nurses in contract talks at UnityPoint Health-Meriter hospital. (Wisconsin Examiner photo)

Union nurses at UnityPoint Health-Meriter hospital in Madison rallied Tuesday, warning that they would strike if they can’t reach a satisfactory labor agreement in their current contract talks.

The rally was held in advance of a bargaining session scheduled for Wednesday between the hospital and the Service Employees International Union (SEIU), which represents about 800 nurses at the hospital.

The nurses are currently working without a contract after their previous agreement expired March 16 and was extended to March 23.

The union is highlighting its demands for written language addressing safety issues, said Pat Raes, SEIU Wisconsin president and a nurse for 35 years at Meriter.

“We are fighting for the safety of every last person there. And part of that in today’s society when rules are being turned upside down, inside out, and backwards, means that we have to find ways to make sure that our safety is codified,” Raes said at the Tuesday afternoon rally. “And one of those ways to do that is with having a contract that talks about safety.”

Sherry Casali, chief nursing executive and vice president of patient care at the hospital, said in a statement Tuesday that the hospital management is “committed to working with SEIU WI to address their concerns through a fair contract that both parties can support.”

The statement said the hospital has implemented a number of safety and security measures and has competitive salaries for nurses.

 Raes said the hospital has safety plans, but that nurses want those plans to go farther, including being enshrined in the labor agreement. She said the union wants to see guaranteed staffing ratios in the name of patient safety as well.

“We are preparing if needed to move forward to a strike,” Raes said. “These nurses are ready to strike. Let me tell you — they are not afraid. But we do not want to strike if we don’t have to.”

To date, the union has not issued a formal strike notice.

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Gov. Tony Evers and Wisconsin Economic Development Corp. CEO Missy Hughes at the Hannover Messe trade show in Germany last week. (Photo courtesy of WEDC)

The sweeping tariffs President Donald Trump put in place last week have left key Wisconsin business leaders as well as the state’s important trading partners confused and uncertain, the state’s top economic development official said Monday.

Missy Hughes, CEO of the Wisconsin Economic Development Corp., spoke to the Wisconsin Examiner from Germany, where she and Gov. Tony Evers are in the midst of a trade mission. Hughes left March 29 and returns to Wisconsin this week.

“The government officials, economic development officials, the businesses that we’ve been talking to are very confused about how we got here after over 75 years worth of partnering and working together,” Hughes said. “The folks here are really wondering what has happened and where this is going.”

Hughes said she’s hearing regularly from Wisconsin businesses that have integrated themselves into the global economy.

“I’ve been in touch with companies that are directly importing things like coffee [for which] there’s really no way to work around the tariffs,” she said. “And so they’re very concerned about just increased costs on their bottom line.”

Other businesses have connected with the supply chains that run between Canada and Mexico through the United States. They are “sending products back and forth across those borders, and are now very confused and concerned about how to make their supply chains work,” Hughes said.

For businesses that have had a good run for the last several years, “[there] is real frustration around instability and unpredictability,” she said. “They were experiencing growth, they were doing well, and now they’re concerned that that might be endangered.”

A ‘man-made crisis’

Hughes contrasted the crisis brought on by the tariffs and the responses to them with the COVID-19 pandemic’s disruption to the economy five years ago.

“This is a man-made crisis,” whereas the pandemic was “a crisis that was not man-made,” she said.

“For the average Wisconsinite the concern I have is the increased cost in their pocketbook,” Hughes said. “There’s going to be increased grocery prices, there might be inflation. It’s going to cost more to replace your dishwasher or your automobile.”

Those present “an impact [that] is difficult to predict,” she said. “This is really going to be an unfolding crisis as we see immediate impacts and then impacts that will evolve, due to changes that are being made on a daily basis.”

In addition to the volatility from the tariffs, Hughes said, there’s also uncertainty from unexpected and sweeping cuts across federal agencies, resulting in disruptions that range from university research programs cut short to social services delayed or ended.

Markets worldwide take another dive as Trump threatens higher tariffs on China

Farmers are losing grants they have been relying on, she said, but also are faced with losing the counsel they’ve relied on at the U.S. Department of Agriculture to help them manage regulations.

Leaders of a biohealth company have expressed “their concern that the FDA [Food and Drug Administration] is no longer going to be the premier global agency that people rely on,” Hughes said.

“There’s things that are going to be immediately apparent and things that are going to be apparent as we see real expertise and institutional knowledge from our agencies disappear,” she added.

Maintaining relationships 

The trade mission took the Wisconsin delegation to France as well as Germany. It is aimed at encouraging businesses in Europe to buy Wisconsin exports and talking up the Badger State for companies interested in establishing or expanding their operations here.

A highlight of the visit was kicking off the 50th anniversary of Wisconsin’s sister-state relationship with the German state of Hesse (Hessen). The group also attended the Hannover Messe, a major worldwide advanced manufacturing trade show.

In the face of the startling reversal from longstanding relationships between the U.S. and the world, Hughes said, leaders the state delegation met with welcomed Wisconsin’s continued overtures.

“Obviously, things are still very volatile,” Hughes said. Despite that, she added, “people have been so happy that we are here extending a handshake and reminding everyone that there are opportunities for relationships beyond what’s happening in Washington, D.C.”

Joining the trip were four Wisconsin companies and representatives of New North, a Wisconsin regional economic development and business organization. The Wisconsin participants were looking at opportunities such as distribution deals in Europe for their products, Hughes said.

“They were by and large very happy with their visits and the opportunities to create relationships,” Hughes said.

The other principal aim of the trip was to connect with companies in Europe that have Wisconsin operations or are interested in establishing a presence in the state.

“While those conversations were positive, there was certainly also concern expressed about, what if there’s a slowdown, what if there’s a recession,” Hughes said. A recurring theme in those conversations, she added, was the “need to understand what the economy is doing, and we need things to not be as volatile as they are right now.”

The Wisconsin team is working “to remind folks that Wisconsin’s is a strong economy,” she said. “We have strong businesses that are interested in being and already participating in the global market and want that to continue. So I think, you know, we are a steady hand during this volatile time and I think that’s really beneficial.”

Business confidence at stake

In the face of the current economic turmoil, Hughes said she worries about the toll on business confidence.

“When you lose confidence you start to become risk averse, you hold off on making investments,” she said. That’s important in Wisconsin because of the state’s role making large, expensive machinery.

“We make CAT scans and MRIs and tractors and big industrial machinery,” Hughes said. “People need confidence before they make those purchases. And so if we lose confidence, it’s going to be harder to recover even if the tariffs were taken away next week, or next month.”

Confidence is hard to measure and not always easily predicted, she acknowledged. “My fear is that people will really start to become risk-averse, and that hinders the whole growth of the economy.”

Despite that fear, however, she said she’s found reasons to buoy her spirits in the conversations she’s had over the last two weeks.

“The desire for a relationship, the desire for connections, the long-term historic partnerships that we’ve had are still here,” Hughes said. She professed optimism that those connections can still be nurtured and survive the current gyrations of the stock market or the economy itself.

“I’m very confident that we have such strong ties that those will stand strong during these times,” she said. “But it is difficult.”

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A Wisconsin Democracy Campaign poll finds nearly 90% of voters say they're concerned about the influence of money in politics. (Getty Images)

After an April  election that broke national  records for spending, Wisconsin voters are eager to see measures to rein in money in politics, a campaign finance watchdog group leader said Monday.

“It is an environment where billionaires are running the show and everyday people like you and me are here watching,” said Nick Ramos, executive director of the Wisconsin Democracy Campaign. “We will continue to see unprecedented spending unless something changes from our Legislature and our lawmakers.”

The numbers that the organization posted Monday haven’t yet pierced the predicted $100 million threshold in the Supreme Court race, but final data won’t be compiled until the end of June. The Democracy Campaign focuses on the money actually spent, as distinct from what was raised or what was budgeted, said research director Sam DeForest-Davis.

As of Monday morning, the campaign for Judge Susan Crawford, who won the Court race, spent $22 million compared with the campaign for Judge Brad Schimel, which spent just under $10 million.

While the campaigns spent a combined $32 million, independent groups supporting the campaigns spent a combined $51 million. Schimel was the larger beneficiary of independent spending, with $33.5 million in his favor or opposing Crawford. Independent spending that favored Crawford or opposed Schimel totaled $18 million.

In the race for state superintendent, the two candidates’ campaigns — for  incumbent Jill Underly, who won, and for her challenger, Brittany Kinser — were just about even in their spending, with $1.3 million for Underly and $1.1 million for Kinser.

Independent spending, however, heavily favored Underly at $1.9 million. Independent spending for Kinser totaled $160,000.

Research director DeForest-Davis said the organization will have a final report in July on spending data, including spending on issue ads that don’t include explicit messages to vote for or against a candidate but are slanted to clearly favor one or the other. That information won’t be available until the end of June. 

Along with the campaign finance data released Monday, the Democracy Campaign released results from an opinion poll of Wisconsin voters on campaign finance.

The survey, of 861 voters conducted from Feb. 11-14, found that 88% of participants were “very concerned” or “extremely concerned” about the influence of money in politics.

“I have a hard time thinking of an issue that has this kind of universal feedback across the state,” Ramos said. “After seeing the gaudy amount of money that was spent in this Supreme Court race, I can only imagine that this number and this percentage are going to increase.”

Nearly as many — more than 85% — said “no” when asked if individuals or groups should be able to spend “unlimited amounts of money” to support political campaigns.  And 83% said there should be limits on how much campaigns can spend.

Nearly 74% said they would support a ban on campaign spending “by outside political action committees (PACs) that are not directly affiliated with a candidate’s campaign.” About 53% ranked spending by “dark money PACS who do not have to disclose their donors” as their greatest concern where the influence of money on politics is concerned.

Another question showed that so far publicly financed campaigns haven’t gained support from a majority of voters. Almost 47% said they would “strongly” or “somewhat” support such a proposal. Just under 30% said they would “somewhat” or “strongly” oppose public financing, while 23.5% said they were unsure.

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Volunteers and staff with Worker Justice Wisconsin pose with the group's banner after an action Friday to call attention to wage theft. (Wisconsin Examiner photo)

A Wisconsin group that helps workers who have experienced wage theft is broadening its tactics to address complaints of employer misconduct.

On Friday staff members of Worker Justice Wisconsin, along with a group of community supporters, showed up at a Middleton contractor’s office where a former employee demanded payment of unpaid overtime wages. 

The public action represents a new step for Worker Justice Wisconsin, according to executive director Rebecca Meier-Rao.

Based in Madison and supported by a group of churches and other religious bodies, Worker Justice Wisconsin has spent the last couple of decades assisting workers who don’t have unions with complaints about their treatment on the job.

For much of its existence the organization has worked one-on-one with individuals, helping them navigate the process of filing complaints with the Wisconsin Department of Workforce Development (DWD) and other agencies.

“The prevalence of wage theft is astronomical,” Meier-Rao told the Wisconsin Examiner. She added that it’s a nationwide problem. “Every year just millions and millions of dollars are stolen from workers.”

People of color and immigrants are the most likely to be targets, she said. The organization does not discuss the immigration status of those who come to the group for help.

In 2024, the group enabled 103 workers to recover more than $328,000 in wages they were shorted by their employers, Meier-Rao said, but those successes represent “just a fraction” of the wage theft incidents that go on each year. The resolved wage theft cases in 2024 were just some of the 155 that Worker Justice Wisconsin opened that year, involving more than $531,000 in unpaid wages.

“I’m sure the actual amount of wage theft was much higher,” Meier-Rao said.

Not only do those cases  deprive people of their rightful earnings, they also cost government the taxes on those earnings, she said.

DWD investigates wage theft complaints and will calculate what is owed to an employee, but “there’s almost no teeth if the employer doesn’t pay,” she added. “That is not going to deter the problem from happening.”

While someone who steals from a store or a warehouse can be charged with theft, wage theft in Wisconsin “is treated not as a criminal offense but a civil offense,” Meier-Rao said.

Worker Justice Wisconsin’s tactics are evolving as it looks for new ways to address the issue. “We’ve been shifting from an advocacy organization to a worker power organization,” Meier-Rao said.

About a year ago the organization began planning to take public actions to call attention to the wage theft incidents it has investigated. The group developed leaders among the workers it has supported and began building a broader support group — a “rapid response network” that has enlisted 120 community members, union activists and other allies.

By directly confronting employers, Meier-Rao said, the organization wants to draw the attention of the public and policymakers to wage theft, encouraging them to enact tougher laws against the practice.

On Friday morning, Worker Justice Wisconsin organizer Robert Christl, Meier-Rao and a small crowd of the organization’s rapid-response volunteers drove up to the storefront of Stone Concepts in a Middleton industrial park.

They were there with Crescencio Albino, who worked for four years building and installing stone countertops at the home design and remodeling contractor.

Albino, who no longer works for the company, said that he had put in  extensive overtime hours, but was paid only his regular hourly wage, not the time-and-a-half premium required under state and federal laws. A DWD investigation determined he was owed $6,875 in unpaid premium wages for the last two years of overtime work.

Outside the Stone Concepts office, with Albino at his side, Christl spoke to an employee and asked if the owner was on site. The employer said he was not, and Christl asked him to convey a letter to the owner. The letter called for Albino to be paid in full within two weeks.

Gathering at the other end of the block afterward, Meier-Rao, Christl and Albino addressed supporters. Christl served as interpreter as Albino spoke in Spanish.

Albino said he pursued the case with DWD after trying several times to resolve the issue directly with the business. Despite the DWD’s finding, Albino said the business owner has still not paid him.

“The employer wanted to pay the money already owed to me with a payment plan of six months, which I rejected,” Albino said. “It’s hard for me to understand why, in such a clear cut situation, I have to go through this whole process to get what is mine.”

He added: “If I hadn’t honored my obligation, or if I had stolen from my boss, the consequences would have been immediate and severe, but it seems that when it’s workers like me who are affected, justice isn’t applied equally. This seems wrong to me.”

Meier-Rao told the group that the action and others like it were aimed at throwing a public spotlight on a problem that has long gone unnoticed.

“For more than two decades, we have helped hundreds of workers file claims with the Department of Workforce Development to [recoup] unpaid wages,” Meier-Rao said.

“Although we have had many successful individual cases, the harsh reality is that this approach does not change the system. No amount of complaints filed will put a stop to wage theft.”

To accomplish that, “we have to organize inside and outside the workplace,” Meier-Rao said. “We have to be public. We have to make noise. We have to build collective power. That is why it’s so important that you are all here today.”

Responding Saturday to an email inquiry the Wisconsin Examiner sent Friday to Stone Concepts, Andreia Nogueira wrote that “we are not refusing to make a payment. I am sending the payment to my lawyer.”

As of Sunday, Worker Justice Wisconsin had not received a response on behalf of the company, Meier-Rao said.

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Justice Ann Walsh Bradley speaks at an election night party for Justice-elect Susan Crawford. (Photo by Baylor Spears/Wisconsin Examiner)

Justice Ann Walsh Bradley will retire from the Wisconsin Supreme Court in July with one more title on her curriculum vitae: chief justice.

Bradley, the Court’s most senior member, was elected by her colleagues Thursday to serve as the leader of the Court. She’ll succeed outgoing Chief Justice Annette Ziegler, whose second two-year term in the top position ends April 30.

Bradley’s term will run about two months starting May 1, and she’ll step down June 30 in anticipation of her retirement. In preparation for that, the justices also elected Justice Jill Karofsky to fill out the remainder of the two-year chief justice term, ending April 30, 2027. 

Both Bradley and Karofsky, who was elected to the Court in 2020, are members of the Court’s liberal majority. 

From the late 19th century to the mid-2010s, the state Supreme Court’s chief justice had been selected by seniority. In 2015, a constitutional amendment drafted by the Legislature’s Republican majority changed the selection process to a majority vote of the Court’s seven justices. The amendment also instituted a two-year term for the chief justice.

The amendment was aimed at unseating Justice Shirley Abrahamson, the Court’s first woman justice. Abrahamson had been chief justice since 1996, the second-longest to serve in the position. After voters ratified the amendment in April 2015, a majority of the justices — at the time, five conservatives — elected Justice Pat Roggensack chief. They reelected her in 2019, then elected Ziegler as her successor in 2021.

Bradley said in a statement that her election as chief justice is a “tremendous honor.”

“It has been my life’s goal to honor the rule of law, enhance access to justice, and serve the 5.9 million people who call Wisconsin home,” Bradley said. “Serving as Chief Justice enables me to further those goals.” 

Bradley also participated in her final oral arguments Thursday morning, where Ziegler delivered kind words about her and called attention to her thorough resume and accomplishments

Prior to her time in law, Bradley served as a high school teacher before earning her law degree at UW-Madison Law School in 1976. Bradley worked in private practice, as a city attorney and as a public defender, including being appointed to the state public defender board in 1983.

In 1985, Bradley was appointed to serve as a circuit court judge in Marathon County. 

Bradley won her first term on the Wisconsin Supreme Court in 1995, and was reelected for two consecutive terms in 2005 and 2015. She decided to retire this year and will be succeeded by Justice-elect Susan Crawford, who defeated her challenger Brad Schimel Tuesday ensuring a 4-3 liberal majority on the Court until at least 2028. 

Ziegler said Bradley has likely heard over 2,400 cases in oral arguments, give or take some cases, during her many years of service.

“I can assure you it’s quite impressive,” Ziegler said. “I don’t know how many opinions that you’ve written, Justice Ann Walsh Bradley, but that number is also certainly impressive, and so, I would like to thank you Justice Ann Walsh Bradley for your service to the public and your service on this court.” 

Bradley thanked Ziegler and said that it’s been an honor to serve. She also thanked her husband and family for their support throughout the years. 

“People ask me, ‘Will you miss this place and miss this job?’ And, of course, I will,” Bradley said. “What makes this job is not only the heavy responsibility and an opportunity to serve, but an opportunity to serve with people who care deeply about the rule of law and care deeply about the people of this state.”

Karofsky said in a statement about her election to serve as chief justice that she appreciates the confidence of her colleagues and she will “continue to work respectfully with every member of this Court to ensure the administration of Court business is conducted in a fair and efficient manner.” 

“The people of Wisconsin have great faith in this Court, and I intend to be a Chief that increases the people’s confidence even further,” Karofsky said. “I hope to be someone that every judge and staff person in the judicial system finds approachable, so we can continue to improve the service we provide in all 72 counties, keeping each of us safe and ensuring access to justice.”

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When a child's birth is covered by Medicaid, county social service agencies may require the father to pay back Medicaid costs as part of a child support order. (Getty Images)

Gov. Tony Evers is asking Wisconsin counties to give up a practice they’ve relied on for years: clawing back money from the absent fathers of children whose mothers were Medicaid recipients when they gave birth.

The practice is called birth cost recovery. When Medicaid covers the birth of a child and the father doesn’t live with the rest of the family, county social service departments and the courts may add a requirement to repay Medicaid to a father’s child support order.

In his 2025-27 state budget proposal, Evers wants to end the practice, and he’s offering counties a deal to give it up: a nearly $4 million boost for child support agencies.

Although permitted under federal law, only two states now authorize the use of birth cost recovery: Kansas and Wisconsin. Proponents of the practice have argued that it’s only fair to try to recoup state funds spent on the birth of a child if the child’s father can afford it.

But research at the Reproductive Equity Action Lab (REAL) questions the benefits of birth cost recovery when compared to the potential harm it can cause. The lab is affiliated with the University of Wisconsin School of Medicine and Public Health.

“This is a policy that takes money out of low-income families’ hands in the state of Wisconsin to pay the state back for the social services they receive,” Klaira Lerma, the lab’s associate director, told the Wisconsin Examiner. “This creates financial strain on families, and families view it as government greed.”

This week REAL published a policy brief on birth cost recovery. The brief summarizes research by the lab’s director, Professor Tiffany Green, along with Lerma and other contributors, that contradicts assumptions proponents have made.

There were 14,880 unmarried Wisconsin residents who gave birth in 2023. The brief reported that unmarried parents already tend to have lower incomes than married parents, making a birth cost recovery debt especially challenging.

Wisconsin gives counties the option to use birth cost recovery, but doesn’t require it. If a county takes the option, 15% of the money it recovers goes to the county’s child support program, while 85% goes back to the state Medicaid program.

ABC for Health, a Madison-based nonprofit public interest law firm, has been campaigning against birth cost recovery for more than a decade and succeeded in persuading Wisconsin’s two largest counties to drop the practice. Dane County stopped filing new birth cost recovery claims in 2020 and stopped pursuing old outstanding cases in 2023. Milwaukee County quit the practice in 2024.

As part of their investigation of the practice, REAL researchers interviewed 40 Wisconsin parents who had been subject to birth cost recovery.

Parents who live together aren’t subject to birth cost recovery — only noncustodial fathers. Lerma said parents told them they weren’t even aware they might be on the hook to repay Medicaid until there was a formal court order for child support.

“They described a lack of transparency and feeling bamboozled” when they were told about paying back Medicaid, Lerma said.

“Parents clearly described how Birth Cost Recovery payments reduce fathers’ ability to financially support their child(ren) by taking money out of their budget,” the policy brief states.

“You’re taking away the way somebody can feed their family,” one parent is quoted as saying. “You’re taking away child care, how somebody can provide for their family. You’re taking away [money for] health care.”

Another told researchers that a birth cost recovery payment “going back to the state is money that can be put into the child.”

For fathers in low-wage jobs, having to pay off a birth cost recovery debt “puts them in risk of losing housing, the ability to put food on the table,” a parent told the researchers.

“It also causes many marginalized fathers to throw up their hands and leave the lives of their children. And eventually, they may get caught, held in contempt. And once again, that whole cycle just starts,” the parent said. “They’re not going to get a job. They have this on their record. They’re not going to get housing. They’ll be always underemployed.”

Lerma said that in families covered by Medicaid, children are more likely to be at risk for illness. Birth cost recovery, she said, is effectively “taxing these families who are more likely to be facing significantly worse health outcomes.”

The brief cites research that found the financial strain from having to pay a birth cost recovery debt was associated with lower employment levels and less ability to maintain child support payments.

“In contrast, evidence shows eliminating Birth Cost Recovery appears to increase child support compliance,” the brief states.

“Ending Birth Cost Recovery across the state may reduce harm on Wisconsin families and result in more child support money going to children and their custodial parent,” the brief concludes.

To offset the expected loss counties would experience by giving up birth cost recovery entirely, Evers’ budget proposal sets aside $3.8 million over the two-year budget for county child support programs.

The brief says implementing that proposal could ensure “that county child support agencies remain fiscally solvent to carry out their mission.”

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Children at The Playing Field, a Madison child care center that participates in the federal Head Start program. (Courtesy of The Playing Field)

Head Start child care providers in Wisconsin and five other Midwestern states were stunned Tuesday to learn that the federal agency’s Chicago regional office was closed and their administrators were placed on leave — throwing new uncertainty into the operation of the 60-year-old child care and early education program.

“The Regional Office is a critical link to maintaining program services and safety for children and families,” said Jennie Mauer, executive director of the Wisconsin Head Start Association, in a statement distributed to news organizations Tuesday afternoon.

The surprise shutdown of the federal agency’s Chicago office — and four others across the country — left Head Start program directors uncertain about where to turn, Mauer said.

“We have received calls throughout the day from panicked Head Start programs worried about impacts to approving their current grants, fiscal issues, and applications to make their programs more responsive to their local communities,” Mauer said.

The regional offices are part of the Office of Head Start in the Administration for Children and Families at the U.S. Department of Health and Human Services (HHS). 

In an interview, Mauer said there had been no official word to Head Start providers about the Chicago office closing. Some program leaders learned of the closing from private contacts with people in the office. 

“We have not seen official information come out” to local Head Start directors, who operate on the federal grants that fund the program, Mayer said. “It’s just really alarming. For an agency that is about serving families, I don’t understand how this can be.”

The National Head Start Association issued a press release Tuesday expressing “deep concern” about the regional office closings. 

“In order to avoid disrupting services for children and families, we urge the administration to reconsider these actions until a plan has been created and shared widely,” the association stated.

Katie Hamm, the deputy assistant secretary for early childhood development at HHS during the Biden administration, posted on LinkedIn shortly before 12 noon Tuesday that she had learned of reduction-in-force (RIF) notices to employees in the Administration for Children and Families earlier in the day. 

RIF notices appear to have gone to all employees of the Office of Head Start and the Office of Child Care in five regional offices, Hamm wrote, in Boston, New York, San Francisco and Seattle in addition to Chicago. 

“Staff are on paid leave effective immediately and no longer have access to their files,” Hamm wrote. “There does not appear to be a transition plan so that Head Start grantees, States, and Tribes are assigned to a new office. For Head Start, it is unclear who will administer grants going forward.”

Hamm left HHS at the end of the Biden administration in January, according to her LinkedIn profile. 

Mauer said regional office employees “are our key partners and colleagues,” and their departure has left Head Start operators “incredibly saddened and deeply concerned.” 

Regional employees work with providers “to ensure the safety and quality of services and to meet the mission of providing care for the most vulnerable families in the country,” Mauer said. 

The regional offices provide grant oversight, distribute funds, monitor Head Start programs and advise centers on complying with regulations, including for child safety, she said. They also provide training and technical assistance for local Head Start programs.

“The Regional Office is a critical link to maintaining program services and safety for children and families,” Mauer said. “These cuts will have a direct impact on programs, children, and families.”

In addition to Wisconsin, the Chicago regional office oversees programs in Ohio, Indiana, Illinois, Michigan and Minnesota. 

Head Start supervises about 284 grants across the six states in programs that  enroll about 115,000 children, according to Mauer. There are 39 Head Start providers in Wisconsin enrolling about 16,000 children and employing about 4,000 staff.

The federal government created Head Start in the mid-1960s to provide early education for children living in low-income households. Head Start operators report that the vast majority of the families they serve rely on the program to provide child care so they can hold jobs.

The regional office closings came two months after a sudden halt in Head Start funding. Head Start operators get a federal reimbursement after they incur expenses, and program directors have been accustomed to being able to submit their expenses and receive reimbursement payments through an online portal.

Over about two weeks in late January and early February, program leaders in Wisconsin and across the country reported that they were unable to log into the system or post their payment requests. The glitches persisted for some programs for several days, but were ultimately resolved by Feb. 10.

Mauer told the Wisconsin Examiner on Tuesday that so far, there have not been new payment delays. But there has also been no communication with Head Start operators about what happens now with the unexpected regional office closings, she said.

“No plan for who will provide support has been shared, and the still-existing regional offices are already understaffed,” Mauer said. “I’m very nervous to see what happens. With no transition plan this will be a disaster.”

In her statement, Mauer said the regional office closing was “another example of the Federal Administration’s continuing assault on Head Start” following the earlier funding freeze and stalled reimbursements.

She said closing regional offices was undermining the program’s ability to function.

“We call on Congress to immediately investigate this blatant effort to hamper Head Start’s ability to provide services,” Mauer stated, “and to hold the Administration accountable for their actions.”

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Legislation introduced in the U.S. Senate would order the U.S. Department of Agriculture to resume frozen payments to farmers on contracts that have already been signed. (Photo by Gregory Conniff for the Wisconsin Examiner)

A group of U.S. Senate Democrats introduced legislation Monday that would order the agriculture department to resume paying farmers on contracts already signed.

“Donald Trump and Elon Musk are stiffing our farmers and processors — taking away resources these folks were guaranteed, threatening small businesses’ ability to stay open and people’s livelihoods,” said Sen. Tammy Baldwin (D-Wisconsin), one of 17 cosponsors.

In addition to 15 Democrats, two independent senators who caucus with them, Sens. Bernie Sanders of Vermont and Angus King of Maine, signed on to the bill.

The U.S. Department of Agriculture (USDA) has stopped reimbursing farmers and farm organizations for money they’ve spent, despite contracts they have already signed with the agency. The contracts call for farmers to be reimbursed for expenses they incur under the contracts.

Honor Farmer Contracts Act, introduced by Sen. Cory Booker (D-New Jersey), would require USDA “to release illegally withheld funding for all contracts and agreements previously entered into by the U.S. Department of Agriculture,” Baldwin’s office said in a statement announcing the legislation.

Under President Donald Trump, “USDA has refused to make reimbursement payments to fulfill signed contracts, without any indication of when or whether farmers will be paid the money they paid out and are owed,” Baldwin’s office said.

Farmers and organizations serving them contract with the USDA for various programs to connect with local markets and improve their productivity. The department then pays farmers back for the expenses they incur under those contracts. The department’s failure to pay strains finances both for the individual farmers and for the organizations that work with them under the programs, Baldwin’s office said.

The legislation would require USDA to unfreeze all signed agreements and make all past due payments as quickly as possible. It would also bar the department from canceling agreements or contracts unless there has been a failure to comply with their terms and conditions.

The bill would prohibit the department from closing county offices, field offices or centers of the Farm Service Agency, the Natural Resources Conservation Service or the Rural Development Service without notification at least 60 days in advance and justifying the closing to Congress.

On March 7, Baldwin said the USDA had resumed another previously stalled stream of funding, $6.5 million in grants for dairy businesses to diversify and market their products.

Baldwin has also demanded the Trump administration to reverse its cancellation in March of a program connecting farmers to local food banks.

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Jack Kelly of Wisconsin Watch waits with reporters outside the state Capitol for a press conference to begin in September 2023. (Wisconsin Examiner photo)

Journalists at Wisconsin Watch — a nonprofit news organization that includes the Milwaukee Neighborhood News Service — have ratified their first union contract.

The agreement, signed on Friday, March 28, includes minimum salary guarantees and annual cost-of-living increases along with layoff restrictions, severance pay and benefits as well as “just cause” protections against arbitrary terminations, according to the Wisconsin Watch Union. The contract also includes provisions for medical, parental, caregiver and bereavement leave.

The union is a subunit of Milwaukee NewsGuild Local 34051, which also represents newsroom employees at the Milwaukee Journal Sentinel.

“I’m really proud of the outcome,” said Jack Kelly, a Wisconsin Watch reporter and union bargaining team member. Staffers represented by the union were active in advocating for their priorities during contract negotiations, giving personal testimony about issues important to them, he said.

“They put some faces and names to the numbers we were asking for,” Kelly said in an interview Monday.  “I think the contract is going to make Wisconsin Watch and Neighborhood News Service better places to work.”

Kelly also commended Wisconsin Watch management’s handling of the bargaining process.

“We certainly had meetings that were long and stressful, but I think in general we were able to engage a collegial approach to bargaining,” Kelly said.

“We’ll continue to do great journalism knowing our workplace is more structured, secure and protected,” said Phoebe Petrovic, a Wisconsin Watch investigative reporter who was among those who initiated the union organizing effort, in a statement released by the union.

Wisconsin Watch journalists announced their union organizing campaign in October 2023, and the organization’s board subsequently agreed to voluntarily recognize the union. Protection against arbitrary firings was among the goals employees cited.

Wisconsin Watch was founded in 2009 as the Wisconsin Center for Investigative Journalism, still its legal name. The Milwaukee Neighborhood News Service became part of Wisconsin Watch in July 2024 and its employees became part of the bargaining unit.

Devin Blake, a Milwaukee Neighborhood News Service reporter who joined the bargaining team, said that in addition to tangible gains the union brought him closer to coworkers. “I have such a clearer sense of what matters to their lives and work,” Blake said in the union’s statement.

Digital news outlets and nonprofit news organizations have seen growing union representation in the last several years, with outlets including ProPublica and The Marshall Project joining the ranks of unionized newsrooms. 

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A new Wisconsin Hospital Association report finds continued challenges for hospitals seeking health care workers. In this January 2024 photo, an information screen for visitors at Sauk Prairie Hospital displays a recruiting message directed at health care workers. (Photo by Erik Gunn/Wisconsin Examiner)

As more Wisconsinites need more hospital care, the supply of health care workers to provide that care remains slim — and to change that outlook will take concerted effort, according to a new report released Monday.

“Wisconsin’s health care workforce must grow faster,” says the 2025 Wisconsin Health Care Workforce Report, produced by the Wisconsin Hospital Association (WHA).

“Health care employers are working hard to retain current employees, re-recruit those who left for what they thought might be greener pastures and attract new talent to health care fields in Wisconsin,” the report states.

The report finds some glimmers of improvement and promising pathways for hospitals to further address their need for more trained staff. Over the last two years hospital job vacancies have fallen slightly and employment has increased.

But filling jobs remains a challenge and will remain that way for years, the report states. It suggests  a combination of strategies to overcome current trends.

Some of the strategies involve  how hospitals themselves structure jobs and hiring practices. But the report contends other sectors — government, educational institutions, and the insurance companies and government programs that pay the lion’s share of health care bills — will also need to shift their policies.

Reimbursement rates are not keeping up with increased costs as hospitals and other providers weather rising payroll and supply expenses, for example, the report finds.

By far the dominant contributor to the workforce challenges hospitals and health systems face, however, is demographic, according to the report. Wisconsinites continue to get collectively older.

“Only Wisconsin’s population over 65 has grown between the 2010 and 2020 census,” said Ann Zenk, senior vice president of workforce and clinical practice for the hospital association. The working-age population ages 18 to 65 decreased in that same period.

Those younger than 40 go to the hospital once a year on average. From ages 40 to 65 that ticks up to three times a year. After 65, “it doubles to six visits a year,” Zenk  said.

“As we age, we need more health care,” she said. “That is going to be a double challenge for hospitals because our available workers are a smaller pool and our demand is even greater.”

The population preparing to enter the workforce — people ages 19 and younger — “is not large enough to replace retiring baby boomers,” the report states. “Growing the health care workforce needed to respond to this demographic challenge will require increasing in-migration, ensuring access to career pathways and increasing interest in hospital careers.”

That starts with giving students in high school or even earlier “the opportunity to have exposure — you’re walking in the shoes of what it’s like to be a health care professional,” Zenk said.

Then there’s the education process itself — “making sure that educational pathways remain accessible,” Zenk said. The report urges policymakers not to add requirements to training programs that would make them longer, more complex or more expensive.

One promising training innovation, said Zenk, is the use of an apprenticeship program to prepare new registered nurses, pioneered in the last few years in Wisconsin by UW Health and the state Department of Workforce Development.

While the program stretches over four years for the equivalent of a two-year associate degree, she said, it also allows the participating students to “earn while you learn.” The concept is being expanded to prepare respiratory therapists.

The report also identifies generational shifts in what people expect from their jobs. Zenk said addressing demands for more flexible and family-friendly schedules can make it possible to hire and retain more successfully. But those changes may also mean demand for even more personnel.

“So where you need a roster of 10 nurses, you need 15 now to cover the exact same shift,” Zenk said.

The report also sees technology offering some relief.

Some of that might be replacing people for tasks such as registering at the front desk for a medical visit, Zenk said. But another example is monitoring equipment that could go home with a patient and be checked remotely, with nurses and clinicians visiting the patient at home every day, she observed.

Zenk said some regulations in health care can be reexamined and streamlined without endangering safety or the quality of care.

Physician assistants, for example, collaborate with and are overseen by a medical doctor. Zenk said in the past a physician could supervise no more than four PAs. That has since been relaxed, making it less burdensome for both doctor and PA alike, she said.

Zenk said another form of regulation has gotten worse, however: When health insurers interpose an increasing number of steps for them to sign off on the care a doctor or hospital provides.

“That requires staff to make those phone calls or enter that data, or requires physicians to document more and more and more to justify the care that they want to provide and that the patient needs,” she said.

She’s seen insurer-driven requirements increase in the last five years.

“That’s a major tug-of-war on clinicians’ time,” Zenk said, “and for patients also very frustrating.”

In the end, however, there’s no single silver bullet to resolve what is likely to be a persistent challenge for hospitals or their employees.

“There’s no one answer. We’re more than likely not going to be able to grow ourselves out of this one fast enough,” Zenk said. “But anything we can do to grow the workforce faster is going to help.”

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