Most older adults want to stay in their homes as they age. But owning a home is getting more expensive as property taxes surge.
Wisconsin homeowners last December saw the largest school property tax increase in more than three decades, according to the Wisconsin Policy Forum.
Property tax increases disproportionately affect older adults who rely on fixed incomes through pensions, savings and Social Security.
At a Northwoods Senior Breakfast this spring in Merrill, one group of attendees asked: How can older adults get help paying property taxes? Wisconsin Watch passed that question along to three experts:
Nicole Heckman, vice president of financial wellbeing at AARP Foundation.
Bekki Schmitt, director of Milwaukee’s Aging and Disabilities Resource Center.
Jenny Fasula, executive director of the Foundation for Rural Housing.
Here’s what we learned:
Where to start
The AARP Foundation offers an online tool to check eligibility for available assistance programs. Eligibility for assistance is often broader than people assume, Heckman said.
Aging and disability resource centers, or ADRCs, can provide information about local assistance programs and other savings opportunities. The Wisconsin Department of Health Services lists ADRCs by county online.
The Wisconsin Department of Revenue’s website lists the latest information on property tax assistance programs and eligibility requirements. Municipalities may also offer local aid.
“There are no great options for people who get behind on property taxes,” Fasula said. She wants to see the state expand assistance. Here are four existing Wisconsin programs to help offset or delay high property tax bills.
Homestead credit: This tax credit helps low-income homeowners and renters. People can get help claiming the credit through Volunteer Income Tax Assistance sites or AARP Foundation tax assistance programs. Inflation has reduced the value of the credit in recent years, as Wisconsin Watch has reported.
School property tax credit: Homeowners and renters can claim this nonrefundable tax credit along with the Homestead credit through their income tax return.
Property tax deferral loan program: Homeowners 65 and older can delay paying property taxes through the Wisconsin Housing and Economic Development Authority. Borrowers repay the loan, plus interest, once the home is sold or transfers ownership.
Lottery and gaming credit: Eligible homeowners can apply online or through their county treasurer to receive a credit toward their property tax bills.
Q&Aging
Did we miss a helpful resource? Do you have a question about aging?
Reading Time: 6minutesClick here to read highlights from the story
Dane County ended a four-year program that distributed pipes and smoking supplies to reduce overdose deaths and disease transmission among people who use drugs.
Public health officials said the program increased visits from people seeking overdose reversal medication, fentanyl test strips and other harm reduction resources.
County officials halted the program in March after questions arose about whether distributing pipes violated Wisconsin paraphernalia law.
People who relied on the free supplies say they may now buy pipes elsewhere, use makeshift devices or inject drugs they previously smoked.
Dane County has ended an initiative to prevent overdose deaths by giving out pipes.
Four years ago, public health officials started giving people pipes and other supplies to reduce health risks associated with smoking drugs.
The program was part of the department’s broader efforts to reduce harms of drug use. For decades, syringe service programs across the country have provided harm reduction supplies to people who inject drugs. Though controversial, these programs reduce hospitalizations and overdose deaths while increasing participation in drug treatment.
But in recent years people have increasingly smoked drugs rather than injecting them. Adapting to that trend, harm reduction providers, including Public Health Madison and Dane County, began offering smoking supplies.
The pipe handouts worked. More people visited health officials to receive overdose reversal medication and other resources to prevent drug-related illnesses and injuries.
But the program was likely illegal under Wisconsin law, which allows injection supplies, not smoking materials.
Staff stopped offering smoking supplies in March. Spokesperson Morgan Finke cited a need to re-evaluate the program after the risk of COVID-19 transmission from shared pipes sharply declined and federal guidance on harm reduction shifted.
The department still offers injection supplies and other harm reduction items not intended for smoking.
“While syringes are classified as disease prevention materials under state law, smoking supplies have less clear protections,” Finke wrote in an email to Wisconsin Watch.
Halting the distribution of smoking supplies is already having an impact.
People who previously received pipes from the health office said they will buy similar supplies at smoke shops and gas stations, use makeshift pipes made from foil and soda cans or inject drugs they would have smoked, according to records and interviews obtained by Wisconsin Watch.
Others said they would likely stop visiting public health altogether.
Why did health officials hand out pipes?
Wisconsin opioid overdose deaths hit a record high in 2022, topping 1,450.
Officials found more evidence of smoking than injecting at fatal overdose scenes across the U.S. in 2022, a shift from years prior, according to the U.S. Centers for Disease Control and Prevention.
Although it still carries overdose risks, evidence shows smoking instead of injecting reduces the spread of diseases like hepatitis, HIV and bacterial infections and abscesses. It may also lower overdose risks. Regular access to new pipes can reduce how often people share pipes or use broken and unsafe materials, according to a national research study that included 2024 survey data from Public Health Madison and Dane County.
Public Health Madison and Dane County offered evidence-based resources to prevent disease and overdoses, including sterile needles, fentanyl test strips and overdose reversal medication. But the office primarily served people who inject drugs, the department’s medical director, Dr. Jonathan Temte, wrote in a 2022 letter explaining why the office would start ordering smoking supplies.
“People who use drugs by means other than injection have no reason to visit,” Temte wrote.
Temte is a family medicine physician and University of Wisconsin-Madison associate dean of public health and community engagement. He advises the health department on a limited basis.
When staff asked Temte to approve adding smoking supplies to the department’s syringe service programs, they told him Wisconsin law allowed it, Temte recalled. He focused on whether medical evidence supported the initiative.
Health research overwhelmingly supports harm reduction, he said.
Adding smoking supplies addressed two major issues: Health officials needed to get life-saving resources to people who smoked drugs. And without access to safer smoking supplies, people were more likely to share pipes or use materials that cause cuts, burns and infections.
Monthly visits jumped nearly 30% once department offices began regularly offering filters, mouthpieces and two kinds of pipes.
Even with increased visits, the department distributed 3.7% fewer syringes between 2021 and 2023.
But despite the public health benefits, Wisconsin paraphernalia laws criminalizes smoking materials.
A woman visited a public health office and asked for a pipe in early April. When she found the office no longer distributed them, she asked for syringes, according to emails obtained by Wisconsin Watch. Staff asked if she would inject the drugs she usually smokes. She said yes. Without a pipe she would dissolve powdered drugs in water and inject them.
Screenshot from a “Harm Reduction Saves Lives” pamphlet included in materials Public Health Madison and Dane County produced in response to a Wisconsin Watch public records request.
Screenshot from a “Harm Reduction Saves Lives” pamphlet included in materials Public Health Madison and Dane County produced in response to a Wisconsin Watch public records request.
Screenshot from a “Harm Reduction Saves Lives” pamphlet included in materials Public Health Madison and Dane County produced in response to a Wisconsin Watch public records request.
Screenshot from a “Harm Reduction Saves Lives” pamphlet included in materials Public Health Madison and Dane County produced in response to a Wisconsin Watch public records request.
Why did the program end?
The city-county agency was likely the state’s only syringe service provider that publicized pipes online, according to a 211 list of syringe service programs.
While reporting a feature highlighting the seemingly unique initiative, Wisconsin Watch emailed Madison City Attorney Michael Haas on March 23 to ask how the department could legally distribute pipes.
The email was forwarded to public health staff, records obtained by Wisconsin Watch show. The public health agency redacted correspondence related to the email, citing attorney client privilege.
The next day, a public health supervisor instructed a staff member to remove smoking supplies from an internal tracking system. By the end of the week the department’s website no longer mentioned safer smoking supplies.
Wisconsin’s paraphernalia law bans equipment used, designed or intended for inhaling a controlled substance. Possessing paraphernalia carries a penalty up to a $500 fine and 30 days in jail.
Dane County lowered local penalties for drug paraphernalia citations in 2023. County sheriffs and local police have continued to fine and charge people for possessing smoking materials similar to those health officials distributed.
Madison police cited paraphernalia possession in around 350 arrests in 2025, department records show.
“Public health programs must follow federal, state and local law,” Finke told Wisconsin Watch. “While we continue to evaluate disease transmissions within the community and evolving guidance from federal agencies, we have currently removed smoking supplies from our offerings.”
But the medical evidence supporting the service has not changed “one iota,” Temte said. “It’s just one more (example) of the politicization of public health.”
A pipe is shown. (Addie Costello / Wisconsin Watch)
The smoking supply rollback came as harm reduction lost support from federal leaders.
The Biden administration spent millions on harm reduction efforts but prohibited spending grant dollars on pipes after reporting on the potential distribution of safer smoking kits went viral and drew criticism.
The Trump administration announced in 2025 a “clear shift away from harm reduction and practices that facilitate illicit drug use and are incompatible with Federal laws.”
Federal health leaders wrote in April that federal dollars cannot be used to buy “drug paraphernalia or supplies that promote or facilitate drug use” including pipes, injection supplies and fentanyl test strips.
The city-county’s harm reduction program focuses on reducing overdose deaths and preventing disease transmission, Finke said.
“We will continue to engage with and educate policy makers to ensure that federal and state policy evolves consistent(ly) alongside the growing evidence base supporting effective substance use prevention and harm reduction strategies.”
Opioid overdoses have dramatically declined since 2023, but overdose deaths involving stimulants have increased. People who smoke stimulants, like methamphetamine and cocaine, are at a growing risk for overdose, said Giavana Margo, Wisconsin program manager for Vital Strategies, a national nonprofit working to reduce overdose deaths.
“There’s a lot to be celebrated, and we’re still losing way too many lives to overdose,” Margo said.
A Public Health Madison and Dane County office is shown, May 22, 2026, in Madison, Wis. Staffers previously distributed pipes and other supplies to reduce health risks associated with smoking drugs, but they were told to stop doing so in March 2026. (Addie Costello / Wisconsin Watch)
Wisconsin’s paraphernalia laws only exempt smoking supplies associated with tobacco consumption.
But Wisconsinites can still buy pipes typically used to smoke illegal drugs, several advocates and people using drugs told Wisconsin Watch. Gas stations, local shops and online sellers advertise the glassware as tobacco products, decorations or household items.
Standing outside the department’s East Madison location in late-April a woman who identified herself as Ashley said she received pipes from the office for years. Without the free pipes, people will buy them at nearby stores for around $8 or “improvise” makeshift supplies, the 39-year-old said.
She visited public health for pipes whenever one broke, usually about twice a month. Staff asked whether she had enough fentanyl test strips and wanted to help her “stay as safe as possible,” she said. She can still go to the office to get things like condoms, bandages, injection supplies and tampons.
“It helps when you’re homeless like I am,” she said.
Most people who received harm reduction supplies from health officials in 2024 left with fentanyl test strips and overdose reversal medication, a survey of more than 250 program participants shows. Respondents reported feeling safer and no longer needing to steal smoking supplies after the visits.
Still, a quarter of respondents said they weren’t sure or would likely stop visiting the offices if smoking supplies vanished.
Editor’s note: A previous version of this story included captions that misidentified the source of screenshots from a harm reduction pamphlet. The pamphlet was produced in response to a public records request submitted to Public Health Madison and Dane County.
Wisconsin Watch is a nonprofit, nonpartisan newsroom. Subscribe to our newsletters for original stories and our Friday news roundup.
Reading Time: 6minutesClick here to read highlights from the story
Wisconsin leads the nation in reported fall deaths among older adults, with more than 1,800 in 2024.
The reasons aren’t fully clear but may include how local officials report deaths, graying demographics and Wisconsin’s culture of alcohol use.
Many falls can be prevented — and Wisconsin is a leader in that work.
Programs from ballroom dancing to parkour help older adults build strength, balance and confidence.
About a dozen gray-haired adults line the playground fence at Madison’s Warner Park. Standing on narrow wood planks, they balance on the balls of their feet.
“Calves are burning, woo!” someone yells. The class stops to shake out their legs. Participants, most in their 60s or 70s, step back onto the boards and lift their heels off the ground — one of several movements in the class to help build muscle to prevent falls and practice parkour.
Alice Morehouse, 70, hits the playground’s blue, rubber surface. She shifts her weight to her left side and pushes herself up onto her toes. An instructor reminds everyone to flatten their hands — a tip Morehouse already picked up during two years in Parkour for Seniors classes.
She drops to the ground and confidently springs back up twice more.
“When I first started, I went home, drank a cup of coffee and took a nap,” Morehouse tells a classmate. “Now I only need the coffee.”
Sitting on a swing, holding two Jenga blocks in the form of a “T,” Morehouse says she has tried other workout classes. But parkour is “way, way more fun,” she adds while pushing off the ground.
Anne Cook, left, practices a balancing exercise with Kathy Reinhard during a parkour class at Warner Park on April 23, 2026, in Madison, Wis. (Joe Timmerman / Wisconsin Watch)
Wisconsin has the nation’s highest reported death rate from falls among older adults, according to the U.S. Centers for Disease Control. More than 1,800 older Wisconsinites died from falls in 2024.
It’s not clear why Wisconsin stands out. Without firm evidence, experts point to several possible factors, including how local officials report deaths, graying demographics and Wisconsin’s culture of alcohol use.
But one thing is certain: Many falls can be prevented.
Wisconsinites are national leaders in fall prevention work. A local nonprofit trains people across the country to provide an evidence-based course, Stepping On, recommended by the CDC. Oshkosh health care providers started a “Mugs-for-Rugs” event to get older adults to trade hazardous throw rugs for free local coffee. Madison area advocates and experts developed a network of balance-enhancing classes, including ballroom dancing and parkour.
Still, the number of fall-related EMS calls in Wisconsin increased between 2023 and 2024, according to the Wisconsin Department of Health Services. Falls made up more than 20% of 911-related ambulance runs in 2024.
Stepping On is offered in 43 Wisconsin counties, including Dane. Madison residents can also access a wide range of additional classes. Still, falls remain a leading cause of injury deaths in the county.
To change those numbers, advocates say they need to reach more older adults. But that costs money. Attempts to dedicate state dollars toward fall prevention failed in the Legislature.
Parkour for Seniors grew popular enough this year to add a Thursday morning class. Morehouse has gained confidence since joining.
“I’m no longer afraid to fall because I know I’m going to do it, and I know how,” she says. “And I’m much, much stronger.”
Her favorite part of the class is watching participants have fun.
Kathy Reinhard, right, lifts her leg while participating in a parkour class at Warner Park on April 23, 2026, in Madison, Wis. (Joe Timmerman / Wisconsin Watch)
She stands in a circle with the others, stretching.
“Have we talked about grapefruit in our armpits yet?” asks Shelby Copeland, a parkour instructor and former “American Ninja Warrior” contestant.
The group looks confused before Copeland explains the warmup. She tells everyone in the circle to pretend they placed two grapefruits inside their armpits. “See if you can juice them using just your shoulders,” she instructs the group.
“What do we do with the juice?” someone asks.
“Citrus deodorant!” another attendee jokes.
‘Every senior should take this class’
“How’s everybody doing with their exercises?” facilitator Marcy DeGreef asks the Stepping On participants.
“I’m thinking about it,” 89-year-old Gary Geller responds after a brief pause.
“We work together on that,” adds Jim Jenkins, 79.
The small group of older adults laugh before reviewing exercises that reduce fall risk. Heel-toe walks help with balance. Knee lifts build strength. They can easily do these at home. TV commercial breaks are long enough to finish several sit-to-stands, someone says. Another attendee says she practices side steps while waiting for hot cocoa to heat in the microwave.
It’s the last of seven weekly classes. They’ll return to the Jewish Social Services building in three months to check in. Before they leave, DeGreef runs through some of what they learned: Vitamin D supplements can help with bone health; trained professionals should install grab bars in the bathroom; they should clean shower mats regularly so they don’t lose their stick; proper footwear is a must. The attendees should talk with their doctors and pharmacists about how their medications affect balance. They should also consider regular bone density screenings and get their vision checked.
A participant in a Parkour for Seniors class at Warner Park, April 23, 2026, in Madison, Wis. The class aims to build balance and coordination to prevent falls. (Joe Timmerman / Wisconsin Watch)
Older adults stand on wooden planks to build strength and improve balance, April 23, 2026, in Madison, Wis. (Joe Timmerman / Wisconsin Watch)
“We just had our eye exam,” Geller says. “They went from 20/20 in my right eye to 20/40 to 20/25.”
“He’s getting better instead of worser,” his wife Denny quipped.
As the review wraps up, Geller offers an endorsement: “Every senior should take this class.”
Stepping On reduces falls by more than 30%, says Jill Renken, executive director of the nonprofit Wisconsin Institute for Healthy Aging, which licenses the program and helps distribute its curriculum nationwide.
But expanding the class and other prevention efforts in Wisconsin requires more funding to train instructors and run awareness campaigns that reach more participants, Renken says.
Earlier this year, Rep. Patrick Snyder, R-Weston, and Sen. Jesse James, R-Thorp, introduced bills to set aside money for the Wisconsin Institute for Healthy Aging and community emergency medical initiatives.
The Assembly unanimously approved Snyder’s proposals in February, but they stalled in the Senate — failing to reach Gov. Tony Evers’ desk before lawmakers wrapped up work for the year.
Snyder says the proposals died due to Senate Republicans’ concerns about funding, including $600,000 for community EMS and $400,000 for fall prevention across the 2025-26 and 2026-27 fiscal years. Neither James nor Senate Majority Leader Devin LeMahieu, R-Oostburg, responded to questions from Wisconsin Watch about the failure of the bills.
Snyder plans to bring the proposal back next session, which starts in 2027. That’s if he’s reelected later this year.
“I’m hoping that next session we can actually get a substantial amount of money for fall prevention,” he says.
Barb Brown, second from left, and Shelby Copeland, second from right, instruct a group of participants during a Parkour for Seniors class at Warner Park on April 23, 2026, in Madison, Wis. (Joe Timmerman / Wisconsin Watch)
An antidote to loneliness
For Jim Jenkins, the class has already prevented a fall.
The day before the final class, he noticed a raised edge in the floor while leaving a restaurant. Paying close attention to his surroundings, he climbed over it.
“Six weeks ago, I probably would have just blundered through there and on down,” he says.
The classes have helped him avoid injury and loneliness, Jenkins says. His wife died more than a year ago, and he now lives alone. Stepping On gave him a social outlet, he says. He plans to take as many classes as he can.
“I wish I was going to be seeing everybody every week,” Jenkins says as the class wrapped up its final spring meeting.
He and others exchanged emails to plan extra outings.
Where to find fall resources
The nonprofit Safe Communities works to reduce injury-related deaths, like falls, in Dane County and keeps a list of fall prevention resources on its website and hosts community events focused on fall prevention.
The Madison School and Community Recreation program guide lists classes — like Parkour for Seniors —- that help people build fall resiliency. People can register online or get assistance by calling 608-204-3000.
AgeBetter provides free home safety assessments for older adults in Dane County. Elsewhere in Wisconsin, residents can ask their Aging and Disability Resource Center about local home safety resources.
Fallsfreewi.org lists schedules and locations for Stepping On across the state.
Wisconsin Watch is a nonprofit, nonpartisan newsroom. Subscribe to our newsletters for original stories and our Friday news roundup.
Falls are the leading cause of injury death for people over 65 years old across the country, and more than 1,800 older Wisconsinites died from them in 2024, according to the U.S. Centers for Disease Control.
But fall injuries don’t have to be so common.
Wisconsin Watch talked with local experts and attended three Madison-area classes designed to improve balance and prevent fall injuries: Stepping On, Parkour for Seniors and Ballroom Basics for Balance.
Here’s what we learned.
Practicing balance can be fun
Children walk on curbs and twirl on purpose. But as people get taller, heavier and older they often stop practicing movements that help with balance, said Susan Frikken, a physical therapist and co-creator of Ballroom Basics for Balance.
The class uses music and different dance genres to teach people to improve balance. Students often waltz on their tip toes, turn during tangos and switch from lead to follower to challenge their minds during salsa.
The nonprofit Safe Communities outlines its “Keys to Better Balance” on its website, including the balance exercises used during ballroom dancing and movements people can do at home.
Throw away the throw rug
Loose rugs and cluttered walkways increase fall risk. Small home improvements like taping down rugs, installing grab bars and adding bright tape to stairs can significantly improve safety, according to the AARP.
AgeBetter Today provides free home safety assessments for older adults in Dane County. Elsewhere in Wisconsin, residents can ask their Aging and Disability Resource Center about local home safety resources.
Talk about falls
Stepping On is a multi-week fall prevention course that has been shown to reduce falls by more than 30%. Wisconsin residents can find a statewide list of classes through the Wisconsin Institute for Healthy Aging.
Attendees at a recent class in Madison reviewed the importance of regular eye exams.
Marcy DeGreef, who facilitated the class, suggested discussing fall risk with health care providers. It’s important for people to understand how the medication they are taking might impact balance, she explained.
The Madison School and Community Recreation program guide lists classes — like Parkour for Seniors —- that help people build fall resiliency. People can register online or get assistance by calling 608-204-3000.
Reading Time: 6minutesClick here to read highlights from the story
Methadone is highly effective at reducing illicit opioid use and overdoses.
The federal government sets minimum standards for clinics to prevent misuse, but Wisconsin imposes more than a dozen additional requirements on providers.
As a result, patients may wait longer to begin treatment, make daily trips to clinics and take more time to reach an effective dose.
Many other states have eased their rules, expanding access without compromising patient safety.
After years of opioid use, Bob saw three paths ahead: jail, death or methadone.
The 70-year-old Stevens Point resident chose methadone, which he has stuck with for more than half his life. He credits the treatment for his long career and ability to raise two daughters. Now retired, he sits in a recliner holding a sheet of paper with a list of old friends; he’s written “OD” next to the names of several loved ones killed by drugs.
Methadone is highly effective at reducing illicit opioid use and overdoses, experts say. It reduces drug cravings, prevents withdrawal and can provide stability without a mind-altering high.
More than 10,000 Wisconsinites used methadone treatment in 2024 to recover from opioid use disorder. But state regulations make accessing treatment more difficult for those patients, providers and researchers say.
The federal government sets minimum standards for clinics providing methadone treatment aimed at preventing misuse. Wisconsin adds more than a dozen more restrictive requirements, according to the Pew Charitable Trusts.
For patients, the state’s laws can mean waiting longer to enroll in treatment, daily drives to the clinic — even on weekends and holidays — and waiting longer to reach an effective dose.
Two years after the federal government relaxed its rules, Wisconsin’s landscape remains largely unchanged. Providers and researchers want Wisconsin to catch up with newer standards adopted by other states, including Minnesota, Michigan, Illinois and Iowa.
The Department of Health Services is reviewing Wisconsin’s rules, but it’s unclear what will change or when.
Long drives for methadone treatment
Bob wakes up at 4:30 a.m. and starts the 40-minute drive to his treatment clinic. Years ago, he left that early to make it to work on time. Now, he just likes to beat the crowd.
Wisconsin Watch is identifying people who use methadone by first name only to protect their private health information.
Bob tries not to pee before starting the drive. He knows clinic staff will likely send him into the bathroom with a cup as soon as he arrives. It’s been two decades since he used drugs or alcohol, but he takes the drug test all the same.
Bob holds a bottle of methadone at his home, April 14, 2026. (Joe Timmerman / Wisconsin Watch)
Bob sits in his recliner, April 14, 2026. (Joe Timmerman / Wisconsin Watch)
Next, he walks up to a clinic window, where someone hands him 13 plastic bottles of a cherry red liquid. Bob locks the medications inside a box he brought from home. A staff member watches as he swallows another dose.
He’ll do it all again in 13 days. The treatment saved his life, but it keeps him tied to this time-intensive routine — and to a clinic in another town.
“Methadone is like having a pair of golden handcuffs,” he says.
Unlike other medications, methadone cannot be picked up from a pharmacy. Only 31 locations across Wisconsin are approved to provide medication-assisted opioid treatments including methadone, according to the state health department.
At the state’s northernmost clinic in Wausau, patients traveled an average of 31 miles, one way, to their clinic in 2024.
Wisconsin allows fewer take-home doses
Methadone can be fatal if misused. To prevent people from overusing it or selling it, the federal government limited the number of take-home doses patients receive.
Early in the pandemic, the federal government allowed states to relax take-home rules to limit crowding at clinics — and many states did so. Studies later showed higher patient satisfaction and feelings of being respected without a significant increase in misuse.
In making the pandemic exceptions permanent in 2024, federal regulators wrote that the previous standards “can pose disruption to employment, education and other daily activities for patients, and several of the criteria reflect outdated biases that promote stigma and discourage people from engaging in care.”
But Wisconsin’s take-home regulations remain stricter than the federal minimums from before the pandemic.
The federal standard allows patients like Bob to take home 28 doses at a time. Wisconsin allows only 13.
Wisconsin patients must visit their clinic seven days a week until they complete a month in treatment and meet other criteria not required by the federal government. It takes a year in Wisconsin to qualify for the number of take-home doses providers in other states can offer patients after two weeks.
Bob sits in his recliner for a portrait alongside his methadone bottles, April 14, 2026. For patients, Wisconsin’s laws regarding methadone can mean waiting longer to enroll in treatment, daily drives to the clinic and starting at a dose too low to alleviate withdrawal symptoms. (Joe Timmerman / Wisconsin Watch)
Random callbacks disrupt routines
State rules also require clinics to regularly “call back” patients, like Bob, who have more than two take-home doses. The callbacks are intended to help providers make sure patients are not selling or misusing take-home doses.
Between visits, Bob’s provider often calls and tells him to arrive at the clinic within 24 hours with all 13 methadone bottles. If he doesn’t, he has to go back to daily clinic visits.
Federal rules do not require callbacks. In a 2024 report, federal regulators said providers should “consider the disruptive nature of random callbacks.”
It’s hard to make plans knowing you might have to change them any moment, Bob says. “I want to be normal again.”
Rules changes under review
Wisconsin is an outlier whose policies are overdue for an update, said Sharel Rogers, CEO of Addiction Medical Solutions and Vin Baker Recovery. She also serves as president of the Wisconsin Association of Treatment for Opioid Dependence.
Rogers was among several providers who backed a bill last month to update state rules. The measure was introduced right before the legislative session ended and was not expected to pass, but supporters hoped it would push regulators to act.
Wisconsin health officials are considering changing opioid treatment regulations, but without legislative action, the process could take years.
The Wisconsin Department of Health Services aims to ensure state regulations support access to “high-quality, evidence-based care for those who need it,” wrote Elizabeth Goodsitt, a spokesperson for the agency.
The agency started the state’s “intentionally thorough” rulemaking process last year to bring state regulations “closer in alignment with current federal regulations,” Goodsitt said.
The agency is still drafting proposed changes. They would be subject to public hearings and lawmaker approval in a process that ensures input from providers, advocates and patients, Goodsitt said.
The health department declined to answer detailed questions. Staff plan to review enrollment and take-home requirements, according to a document submitted to the Legislature. It’s not clear if other discrepancies, like callbacks, lab testing or dosage levels, will be addressed.
Opioid treatment providers should be carefully regulated, but Wisconsin’s current rules create barriers for patients, Rogers said.
“I’m just amazed at these patients every day, what they will do for their own recovery,” she said.
Bob flips through a 1974 copy of The Physicians’ Desk Reference to find the drug listing for methadone, April 14, 2026. (Joe Timmerman / Wisconsin Watch)
Bob lined up his methadone bottles on a table at his home for a portrait, April 14, 2026. (Joe Timmerman / Wisconsin Watch)
Recovery under tight restrictions
Timothy overdosed three times before starting treatment.
After nine months in Marathon County jail, he relapsed unaware of his lowered tolerance and the strength of the drug supply in 2022.
Within a couple of months, he started methadone.
“Some people don’t get out of that. A lot of people don’t,” Timothy said. “I’m grateful.”
Opioid overdose deaths dropped by more than 42% in Wisconsin between 2023 and 2024, according to the state health department. Still, opioids killed 815 people in Wisconsin in 2024, compared with fewer than 300 deaths two decades earlier.
Rising overdose rates are driven in part by fentanyl, a more potent opioid. Patients with a history of fentanyl use typically need higher methadone doses, said Dr. Hillary Tamar, who oversees Wisconsin treatment providers as a medical director for Community Medical Services.
Wisconsin rules prohibit providers from giving new patients a starting dose above 30 milligrams of methadone. That limit is outdated in the fentanyl era, Tamar said. The average dose at most Wisconsin clinics in 2024 was above 100 milligrams.
Updated federal limits allow providers to start patients at 50 milligrams or higher, based on their clinical judgment. A higher starting dose can help patients avoid withdrawal and reach a stable dose sooner, Tamar said.
Federal regulations also give providers greater ability to decide whether a patient may benefit from fewer visits.
“The regulations in Wisconsin bind us to creating a one size fits all plan, and that is just not how humans work,” Tamar said.
Despite attending regular counseling and dosing in-person daily for four years, Timothy still doesn’t qualify for a single take-home dose in Wisconsin.
That’s because he started using cannabis while undergoing chemotherapy around the time he started methadone treatment. Now in remission, he is working with his counselor to stop using cannabis, but it still prevents him from receiving take-home doses in Wisconsin.
In other states, marijuana use does not bar patients from receiving take-homes, Tamar said.
Last month, Timothy received two take-home methadone bottles while visiting his daughter in Florida.
Before leaving Wisconsin, he worked with staff at his clinic to set up a week’s worth of visits with a Florida provider. He was surprised when the new clinic told him he would receive take-home doses over the weekend.
When at home in Wisconsin, Timothy doesn’t mind the daily clinic visits. But when he’s with his daughter, they remind him of his past mistakes.
For two days he mixed his medication with apple juice and celebrated his 45th birthday with his family without stopping at the clinic.
He said it was the best time of his life.
Wisconsin Watch is a nonprofit, nonpartisan newsroom. Subscribe to our newsletters for original stories and our Friday news roundup.
Hi, Wisconsin! Health reporter Addie Costello here.
I spent last Saturday with around 80 attendees of a senior breakfast in Merrill, and it was one of my best-spent weekends so far in 2026.
Northwoods residents packed a banquet hall to eat, talk with neighbors and list the biggest issues they face as older adults.
The Senior Empowerment Project, an organizing group focused on issues impacting older people in rural areas and small towns, organized the event and asked me to give a short presentation about my reporting on long-term care issues. The most exciting part? Once I finished talking, a microphone was passed from table to table as older adults shared the questions and issues they think about the most.
Where can they get transportation on the weekends? How can older adults afford to stay in their homes as property taxes increase? Where can they get nutritious food?
Wall decor is shown at the Northwoods Senior Breakfast at the Eagles Club in Merrill, Wis., March 28, 2026. (Addie Costello / Wisconsin Watch)
I left the event with a long list of questions I plan to answer in a new project. We’re calling it Q&Aging, a series of short stories where I interview experts to answer your questions about getting older in Wisconsin — whether about health care, housing or what comes next.
I reported this as part of our collaboration with several Multi-Media Channels, which cover swaths of northeast and central Wisconsin. Find the full Dignity in Care project here.
Choosing a long-term care provider is an important, expensive decision. Like test-driving a car, unannounced visits can provide helpful insight.
So what should someone do before a “walk-in” visit?
Wisconsin Watch asked two experts to weigh in:
Devon Christianson, director of the Aging and Disability Resource Center of Brown County.
Mike Pochowski, president and CEO of the Wisconsin Assisted Living Association.
Here’s what they recommend:
Start with a scheduled tour. The person giving tours likely has important information about a facility’s care and costs. The state health department provides a guide for comparing assisted living providers, and the federal government has a similar guide for nursing homes. ADRCs can also help people prepare for tours.
Ask about “walk-in” visits. Facility staff might list certain times that are not ideal or explain security concerns, especially in a facility that offers memory care. But if the answer is an absolute no, that is something to consider when comparing providers.
Be transparent. The goal of drop-in visits is not to catch a provider doing something bad. Prospective residents or their family members should tell staff who they are and go through the normal guest registration process.
Be respectful. Nursing and assisted living facilities are people’s homes. Visit at a reasonable time and stay in common areas.
Ask residents and their families if they would be open to talking, Christianson said. Don’t base your decision around one resident’s experience. Use these conversations as a tool to help inform your decision.
This article was inspired by a reader sharing an experience touring facilities for a loved one. Do you have something to share? Please reach out.
Q&Aging
Aging comes with big questions — whether it’s about health care, housing or what comes next.
Wisconsin Watch is working to answer questions and share practical tips about aging in Wisconsin. To ask a question or offer a suggestion, fill out this form or contact reporter Addie Costello via email (acostello@wisconsinwatch.org) or phone (608-616-5239).
People cannot avoid death, but they often avoid talking about it. That’s why many people don’t receive as much — or any — hospice care they qualify for, experts say.
“There’s a real taboo in society that hospice equals death,” said Alisa Gerke, the board chair of Wisconsin Hospice and Palliative Care Collaborative and executive director at Unity Hospice and Palliative Care, a nonprofit provider that serves 14 northeast Wisconsin counties.
The goal of hospice isn’t to speed up the dying process; it’s to make people more comfortable — treating the symptoms of an illness instead of trying to cure it.
Once families enroll in hospice, Gerke said, they often ask: “How come nobody told us about this sooner?”
When to talk about hospice
Don’t wait for your provider to bring up hospice.
Patients and providers often wait for the other person to bring hospice up, said Angela Novas, an advanced certified hospice and palliative care nurse and consultant at the nonprofit Hospice Foundation of America. Let providers know that’s something you might be interested in.
Patients or their loved ones can also reach out to hospice providers directly and ask for an eligibility assessment, Novas said.
The basic requirements for adults to receive hospice care under Medicare include:
Verification from two physicians that a patient has a life expectancy of six months or less.
A patient’s willingness to pursue treatments to provide comfort instead of treatments aimed at extending life expectancy.
Clearing up misunderstandings about hospice
Some people may have misperceptions about hospice. Here is what it is not:
A place. Instead, it’s a model of care, Gerke said. While some providers may run facilities, hospice care can be provided at home and in nursing homes, assisted living facilities, hospitals and other settings.
Constant nursing care. Hospice is meant to supplement care from family or facility caregivers, Novas said. But providers should be readily accessible for questions and concerns.
Stopped if someone lives longer than six months. Instead, providers work to re-certify that someone is still likely to die within the next six months, Gerke said. Patients are no longer eligible for hospice if their life expectancy unexpectedly improves.
Permanent. Patients can decide to stop hospice and try curative treatment. If their outlook doesn’t improve, they can return to hospice, Gerke said. They can also freely switch providers.
So what’s palliative care?
Palliative care is a philosophy and medical speciality focused on alleviating suffering, according to Dr. Sara Johnson, a palliative care physician and University of Wisconsin School of Medicine and Public Health professor.
Hospice is a form of palliative care for people at the end of life. But people with a serious illness can access palliative care earlier in their diagnosis and while receiving curative treatments.
Palliative care services are becoming more accessible, Johnson said.
Palliative care specialists add a layer of support for patients and their families, Johnson said.
There is no harm in asking a provider about palliative care options, Johnson said. “If you’re thinking about it, just ask.”
How to find the right provider
Ask local providers for hospice care recommendations, Novas said. But don’t be afraid to shop around. Experts recommend asking these questions before choosing a provider:
How long have you served this area, and where are your staff located?
“Having staff that know that community, live in that community, are a part of that community is huge,” Gerke said.
What is your response time?
A patient’s condition can quickly change, making it important to know how quickly staff will answer calls or arrive in those cases.
What is your relationship with nearby providers?
If you know you want to use a particular nursing home, hospital or physician, it helps to know whether hospice providers have relationships and contracts with them.
What grief support do you offer?
Medicare requires hospice companies to provide families with bereavement services. But the level of those services can range widely.
What is your Medicare rating?
Medicare.gov offers a hospice look-up tool with quality care ratings. The federal agency provides comparative ratings based on family surveys and metrics like nursing visits in patients’ last days before death.
Are you for-profit or nonprofit?
Private equity and publicly traded companies are increasingly taking hold of the hospice industry. Those providers have been associated with lower quality of care, according to a Cornell University study.
For-profits face expectations around financial performance and typically have obligations to shareholders, Gerke said.
But a nonprofit status does not guarantee better care, Novas said. People should prioritize whether a provider fits their specific needs.
What services do your volunteers provide?
Medicare requires hospice providers to have a volunteer program. Do volunteers play games with patients? Provide pet therapy? Read to people? Some volunteer programs are more robust than others, Novas said.
What medications do you not cover?
Not all medications and supplies are covered under the Medicare hospice benefit, Novas said. It’s important to know what you might have to pay for out-of-pocket or with other health coverage.
Aging comes with big questions — whether it’s about health care, housing or what comes next.
Wisconsin Watch is working to answer questions and share practical tips about aging in Wisconsin. To ask a question or offer a suggestion, fill out this form or contact reporter Addie Costello via email (acostello@wisconsinwatch.org) or phone (608-616-5239).
Wisconsin Watch is a nonprofit, nonpartisan newsroom. Subscribe to our newsletters for original stories and our Friday news roundup.
Wisconsin has thousands of assisted living providers. Some are small houses; others are more like apartment complexes. Some take Medicaid, while others require residents to pay out of pocket. It’s a lot to sort through, especially when someone needs care fast.
Searching “assisted living” on Google pulls up several pages of facilities, many listed under a prominent “sponsored results” section.
Mixed in with actual providers are referral companies that promise a way to compare options. Long-term care referral companies don’t typically charge families for their services. Instead, they often receive money from facilities they recommend.
Wisconsin lawmakers in May proposed legislation to make any financial relationships between a referral agency and an assisted living facility clearer.
Supporters of the bill said disclosure requirements could help families make more informed decisions. Opposing the bill, referral companies argue that they are already transparent and that proposed guardrails would prevent them from helping more families.
The bill failed to pass before the Assembly adjourned last month. But the debate left me wondering: Where should someone start the search for care?
Aging and disability resource centers
Aging and disability resource centers (ADRCs) can provide objective provider lists for free, alongside information about services and payment options, said Janet Zander, the advocacy and public policy coordinator with the Greater Wisconsin Agency on Aging Resources, Inc.
ADRCs cannot recommend one facility over another, Zander said. But they can suggest what to look for during a tour. Zander also recommends looking at a facility’s Wisconsin Division of Quality Assurance surveys.
They can also help people identify what kind of care makes the most sense and explore aging at home, said Sara Tribe Clark, the director of the Eldercare Locator, which offers local resources for older adults, people with disabilities and caregivers.
If you work with a referral agency, ask questions
Tribe Clark recommends asking:
Do you receive compensation from the providers you recommend?
Are your referrals limited to certain facilities?
How do you determine which providers to suggest? What is the criteria for inclusion/exclusion?
Are there providers in my area that you do not represent?
We want to answer your questions
Getting answers to my own questions is a perk of being a reporter. But I haven’t yet navigated Wisconsin’s aging and disability resources for myself or a loved one. I know I’m missing important questions, so please send me yours, alongside your perspectives.
What has been confusing or frustrating about finding care?
What do you wish you’d known sooner?
What made the process easier?
Even after more than two years reporting on long-term care in Wisconsin, I won’t have all the answers. But I will find experts who do. Email me at acostello@wisconsinwatch.org or call 608-616-5239.
Wisconsin Watch is a nonprofit, nonpartisan newsroom. Subscribe to our newsletters for original stories and our Friday news roundup.
Login
