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• Wisconsin Watch reporters joined more than 60 volunteers in Brown County’s summer point-in-time count last month — a one-night snapshot of the number of people experiencing homelessness in communities across the United States, including Wisconsin.

• Some volunteers had experienced homelessness themselves. 

• The volunteers officially counted 179 people experiencing homelessness. That’s seen as an undercount because volunteers do not count people who are sleeping or unable to respond to surveys. And some people don’t want to be found.

At  4:31 a.m. the first slivers of light peeked through dark clouds over Green Bay’s waters. 

Along the edge of Point Comfort in the town of Scott, a pair of volunteers surveyed the landscape for people experiencing homelessness as the summer “point-in-time” (PIT) count wound down in Brown County. 

One was Cody Oberhuber, a county economic support specialist. He has missed just one count since January 2022, initially working as part of his former job at the anti-poverty agency Newcap, Inc. His passion for talking to the people behind the numbers prompted him to return this year as a volunteer after switching jobs. 

“It gives you a fresh perspective of being boots on the ground talking to these individuals, you’re kind of looking at the humanity side of things,” Oberhuber said. “That’s what drives me, that’s my mission.”

Oberhuber joined 66 other volunteers between 11:30 p.m. to nearly 6 a.m. beginning on July 23, hitting spots where the group previously encountered people experiencing homelessness. 

The PIT count serves as a one-night snapshot of the number of people experiencing homelessness in communities across the United States, including Wisconsin. Wisconsin Watch in January followed the annual winter count in Jefferson County — examining why the data recorded in the process underestimate the true levels of homelessness in communities, especially rural ones. The  U.S. Department of Housing and Urban Development mandates such winter counts. 

Wisconsin Balance of State Continuum of Care, which covers all 69 counties in Wisconsin besides Milwaukee, Dane and Racine, requires each county to also count during the summer, when the tally is typically far higher than winter, when freezing weather pushes more people to shelters.

The majority of Brown County volunteers most years work with direct housing providers or other housing-related programs, according to Meaghan Gleason, Newcap’s funder expert and the Brown County PIT count lead. 

But this year, almost half of volunteers had no association with housing providers, a record number of unaffiliated folks. Thirteen volunteers shared that they previously experienced homelessness in their life. That’s a point of pride for Gleason.

To address the problem of homelessness, she said, “we need to include the people who know what that experience is.”

The Brown County volunteers broke into groups to cover more ground. In the county’s northwest corner, a group searched for people sleeping in cars in the rural village of Pulaski. In the county’s urban center, volunteers counted people camping in Green Bay’s downtown parks. 

PIT counts often happen at night, when people settle into the places they sleep, Oberhuber said. This approach, he explained, prevents volunteers from simply assuming where someone stays. 

Volunteers usually see the most unsheltered people on downtown Green Bay’s east side, and that was the case this year. Several people sheltered in open spaces and under hooded structures, often surrounded by their belongings: bikes, coolers, wheelchairs, bags and blankets. Some slept on church steps or on park benches. Bugs swarmed in the humidity following recent rain.

A volunteer asked a man where he had gone earlier to stay dry. 

“Nowhere,” he replied. “I’m wet. I’m still wet.”

Others asked volunteers for food or dry tarps. Volunteers handed out gift cards and asked people to take a brief survey to shed light on what resources might help.

The surveys included questions such as: Have you served in the active duty or other armed forces of the U.S.? Are you fleeing or attempting to flee domestic violence, dating violence or stalking? Have you ever been in the foster care system? Is this the first time you’ve been homeless?

Some people answered questions they were comfortable with. Others thanked the volunteers and declined to participate.

“I’m going through enough as it is,” one person told the volunteers.

When people are found sleeping, decline to participate in the survey or are in locations volunteers can’t safely access, their presence is documented through observation forms. Although the official count tally excludes those observations, they paint a broader picture of the unhoused landscape. Outreach workers sometimes later follow up to verify their status and connect them with services. 

Brown County’s official tally this year: 179 people experiencing homelessness. That included 100 single individuals and 25 households with children. The official unsheltered count has increased each year since at least 2022, when 89 people were counted in July.

Northwest of Brown County, Newcap’s Northeast Coalition counts unsheltered people in mostly rural Florence, Marinette, Menominee, Oconto and Shawano counties. The summer count recorded 36 people. 

“That may not sound like much,” Gleason later wrote in an email. “But it is the highest count I have seen out of the last eight counts.”

In Brown County, volunteers tallied zero people in the rural areas Wisconsin Watch observed. But Oberhuber knows people are experiencing homelessness in communities like Pulaski, based on previous counts and conversations with police. Those people might not want to be found, Oberhuber said. They might intentionally set up camp outside of town or in the woods, where PIT count volunteers won’t look.

“That’s the difficulty with the rural count,” Oberhuber said. “There’s people out there, we just struggle to find them.”

Gleason said a “happy accident” prompted her to work in housing services after having volunteered at a shelter in college. She wouldn’t give up her position as the PIT count lead for Brown County even if someone told her to. 

She knows it’s impossible to count every person. But that’s what drives her to improve each count. Yes, homelessness is increasing, she said. 

“But if we can also increase our efficiency and our ability to capture that data and connect with those people, then that’s the best we can do in that moment.”

Homelessness is increasing in Brown County. These volunteers traded a night’s sleep to document the challenge is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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Jack Link’s, the world’s largest manufacturer of meat snacks, has spent years integrating itself into the country’s cultural and political arenas.

Riding a wave of protein-crazed consumers and a booming snack industry, the company’s iconic Sasquatch marketing campaign has helped its products become a staple in gas stations, grocery checkout lines and school vending machines.

The company has also spent years cultivating deep political ties, funneling millions to Donald Trump and nurturing a relationship with the president that has led to White House access.

Trump has been a strong supporter of the meat industry and welcomed Jack Link’s officials to a White House event during his first term. However, the Trump administration’s “Make America Healthy Again” movement is currently pushing for healthier eating standards and for states to restrict processed foods in their nutrition programs.

Now, Jack Link’s and the processed meat industry are caught between conflicting ideologies within the Trump administration and a battle over the future of food policy.

“There’s very much a conflict within this administration about the role of corporate power and public health,” said Judith McGeary, executive director of the Texas-based sustainable agriculture and farmer advocacy group Farm and Ranch Freedom Alliance.

In May, the federal MAHA commission, led by Health and Human Services Secretary Robert F. Kennedy Jr., recommended in a new report that Americans consume fewer sugary drinks, snacks and processed foods.

While the report didn’t specifically mention processed meat snacks, it grabbed the attention of snack giants like Jack Link’s and other corporate agriculture groups, which are opposed to any additional regulations or changes to the food industry, McGeary said.

The report did note that low-income children and families consume more processed meat than their peers and that these products have been classified as carcinogens linked to serious health risks.

Kennedy, along with U.S. Department of Agriculture Secretary Brooke Rollins, has encouraged states to restrict what foods can be purchased with benefits from the Supplemental Nutrition Assistance Program, known as SNAP.

States, from West Virginia to California, have responded by approving bans that limit purchases of sugary beverages, snacks and foods with dyes and artificial ingredients.

Jack Link’s responded by hiring a lobbying firm, a move that paid off when it faced increased regulations during Trump’s first term.

Jack Link’s benefits from political, consumer trends

Minong, Wisconsin — a small, rural village in the state’s northwestern tip, home to taverns, gravel roads, rows of northern Wisconsin pine trees, and plenty of grazing land for beef cattle — is one of dozens of small towns across the state with roots in the cattle and lumber industries.

Minong is also home to a bigfoot-sized footprint of Jack Link’s that is hard to ignore.

Jack Link’s, owned by Link Snacks, is a $2 billion, privately owned company with dual headquarters in Minong and downtown Minneapolis, a few hours away.

The company employs roughly 4,000 people worldwide. Jack Link’s leadership has long served on local college and hospital boards and, in 2016, broke ground for the Jack Link’s Aquatic & Activity Center in Minong.

What started in the late 1980s as a family-owned jerky company has evolved into a global enterprise with offices and production plants in Canada, Australia, Mexico and Brazil.

Troy Link, son of company founder and current board member John “Jack” Link, has led the company’s global expansion since he became CEO in 2013.

Link has also developed a relationship with the Trump administration over the years by hosting private fundraising events and donating to his campaigns.

Last year, Link also donated half a million dollars to America PAC, a political action committee founded and operated by Elon Musk, according to Federal Elections Committee filings.

This donation placed Link among a highly influential group of donors and prominent technology and cryptocurrency industry moguls, such as Tyler and Cameron Winklevoss.

Link donated $1.3 million during Trump’s 2020 re-election bid and also welcomed the president to a private fundraiser in July 2020 at his Florida mansion.

As a whole, the Link family has donated roughly $2.3 million to candidates, committees and state parties in the last decade. The majority of this occurred during the 2020 and 2024 Trump campaigns.

In 2018, the company was invited to the White House as part of a “Made In America” exhibition, where each state showcased a single business with products made in the country.

Troy Link did not respond to repeated requests for comment regarding the relationship of Jack Link’s and the Trump administration.

This relationship with politicians has served the company in the past. In Trump’s first term, Jack Link’s lobbied for beef jerky and meat snack sticks to qualify for the nation’s Child Nutrition Programs, such as school meals.

An Obama-era rule prohibited the reimbursement of beef jerky and dried meat products for school food purchases in 2011. When the rules were revisited under Trump in 2018, Jack Link’s argued in documents submitted to the USDA that dried meat products should receive the same crediting and treatment as other meat, like hamburgers and chicken strips.

“These food products should be held to the same standard as any other meat product when determining eligibility,” a Jack Link’s attorney wrote. “Currently, this is not the case because USDA has arbitrarily disqualified dried meat products from the program.”

A bipartisan trio of Wisconsin federal officials came to the aid of Jack Link’s during this regulatory update, with Democratic U.S. Sen. Tammy Baldwin, Republican Sen. Ron Johnson and former Congressman and current U.S. Department of Transportation Secretary Sean Duffy writing in support of this change soon after.

“We are concerned that (Food and Nutrition Service) has overstepped in excluding this entire product class from consideration,” the officials wrote in a February 2018 letter. “Therefore, we respectfully request USDA to reevaluate this categorical exclusion.”

Link family members donated a combined $73,000 to the authors of the letter.

The lobbying effort worked. The Food and Nutrition Service announced in December 2018 that beef jerky and dried meat products were now eligible for reimbursement as part of school snacks and meals. Jack Link’s currently markets its snacks directly to school food purchasers.

The addition of school contracts and other market growth helped fuel the company’s expansion.

In recent years, Jack Link’s has broken ground on new manufacturing facilities across the country and purchased jerky companies from Tyson Foods and British packaged goods giant Unilever.

The company also launched Lorissa’s Kitchen, a healthy meat snack brand fronted by Troy’s spouse, Lorissa, and sold at Walmart and Costco nationwide. The brand differentiates itself from Jack Link’s by selling snacks “without added preservatives, nitrites or MSG and allergen-free products,” according to company media statements.

During the 2024 Republican National Convention, Link also appeared on a Fox News business segment to argue that inflation under Biden was making it more expensive for consumers to purchase snacks.

“Buying snacks should not be a luxury item; this should be an everyday occurrence,” Link said. “We just need to put more money back into the consumer’s pocket.”

Protein snacks boom amid calls to reduce meat consumption

As Jack Link’s worked to build a close relationship with the Trump administration, meat consumption was booming, especially thanks to right-wing influencers.

Online personalities, such as podcast hosts Joe Rogan and Jordan Peterson, have advocated for all-meat diets, including raw meat and eggs.

The connection between meat consumption and conservative politics dates back decades, according to food studies researcher Adrienne Bitar.

“Higher meat consumption has always been understood as sort of more conservative,” said Bitar, author of “Diet and the Disease of Civilization.”

“Where it comes up in the alt-right is the idea that the feminizing effects of civilization are unnatural, restrictive, repressive, and to liberate yourself from the accoutrements of civilization means to follow your appetite, with the hunger for meat being one of those appetites.”

Meat snacks sales increased 40% from 2019 to 2022, according to an industry report. The desire for more protein-dense snacks has risen across the entire food sector, from protein-packed popcorn to chocolate muffins.

However, the nation’s protein consumption far outpaces that of similar nations and needs to be reassessed, according to grocery experts and leading nutritionists.

“Unless you’re a competitive athlete or competitive bodybuilder, you’re probably eating too much protein,” said Errol Schweizer, publisher of The Checkout Grocery Update, a grocery industry publication, and former vice president of grocery for the multinational supermarket Whole Foods.

Schweizer said the popularity of protein snacks has ebbed and flowed with American consumers, following the trends of certain diets and lifestyles over the past few decades. U.S. consumers are “obsessed” with protein intake, he said, and typically have diets that consist of fewer fresh fruits, vegetables, fiber and healthy fats.

Schweizer’s observations align with the nation’s blueprint for diet and nutrition.

Updated every five years, the Dietary Guidelines for Americans helps shape national standards for nutrition labeling, school meals and chronic disease prevention.

In October 2024, the Dietary Guidelines Advisory Committee, a 20-person group of nutrition experts, released its recommended updates to both the USDA and the HHS. Now those two agencies will review recommendations and public comments to set the final dietary guidelines later this year.

Since 2000, the panel has consistently urged Americans to cut back on red and processed meats in favor of lean meat, seafood and plant-based proteins.

The committee’s 2024 report recommends diets “lower in red and processed meats, sugar-sweetened foods and beverages, refined grains and saturated fats.”

The country’s leading meat industry group, The Meat Institute, whose members include Jack Link’s and other major meatpacking and meat snack companies, has argued against the committee’s recommendations.

“The Meat Institute is extremely concerned that consumers will inaccurately perceive meat and poultry products as poor dietary choices, which may lead to a variety of unintended consequences, including nutritional deficiencies in certain sub-populations,” the Virginia-based group wrote to the HHS in February.

The National Pork Board, the pork checkoff organization based in Clive, Iowa, wrote to the health department in February, stating that recommendations to reduce consumption of red meats are short-sighted and efforts to push foods such as legumes and beans over meats “does not seem to be supported by a robust body of evidence.”

“The elevation of plant-based protein sources over lean meats could inadvertently discourage the consumption of nutrient-dense lean meats, thus increasing the risk of nutritional deficiencies,” the letter stated.

In its inaugural report, the MAHA Commission wrote that the Dietary Guidelines for Americans has a “history of being unduly influenced by corporate interests,” noting how a past attempt to reduce the push for reducing intake of processed meats has been met with backlash and scientific discrediting from the meat industry.

Processed food industry fortifies as feds debate SNAP, diet guidelines

In late June, Oklahoma Gov. Kevin Stitt, flanked by Kennedy in the state capitol, announced a sweeping set of executive orders to remove processed foods and foods with additives from the state’s nutrition programs.

“For far too long, we have settled for food that has made us sicker as a nation,” said Stitt at a June press event. “In Oklahoma, we’re choosing common sense, medical freedom, and personal responsibility. President Trump and Secretary Kennedy have led the charge nationally; I’m grateful for their support as we Make Oklahoma Healthy Again.”

Other states have followed suit with Arkansas, Indiana, West Virginia and California enacting bans on processed foods from SNAP purchases, or are exploring ways to reduce ultra-processed foods in the state, often with the support of Kennedy and Rollins and other federal leaders.

However, Joelle Johnson, deputy director for the food and nutrition consumer advocacy group Center for Science in the Public Interest, said despite growing debates about ultra-processed foods in the nation’s food programs, there is a lack of clear guidance from the federal government to retailers and food purchasers about what would and wouldn’t qualify as being ultra-processed.

“I would be surprised if we see bans of ultra-processed foods in SNAP, beyond candy and sweetened beverages, anytime soon,” she said.

Still, major snack and processed food companies, including Jack Link’s, are bracing for any changes that could harm their sales.

Consumer Brands Association, a Virginia-based organization representing major packaged food companies, including Tyson Foods and Coca-Cola, spent $42 million in lobbying over the past decade, focusing on issues including SNAP funding and dietary guidelines, among other issues.

Since 2023, the organization has worked with lobbyist Clete Willems, the deputy assistant of international economics during Trump’s first term and a former Obama administration official, according to lobbying disclosure documents.

Conagra Brands, the publicly traded, packaged food conglomerate that owns major brands such as Slim Jims, Orville Redenbacher, Birds Eye Frozen Foods and Reddi-Wip, spent over half a million dollars in the past year lobbying federal officials and has spent $4.6 million in lobbying in the past decade. Conagra and Consumer Brands Association did not respond to repeated requests for comment.

In April, Link Snacks, the parent company of Jack Link’s, hired lobbying firm Bockorny Group, which has also represented the meatpacking company Agri-Beef Co. and pork industry publication National Hog Farmer. This was the first time the beef jerky giant has lobbied federal officials.

Lobbyists working for Jack Link’s include Pete Lawson, a former VP for Ford Motors and staff attorney for Virginia Democratic Congressman Jim Moran, and Eric Bohl, a former staffer for the congressional offices of Missouri Republicans Vicky Hartzler and Jason Smith, who worked on the 2014 Farm Bill.

This year, Link Snacks has spent $25,000 on lobbying the federal government to support “protein snacks in SNAP program” as well as issues with the Dietary Guidelines for Americans, according to lobbying disclosure documents.

This story was originally published on Investigate Midwest.

Jack Link’s beef: How the snack giant is lobbying Trump and fighting the Make America Healthy Again movement is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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• Responding to an order from President Donald Trump, several federal agencies are seeking to block undocumented immigrants and some immigrants with legal status from accessing programs that provide literacy classes, career education, medical and mental health care, substance abuse treatment, free preschool and more. 

• A range of institutions — including colleges, government agencies and nonprofits — manage the affected programs.

• The order has caused widespread confusion about which organizations must check immigration status of the people they serve and how they could do that. Parts of the order appear to conflict with federal law. 

• Wisconsin joined 20 other states in a lawsuit challenging the new restrictions.

A group of federal agencies announced in July that at least 15 federally funded health, education and social service programs would exclude undocumented immigrants and some who are living in the country legally. 

Responding to President Donald Trump’s February executive order to “identify all federally funded programs currently providing financial benefits to illegal aliens and take corrective action,” the departments of Education, Health and Human Services, Justice and Labor listed programs that provide literacy classes, career education, medical and mental health care, substance abuse treatment, free preschool and more. 

In Wisconsin alone, the state Department of Justice estimates the new federal restrictions “put at risk more than $43 million each year in substance abuse and community mental health block grants that fund services in all 72 counties, 11 Tribal nations, and approximately 50 nonprofit organizations.” 

Wisconsin Watch contacted more than a dozen Wisconsin organizations, government agencies and national experts to learn about the new policy’s effects. But we found more questions than answers. Most are unsure who is subject to the new rules or how to comply. 

While we were reporting this story, Wisconsin joined 20 other states in a lawsuit challenging the new restrictions. That suit is still pending, but the parties have agreed to a deal that would delay most of the restrictions in those states until September. 

Confusion created by the guidance could have serious consequences, experts say. Some providers might delay or cancel programs unnecessarily out of an abundance of caution, while some immigrants may avoid services for which they remain eligible, such as health care and education.

While much remains unclear, here’s what we know so far. 

Which immigrants would be barred?

A 1996 law already prohibited certain immigrants from receiving 31 “federal public benefits,” including Medicaid, Medicare, Social Security and cash assistance. The Trump administration’s new guidance bars the same immigrants from additional programs, according to the National Immigration Law Center.

Those ineligible include: 

• People with Temporary Protected Status (TPS). 
• People with nonimmigrant visas, such as student visas, work visas and U visas for survivors of serious crimes. 
• People who have pending applications for asylum or a U visa. 
• People granted Deferred Enforced Departure or deferred action. This includes Deferred Action for Childhood Arrivals (DACA) recipients — those who entered the country as children.
• Undocumented immigrants.
• Lawfully present immigrants who don’t fall into categories below. 

People in the following groups would remain eligible:

• Lawful permanent residents (green card holders). 
• Refugees. 
• People who have been granted asylum or withholding of removal. 
• Certain survivors of domestic violence.
• Certain survivors of trafficking. 
• Certain Cuban and Haitian nationals.
• People residing under a Compact of Free Association with Palau, Micronesia and the Marshall Islands.

Why the confusion? 

A range of institutions — including colleges, government agencies and nonprofits — manage the affected programs. Many did not previously check the immigration status of the people they serve; creating a process to do so may add costs and logistical challenges. It could prove especially daunting for organizations like soup kitchens and homeless shelters, which provide urgent services to people without easy access to documents. 

Meanwhile, entities that administer these federal funds include nonprofits and federally funded community health centers, which operate under laws that conflict with the guidance.

Health and Human Services said its settlement with the suing states “will permit the agency to consider, as appropriate, whether to provide additional information” about the restrictions it announced. 

How would the changes affect health care in Wisconsin?

Wisconsin has 16 federally qualified community health centers serving patients at 217 sites. They receive money from Congress to provide primary care to all, regardless of their ability to pay. Nationally, such clinics serve more than 32 million patients, making up 1 in 10 people in the United States and 1 in 5 people in rural America, according to the National Association of Community Health Centers. 

Aside from emergency rooms, they are often the only care options for undocumented immigrants or those with limited English proficiency, said Drishti Pillai, director of immigrant health policy at KFF, a national nonprofit providing information on health issues.

Federal law requiring those clinics to accept “all residents of the area served by the center” contradicts the Trump administration guidance. 

The national association said in a July 10 statement that it’s working with experts and legislators to understand the impact of the new rules and ensure centers “have the information and resources needed” to continue serving their patients. 

Access Community Health Centers, a nonprofit that provides medical, dental and mental health care at five south central Wisconsin clinics, will make “adjustments” if further federal guidance comes, CEO Ken Loving said.

“We don’t have the information we need to understand how this is going to impact us and how we can adapt to help our patients,” he said.

How would the changes affect education in Wisconsin?

The new restrictions target adult education services under the Adult Education and Family Literacy Act and career and technical education services under the Carl D. Perkins Career and Technical Education Act. Community and technical colleges would likely face the brunt of the impact, but just how much is unclear. 

The Wisconsin Technical College System has followed 1997 guidance that said public benefit restrictions did not apply to such educational services, spokesperson Katy Petterson said. She’s not sure how the updated guidance might affect the system, which will “wait to learn the impact of the lawsuit.” 

If community-college-operated programs begin checking immigration status, ineligible immigrants may remain able to take federally funded classes through nonprofits that are subject to different rules. 

The nation’s 1,600 Head Start agencies, which provide free early childhood education and family support services for low-income families, fall under the restrictions announced in the Department of Health and Human Services notice. But the document doesn’t say whether Head Start staff must verify the immigration status of children, parents or both.

“It’s very ambiguous about who this impacts. … If you read the language, it’s 26-plus-ish pages of legal jargon, and it’s shifting,” said Jennie Mauer, executive director of the Wisconsin Head Start Association, which supports the state’s roughly 300 Head Start service sites.

One thing Mauer wants families to know: Children already enrolled in Head Start won’t be forced out. 

“We want to follow the rules, but Head Start is not required to redetermine eligibility,” Mauer said, noting it has never been required to do so in 60 years. She’s been telling the center directors to sit tight, even as worried parents ask questions. 

One entity that won’t start checking immigration status: K-12 schools. The U.S. Supreme Court ruled in 1982 that denying education to undocumented students violated their constitutional rights.

Must nonprofit providers start checking immigration status?

Probably not. The 1996 law restricting public benefits says nonprofit charities are not required to “determine, verify, or otherwise require proof of eligibility of any applicant for such benefits.”

At Literacy Network, a nonprofit offering a variety of free ESL and basic education classes in Madison, staff aren’t planning changes based on the new rule. 

“It could certainly impact many of our students in other areas of their lives and therefore their ability to participate in our programs, but not who we can serve,” spokesperson Margaret Franchino said.

Still, guidance from the Department of Education is vague. It states that the exemption for nonprofits is “narrowly crafted,” and “the Department does not interpret (it) to relieve states or other governmental entities … from the requirements to ensure that all relevant programs are in compliance.”

Ryan Graham is the homeless systems manager at Wisconsin Balance of State Continuum of Care, a nonprofit that supports agencies responding to homelessness across most of the state. 

As his agency discusses updates with partner agencies, it is preparing for an “increased administrative burden on already stretched staff.”

“We don’t yet know whether there will be delays caused by having to check or validate someone’s citizenship status, especially in emergency situations where time is critical,” Graham said. 

When do the new rules take effect?

The notices published in July took effect immediately, though some federal agencies said they would likely not enforce them for about a month. The Trump administration later agreed to pause enforcement until Sept. 3 in the 21 states that sued. 

The Department of Health and Human Services, meanwhile, has voluntarily stayed enforcement of its directive in all states until Sept. 10. 

What is the basis of legal challenges? 

The multistate lawsuit argues the Trump administration failed to follow proper procedures in implementation and that it can’t retroactively change the rules after states accept grants to administer programs. Requirements to check the immigration status of every person served would unreasonably burden program staff and possibly force programs to close, the states argue. 

States “will suffer continued, irreparable harm if forced to dramatically restructure their social safety nets and render them inaccessible to countless of the States’ most vulnerable residents,” the plaintiffs wrote.

The American Civil Liberties Union and Head Start groups nationwide had already sued before the Trump administration published new guidance. That suit argued staffing cuts, funding delays and bans on diversity efforts threatened to destabilize Head Start — a long-standing, congressionally mandated program. A hearing in that suit was held Aug. 5 on a request to temporarily block the Health and Human Services notice. 

What does the Trump administration say? 

The 1996 public benefits ban exempted federal programs that offered services available to all people on the grounds that they were “necessary for the protection of life and safety.” 

Trump calls that exemption too broad. 

“A surge in illegal immigration, enabled by the previous Administration, is siphoning dollars and essential services from American citizens while state and local budgets grow increasingly strained,” the White House said.

Citing studies from congressional committees and groups that seek to severely curtail immigration, the White House argues that allowing broad access to federal resources incentivizes illegal immigration and costs U.S. taxpayers. The recent federal spending package also eliminated access to Medicaid, Medicare and food stamps for some authorized immigrants, including refugees and asylees.

Trump ran for office on a promise to carry out mass deportations, and the bureaucratic moves appear to be a new frontier in that immigration crackdown. Since he took office, the administration has raided stores and workplaces, built new detention centers and attempted to shut down the asylum process at the southern border. It has also urged many immigrants without permanent legal status, including DACA recipients, to self-deport. 

Why does this policy change matter?

Experts worry the confusion about the new rule could have a chilling effect, leading even eligible immigrants to stop using services. 

Pillai of KFF noted that the restrictions on community health centers, alongside congressionally approved changes “that limit health coverage to a smaller group of lawfully present immigrants,” will likely make immigrant families even more reluctant to seek health care and social services. 

The changes “may increase their reliance on emergency room care, which can be more costly in the long term,” she added. 

Graham, the homeless systems manager, believes the Trump change will create “a direct barrier to safe and stable shelter for undocumented individuals and mixed-status families” and qualified immigrants or citizens who “may not have identification or the means to attain identification after fleeing a dangerous situation or crisis.”

It could also prompt administrators of some programs not covered by the rule to start screening participants as a precaution, or shut down programs to avoid screening challenges.

That has happened before. When Trump issued an executive order in January saying the administration would no longer “fund, sponsor, promote, assist, or support” gender-affirming health care for people under 19, some providers stopped offering those services even though state law protected them. 

Likewise, a 2023 KFF study found that in states that institute abortion bans, the majority of health care providers say they worry about accidentally running afoul of the law.

Braden Goetz, who worked for more than 20 years in the U.S. Department of Education and now works as a senior policy adviser at the New America Foundation’s Center on Education and Labor, said it’s unusual for federal guidance to be so sparse and ambiguous. 

“​​Maybe that’s the intention: to confuse people and chill services to people who are not citizens or not legal permanent residents, and scare people,” Goetz said.

Natalie Yahr reports on pathways to success in Wisconsin, working in partnership with Open Campus. Sreejita Patra is statehouse reporting intern for Wisconsin Watch.

Trump is trying to exclude immigrants from many federally funded programs. Here’s what it means for Wisconsin. is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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• Measles was once declared eliminated in the U.S., but it’s spreading again. And now it has reached Wisconsin. State health officials on Saturday announced nine cases in Oconto County — the first infections confirmed in the state this year.
• Older Wisconsin residents recall painful and disruptive bouts with childhood measles during the pre-vaccine era. Some are still affected, such as those who lost their hearing as a result. 
• Of the estimated 3 to 4 million Americans infected each year before vaccinations, an estimated 48,000 were hospitalized and 400 to 500 died.
• Health professionals are preparing to recognize the signs of a disease they’ve rarely, if ever, treated — and to respond to potential outbreaks.

The measles started like a typical childhood illness for Dorothy Thompson — with just a runny nose. But she soon developed itchy red blotches across her skin and a fever so high doctors feared it could cause brain damage. She was just 5 years old, but decades later, some of her memories remain vivid.

“It was so horrible,” recalled Thompson, 72, of Richland Center. “I would never wish it on anyone.”

In the years before a measles vaccine became widely available in the 1960s, Thompson’s experience was not uncommon. Nearly every child in the United States caught measles before age 15. What many considered a normal part of childhood was disruptive and even deadly. It wasn’t unusual for students to go home from school sick. In hundreds of cases each year, they never returned. 

After vaccine advances eliminated the virus in the U.S., measles is spreading again. More than 1,300 measles cases have been confirmed across 41 states, the latest being Wisconsin. 

The state Department of Health Services on Saturday announced it confirmed nine measles infections in Oconto County — the first in Wisconsin this year. 

To understand what the reemergence of measles might look like, Wisconsin Watch spoke with residents who contracted the disease decades ago as children, including some who still live with complications today. They described high fevers and days of bed-ridden isolation during the infections, as well as lasting damage to their bodies — like the hearing loss some live with now.

Health professionals across the state told Wisconsin Watch they’re preparing to recognize the signs of a disease they’ve rarely, if ever, treated — and to respond to potential outbreaks.

When nothing stopped measles

In the days when measles ran rampant, medical treatment was limited. Families largely cared for sick children at home, relying on home remedies and passed-down knowledge, or the occasional house call from a doctor.

Thompson remembers her days sick at home. Her mother applied calamine lotion to relieve itching around her rashes, and Thompson was required to stay in a dark room wearing sunglasses for fear that the disease would damage her eyes. The worst part, she recalled, was being packed in ice to manage her over 100-degree fever.

Other common treatments in decades past included isolating to prevent spreading the virus to others and spending days in bed until symptoms wore off. 

With no vaccine to block infections, some officials advised parents to have their children catch measles early — particularly for daughters, so they would be less likely to contract it later during a pregnancy. 

Newspaper accounts in the 1950s and 1960s described the phenomenon of “measles parties,” in which children were deliberately exposed to others infected with the virus.

Those also applied to German measles, or rubella, a milder virus linked to severe birth defects during pregnancy. 

Kathleen Cooper of Rhinelander remembers those parties. When she ultimately caught measles at age 6, she was confined to a darkened room and prevented from watching television due to fears that bright light might cause blindness — similar to what Thompson recalled.

Cooper was supposed to attend a birthday party that weekend. Instead, the party came to her.

“That’s how they treated it back then,” said Cooper, now 73. “If one kid in the neighborhood got the chickenpox or the measles, everybody went over to their house so the mothers could just get it over with, because it was just something that you had to get through.”

Lasting toll from measles

But measles parties did not protect people from the misery of the disease. Infections only spread. 

“I was ill and bedridden for weeks. When I was finally able to get up I was a skeleton. My pants couldn’t stay up and my clothes hung on me,” Door County resident Pam Goodlet recalled of a measles bout in 1963 as a 13-year-old. 

Delirious with fever and unable to eat or drink water, Goodlet stayed hydrated by sucking on ice cubes. She recalled being visited by a doctor just once and was never taken to a hospital or clinic.

Goodlet ultimately recovered without long-term health consequences, but many others weren’t so lucky.

Of the estimated 3 to 4 million Americans infected each year before vaccinations, an estimated 48,000 were hospitalized and 400 to 500 died, according to the U.S. Centers for Disease Control and Prevention. 

In 1967, a column published in the Waukesha Daily Freeman described the stories of children whose lives were permanently altered by the disease. 

They included a Watertown toddler who was hospitalized and diagnosed with a cognitive impairment after an infection that occurred one year before vaccines became widely available in 1963. 

“Too late for Valerie,” the toddler’s mother reportedly lamented.

Another child was described as healthy until developing encephalitis — a dangerous inflammation of the brain — at the age of 2 due to measles. The condition left her mentally impaired and also deaf, the newspaper reported. An estimated 1,000 children annually suffered encephalitis from measles in the pre-vaccination era.

Leslie Fedorchuk of Milwaukee still lives with the effects of her measles infection.

She was about 6 years old when she realized something wasn’t right with her hearing. As her mother’s friend kept dialing her home’s wall-mounted phone, Fedorchuk, perched on a chair to reach it, would answer, hear nothing and hang up.

It took her mother picking up to realize her friend was speaking each time, but Fedorchuk couldn’t hear from her right ear. The episode happened shortly after Fedorchuk contracted measles and mumps simultaneously.

“I’m in my 70s, and I’ve lived with it my whole life,” Fedorchuk said. “When I hear people say, ‘Oh, nothing can happen if you don’t get a vaccination,’ I think, ‘Oh, yeah, something can definitely happen.’”

Peggy Haas, 69, a registered nurse in Waukesha County, became a firm believer in vaccines after witnessing the damage measles could inflict.

While finishing her master’s degree at Marquette University in 1987, she taught undergraduate students in the pediatrics ward at St. Joseph Hospital in Milwaukee. One day she assigned a student to care for a woman in her 20s who, due to measles complications, had the developmental capacity of an infant.

“She couldn’t talk, she couldn’t feed herself, she couldn’t even walk,” Haas said. “That was the first time I’d seen anybody who had failed to vaccinate their child and what it could do.”

Potential measles complications run the gamut from ear infections and diarrhea to more serious issues like pneumonia and encephalitis. Such brain swelling can cause permanent tissue damage, leading to hearing loss or other serious neurological complications.

Some potential effects aren’t immediately visible. Measles can disrupt the part of the immune system that remembers previous infections, a phenomenon known as immunity amnesia. That leaves people more vulnerable to future viruses for two to three years after a measles infection.

“For example, if you’ve been immunized for polio, and then you get a measles infection, the immunity you had to polio could be wiped out or reduced,” said Malia Jones, a University of Wisconsin-Madison assistant professor in the Department of Community and Environmental Sociology. “You wouldn’t even know that you’re susceptible to some of this stuff.”

The mortality rate for measles is just 1 in 1,000, but the risk of a weakened immune system makes the toll of measles higher, Jones noted. And while medical care has dramatically improved since the 1960s, no specific treatment exists for measles today.

“We just offer supportive care — in the hospital for those who become very sick — and hope for the best,” Jones said.

Vaccine was ‘a turning point in public health’ 

By the 1960s, vaccine breakthroughs showed that cases of measles were preventable. 

The first measles vaccine was licensed in the U.S. in 1963. By 1971 it was combined with vaccines for mumps and rubella, paving the way for the MMR vaccine used today. 

Early uptake was limited, and in 1983, the MMR vaccine was only routinely recommended for 1-year-olds.

But it soon became clear that a single dose fell short of offering full long-term protection. A second dose was added in 1989 to the routine schedule for children before starting school. Taking two vaccine doses is about 97% effective at preventing measles, the CDC says, compared to 93% for one dose.

The two-dose regimen initiated more regular contact between young children and health care providers. That led to more early developmental checks, including hearing, vision and behavioral assessments now standard in pediatric care. It also paved the way for childhood vaccination schedules to prevent other diseases, said Dr. Jim Conway, a UW-Madison professor in the Divisions of Infectious Diseases and Global Pediatrics.

“The MMR vaccine was a really major turning point in public health,” he said.

By the early 2000s, measles was declared eliminated in the U.S., meaning it wasn’t continuously spreading for a period longer than a year. 

How health officials are responding

But the virus is back, with the U.S. seeing more than four times as many infections in 2025 than in all of 2024. And it has now been detected in Wisconsin. 

In Oconto County, “all of the cases were exposed to a common source during out-of-state travel,” the state health department said in a statement Saturday.

“DHS, in coordination with the Oconto County Public Health, is working to identify and notify people who may have been exposed to the measles virus,” the statement said. “At this time no public points of exposure have been identified and the risk to the community remains low.”  

Wisconsin is vulnerable to an outbreak due to its relatively low childhood vaccination rates. It is one of just 15 states that allow vaccine exemptions for medical, religious and personal belief reasons. No Wisconsin county comes close to reaching the vaccination rate of 95% that is considered the benchmark for herd immunity protection. 

Public health officials are bracing themselves to respond.

Jennifer Weitzel, director for public health in Sauk County, said her department began closely monitoring measles this year after a Texas outbreak resulted in hundreds of infections and killed two unvaccinated school children. The department is being attentive as popular destinations like Wisconsin Dells and Devil’s Lake draw out-of-state visitors this summer. Just 70% of Sauk County’s kindergarten-aged children received two doses of the vaccine in 2024, down from 76% in 2019. 

The health department is working with providers and doctors to communicate the important protections vaccines bring. 

“I think that’s part of the challenge … no one sees these diseases anymore, so we forget just how effective vaccines have been and how awful these diseases really are,” Weitzel said.

Her colleagues coordinate tabletop exercises with other health departments, including those in Richland County and the Ho-Chunk Nation, practicing communication and response protocols in worst-case scenarios.

Health officials say they are trying to build trust in an era of misinformation surrounding viruses and vaccines. 

“Public health also took a big hit during COVID,” Weitzel said. “Folks are leery of government overreach, of recommendations, so we’re trying to build back that trust at a time where it’s critical, because measles is spreading, and we know that we could prevent it.”

But Holly Neri, a public health nurse in Door County, sees some positives from the COVID-19 pandemic: It prompted public health professionals to better prepare for virus outbreaks.

Door County nurses have sought to make sure patients are up to date on vaccinations. A state immunization grant for purchasing vaccines has helped, Neri said. The goal is for at least 78% of Door County children to be current on their vaccines by age 2, including MMR.

Their department is sharing information with local medical providers about identifying and responding to measles. 

Some groups, such as pregnant women and very young infants, cannot be safely vaccinated. That makes it particularly important for others to do so — aiming to get as close to herd immunity as possible, said Rebecca Wold, public health supervisor for the Oneida County Health Department. 

“If you’re not sure of your immunity or vaccination status, you don’t have any record of having a measles vaccine or having had measles as a child, it is safe to get a measles vaccine, and we would recommend it,” Wold said.

Want more information about measles? 

See this guide from Wisconsin Watch that rounds up medical professionals’ recommendations for protecting yourself and others. 

Door County Knock reporter Emily Small contributed to this report. 

‘I would never wish it on anyone:’ Measles resurgence spurs memories of past toll in Wisconsin is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 4 minutes

Before the 1960s, hundreds of thousands of Americans faced measles infections each year. The advent of vaccination eliminated the disease in the United States by 2000. But outbreaks have returned to some U.S. communities as trust in vaccines wanes in many communities.

More than 1,300 measles cases have been confirmed this year across 41 states, the latest being Wisconsin. That’s after the state Department of Health Services on Saturday announced it confirmed nine measles infections in Oconto County — the first in Wisconsin this year. 

Each Oconto County infection involved exposure to a “common source during out-of-state travel,” the state health department said in a statement. 

“DHS, in coordination with the Oconto County Public Health, is working to identify and notify people who may have been exposed to the measles virus,” the statement said. “At this time no public points of exposure have been identified and the risk to the community remains low.”  

What should Wisconsin families know about measles? 

Wisconsin Watch spoke with two University of Wisconsin-Madison experts: Dr. Jim Conway, a professor in the Divisions of Infectious Diseases and Global Pediatrics; and Malia Jones, an assistant professor in the Department of Community and Environmental Health.

We gathered additional information from officials at multiple rural public health departments across Wisconsin and reports from the U.S. Centers for Disease Control and Prevention.

Below are some takeaways. 

When and where am I most susceptible to measles?

That depends on individual health and vaccination status. Very young people (especially infants too young to be vaccinated), older adults and people with compromised immune systems face higher risks for contracting measles and developing severe complications.

Measles tends to spread more easily in crowded urban environments and during travel. However, it can spread anywhere, as evidenced by recent rural outbreaks, including those in Texas, where hundreds of infections have been confirmed and two school children have died. All it really takes is exposure to an infected person. Measles is one of the most highly contagious known diseases. It can remain infectious in the air or on surfaces even after an infected person leaves the area.

To put it in perspective, measles is often reported to have an R nought value — the number used to describe contagiousness — between 12 and 18. That means if one person with measles walked into a room of vulnerable people, odds are they would infect 12 to 18 others in the room. 

What should I do if I start having measles symptoms?

Measles often starts with general cold-like symptoms such as fever, cough, runny nose and watery eyes, making it hard to immediately recognize. The rash typically appears a few days after infection — and after a contagious person may have exposed others. 

If you think you might have measles or have been exposed to it, contact your local health department or healthcare provider immediately — especially if you’re unvaccinated or traveled to an area where cases were reported.  Suspected cases can be reported to local health departments even before confirmation, allowing officials to respond more quickly. Experts recommend staying home while waiting for test results to avoid spreading the virus.

What are the risks of measles?

While some think of measles as a mild childhood illness that everyone used to get, it can be dangerous. The disease can lead to a range of complications, from ear infections and diarrhea to more severe pneumonia or brain-swelling encephalitis. Such brain inflammation can affect multiple parts of the body and even cause permanent damage, especially to the brain and hearing. 

Meanwhile, a  rare but fatal long-term brain disease called subacute sclerosing panencephalitis can develop years after the initial infection. 

Some people infected by measles may experience neurological issues or nerve damage later in life.

One lesser-known risk factor: Measles can disrupt the part of the immune system that remembers previous infections, a phenomenon known as immunity amnesia. That leaves people more vulnerable to future viruses for two to three years after a measles infection.

In higher-income countries measles kills 1 to 3 of every 1,000 people infected, 10% to 20% of infections requiring hospitalization — often due to pneumonia, dehydration or severe diarrhea. Encephalitis occurs in about 1 in 1,000 cases, and pneumonia occurs in about 5% of infections. Children who are malnourished or have limited access to medical care face significantly greater risks. 

U.S. health officials have confirmed three measles-related deaths this year. 

What if I’m unsure whether I’ve had measles or the vaccine?

If you were born before 1957, you’re generally considered immune to measles because the virus was so widespread during the pre-vaccine era. Many adults born in the 1960s and 1970s may assume they’re protected when, in fact, they were never fully vaccinated, or even vaccinated at all. A second dose of the measles, mumps and rubella (MMR) vaccine wasn’t added to routine childhood immunization schedules until 1989, so many adults missed one or both recommended doses. 

The bottom-line is if there’s any uncertainty around your vaccination status, it’s safe to get vaccinated again. There’s no harm in receiving an additional dose of the MMR vaccine. In fact, an extra dose is both safe and more practical — quicker and more cost-effective than getting a blood test to check your immunity.

“More is better,” Conway said. “This is not one of the vaccines that has particularly tough side effects.”

Staying up to date not only protects you from serious illness but also helps safeguard others in your community who may be more vulnerable to complications from measles.

What can I do to protect myself and others?

Vaccination is your best defense. The MMR vaccine is the most effective way to protect yourself and those around you from measles. Make sure you’ve received both recommended doses, and stay informed about outbreaks in your community, especially if you’re traveling or belong to a vulnerable group.

Visit these resources for more information

• About measles (U.S. Centers for Disease Control and Prevention)
• How to protect your children during a measles outbreak (American Academy of Pediatrics)
• Measles cases are rising—here’s how to protect your family (Public Good News)
• How are routine vaccines tested for safety? (Public Good News)
• No, vitamin A does not prevent measles (Public Good News)

Measles has made it to Wisconsin. Here’s what to know about the virus. is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 2 minutes

Like millions of other Americans, I have a loved one who faces substance use challenges. I can still remember the gut-wrenching feeling early in the pandemic whenever I encountered headlines describing rising rates of overdoses and fentanyl poisonings.

But around 2022, some of that news coverage contained hope. Millions of dollars from a national legal settlement with drug makers, distributors and pharmacies was headed to communities reeling from the opioid epidemic, with the potential to help families like mine. 

I was immediately curious about how communities would spend the money. I’m from Nebraska, which has no public reporting requirements for opioid settlement funds, leaving the public in the dark. When I moved to Wisconsin last year, I was excited to see significantly more transparency. 

Within my first few days at WPR and Wisconsin Watch, I pitched a story on how local governments were spending these dollars. My editors were interested, but that idea got buried under other pressing reporting — from seniors getting kicked out of nursing homes, to people losing health coverage. 

May offered a fresh opportunity to revisit the settlement story. That’s when a legislative committee published a fresh batch of spending reports from Wisconsin counties and municipalities that received payouts. 

A 2021 state law requires Wisconsin governments to report basic information about their opioid settlement accounts each year. But when I started looking at those reports, they weren’t easy to digest. They are published in massive PDFs. Some included handwritten responses, with occasional missing or incorrect information. 

An assignment I thought would take a couple of weeks to report and write, lasted well over a month. 

I used a tool called Google Pinpoint to scrape information from three years or reports submitted by 87 different local governments. It took multiple late nights to check, edit and combine information from each report into a set of spreadsheets. I spent hours each day calling county and municipal offices, listening to hold music as I tracked down missing or corrected spending numbers.

As a self-proclaimed “words person,” the toughest part was calculating each government’s total earnings, spending and interest from settlement payouts. 

In response to my questions, seven governments filed reports that had been missing. Others corrected mistakes I identified on reports they had filed. 

The exhausting process was worth it. We did our best to create a place where people can  easily learn  — without sifting through meeting minutes or long PDFs — how their county or municipality is spending dollars intended to address a crisis. Or in the case of nearly 30 governments, that they have yet to spend any of it.

I’m not done with this reporting. If you have questions about my process or findings, please reach out. I hope to hear from anyone with opinions about how their local government is spending these dollars, whether positive or negative. You can reach me here: acostello@wisconsinwatch.org. 

Why we’re tracking opioid settlement spending is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 7 minutes

Click here to read highlights from the story

• Wisconsin is expected to receive about $780 million by 2038 through national litigation surrounding drug companies’ role in the opioid crisis, with 70% flowing to the state and 30% split between 71 counties and 16 municipalities. 
  
• The state has reported spending $36 million so far. Local governments have spent about $20 million. 
  
• Nearly 30 local governments have yet to report any spending, with some citing a need for more guidance. 
  
• Transparency varies among local governments. Seven filed required spending reports only after a reporter asked why theirs was missing. Wisconsin Watch and WPR found errors on reporting filed by more than a dozen local governments.  

Wisconsin and its local governments are expected to receive more than $780 million by 2038 as part of a national legal settlement over the role of drug makers, distributors and pharmacies in the opioid crisis — potentially transformational funding in efforts to reduce drug deaths.

But it’s not easy to track where some of that money is going. 

While Wisconsin does a better job than many states in making that information accessible, advocates say it has room to improve, particularly when it comes to transparency around local spending. Not every local government has filed required reports on time, and Wisconsin Watch and WPR found reporting errors on documents submitted by more than a dozen local governments.

The state gets 30% of the settlement funding and documents its spending on a web page.

The rest flows to 71 Wisconsin counties (all but Polk, where the county board declined to join Wisconsin’s lawsuit) and 16 municipalities, according to Wisconsin’s settlement agreement finalized in 2022.

It’s considered compensation for a public health crisis that killed at least 14,747 Wisconsinites between 2000 and 2023.

Local governments have spent $20 million during the first three years of disbursements, investing in strategies ranging from residential treatment and jail recovery programs to technology for police and T-shirts for school-based drug prevention programs.

The millions spent so far make up less than 15% of what local governments have received. With more than $115 million sitting in county and municipal accounts as of last December and about $400 million more on the way, local spending will likely ramp up in the coming years.

But transparency varies across local governments. 

A 2021 state law requires that local governments spend opioid settlement dollars within a list of approved uses related to the opioid crisis. But the law does not require local officials to tell the state how they spend it. Instead, counties and municipalities are required to report only how many settlement dollars they have received and spent, alongside their year-end balances.

Debates have unfolded nationwide about how to use settlement funds — including about the merits of spending on policing or programs that promote supervised drug use to reduce harm.

In making those decisions, local governments should be transparent and involve people directly impacted by the opioid epidemic, experts say.

Rick Schaefer lost his job and house after developing an opioid addiction. He accepts he’ll never be made whole.

“But we should be more involved in how the (settlement) money is spent,” Schaefer said, adding that most people he talks to know little about the settlement funding. While he wishes people would pay more attention, he wants governments to better engage the public.

“I want to see more people with lived experience doing the work,” he said.

Some localities have followed that practice by including people with lived experience on advisory committees. Others post detailed spending information online, conduct regional surveys and hold community listening events.

The majority of Wisconsin’s local governments elaborate on their plans in supplementary annual surveys by the Wisconsin Counties Association.

Milwaukee County is seen nationally as a model for transparency and public involvement. It submitted nearly 30 pages of details to the state this year alongside its required figures.

But a dozen counties and municipalities have skipped or minimally answered the optional questions. Multiple municipalities failed to report opioid settlement spending totals one to two years after state deadlines. And seven governments submitted reports only after a reporter asked why theirs was missing. 

The Wisconsin Department of Justice reviews the reports annually and has flagged and reported issues when they are identified, but the department “does not have any enforcement role with respect to the submission of these reports,” spokesperson Samantha Standley said in an email.  

The Legislature’s Joint Finance Committee also receives the reports annually. Co-chairs Rep. Mark Born, R-Beaver Dam, and Sen. Howard Marklein, R-Spring Green, did not respond to requests for comment.

Lessons from tobacco settlement 

Drug overdose rates dropped in 2024 across Wisconsin and the country, the first annual decline since 2019. 

The decrease represents major progress, said Giavana Margo, Wisconsin program manager for Vital Strategies, a national nonprofit working to reduce overdose deaths.

Still, plenty of work remains, and progress is uneven.

Black and Indigenous communities continue to face disproportionate harm from the opioid epidemic. In Milwaukee, for instance, older Black men are accounting for a growing share of drug deaths as fentanyl creeps into cocaine supplies. 

Wisconsin still saw more than 1,000 drug-related deaths from February 2024 to February 2025, preliminary U.S. Centers for Disease Control data show.

Settlement dollars have the potential to save lives if spent strategically, Margo said.

That did not happen the last time states reaped billions in compensation for a public health crisis. 

States, including Wisconsin, settled with tobacco companies in 1998 for an estimated $246 billion over the first 25 years. 

While states promised to use the funding to fight tobacco use, the bulk went toward plugging budget holes. Most states still spend less on tobacco prevention than the CDC recommends.

For its part, Wisconsin receives hundreds of millions each year from settlements and taxes on tobacco but spends less than 12% of what the CDC recommends on prevention. 

Advocates want to avoid a repeat as opioid settlement funds flow in, said Kristen Pendergrass, vice president of state policy at Shatterproof, a national nonprofit focused on the addiction crisis. It’s why experts call for transparency.

Wisconsin is off to a better start this time.

The Department of Health Services opioid settlement web page details $36 million in department spending so far — much of it funding treatment center construction and renovation. 

Wisconsin is among 20 states with some level of public reporting requirements for 100% of settlement funds at the state and local levels, according to OpioidSettlementTracker.com.

Many states lack any reporting requirements for locally disbursed funds, leaving interested residents to sift through county board minutes and a scattering of local government websites. 

Wisconsin’s annual reporting requirement creates a central location for spending information, Margo said, even if it’s not as robust or accessible as it could be. 

States such as Minnesota and Indiana break down local spending on dashboards and spreadsheets linked on health and substance abuse-related websites. Wisconsin’s reports aren’t as easily findable. They are published as PDFs on the Joint Finance Committee website, alongside hundreds of other spending reports unrelated to opioids. The reports are also available by request through the state DOJ. The Wisconsin Counties Association separately published the 2023 and 2024 spending reports to a resource page created for county officials.

The city of Milwaukee receives more settlement funding than any local government except for Dane and Milwaukee counties. But it failed to initially report two years of spending and receipts after “an oversight resulted in delays,” wrote Comptroller Bill Christianson. After being contacted by a reporter the city submitted reports detailing more than $500,000 in spending, and it created procedures to meet future reporting deadlines.

Some local government officials said they didn’t know they were required to submit reports if they had yet to spend any settlement money. Several corrected missing expenditure figures, misreported receipts and mismatched account balances between years after a reporter flagged discrepancies. 

Calls for public input

The overdose reversal drug Narcan saved Schaefer’s life multiple times before he started his recovery journey and became a certified peer support specialist. Growing availability of Narcan and other harm reduction resources is likely fueling the decline in overdose deaths — at least in part, Schaefer said.

Many Wisconsin local governments have reported purchasing drugs like Narcan and training for its use. 

“Things are going in the right direction,” Schaefer said. “So let’s decide where to throw more money. What else can we try?”

He and other members of DUO Wisconsin, an organization for current and former drug users, hope governments will listen to people with lived experience. Their proximity to the crisis forges unique perspectives.

Many local governments have launched advisory councils and seek public input, including from people affected by the opioid crisis. Twenty-one local governments in annual reports to the state mentioned soliciting some form of community input. 

But even in those cases, people don’t always know how to get involved or whether they will be listened to, said Jess Morrow, a DUO member.

“How do you even begin to look or find out?” she asked. 

Morrow and Schaefer live in Dane County, which holds public meetings on opioid settlement spending and includes people with living experience on its advisory committee.

“When you look at the successes of other counties and other states, it’s meeting people where they’re at,” said Dane County Supervisor Rick Rose, who helped create that committee.

He aims to streamline the county’s allocation process so more dollars can more quickly flow where needed.

“This disease is changing every day,” Rose said.

Several local governments reported spending money on test strips for the potent drug fentanyl and xylazine, a veterinary sedative increasingly found in illicit drugs. But DUO members say people are also unknowingly buying drugs cut with harmful substances strips don’t test for, like plastic and dog dewormer.

“Everybody who uses probably has way too many (test strips), because they’re everywhere,” Schaefer said. “We need something that does a better job of accurately telling you, really what’s in everything. … The technology is improving to get us there.”

Some local governments have yet to spend

Nearly 30 counties and municipalities reported spending zero settlement dollars so far, including several who said they weren’t sure how to spend it.

Monroe County in 2023 cited as a barrier “minimal information available and guidance on how to appropriately use opioid settlement funds.”

Delaying spending could make sense in some scenarios, Pendergrass said. Governments might want to take extra time for research and outreach. Or they could invest in interest-earning accounts that grow funds for ambitious future projects. But they owe an explanation to the public, she said.

And the funds could save lives now.  

“It’s great news that overdose rates are going down,” Pendergrass said. “But we can’t take our foot off the brake because people are still dying every day.” 

How are Wisconsin’s local governments spending millions in opioid settlement payouts?  is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 4 minutes

Michael Adams, president of JobsWork MKE, ignored the warning signs his body gave him before having a heart attack on Jan. 29, 2024. 

He now encourages Black men to pay attention to their health and trust the health care system. 

“I think Black men aren’t trusting the system due to economics and the feeling of not being in control of the situation,” Adams said. 

Ignored warning signs

Before his heart attack, Adams woke up vomiting with a burning throat. He took an Alka-Seltzer hoping it was indigestion. 

Later that day, he gave a presentation at the Medical College of Wisconsin for work. During the presentation, his symptoms got worse. He experienced severe sweating, shortness of breath and body aches. 

“I try to stay as active as I can, but I couldn’t understand why I’m walking across the street from the parking lot to the building out of breath,” Adams said. 

Friendship and health 

Timothy Grove, a network senior director of Trauma Informed Strategy and Practice at Wellpoint Care Network and a friend of Adams, was with him that day. He noticed before the presentation while walking with Adams that his friend was struggling.  

“The way he was talking about his symptoms made me think it was important to encourage him to get checked out right away. I was also concerned about my friend and wanted him to be OK,” Grove said. 

After the presentation, Grove took him to the doctor before he was sent to the emergency room. 

Adams described Grove as a good friend for being there for him.

“Tim got on my nerves because I wanted him to drop me off and leave. Through it all, he was there, and stayed until I was OK,” Adams said.

Black men and hospitals

When he was admitted to the ER, hospital staff tried to calm Adams to prevent distress before they told him he was having a heart attack. 

“Black men don’t listen to themselves. We don’t go to the ER because we don’t want all that comes with it,” Adams said. “At the end of the day, we are dying because we don’t listen to ourselves and our body.”

According to a study by the Milwaukee Health Department, the top cause of death for Milwaukee men is heart disease. 

Understanding a heart attack 

Adams discovered there was 95% blockage in one of his arteries. The day after his heart attack, doctors inserted a stent to open his artery and help restore blood flow. 

“I came to the realization that over a year I haven’t felt right and my circulation has been off all along,” Adams said. 

Adams experienced cramps and had inconsistent blood pressure readings. 

After the stent was inserted, Adams was prescribed medication, and it was recommended he attend water physical therapy because of its low impact on the body. 

A new lifestyle 

Before his heart attack, Adams, a native of Milwaukee’s North Side, lived an active lifestyle, teaching martial arts and hiking regularly. 

Now, Adams attends Noyes Pool three days a week. He swims laps there and is trained by a lifeguard and private swim coach. 

“People always tell me ‘sorry for the heart attack,’ but I have a different perspective on it, and the best of life opened up to me since then,” Adams said.

Adams has lost 40 pounds and is glad he’s eating higher-quality food such as lean beef, vegetables and fruits. He also cut salt from his diet and drinks only water.

Witnessing transforming moments 

Adams’ daughter, Lauren, proudly supports her father’s decision to make health a priority as a Black man. 

“I tell my dad all the time that one day he’s going to break my heart by passing away. To know that he’s taking his health so seriously, I love that,” she said. “I’m an only child, and my dad is my favorite person.” 

Heart disease runs in their family, Lauren said. Both of Michael’s parents died from heart disease. 

Since his life-changing medical emergency, Michael has met other individuals who also experienced heart attacks. Some are members from his church, All Saints Catholic Church. 

“When I was released to go to church, the men came up to me and said ‘Welcome to the club,’ ” he said.  

Feeling a part of the process 

Adams felt cautious about the steps he would have to take with his health. He felt the need to attach himself to his health care providers so he could trust the work they’re doing.

His initial doctor, Ian Gilson of Froedtert Hospital, retired after 20 years of caring for him.

“I liked that doctor because he understood Black anatomy really well,” Adams said. 

Benjamin Tobin, a Black doctor at Froedtert & the Medical College of Wisconsin, is his current provider.

Adams appreciates how his health providers are making him feel seen and heard. 

“As Black men, we often get dictated to on how our health should go. My health providers made me a part of the plan, and I just signed off on it,” Adams said.

He urges Black men to take their health seriously. 

“I survived, and I want other people to understand that you can, too,” Adams said.

He survived a heart attack. Now he wants other Black men to do the same. is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 5 minutes

After a recent government study found that Native people are more than twice as likely to deal with food shortages and lack of nutritional meals than all U.S. households combined, the U.S. Government Accountability Office (GAO) made six recommendations to the U.S. Department of Agriculture (USDA) aiming to improve food security. But a year later, the USDA, which agreed with the recommendations, has yet to act on them. 

In July 2024, the GAO issued the recommendations in a report outlining opportunities the USDA could take to address challenges in federal nutrition programs. The report also asked Congress to consider “addressing in statute” the role of tribes in administering federal nutrition programs. 

Barriers to food security vary from tribe to tribe, but commonalities exist, according to GAO director Kathryn Larin. In many cases the rural locations of tribal communities make access to a variety of nutritious foods difficult. “And the costs of the foods are higher than in more urban areas, partly due to transportation costs or other factors,” Larin told Buffalo’s Fire.

Those challenges have led to significant health disparities, including higher rates of diabetes and obesity among Indigenous people. 

The way food is distributed and administered in tribal communities may be contributing to the problem.

After interviewing tribes and tribal organizations in seven states, as well as state and USDA officials, the GAO asked Congress to consider requiring states to consult with tribes when carrying out federal nutrition programs on reservations and in Native neighborhoods. Lawmakers have yet to address the matter.

Currently, tribes can administer several programs, including Food Distribution Programs on Indian Reservations (FDPIR),  Special Supplemental Nutrition Program for Women, Infants and Children (WIC), and the Supplemental Nutrition Assistance Program (SNAP), if it’s determined that the state isn’t able to do so effectively.

In some cases, state programs or administrators are required to consult with tribes. “In other instances,” Larin said, “there’s no clear direction as to what the tribal role is. So we’ve asked that Congress address that explicitly.”

Some tribes told the GAO that their members were more likely to participate in programs the tribes administered, which tend to be located on reservations. Non-tribal programs are often off the reservation, which creates an additional burden of traveling.  

“We know people are falling through the cracks,” said Mary Greene Trottier, a Spirit Lake member who serves as the director of its food distribution program and the National Association of Food Delivery Program on Indian Reservations. 

Trottier says her people are struggling with diet, good nutrition and proper access to health services, and she estimates that 60-70% of schools on the Spirit Lake reservation have students in the free lunch program. 

“We know the problems,” said Trottier, on the findings of the GAO study. “We know we can address the solutions.” She said tribal leaders and program directors are “boots on the ground” who just need to be heard and have their knowledge applied to improving food issues in tribal communities. “We know how to run our programs. We know what works, what doesn’t work.” 

Letting tribes take the lead

Like Trottier, Marlon Skendandore is a proponent for having tribes administer more food programs. He sees it as a move toward food sovereignty. 

Before being elected as an Oneida tribal councilor, Skendandore worked as a food pantry manager for the tribe for six years, helping members across Wisconsin get fed “without red tape.” One of the GAO recommendations — that the USDA work to avoid dual participation in both the Food Distribution Program and SNAP and help qualified applicants get enrolled in a timely fashion — addresses what he sees as a “weird caveat” in the current system.

“Say you were on SNAP low income (and) you start building yourself up,” said Skenandore, describing how some SNAP recipients get work or otherwise improve their earnings. “You’re no longer income eligible.” He added there’s then a waiting period of 30 days before someone leaving SNAP can apply for the Food Distribution program. “I don’t know what the sense of 30 days of waiting is because they’re being administered by two totally different departments.”  

The GAO has recommended that Food and Nutrition Service administrators study how switching from one program to another affects food security and then share that information with Congress. 

Skenandore says both nutritious-food access and affordability are issues affecting the Oneida. Besides his work with the food pantry, he launched the Tribal Elder Food Box Program during the COVID-19 pandemic to alleviate food insecurity among Wisconsin tribes.

“We’re now up to making 2,400 boxes every couple of weeks,” he said.

Skenandore said that earlier this year funding cuts to the USDA’s Local Food Purchase Assistance Cooperative Agreement program made the Tribal Elder Food Box Program’s future look bleak. But the program has since secured $3 million in state funding, which will allow it to continue for another two years. 

The GAO also recommended that the USDA include national data on Native food security in an annual report and discontinue visual observation as a way to determine race and ethnicity for the Food Distribution Program on reservations. Finally, the GAO wants the agriculture secretary to identify and rectify gaps in outreach to tribal communities and make administering these programs more flexible in ways that support food security. 

The USDA told Buffalo’s Fire in an email that it’s “working diligently” to address the GAO’s recommendations. But when asked about the timeline for implementing them, the press office did not provide one.

In a separate email, the USDA said the department and Agriculture Secretary Brooke Rollins are “committed to working with states, tribes, territories, and local government partners” to improve and modernize their programs, while “upholding our responsibility to program participants and American taxpayers.”

“The bottom line is that we feel strongly that the recommendations we made are key to addressing the issue of food insecurity in tribal communities,” the GAO’s Larin said, adding, “That’s why we’re committed to following up with the agency and hopefully encouraging them to implement the recommendations.”

The Senate Committee on Indian Affairs and the House Subcommittee on Indian and Insular Affairs did not respond to requests for comment.

Self-education

In the meantime, both Trottier and Skenandore say there’s much to teach their respective communities about proper nutrition and health. This means adapting more traditional foods into their diet and scaling back fast food and ultra-processed items that either lack nutritional value or add to health problems. And with some traditional staples like wild rice and berries getting expensive, focusing on community gardens is seen as a way to help offset some of the issues. 

“We have little kids that we’re really trying to instill with gardening and nutrition knowledge so they make better choices,” said Trottier. “We might not be able to change the older generation, but we’ve got a start with the younger generation. There’s always new hope to be found.”

This story was originally published by Buffalo’s Fire.

References

United States Government Accountability Office. (July 2024). Tribal Food Security

The Centers for Disease Control and Prevention website

U.S. Department of Health and Human Services Office of Minority Health website

‘People are falling through the cracks’: Congress and USDA have not acted on recommendations to alleviate food insecurity among tribes is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 8 minutes

Editor’s note: This story discusses suicide. If you or someone you know may be experiencing a mental health crisis, contact the 988 Suicide & Crisis Lifeline by dialing “988.” Or you can send a text message to 988 or use the chat feature at 988lifeline.org.

Click here to read highlights from the story

• Older adults account for 1 in 5 suicides in Wisconsin, with the rate among men over 75 twice the statewide rate for everyone.

• The latest data from 2023 show suicide rates among older people declined over the previous year, when they were higher than the national average.

• The state budget includes additional mental health resources in the Fox Valley and for Winnebago Mental Health Institute in Oshkosh. Republican lawmakers are calling for additional telehealth resources, while Democrats want to reinstate the 48-hour waiting period for gun purchases.

Earl Lowrie doesn’t spend a day of retirement without thinking about suicide.

The disabled 66-year-old lives with two grandchildren in the village of Cameron in northwest Wisconsin, where he is $50,000 in debt and suffering from multiple autoimmune diseases. Nowadays, Lowrie spends his time trying to elude a pernicious voice, telling him “there really isn’t any recourse now” and to “take some opioids and go to sleep.”

Nationwide, adults over 65 have some of the highest suicide rates by age group, though they are among the least likely to seek or receive mental health support. They made up 20% of all suicide deaths in Wisconsin between 2018 and 2023 — but in 2023, only 3,142 older people used county mental health services, down from a peak of nearly 4,000 who used them in 2018.

Wisconsin Watch spoke to policymakers, health professionals, advocates and older adults about the current mental health landscape for older people in Wisconsin and the possible roads to geriatric suicide prevention in the future. Their goals beyond prevention are to help older adults realize that they are not forgotten and to raise awareness about community supports at every stage of life.

That’s what Lowrie is working to remember. 

Older men kill themselves at two times the statewide rate

In 2023, 184 older Wisconsin adults ended their own lives, out of 921 total suicides. The statewide age-adjusted suicide rate was 15 out of 100,000 residents, while the rate for those between 65 and 74 years old was 15.7. Suicides among those 75 and older were higher at 17.1.

That’s down from the previous year, when Wisconsin adults above 65 died at a higher rate than the national average, 18.6 vs. 17.7. It’s unclear why the numbers went down or whether it will continue in future years.

Nonetheless, depression and anxiety disorders “have really picked up” recently for the patients of Kenneth Robbins, a geriatric psychiatrist based in Rock County. He has especially noticed issues with older men, who died from suicide at more than two times the statewide rate in 2023. 

Robbins said that one of the biggest contributors to this suicide rate is isolation.

“What’s unique about older white men is that many of them are not very socially adept,” Robbins said. “When they retire, they’re not quite sure what to do with their lives exactly and often become very lonely and feel like they’re not doing anything meaningful and start to wonder, ‘What’s the point of living?’”

Robbins also noted that older adults who struggle with medical problems, such as dementia or cancer, are highly likely to attempt suicide for fear of physical pain and becoming a “burden” to their loved ones.

According to the Wisconsin Department of Health Services, more than half of residents 55 years and older who died by suicide in 2023 had health problems that “appeared to have contributed to their deaths.”

Sen. Jesse James, R-Thorp, said he was at a wedding when his wife’s great-grandmother, suffering from dementia, told him to kill her. James’ father told him he would rather die by suicide than live with the disease.

“I’ve had many family members state they would rather die by suicide than to remain on the Earth if they were attacked by dementia,” said James, who worked to ensure the recently approved state budget included more mental health services in the Chippewa Valley.

Older adults in rural Wisconsin face extra challenges

Lowrie retired from truck driving in 2019 after he had a fall at work and needed a spinal fusion for his back. Around that time, he developed rheumatoid and psoriatic arthritis, and later stage 4 cancer. 

“My mental illness went off the rails,” he said. “The only reason that I didn’t (take my life) was because I’ve seen how painful it is for others around you.”

The pain Lowrie was referring to was the loss of his youngest son, Justin, who shot himself a little less than a decade ago. Ever since then Lowrie retreats for long periods into a depression “closet” that lets very few people inside.

“I’ve been trying to break out of that here more recently,” he said. “Often you don’t have that trigger that you needed to get you out of the closet to go out and find something that’s going to bring you out of this slump.”

Lowrie’s home county has an age-adjusted suicide rate lower than the statewide average, but many rural counties in the state have significantly higher than average rates. Of the 184 suicides among older adults in 2023, 115 were in areas with populations under 50,000 and 42 were in areas with populations under 10,000.

Older adults in rural areas often live far away from mental health providers, many of whom don’t accept Medicare, according to Robbins. They also often live far away from family and community.

“That further adds to the hopelessness you feel and the loneliness that you feel,” Robbins said. “Nobody’s noticing that you’re getting more and more depressed, and becoming less and less functional.”

No legislation geared toward geriatric mental health

Though there is no legislation circulating to address geriatric mental health and suicide prevention, legislators are pushing broader bills related to mental health, substance abuse and gun control, which they say will start to help. 

Gov. Tony Evers’ initial 2025-27 state budget recommendations included $1.2 million and six full-time equivalent positions for Mendota Mental Health Institute’s geropsychiatric treatment unit, which serves mentally ill, disabled or drug-dependent older adults who require more specialized services than are generally available.

The request was for hiring additional staff and moving the unit to a nearby building with larger treatment space. Jennifer Miller, the communications specialist for Mendota, said the Wisconsin DHS made the request because it is seeing an increase in older patients who need mental health services.

With the new space, “there (would have been) additional capacity at (Mendota) to serve these individuals in a space designed to meet the unique mental health treatment and service needs facing an aging population,” Miller said. 

However, legislative Republicans removed the additional funding for Mendota. Instead, the budget provides almost $16 million to address the current deficit at the Winnebago Mental Health Institute’s “civil patient treatment program” for 2025. Winnebago, located in Oshkosh, treats patients legally ordered to undergo mental health treatment, but the funding is not specifically for geriatrics.

The budget also includes $10 million in funding for the development of a mental health campus and $1 million for reopening a substance abuse treatment facility in the Chippewa Valley, which has a significantly higher suicide rate than the statewide average. 

James and Rep. Clint Moses, R-Menomonie, who co-authored the provisions, said the campus will restore the region’s mental health beds lost after two nearby hospitals closed last year. Moses also said that he has been working on general telehealth bills that would help bridge gaps in mental health care for older adults in rural areas.

“It’s about making sure they’ve got access — (especially) if they don’t have family members — to someone they can talk to,” Moses said. He believes older adults should be able to do an online video meeting rather than drive 45 minutes or an hour to talk to someone about their issues.

For suicide prevention, Democrats have circulated multiple bills related to gun safety, one of which would reinstate the previous 48-hour mandatory handgun purchase waiting period repealed by Republicans in 2015. 

Former Democratic state Rep. Jonathan Brostoff — who last year purchased a handgun and killed himself within hours — had argued for reinstating the waiting period, saying it had prevented his own previous suicide attempts. 

Sen. Chris Larson, D-Milwaukee, a close friend of Brostoff who reintroduced the bill to the Senate in June, said the law had protected an “untold number of people.”

“There’s the false narrative of, ‘if you don’t have a gun, you’re not safe,’ right? … (But) the statistics show that most suicides that end in death are with a handgun,” Larson said. “The more time we can put in between the time that somebody is trying to obtain a handgun and when they actually get it, it saves lives.”

People 65 and older carry out 25% of all firearms suicides in Wisconsin and use firearms for suicide at by far the highest rate. Lowrie disagrees that gun legislation would prevent suicides and said older adults start to feel a “very large sense of helplessness” when their guns are taken away.

Finding community

Lowrie attributes suicide challenges and reluctance among older adults to seek mental health support to the way his generation was raised. 

Organizations such as NewBridge, a Madison nonprofit dedicated to serving low-income older adults, seek to proactively address the issue by providing older adults with community programming and case management, but especially mental health care.

Kathleen Pater, the mental health manager at NewBridge, described older adults as a “forgotten group” who “might not be the best advocates for themselves.” Her team is often the first human interaction their clients have in a long time and the first to have honest conversations about mental health.

We need to “really focus and see the importance of this stage in life and how much seniors can really offer the community back,” Pater said. “It’s connecting them back into the community with intergenerational programs, and just a societal shift in seeing our elders as valuable and knowledgeable and having all this life experience rather than being isolated and forgotten.”

In January, Lowrie finally sought out help for his mental illness after an interaction with his ex-wife sent him into a “tailspin” of anxiety and suicidal thoughts. When an online artificial intelligence therapist didn’t work, his best friend Wes told him about the National Alliance on Mental Illness.

Initially, Wes had suggested a NAMI chapter in Rice Lake, about seven miles away from his village. But Lowrie soon found the Rice Lake office was closed, and the nearest location in Eau Claire was 50 miles away.

Despite “talking (himself) into it and out of it above half a dozen times,” Lowrie took a leap of faith with the encouragement of Wes and his granddaughter and went to Eau Claire. He now describes NAMI as “a rope pulling me out of the water, keeping me from drowning.”

“There’s people from every walk of life and every different kind of problem that you could imagine, but mine was no more twisted and weird than their own,” Lowrie said. “It was through them I found enough encouragement and ideas of finding more help.”

Through NAMI, Lowrie was connected to individual, weekly counseling, a nutritionist, a dietitian, and a mental health prescription that gives him hope. He continues to attend NAMI Eau Claire’s biweekly meetings, and his cancer is now in complete remission.

Despite newfound support, Lowrie said he is often “suffocated” by his mental illness and that most of the time, he would rather be dead than suffer. In his worst moments, not even his favorite things, like the laughter of children or the breeze on his skin, can draw him out.

But Lowrie doesn’t intend to stop fighting. 

“I am going to do everything in my power to get to the other side of my mental illness,” Lowrie told Wisconsin Watch. “I’m on a mission, and I’m not holding back at all … I’m coming out the other side one way or another.”

Older adults make up 1 in 5 suicides in Wisconsin. Here’s what can be done to fix that. is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 9 minutes

Click here to read highlights from the story

• Wisconsin’s state budget doesn’t include $24 million that Gov. Tony Evers proposed to address homelessness in the state.

• At the same time, the Trump administration is looking to pull back on resources that address housing, including consolidating a grant for permanent housing solutions into one that can only be used to provide up to two years of temporary housing.

• Rural service providers are looking to philanthropic sources and others across the state to address the growing homeless population in their local communities.

At a recent gathering of social service organizations in Brown County, participants contended with a double gut punch to their efforts to reverse Wisconsin’s recent rise in rural homelessness: almost no new support in the state budget and federal funding cuts.

The Brown County Homeless and Housing Coalition, which focuses its efforts not only on the urban growth around Green Bay but also on the rural towns along the outskirts of the county, consists of at least 45 partner and supporting member organizations — representing the vast complexity of the issue they’re attempting to fix.

Gov. Tony Evers’ budget proposal gave them reason for hope. It included over $24 million of new funding to address homelessness.

The funding would have increased support for programs, including the Housing Assistance Program that provides support services for those experiencing homelessness and the State Shelter Subsidy Grant Program that funds shelter operations. 

But after the Republican-controlled budget committee cut Evers’ proposal, organizations were left with the same state resources they had last year, despite increasing homelessness across the state and looming cuts in federal support.

Joint Finance Committee co-chairs Rep. Mark Born, R-Beaver Dam, and Sen. Howard Marklein, R-Spring Green, who both represent mostly rural districts in Wisconsin, did not reply to multiple requests for comment.

Sen. Romaine Robert Quinn, R-Birchwood, a JFC member who represents the rural northwestern corner of Wisconsin, including the city of Shell Lake where Wisconsin Watch reported on a father and daughter experiencing homelessness, declined an interview request. Sen. Eric Wimberger, R-Oconto, who represents the western part of Brown County, did not reply to multiple requests for comment.

Federal cuts coming for homeless services

President Donald Trump’s proposed federal budget reductions would cut funding for key programs administered by the U.S. Department of Housing and Urban Development (HUD), including grants that many local organizations depend on to provide housing and supportive services. 

The Trump administration’s efforts to reduce federal funding began with a Jan. 27 executive order that temporarily paused many federal grants and financial assistance programs — including those supporting homelessness services — causing immediate disruptions for organizations like RAYS Youth Services in Green Bay.

Josh Benti, program coordinator for RAYS and homeless initiative project director for the Brown County coalition, recalled how his organization’s basic services were abruptly halted, leaving it unable to support a child in need.

Benti’s organization provides services designed to promote stability and independence for youth up to age 24. They include placement in licensed foster homes, similar to emergency shelter stays.

Shortly after Trump signed the order in January, Benti received a text from his boss saying the organization could no longer move forward with placing a child in a host home. He had to inform the child it was uncertain whether the program would be funded. 

Even after federal funds were reinstated weeks later, disbursement delays further affected how employees were paid. Benti’s role, originally salaried, was switched to hourly so that he and his colleagues could maintain their positions.

Benti explained that because RAYS’ federal funds are matched by private grants, the organization’s development staff has begun applying for grants across the state. The organization seeks to expand its services and collaborate with statewide partners to become “too big to fail.” 

“We can’t do it all by ourselves,” Benti said. “We need those funds to take care of those pieces we do every day.”  

Trump’s big bill brought new limitations to RAYS through changes to social safety net programs, such as provisions introducing new work requirements for Medicaid and the Supplemental Nutrition Assistance Program, which limited eligibility and access of certain recipients. 

These policy shifts have raised additional concerns about the potential losses to critical areas of the organization, especially Medicaid. Reductions to the federal health care program for low-income people threaten a large portion of Foundations Health and Wholeness, a nonprofit that provides mental health care to uninsured and underinsured individuals, many of whom rely on Medicaid as a source of health coverage.

Carrie Poser, executive director of Wisconsin Balance of State Continuum of Care — a nonprofit committed to ending homelessness — pointed out that Medicaid cuts, along with restrictions on food stamps, won’t only affect people experiencing homelessness directly. 

“It will impact those living in poverty who are maybe just … a paycheck away from becoming homeless, and now you’ve just hit them with the potential of losing their health insurance, or losing access to food,” Poser said.

The organization manages a variety of federal grants, including funding for Coordinated Entry Systems that prioritize housing resources based on need, as well as a large federal Rapid Re-housing project of more than $5 million focused on domestic violence survivors.

Trump calls for shift from permanent to temporary housing

Trump’s budget proposal could eliminate federal funding for the Continuum of Care program, funneling those resources into state grants for up to two years of housing assistance. The shift would eliminate Permanent Supportive Housing, which is geared toward homeless individuals with disabilities. Under current law, those temporary housing grants can’t be used for permanent housing.

Trump’s budget also would zero out the funding for the Housing Opportunities for Persons with AIDS program.

“The top-line takeaway is that rural and suburban communities are going to suffer the most loss,” said Mary Frances Kenion, chief equity officer at the National Alliance to End Homelessness.

About 48% of Wisconsin’s permanent supportive housing is currently funded through Continuum of Care dollars. Areas served by the outstate organization rely on federal funding for roughly 41% of their homelessness services budget.

The outstate organization also receives Housing Assistance Program grants, which it subgrants to organizations aiming to address specific gaps in their communities and offers them support that may not be available through federal funding.

Without added state support, the organization can’t expand its efforts to end homelessness, though it can maintain current levels. Currently, Housing Assistance Program funds support half a dozen projects outside Milwaukee, Dane and Racine counties, a limited reach that additional funding would have broadened for the organization.

Additionally, more state funding for shelter operations could have helped shelters pay more staff and reopen after many closed during the COVID-19 pandemic, Poser said.

Now, as the demand for shelter continues to rise, other service providers also face limited resources to expand their services.

The shelter funds provide support to the Northwest Wisconsin Community Services Agency for operating its shelters. However, CEO Millie Rounsville said the funding has remained flat for years, despite growing demand for services.

“As you’re trying to create additional projects … there’s no additional resources to be able to support those and actually would take away resources from other communities because the pot is the same size and the programs are expanding, which means that there’s less money to go around, and no new money to address any of the increase in the unsheltered,” Rounsville said.

With no increases in funding, expanding programs or launching new initiatives to meet rising homelessness has become increasingly difficult.

As several housing assistance organizations face limitations to state and federal funding to maintain many of their day-to-day programs and services, Kenion urges them to take stock of existing resources and make contingency plans.

Kenion advised communities to map out what services they currently offer, whether that’s through permanent supportive housing or homelessness programs, and to clearly understand where their funding may come from. She added that rural communities, in particular, should begin having difficult conversations about their funding landscape and work to broaden partnerships such as those with faith-based groups, clinics, small businesses, victim service providers and philanthropies.

Rural areas face challenges accessing support

Don Cramer, a researcher for the Wisconsin Policy Forum, points to some of the difficulty rural areas might face in obtaining funding to address homelessness. 

In rural parts of the state, limited staff capacity could mean that local agencies miss out on some of the state and federal funding opportunities that their urban counterparts are able to obtain. Cramer suggested that larger cities with high homeless populations, like Milwaukee, typically have more staff and time to dedicate to pursuing grants, while smaller counties, even those with higher homeless populations, often don’t have the employees who focus their time exclusively on applying for these funds.

Cramer also pointed out that rural communities often struggle not only to secure funding, but to capture the scope of homelessness in their areas, making it even harder to recognize and address the issue.

As Wisconsin Watch previously reported following the winter “point in time” count, one of two annual nights in the year that portray the number of people experiencing homelessness across the country, the state’s mostly rural homeless population reached 3,201 last year, its highest number since 2017.

The reported number of homeless students in Wisconsin last year reached its highest number since 2019, with 20,195 students experiencing homelessness, according to a report by the Wisconsin Policy Forum. Last year was the third consecutive year the number of reported homeless students has increased after hitting its lowest level in 2021 during the pandemic. 

The sheer difference in the number of students experiencing homelessness and individuals experiencing homelessness further highlights how the methodology for quantifying homelessness across the state, which is used to determine a community’s level of need, “doesn’t make sense for those who don’t know the differences in the methodologies,” Cramer said. 

The standards of counting between Wisconsin’s Department of Public Instruction (DPI), which would count a student who may be sleeping on a relative’s couch in its homeless count, and HUD, which wouldn’t, illustrate the strict guidelines that likely don’t come close to representing the full picture of homelessness in the state. 

“When you think of the (homeless counts), many assume those are undercounts,” Cramer said. “But I think the students would be pretty accurate — because schools are working with a majority of the state’s student population, and kindergartners aren’t hiding that information.”

‘We need to take into account our increasing need’

Katie Van Groll sees this issue firsthand through her work as the director of Home Base, an arm of the Boys and Girls Club of the Fox Valley that specifically works with youth up to age 21 who are experiencing challenges related to housing insecurity. 

Van Groll added that the difference between the HUD and DPI counts contributes to a systemic misunderstanding of what homelessness looks like for young people. For example, couch surfing is much more common in young people experiencing homelessness than it is for adults, but because the HUD count doesn’t include that frequent circumstance, the difference between being sheltered and being homeless “almost gets forgotten,” Van Groll said. 

“What that does is it makes them ineligible for other funding and other resources because they don’t meet the HUD definition until they are literally on the street, and that’s what we’re trying to avoid,” Van Groll said. “The sooner that we can intervene, the quicker we can disrupt that cycle and change those generational experiences of homelessness.”

While the number of youth experiencing homelessness in the state continues to rise, Evers’ budget proposal to increase funding for the Runaway and Homeless Youth program, which already operates on a difficult-to-obtain regional lottery system that Home Base competes for each year alongside other youth-oriented programs, was denied an increase in funding. 

Only one program serving runaway and homeless youth per region receives funding by the state, which in itself “is a disservice,” Van Groll said. “Right now, we’re lucky in that we are in a current federal grant so we are not looking at reapplying to the (state) funding that was just released, but we expect that other programs may not be in the same situation.” 

“Many people are going to be like, ‘well, what are you complaining about? You’re not losing any money,’” Van Groll said. “But you kind of are because we need to take into account the state of our economy, we need to take into account our increasing need, we need to take into account the fact that losing those decreases likely impacts those programs just like it does ours, which means it continues to be largely competitive across the state, inhibiting some programs from accessing those fundings.”

Meaghan Gleason, who leads the Brown County count, announced during the Brown County coalition meeting on July 9 that the current number of volunteers signed up for the summer homeless count is lower than the last two counts. She asked attendees to contribute in any way they can. 

“I would encourage you to contact your friends, family, community members, board members, funders — anyone who may be interested in going out and helping and seeing the work that we do in action,” Gleason said. 

In a phone interview on July 16, Gleason said that after reaching out to the coalition for more volunteers, involvement for the July 23-24 overnight summer count in Brown County will now see the highest number of volunteers she’s directed since taking on the role two years ago.

Homeless advocates added that there’s been an increase in encampments, with people experiencing homelessness moving deeper into the woods as the summer goes on. 

Amid the wet and hot season lately, Peter Silski, Green Bay homeless outreach case coordinator, explained that many of the people he encounters have no other choice than to build simple tents and shelters. 

Through conversations with people experiencing homelessness and connecting them with local, grassroots programs, Silski said the goal is “to empower individuals to become self-sufficient, but we want to make sure we’re there for them for as long as they need us.”

Wisconsin Watch reporter Margaret Shreiner contributed to this report.

‘We can’t do it all by ourselves’: As rural homelessness grows in Wisconsin, Republicans balk at boosting support is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 11 minutes

This story was originally published by ProPublica. Co-published with APM Reports.

Photography by Sarahbeth Maney.

Reporting highlights

• A powerful doctor: Dr. Nancy Harper is a leading child abuse pediatrician based in Minnesota. She testifies in criminal trials across the Midwest, almost always for the prosecution.

• Casting doubt: Defense attorneys and judges have called Harper’s testimony into question. Two families have filed federal lawsuits against Harper.

• A new review: Prosecutors in Hennepin County said they are conducting a “final, thorough review” of one of Harper’s cases that will include an evaluation of the “medical conclusions.”

In court, Dr. Nancy Harper comes across as professional and authoritative. Often she begins her testimony by explaining her subspeciality: child abuse pediatrics, which focuses on the diagnosis and documentation of signs of child abuse. Her role, she often reminds judges and juries, is solely medical. Whether or not to remove a child from their home, terminate the parent’s rights or, in the most serious cases, charge a caregiver criminally is not up to her.

According to Harper’s testimony, she and her team at the Otto Bremer Trust Center for Safe and Healthy Children in Minneapolis handle about 700 cases of suspected abuse each year. She has testified that 10% to 20% of those wind up confirmed for physical abuse, although it is difficult to determine if these figures are accurate since child protection cases are not public.

When Harper, the center’s director, and her team diagnose abuse, parents and caregivers often struggle to challenge those opinions. By Harper’s own estimation, she’s never been wrong.

“I don’t think I’ve ever had a case where I thought it was abusive head trauma and the other specialist didn’t,” Harper testified in 2023, in the case of a day care provider charged with the death of a child in her care.

The defense attorney in the case pressed her: “Have you ever incorrectly diagnosed a child with abusive head trauma?”

“Not currently to my recollection,” she answered.

But in a handful of cases, judges and juries have found day care providers and parents not guilty of crimes after Harper has testified that abuse occurred, though a verdict cannot necessarily be interpreted as a repudiation of Harper or any other expert witness’ determinations or credibility.

Additionally, two federal lawsuits filed recently accuse Harper of ignoring or even concealing alternative explanations for children’s injuries. And, more broadly, medical and legal experts are increasingly questioning a leading child abuse diagnosis, shaken baby syndrome, which is also known as abusive head trauma.

Harper did not respond to requests for comment. She has yet to respond to either lawsuit. In past court testimony, Harper has said that both shaken baby syndrome and abusive head trauma are considered scientifically valid diagnoses by the mainstream medical community. Any controversy, she has said, exists primarily in the legal world rather than the medical one.

Kathleen Pakes, a former prosecutor who now specializes in the forensics of child abuse cases for the Office of the Wisconsin State Public Defender, said Harper’s claim of never making an incorrect diagnosis strains credulity.

“There is no other specialty in medicine that has zero error rate. None,” she said.

Below are four cases in which Harper concluded there was abuse but courts or juries determined otherwise.

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On July 12, 2017, an 11-month-old boy named Gabriel Cooper collapsed in his high chair at the day care that Sylwia Pawlak-Reynolds operated in South Minneapolis. Paramedics took him to Hennepin County Medical Center, where he was declared brain dead a day later.

Harper reviewed Cooper’s medical records and wrote that “in the absence of a well-documented consistent severe accidental injury, non-accidental trauma or abusive head trauma remains the primary diagnostic consideration.” The child, she wrote, was essentially shaken to death. Before any criminal charges were filed, Pawlak-Reynolds boarded a plane for her native Poland to care for her ailing father, according to her attorney. In February 2018, prosecutors charged Pawlak-Reynolds with two counts of second-degree murder, citing Harper’s diagnosis.

According to her husband, Will Reynolds, they did not realize Pawlak-Reynolds was pregnant when she boarded her flight to Poland. She remained there to give birth to their third child, who is now 6, while Reynolds remained in Minnesota with their two older children, who are now 13 and 16. Reynolds said he and his wife have no confidence that she will get a fair trial, and that she fears she will lose custody of their youngest child if she reenters the country. The family has now been separated for eight years.

Early in the case, Pawlak-Reynolds’ attorneys obtained the same copy of Cooper’s hospital records that had been provided to Minneapolis police, which included the paramedics’ report. The document had been printed out at a significantly reduced scale, shrinking the text to the point that some fields were illegible. Two years later, they obtained a second copy, printed at normal size, which revealed a possible alternate explanation for the injuries: “Mom recalls (patient) did fall 2 days ago, striking the back of his head.”

“That was the sort of proverbial silver-bullet evidence that we’re always looking for in every case and usually never find,” said Brock Hunter, Pawlak-Reynolds’ lawyer.

Polish courts, including an appeals court, have denied extradition requests from the U.S. three times, and the country’s minister of justice has affirmed the rulings. The denials are particularly critical of Harper’s assessment. Polish forensic experts evaluated the case records and took note of a finding by a neurology expert hired by Pawlak-Reynolds, who wrote that Cooper carried a gene tied to a blood clotting disorder.

The ambulance report, the Polish judges wrote, “was concealed from the defense.”

“Then, after the fact was made public, it did not affect the actions of the American authorities in any way,” a Polish district court judge wrote in 2022.

The Hennepin County Medical Examiner’s Office certified Cooper’s manner of death as “undetermined” and the date and place of injury “unknown,” a tacit disagreement with Harper’s opinion that Cooper would have collapsed “shortly after infliction of the trauma.”

The Hennepin County Medical Examiner’s Office declined to comment.

Then in 2023, Hennepin County Attorney Mary Moriarty wrote to Pawlak-Reynolds’ attorneys after meeting with them: “We agree that to resolve the current impasse regarding Ms. Pawlak-Reynolds, the best course for all involved is to dismiss the pending charges without prejudice, and for her to return to the United States.”

But months later, Moriarty changed her mind.

In a statement to ProPublica, a spokesperson for the Hennepin County Attorney’s Office wrote that the office is completing a “final, thorough review” of the case that will include an evaluation of “concerns regarding the medical conclusions and the overall strength of the case.”

Gabriel’s parents, Joseph and Samantha Cooper, did not respond to requests for comment. In a television interview in June, they denied that Cooper struck the back of his head two days before his collapse. They said that they want justice for their son.

Pawlak-Reynolds declined to comment through her attorney. In late February, her husband filed a federal lawsuit against Harper that claims she “knowingly and intentionally falsified, modified and erased exculpatory information” from her evaluation of Cooper, and she diagnosed abusive head trauma to “promote her own personal, academic, reputational and financial needs.”

Harper has yet to respond to the lawsuit. A spokesperson for Hennepin Healthcare, which operates Hennepin County Medical Center, declined to comment on the case or the lawsuit.

“There is no oversight,” Reynolds said. “It’s the thing they’re most resistant against and the thing that is most necessary to stop this legacy of brutality, that results in kids being taken away from innocent caregivers and innocent caregivers going to prison.”

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In August 2017, Kathryn Campbell called 911 after a 4-month-old girl at her day care seemed lethargic and was “breathing wrong.” First responders did not take the baby to the hospital, but her mother eventually did. At the hospital, MRI scans showed fluid in the baby’s brain and doctors noted small bruises.

Dr. Barbara Knox, a child abuse pediatrician then with the University of Wisconsin, told police it was “obvious child abuse.” The Dane County district attorney charged Campbell with physical abuse of a child. Campbell pleaded not guilty.

But before the 2021 trial, Knox left the University of Wisconsin after she was placed on leave for “unprofessional acts that may constitute retaliation” and intimidation of her own staff. A Wisconsin Watch investigation cast doubt on Knox’s judgment in several cases of alleged abuse.

Knox did not respond to the Wisconsin Watch series or to ProPublica’s requests for comment. After two families in Alaska sued her in 2022, alleging she had wrongly concluded their children had been abused, Knox wrote in an affidavit that she has no control over whether police and child protection services workers take children away from parents, that she did not “conspire” with police or anyone else on custody issues, and that she did not personally evaluate one of the children. The lawsuit was dismissed in 2024 after the families agreed to drop the matter.

Knox moved on to a job at the University of Florida. According to a spokesperson for the university, Knox resigned as a pediatrician with the Child Protective Team in late June, effective Aug. 15. He declined to comment on the circumstances.

At Campbell’s trial, Knox’s name was never mentioned. Instead, Harper stepped in as an expert witness. When Campbell heard Knox had been replaced, she was initially hopeful.

“I’m like, oh, great, new eyes,” Campbell said. “They’re going to look at it and go, ‘This is nuts, I don’t agree with this.’ And I definitely was wrong.”

Harper’s assessment affirmed Knox’s diagnosis of abuse. She told the jury that the bruises were likely caused by squeezing by an adult’s hand. A medical expert hired by Campbell’s defense argued that the child’s bleeding could not be precisely dated and that a preexisting medical condition could have caused it.

After just two hours of deliberation, the jury returned a not guilty verdict. Campbell said she is grateful to have the case concluded, though she said she is still haunted by the accusations against her.

“That was the hardest thing too, going home after this case was done, and being like, ‘Am I allowed to be alone with my children now?’” she said. “It’s all because of the quote-unquote experts not doing their due diligence and looking further into underlying issues that these kids could have.”

In a statement to ProPublica, Dane County District Attorney Ismael Ozanne expressed confidence in both Harper and Knox, saying “their testimony had been consistent with many different medical professionals and experts in their own areas of practice.”

“It is important to note that a not guilty verdict by lay jurors hardly invalidates the widespread acceptance of abusive head trauma as a diagnosis in the medical community nor would it cause us to have concerns about Dr. Harper’s qualifications or knowledge in the field,” he added. “Jurors are not bound to accept any expert testimony as accurate.”

---

In the winter of 2022, a 4-month-old boy began breathing abnormally at his day care in Mineral Point, Wisconsin. His parents took him to a hospital, where he died days later. A police investigation determined that his day care provider, Joanna Ford, left him and several other children alone in her home for over an hour while she went to a tattoo and piercing parlor.

Prosecutors used Harper as an expert witness in the case. After evaluating the child’s medical records, she concluded that his injuries were “clinically diagnostic of abusive head trauma,” or, put another way, Ford shook the baby violently. She was charged with first-degree reckless homicide. Ford pleaded not guilty.

Ford’s defense lawyers successfully petitioned the judge in the case for a hearing to determine whether Harper’s expert witness testimony would be scientifically valid and admissible at trial. In response to questions, Harper explained why the child’s symptoms — brain swelling, blood under his skull, damage to his eyes — pointed to abuse, and why, despite the controversy surrounding it, the diagnosis of abusive head trauma was scientifically sound. She also explained that, because the baby was not walking or crawling, the fact that none of his caregivers could explain his injuries indicated abuse.

“People should know what happened,” she testified.

On cross examination by Ford’s lawyers, Harper said she couldn’t say for certain what time the abuse would have occurred, exactly how Ford had injured the baby and that there are no “great biomechanical models” for shaken baby syndrome.

A little over a month later, Judge Lisa McDougal delivered a highly critical ruling that barred Harper from telling the jury that the child died as the result of “abusive head trauma, non-accidental injury, child abuse or murder.” She also took issue with the idea that a lack of explanation for injuries is indicative of abuse, calling it a “leap in logic.”

“Offering a conclusive opinion as to how an injury may have occurred crosses a line and does not fit within the dictionary definition of what diagnosis is,” McDougal said. The judge also said that Harper views herself as an advocate, and that that casts doubt on her “fidelity to the scientific validation of abusive head trauma diagnoses, especially when it is a close call.”

The murder charge was dismissed. For leaving the children alone, Ford pleaded guilty to the lesser charge of neglect of a child where the consequence is death. She is serving a 10-year prison sentence. Ford, through her attorney, declined a request for an interview. The Iowa County district attorney also declined to comment.

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On Feb. 4, 2022, Paul and Sarah Marshall hosted a dinner for her parents and a family friend at their home in Hudson, Wisconsin. Afterward, their 7-week-old son, Fox, became fussy. Paul Marshall carried him into the mother-in-law unit on the lower level of the house, which was cool and dark, to try to calm him. He emerged minutes later in a panic, yelling that the baby spit up and stopped breathing.

Paramedics rushed Fox to Children’s Minnesota, a hospital about 25 minutes across the state border in St. Paul. Doctors ran tests, and a scan showed Fox had a skull fracture with fluid pooling on both sides of his brain. He died days later.

Harper examined Fox, as well as his twin sister, Liana, and found “skull fractures, likely rib fractures, metaphyseal fractures.”

“This constellation of findings in a nonambulatory infant is clinically diagnostic of inflicted injury or child physical abuse likely occurring on more than one occasion,” she wrote.

But the Marshalls said that wasn’t true. They told Harper that Sarah Marshall had experienced a difficult pregnancy with gestational diabetes and severe anemia, and that Liana had a vacuum-assisted delivery. Both twins had been to their regular pediatrician over health concerns. While Liana’s health improved, Fox’s had not.

A spokesperson for Children’s Minnesota declined to comment on the case.

Because he was the last person alone with Fox before he stopped breathing, Paul Marshall was charged with first-degree reckless homicide. He was also charged with physical abuse of a child for hurting Liana. Sarah Marshall said there was no evidence that her soft-spoken husband had hurt their children.

“The state wanted to cast me as a naive idiot,” she said. “I chose not to believe it because of the logic and facts in my face. I had no reason to believe the accusation.”

At Paul Marshall’s 2023 trial, his defense lawyer, Aaron Nelson, cross-examined the other doctors who treated or evaluated Fox and Liana, and was able to highlight points of medical disagreement. A doctor who tested Liana for genetic disorders said she could not rule out rickets as a possible cause of her bone fractures. A neuropathologist did not agree with Harper that Fox had a trauma-induced blood clotting disorder. By Harper’s own admission on cross-examination, determining the age of the skull fractures in children Fox and Liana’s age was difficult. Nelson called six of his own medical experts to suggest that the difficult birth or a vitamin deficiency could explain the twins’ injuries.

“How many people have to be wrong for Dr. Harper to be right?” Nelson said in closing arguments.

After an 11-day trial, the jury found Marshall not guilty.

In a statement to ProPublica, St. Croix County District Attorney Karl Anderson pointed out that Harper was not the only treating physician who was concerned that Fox and Liana had been abused.

“A not guilty verdict does not mean that the jury concluded that the children were not abused,” Anderson said. “Rather, it means that they did not conclude that the state proved that Paul Marshall caused the death, beyond a reasonable doubt.”

Six weeks after the trial, the family moved three hours away into a century-old farmhouse that is far from the community that they felt wrongfully villainized by.

One of the cruelest impacts of the abuse diagnosis, they said, came after it was clear that Fox would die and the hospital staff began making preparations for his organs to be donated. Sarah Marshall said she had hoped to someday hear her son’s heart beating in another child’s chest. Instead, a court order put a halt to the procedure.

“They were already treating him as evidence,” she said.

The experience of going from a grieving parent to an accused murderer, her husband said, has given the couple post-traumatic stress. Paul Marshall said he is grateful to be with his wife and children, but what he calls a “broken system” has left them unsure whether or not to have another baby or even be left alone with one of their daughters.

“You get pregnant. You go to all of your appointments. You voice all of your concerns. You do everything you’re supposed to do as a parent and your child still dies. And the state tells you it’s your fault,” Sarah Marshall said. “I don’t understand why I live in a world like that.”

Mariam Elba contributed research.

ProPublica is a Pulitzer Prize-winning investigative newsroom. Sign up for The Big Story newsletter to receive stories like this one in your inbox.

This doctor specializes in diagnosing child abuse. Some of her conclusions have been called into question. is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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When Joshua Liston-Zawadi’s wife, Symphony, delivered their fourth child, Harlem, at home_, the 31-year-old felt excluded.

The midwife would check on Symphony frequently, but not him. 

That experience prompted him to do something for the fathers.

In 2021, Joshua launched Dad Doula University to provide non-birthing parents with free workshops on emotional changes, pregnancy and personal growth.

“As you go through becoming a parent, no one educates the non-birthing people or men on how to navigate changes within yourself,” Joshua said. 

Doulas are certified individuals who provide emotional, physical and informational support during the prenatal, birthing and postpartum process.

From struggles to lessons

Symphony and midwife Dr. Lakeeta Watts encouraged Joshua to take his struggles and turn them into lessons for others. 

Symphony helped create curricula, co-facilitate sessions and coordinate, while Watts provided Joshua with certified doula training. 

“To see him commit to supporting other families in his unique way has been a pleasure to watch and support,”  Symphony said. 

A male perspective

Watts noticed Joshua often stepping back to elevate women’s voices in different environments but reminded him that his perspective matters, too. 

“I told him that even though that’s very honorable of him, we often lose the voice of men in these spaces as well,” Watts said. 

Dad Doula University initially started as a virtual program via Zoom and Clubhouse because of the COVID pandemic. 

The program eventually secured a spot inside the Sherman Phoenix Marketplace, 3536 W. Fond du Lac Ave., Milwaukee, where in-person sessions are held. 

(Joshua said the virtual option is still being offered to dads seeking support abroad.) 

“Any dad who needs support, regardless of where you are, I got you,” Joshua said. 

A safe space for dads

Among the participants of Dad Doula University is 34-year-old Markus Thompson, a single dad of two daughters who joined the program to connect with other fathers. 

Thompson described the program as a great emotional space to release anxiety, fears and self-doubt. 

“The men I was around were there during the times I felt alone,” Thompson said. 

Throughout the program, Joshua taught Thompson about a birthing plan, a document created before labor to tell hospital staff one’s preferences on how the birthing should go. 

“I teach men that it’s their job to be in charge of this process, and the only way they can do that is if they involve the person that they’re caring for,” Joshua said. 

Thompson said the birth plan included things you’d never think of like whether the mother wants music during labor or how to advocate for her when she can’t herself. 

“Raising children isn’t a one-parent thing,” he said.

Thompson is now a 2025 alumnus of Dad Doula University’s two-week program and encourages other dads to join. 

At the end of the program, graduates get a certificate, take their first family photo and receive free baby essentials and a year’s supply of diapers. 

For fathers hesitant about seeking support during pregnancy, Joshua lives by a motto that says: “If I’m not OK, then nothing I touch will be.”

For more information

Click here to register and learn about upcoming sessions. 

In case you missed it: Our friends at TMJ4 also profiled the program.

Dad Doula University: Milwaukee program supports new fathers is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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As we continue to report on Wisconsin’s readiness for potential measles outbreaks, we have spoken to several people who have shared their memories of having measles before a vaccines were widely available. We’d love to hear from more of you. 

Before the 1960s, hundreds of thousands of Americans faced measles infections each year. The advent of vaccination eliminated the disease in the United States by 2000. But outbreaks have returned to some U.S. communities as trust in vaccines wanes in many communities.

We’re following whether measles will return to Wisconsin, which has some of the nation’s lowest vaccination rates for children.

If you have a story to share, whether it’s your own experience with measles or your observations of what it was like at the time, please take a moment to fill out this short form. Your submissions will shape the direction of our reporting and will not be shared publicly. But we may follow up with those who indicate they are comfortable with us doing so. 

Thanks to those who have already shared their perspectives and questions. 

Here are the stories your feedback has inspired so far: 

• Wisconsin, once a leader in childhood vaccinations, now a leader in vaccine skepticism
• DataWatch: Measles will likely arrive in Wisconsin. Here’s where vaccination rates are trending

Did you witness measles outbreaks decades ago? Share your experience  is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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The Wisconsin Supreme Court’s liberal majority struck down the state’s 176-year-old abortion ban on Wednesday, ruling 4-3 that it was superseded by newer state laws regulating the procedure, including statutes that criminalize abortions only after a fetus can survive outside the womb.

The ruling came as no surprise given that liberal justices control the court. One of them went so far as to promise to uphold abortion rights during her campaign two years ago, and they blasted the ban during oral arguments in November.

Ban outlawed destroying ‘an unborn child’

The statute Wisconsin legislators adopted in 1849, widely interpreted as a near-total ban on abortions, made it a felony for anyone other than the mother or a doctor in a medical emergency to destroy “an unborn child.”

The ban was in effect until 1973, when the U.S. Supreme Court’s landmark Roe v. Wade decision legalizing abortion nationwide nullified it. Legislators never officially repealed it, however, and conservatives argued that the U.S. Supreme Court’s 2022 decision to overturn Roe reactivated it.

Ruling: Post-Roe laws effectively replaced ban

Wisconsin Attorney General Josh Kaul, a Democrat, filed a lawsuit that year arguing that abortion restrictions enacted by Republican legislators during the nearly half-century that Roe was in effect trumped the ban. Kaul specifically cited a 1985 law that essentially permits abortions until viability. Some babies can survive with medical help after 21 weeks of gestation.

Lawmakers also enacted abortion restrictions under Roe requiring women to undergo ultrasounds, wait 24 hours before having the procedure and provide written consent and receive abortion-inducing drugs only from doctors during an in-person visit.

“That comprehensive legislation so thoroughly covers the entire subject of abortion that it was clearly meant as a substitute for the 19th century near-total ban on abortion,” Justice Rebeca Dallet wrote for the majority.

Sheboygan County District Attorney Joel Urmanski, a Republican, defended the ban in court, arguing that it can coexist with the newer abortion restrictions.

Dane County Circuit Judge Diane Schlipper ruled in 2023 that the 1849 ban outlaws feticide — which she defined as the killing of a fetus without the mother’s consent — but not consensual abortions. Abortions have been available in the state since that ruling, but the state Supreme Court decision gives providers and patients more certainty that abortions will remain legal in Wisconsin.

Urmanski had asked the state Supreme Court to overturn Schlipper’s ruling without waiting for a decision from a lower appellate court.

Liberal justices signaled repeal was imminent

The liberal justices all but telegraphed how they would rule. Justice Janet Protasiewicz stated on the campaign trail that she supports abortion rights. During oral arguments, Dallet declared that the ban was authored by white men who held all the power in the 19th century. Justice Jill Karofsky likened the ban to a “death warrant” for women and children who need medical care.

A solid majority of Wisconsin voters in the 2024 election, 62%, said abortion should be legal in all or most cases, according to AP VoteCast. About one-third said abortion should be illegal in most cases, and only 5% said it should be illegal in all cases.

In a dissent, Justice Annette Ziegler called the ruling “a jaw-dropping exercise of judicial will.” She said the liberal justices caved in to their Democratic constituencies.

“Put bluntly, our court has no business usurping the role of the legislature, inventing legal theories on the fly in order to make four justices’ personal preference the law,” Ziegler said.

Urmanski’s attorney, Andrew Phillips, didn’t respond to an email. Kaul told reporters during a news conference that the ruling is a “major victory” for reproductive rights.

Heather Weininger, executive director of Wisconsin Right to Life, called the ruling “deeply disappointing.” She said that the liberals failed to point to any statute that explicitly repealed the 1849 ban.

“To assert that a repeal is implied is to legislate from the bench,” she said.

Court dismisses constitutional challenge

Planned Parenthood of Wisconsin asked the Supreme Court in February 2024 to decide whether the ban was constitutional. The court dismissed that case with no explanation Wednesday.

Michelle Velasquez, chief strategy officer for Planned Parenthood of Wisconsin, said Wednesday’s ruling creates stability for abortion providers and patients, but she was disappointed the justices dismissed the constitutional challenge. She hinted that the organization might look next to challenge the state’s remaining abortion restrictions.

Kaul said he has no plans to challenge the remaining restrictions, saying the Legislature should instead revisit abortion policy.

Democratic-backed Susan Crawford defeated conservative Brad Schimel for an open seat on the court in April, ensuring liberals will maintain their 4-3 edge until at least 2028. Crawford has not been sworn in yet and was not part of Wednesday’s ruling.

Abortion fight figures to play in 2026 court race

Abortion figures to be a key issue again next spring in another race for a state Supreme Court seat. Chris Taylor, a state appellate judge who served as Planned Parenthood of Wisconsin’s policy director before a stint as a Democratic legislator, is challenging conservative Justice Rebecca Bradley.

Taylor’s campaign sent out an email Wednesday calling the ruling a “huge victory” and asking for donations. She issued a statement calling the decision the correct one and blasting Bradley’s dissent as “an unhinged political rant.”

Bradley wrote that the four liberal justices fancy themselves “super legislators” and committed “an affront to democracy.”

Wisconsin Watch is a nonprofit and nonpartisan newsroom. Subscribe to our newsletters to get our investigative stories and Friday news roundup. This story is published in partnership with The Associated Press.

Wisconsin Supreme Court strikes down state’s 1849 abortion ban is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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• Sauk County’s public nursing home will remain county-owned — and open — after a resolution to begin closing the facility failed to advance during a chaotic Board of Supervisors meeting. It was a win for organizers who have relentlessly resisted efforts to privatize the facility. 

• Tensions have escalated since last year, when the board approved selling the nursing home to the for-profit Aria Healthcare. Opponents sued the county to halt the sale, and Aria backed out of the deal. 

• Some county board members say a sale is the best way to keep the facility open as costs increase. Opponents argue the board should prioritize investing in the home, rather than risking inferior privatized care. 

• Similar debates have unfolded in at least four other Wisconsin counties over the last two years.

Sauk County’s public nursing home will remain county-owned — for now. That’s after a resolution to begin closing the facility failed to advance to the full county board during a meeting that ended in chaos last week.

It was the latest twist during a relentless campaign by local residents to keep county control of services that have existed locally in some form since the 1800s. Heading into a special meeting Thursday, proponents of keeping the Sauk County Health Care Center public feared defeat. 

The Sauk County Board of Supervisors was expected to vote on a resolution to close the nursing home if it weren’t sold. The meeting drew more than 80 attendees to the county board room. Several held signs, declaring “SAVE OUR SAUK CO. HEALTH CARE,” and “WE LOVE OUR SAUK COUNTY NURSING HOME.”   

Instead, no vote took place, and the board adjourned the meeting within two minutes without allowing public comment.

Organizers yelled “shame on you” as board members left the room.

 “You won,” County Board Chair Tim McCumber shouted at the chanting organizers. “The damn nursing home hasn’t been sold, and it hasn’t been closed.”

Tensions have escalated since last year, when the board approved selling the nursing home to the for-profit Aria Healthcare. Opponents sued the county to halt the sale. The litigation and broader opposition prompted Aria, which did not respond to a request for comment, to back out this month, according to Thursday night’s tabled resolution. 

Board members supporting a sale call it the best way to keep the facility open as costs increased. Opponents argue the board should prioritize investing in the home, rather than risking inferior privatized care. 

Wisconsin counties debate nursing home sales

Similar debates have unfolded in at least four other Wisconsin counties over the last two years. St. Croix found new revenue streams to keep its nursing home public, while Washington County sold its facility to a private nursing home chain. Lincoln County approved a sale this month, and Portage County continues seeking buyers.  

Wisconsin still maintains more county-owned nursing homes than most states, but that number has shrunk in recent years, concerning nursing home residents and their loved ones.

County-owned nursing homes tend to be better staffed, have higher quality of care and draw fewer complaints than facilities owned by for-profits and nonprofits, a 2024 WPR/Wisconsin Watch analysis of U.S. Centers for Medicare and Medicaid Services data shows.

Sauk County’s nursing home has a history of high care ratings, but those have recently slipped. Federal inspections between October 2024 and April yielded three “immediate jeopardy” citations related to patient care. Those citations, the most severe type, dropped the facility’s overall rating to “much below average,” CMS data shows. 

Meanwhile, the nursing home has struggled with staffing, losing 10 employees since May 23, including its director of nursing, Thursday’s resolution said. More expensive contractors, many from out of town, are filling in. 

“We need to do everything to make sure that that facility is as successful as it used to be,” said Judy Brey, a leader of the citizen group suing the county. 

Her group filled the board room Thursday night.

By tabling the resolution, the board preserved the status quo. 

“It’ll be county-run until we have more patient care problems out there and the state intervenes, or we’re able to sell it,” said McCumber, who has had family stay at the facility.

While Thursday’s resolution had left room for Aria or another company to buy the home before finalizing its closure, some board members — even proponents of a sale — were not comfortable voting to potentially close it, said Supervisor Terry Spencer.

Spencer, who favors a sale, sits on the Public Works and Infrastructure Committee, one of three committees that met before the full board meeting and took no vote on the resolution.

“If it’s going to fail on its own, we’ll just let it fail on its own, and then we’ll close it,” Spencer said. “But I’d rather see it try than just say we’re closing our doors.”

Resident: Nursing home is ‘one big family’ 

Sauk County has operated a care facility in some form since 1871 — using it to treat diseases ranging from smallpox in the early 1900s to Alzheimer’s in the 1990s, according to the county’s website. Around 50 people live in the facility today, including Robert Leopold, 84, who has been there about a year. He and two other nursing home residents came to the board meeting to speak out against a closure.

“We (nursing home residents) play cards, we have fun, and it’s one big family,” Leopold, a retired teacher and longtime 4-H volunteer locally, said with tears in his eyes. 

“If we have to go someplace else, we’re all going to be a family gone,” he added. “I just hope the board realizes what a beautiful facility they’ve got and be proud of it and do something with it.”

The meeting’s rapid adjournment left no opportunity for Leopold — who was attending his first board meeting during the nursing home debate — or others to publicly voice their perspectives. Brey and others shouted demands that the board allow public comment, pointing out that nursing home residents had traveled 30 minutes to be there.

McCumber responded: “Shame on you for dragging people out of a nursing home.” 

“(Nursing home residents) showed up and they wanted to speak, but nobody gave them the chance,” Brey replied. “That is despicable.”

Sale falls through

While energized by Thursday’s outcome, residents are bracing for a future attempt to sell or close the home.

But McCumber said the county’s best option, Aria, likely won’t buy the facility until what he calls a “frivolous” lawsuit is dropped or dismissed.

Aria received board approval to purchase the facility in September, but the county still needed state approval. The Department of Health Services previously blocked Aria from buying another nursing home, citing past citations that, the department said, “demonstrate a history of noncompliance,” according to the Cap Times.

Aria’s four Wisconsin nursing homes have federal ratings ranging from “much above average” to “much below average.”

The state ultimately approved the Sauk County purchase in May, but the lawsuit prompted Aria to instead seek a leasing agreement with the county.

While the county board approved that arrangement, the state health department required additional approval, according to the resolution. The original state-approved sale plan required Aria to take over the nursing home by July 1. Moving forward with a sale or lease after that deadline would require a new license application, which can take up to 60 days.

Aria told county officials it no longer wished to continue due to misrepresentations of the company online and “unwarranted attacks” that could interfere with business operations and patient care, according to the resolution.

Asked about the potential for a future Aria purchase of the nursing home, resident Mary Camp responded: “You don’t want to know.”

The 79-year-old has lived there for four years and described it as the “best place in the world.”

“I thought it was terrible they were going to sell,” Camp said. “I don’t think (Aria is) going to buy it now. I don’t know. I hope not.”

Her favorite part about her home? The people. At least twice a day someone asks her how she’s doing, and “it’s fantastic,” she said. Her 56-year-old son lives there too.

As they peer into an uncertain future, Brey said she has no plans to slow down her group’s work. As Thursday’s meeting ended, she collected donations for legal fees during a discussion about next steps, including potentially campaigning to recall board members who favored a sale. 

“I feel the power of people being together and united on this,” Brey said. “They know we mean business.”

Sauk County organizers fight off nursing home closure — for now is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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The Social Development Commission, or SDC, is asking the federal government to reverse a decision made by the state that could alter the anti-poverty agency’s funding options. 

Here’s what we know.

The community action decision 

The Wisconsin Department of Children and Families decided in May to remove the SDC’s community action agency status, effective July 3.

Although the department believes SDC has not been operating anti-poverty services since it shut down in April 2024, despite reopening in December, SDC’s leaders have said the state did not follow the proper process to make this decision.

Without this designation, SDC will not be eligible for a Community Services Block Grant, which is a small portion of its budget but significant to its efforts to pay back employees and rebuild its service programs.

How does a federal review work? 

When a state decides to rescind community action status or the related block grant funding from a local agency, the agency can request a review from the U.S. Department of Health and Human Services within 30 days. 

SDC submitted a request for a review of the state’s community action decision to the department on June 9, citing concerns about due process. 

The Department of Health and Human Services, or HHS, will evaluate if the state’s determination process followed the guidance on the termination or reduction of funding for entities eligible for the Community Services Block Grant, according to a spokesperson from the department. 

The Division of Community Assistance, which is part of the Office of Community Services within the federal department, oversees block grant funding for community action agencies. 

“I think that HHS is concerned about the process that was used to de-designate SDC, and so my expectation is that they will be talking to the state about the process,” said William Sulton, SDC’s attorney.

The Department of Children and Families received notification on June 11 from the Office of Community Services that SDC requested a review, but did not receive the request itself, according to Gina Paige, communications director for the department.

The review will be completed within 90 days of receiving all required documentation from the state, according to federal law. If not completed in the 90-day time frame, the state’s decision will be upheld. 

As part of the request, SDC is asking the Department of Health and Human Services for direct financial assistance. 

According to the CSBG Act, if a state violates the de-designation process –  by terminating or reducing funding of an eligible entity before the state hearing and the secretary’s review – the Health and Human Services secretary is authorized to provide financial assistance to the entity affected until the violation is corrected.

SDC’s concerns 

SDC raised two main concerns with the state’s determination process in the request, based on state and federal laws.  

The first concern is that the public hearing on SDC’s community action status, held by the Department of Children and Families on April 4, did not meet the legal requirements of a “hearing on the record.”

“You’re supposed to be permitted to call witnesses and present evidence,” Sulton said. “… We were given seven minutes to make a speech, and that was it.” 

SDC also says that both the Department of Children and Families’ secretary and the legislative bodies of the city of Milwaukee and Milwaukee County would have to sign off on the decision, based on a state statute that requires the legislative body that initially granted the agency community action status to approve rescinding it. 

“They didn’t go out and get position statements from the city and the county’s legislative bodies,” Sulton said. 

The department did not comment on these claims. (Paige previously said it has worked closely with the Office of Community Services and Milwaukee County to determine the process needed to move forward with de-designating SDC.)

Although Milwaukee County’s Office of Corporation Counsel submitted a letter to say it found no records of the Board of Supervisors taking action on SDC’s status as a community action agency, Sulton said that doesn’t mean there are no records. 

He argues that this provision of the law, added in 1983, was put in place to protect SDC from arbitrary state action.

Funding deadline

In May, three state lawmakers asked SDC to consider voluntarily de-designating, which would allow the state and Milwaukee County to more quickly find an interim service provider to use SDC’s allocated funds in Milwaukee County. 

The $1.18 million in 2024 block grant funding could be recouped by the federal government if not spent by Sept. 30, 2025, according to the Department of Children and Families. 

However, Sulton said when he reached out to the Department of Health and Human Services before filing the review, an employee told him the 2024 funds had to be obligated by 2026.

“To the extent that anybody has the impression that this money has to be obligated by September or it’ll be lost, HHS says it’s not the case,” he said. 

States and subrecipients usually have two years to distribute funds, but it depends on state-specific policies, according to HHS.

The state’s Sept. 30 deadline marks two years after the beginning of the 2024 fiscal year in October 2023, according to Paige. 

Though Paige said that SDC’s request for review is perpetuating the lack of services in Milwaukee County, she added that the department plans to seek a six-month liquidation extension from the federal government.

“It’s quite possible that we’re gonna be on a really tight timeline to get that money out the door, so that’s why we’re hoping that we can work with the federal government and see if they can allow us an extension to expend it a little bit longer,” Paige said. 

Board member changes

The SDC board added two commissioners in May – Milwaukee Public Schools appointed Michael Harris, and the Interfaith Conference of Greater Milwaukee appointed Peter Fetzer, an attorney at Foley & Lardner LLP. 

In the last seven months, the SDC board has expanded from three to 10 commissioners, thanks to several appointments to vacant seats. The board is designed to have 18 members at full capacity. 

Commissioner Lucero Ayala’s term has ended, according to Sulton. Ayala was nominated and selected last year to fill the remainder of Serina Chavez’s term as an elected commissioner.

Milwaukee Social Development Commission wants feds to reverse state funding decision   is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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Wisconsin’s rate for vaccinating 5- and 6-year-olds against measles, mumps and rubella (MMR) has continued to slide since the COVID-19 pandemic began, with 74.1% of such children receiving two doses of the shot in 2024 — down from 79.3% in 2019. 

Nearly every Wisconsin county last year vaccinated a lower share of kindergarten-aged children for MMR than before the pandemic. Menominee County, home to the Menominee Indian tribe of Wisconsin, was the lone exception, according to Wisconsin Department of Health Services data. 

After dipping from nearly 80.7% in 2019 to as low as 74.7% during the height of the pandemic, Menominee County’s MMR vaccination rate for kindergartners grew to nearly 83.6% in 2024, the state’s highest rate. 

That success was due to local health officials “being proactive” and conducting outreach that included “looking up kids that were behind, reaching out to parents and encouraging them to bring them in,” said Faye Dodge, director of community health nursing services at the Menominee Tribal Clinic.

Vaccination rates matter because measles is highly contagious and potentially dangerous.

Before the 1960s, hundreds of thousands of Americans faced measles infections each year. The advent of vaccination eliminated the disease in the United States by 2000. But outbreaks have returned to some U.S. communities as trust in vaccines wanes in many communities.

The U.S. Centers for Disease Control though June 19 confirmed more than 1,200 measles cases this year in 36 states, including every state bordering Wisconsin. About 12% of cases sent patients to the hospital. Three people have died.  

Wisconsin, which has some of the nation’s lowest vaccination rates for children, has been lucky to have dodged cases so far, said Margaret Hennessy, a pediatrician and member of the Wisconsin Council on Immunization Practices.

Wisconsin’s risk of outbreaks will grow as families with children travel over the summer.

“They’re going to be traveling all over the country,” Hennessy said. “Realistically, it’s likely a matter of time for somebody who’s not vaccinated or doesn’t have immunity to get the disease.”

Wisconsin Watch analyzed statewide vaccination data for 5- and 6-year-olds in the state, conducted other research and spoke to public health officials.

Here are some takeaways:

• The COVID-19 pandemic disrupted local vaccination programs, leaving children behind in their vaccination schedules. Understaffed, under-resourced counties have struggled to catch up. 
• Creating relationships with trusted community members and reducing access barriers is the most effective way to inoculate more children against contagious diseases like measles, public health officials say. 
• No Wisconsin county comes close to reaching the vaccination rate of 95% that is considered the benchmark for herd immunity protection. That was true in 2024 and before the pandemic. 
• Just three counties — Manitowoc, Marathon and Kewaunee — fully vaccinated at least 80% of kindergarten-aged children in every year from 2019 to 2024. 
• While vaccination rates are lagging from pre-pandemic levels in most counties, 28 of Wisconsin’s 72 counties reported vaccination gains between 2023 and 2024 — four more than the previous year. Still, the majority of counties saw declines.

Vaccination rates are plunging in Clark County, which consistently ranks lowest statewide for vaccinating 5- and 6-year-olds against measles. Just 42.9% of those children received both MMR doses in 2024, down from 57.9% in 2019. 

Brittany Mews, Clark County’s health officer and director, cites a range of challenges in her sprawling county. Those include distances between few clinics in communities with no public transportation, low levels of health insurance access and diverse populations who face language barriers — and may adhere to cultural norms that prioritize traditional remedies over Western medicine.

But the county has found some success in partners ranging from school districts and child care centers to faith communities, Mews said. The health department has asked schools to notify parents when their children need vaccines, for instance, and positive feedback prompted the scheduling of multiple vaccine clinics at the schools and community churches.

Community partnerships in familiar places make people feel more comfortable — particularly in the county’s diverse communities, including those with language and cultural differences. 

Clark County is also working to increase vaccine access by partnering with neighboring health departments to offer vaccination clinics six times a year at a church food pantry, creating a “one-stop-shop” system, Mews said.   

Forging personal connections can grow trust and spread accurate information at a time when disinformation is running rampant online, Hennessy said. Hearing about positive vaccination experiences from a parent, neighbor or other trusted source can hold more weight than information a physician shares. 

“It’s unfortunate that we all can’t be everywhere all the time to fill that,” Hennessy said.

Heather Feest, a Manitowoc County public health nurse manager, said patience and understanding of concerns are also key to increased vaccinations.

“We’re not trying to persuade one way or another, it’s giving that information and answering questions — and allowing them to get factual information and have a conversation without judging,” Feest said. “It’s harder now than what it used to be.”

DataWatch: Measles will likely arrive in Wisconsin. Here’s where vaccination rates are trending is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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• Health care systems including SSM Health, Aurora Health, UW Health and, most recently, Ascension have removed from their websites language related to diversity, equity and inclusion (DEI).

• The changes have come in the months since President Donald Trump has signed executive orders abolishing federal DEI programs.

• UW Health publicly announced changes such as the removal of anti-racism modules titled “Being a leader in anti-racism” and “anti-racism funding” and replacement with modules called “Being a social impact leader” and “Community giving.”

Multiple Wisconsin health care systems have removed diversity, equity and inclusion language or resources from their websites in the wake of President Donald Trump’s federal ban on funding for DEI programming.

The systems include SSM Health, Aurora Health, UW Health and, most recently, Ascension. Froedtert ThedaCare Health has maintained its DEI webpage, though it removed a link to its equal employment opportunity policy in recent months. 

Aurora Health, Ascension, Froedtert and SSM Health made the changes quietly, without directly alerting the public. UW Health, however, released an op-ed in Madison 365 April 8 explaining the changes.

“As we enter the next phase of this important work, we are further aligning with our organizational mission under the name of Social Impact and Belonging,” the op-ed said. “This reflects both the evolved nature of the work and our desire that these mission-focused priorities endure despite the current tumultuous political environment.”

The changes occurred in the weeks after President Donald Trump’s executive order abolishing DEI programs from all federally funded institutions and programs. 

The executive order, issued Jan. 20, states the “Biden Administration forced illegal and immoral discrimination programs, going by the name ‘diversity, equity, and inclusion’ (DEI), into virtually all aspects of the Federal Government, in areas ranging from airline safety to the military.” 

In response to attacks on DEI programs by the federal government, some organizations have pushed back, arguing Trump’s actions are a threat to a multiracial democracy. Some institutions are also suing the federal government for its actions, such as threatening to withhold federal grants and funding. 

Harvard University has filed a lawsuit, citing First Amendment principles to protect “academic freedom” and “private actors’ speech.”

But while some federally funded institutions are pushing back, others are not.

Different approaches to DEI purge

In the past couple of months, SSM Health removed the word “diversity” from its website, including changing a page titled “Our Commitment to Diversity” to “Our Commitment to Healthy Culture.”

SSM has hospitals located throughout Wisconsin including Ripon, Fond du Lac, Waupun, Baraboo, Janesville, Madison and Monroe.

In changing the webpage, SSM Health also removed an entire section regarding its commitment to fostering a diverse workplace and health care center, including a section that read, “​​SSM Health makes it a point to work with diverse organizations broadening our reach into the communities we serve to support and promote a more inclusive society.”

SSM Health also notably replaced the section discussing diversity with comment on SSM Health’s mission as a Catholic ministry. On the updated page, the system discusses its commitment to follow in the footsteps of its founders to ensure “all people have access to the high-quality, compassionate care they need.” 

In removing the word “diversity,” SSM replaced the statement “At SSM Health, diversity is an integral part of who we are and a reflection of our mission and values” with “At SSM Health, inclusion is an integral part of who we are and a reflection of our Mission, Vision and Values.”

”Today, our belief that every person was created in the image of God with inherent dignity and value calls us to foster a healthy culture, inviting each person to be the best version of themselves,” SSM Health communications consultant Shari Wrezinski said when asked for comment. 

Wrezinski said the organization’s mission has remained the same, and its communications, policies, programs and practices reflect the organization’s mission.

“This has not and will not change,” Wrezinski said. “As such, our website and other communications materials are continually updated as we strive to clearly convey our commitment to a welcoming environment where everyone feels valued and respected.”

Despite removing the section on diversity, SSM Health has maintained its equal opportunity section.

Froedtert did the opposite, by maintaining its webpages on diversity, equity and inclusion, but removing its equal opportunity policy document from the pages. 

The equal opportunity document, which can still be found online but was removed from the DEI website, specifically outlines Froedtert’s commitment and policy to maintain equitable and nondiscriminatory recruitment, hiring and human resources practices. 

The document outlines two policies specifically: “FH is committed to its affirmative action policies and practices in employment programs to achieve a balanced workforce” and “FH will provide equal opportunity to all individuals, regardless of their race, creed, color, religion, sex, age, national origin, disability, military and veteran status, sexual orientation, gender identity, marital status or any other characteristics protected by state or federal law.”

Froedtert did not respond to requests for comment. 

The Froedtert system serves patients primarily in the Milwaukee area. Froedtert recently merged with ThedaCare, serving Wisconsin residents in the Fox Valley and Green Bay. In 2020, the system reported receiving tens of millions in federal funding through the CARES Act in response to the COVID-19 pandemic.

While removing a link to an equal opportunity document may be a simple change, the Rev. Marilyn Miller, a partner in Leading for Racial Equity LLC, said every small change pushes society further back in achieving full access and equity. 

“So it might be a small tweak now, but what does that open the door to later? So, yeah, it’s impactful because any change that’s stepping back from full equity is a problem,” Miller said. “There’s populations that don’t feel any security anymore.”

Aurora Health Care also has removed DEI language in the past couple of months since the executive order. 

In 2018, Aurora merged with Advocate Health, a system with more than 26 hospitals throughout the Midwest. Advocate Aurora Health later merged with Atrium Health in 2022, creating the third largest nonprofit in the nation.

Earlier this year, Aurora removed an entire page on diversity, equity and inclusion. The page now redirects to Advocate’s page titled “Access & Opportunity.”

That change cut statements such as: “Our diversity, equity and inclusion strategy is anchored by our purpose to help people live well and to deliver safe, consistent, and equitable health outcomes and experiences for the patients and communities we serve.” 

A spokesperson for Aurora Health Care said the organization will continue to “deliver compassionate, high-quality, consistent care for all those we serve.”

“As our newly combined purpose and commitments state, we lift everyone up by ensuring access and opportunity for all,” the spokesperson said. “To provide our patients and communities clear and consistent information that explains our programs, policies and services, we are making various changes to our websites.”

Ascension, one of the largest nonprofit hospital systems in the nation, took down the entire page on diversity, equity and inclusion. The health care system currently operates at over 165 locations in Milwaukee, Racine, Appleton and Fox Valley.  The system still has modules on “Identifying & Addressing Barriers to Health” and “Ensuring Health Equity.” Ascension did not respond to a request for a comment.

Making a statement

UW Health removed its page on diversity, equity and inclusion, replacing it with a page titled “social impact and belonging.” In doing so, UW Health removed “anti-racism” from its entire website. It used to be one of the main themes.

UW Health removed the anti-racism modules titled “Being a leader in anti-racism” and “anti-racism funding,” and now in their place are modules called “Being a social impact leader” and “Community giving.” 

Chief Social Impact Officer Shiva Bidar-Sielaff and CEO Alan Kaplan addressed the changes in a video, stating social impact and belonging align with their mission, values and strategies as a health care organization.

“At UW Health, social impact refers to the effects health care policies, practices and interventions have on the well-being of individuals and communities, improving health outcomes, access to care and quality of life,” Bidar-Sielaff said. “Belonging is the understanding that you are valued and respected for who you are as an individual.”

The UW-Madison School of Medicine and Public Health, which has faculty who also work for and provide clinical care at UW Health, reported receiving $315 million in federal research funding last year. That total is 37% of all grant funding awarded to UW-Madison. UW Health received roughly $5.1 million in federal grants.

Despite claims by health care centers that missions remain the same, advocacy groups in Wisconsin are raising concerns regarding the impact these changes could have on communities in Wisconsin.

Chris Allen, president and CEO of Diverse & Resilient — an advocacy group focused on health inequities for LGBTQ+ people in Wisconsin — said these quiet language shifts are significant. 

“They send a message that commitments to addressing disparities may be weakening, even if that’s not the stated intention,” Allen said. 

William Parke Sutherland, government affairs director at Kids Forward, a statewide policy center that advocates for low-income and minority families, said many health care partners feel pressured to preserve funding sources.

In Wisconsin, maternal mortality rates are 2.5 times higher for Black women than white women. Maternal morbidities — or serious birth complications — were the highest among Black women and people enrolled in BadgerCare, the state’s largest Medicaid program. From 2020 to 2022 there were 7.8 stillbirth deaths per 1,000 births among Black babies, compared with 4.5 among white babies.

Disparities in maternal and infant mortality rates could be attributed to stress caused by poverty, lack of access to quality care, or systemic racism, according to health care researchers. If a mother is stressed over a long period of time, that can cause elevated levels of stress hormones, which could increase premature births or low birth weights for infants.

For Black women, midwives have been found to reduce the disparities they otherwise may experience during pregnancy, reducing the risk of maternal mortality or morbidity. Access to midwives is currently covered by Medicaid, so losing federal funding could harm these services.

Regardless of language, “Wisconsin’s racial disparities in health access and outcomes aren’t going away on their own,” Sutherland said in an email.

Removing language that acknowledges DEI efforts will not reduce the health care disparities felt by Wisconsin residents, Sutherland said. Federal funding cuts could also hurt rural families in Wisconsin, specifically those who rely on Medicaid for their health care needs. 

“We cannot begin to address these challenges if we’re not willing to acknowledge them,” Sutherland said. “A colorblind approach has not helped in the past.”

Editor’s note: This story was updated to correct a reference to how much federal funding UW Health receives.

We don’t talk about DEI: Wisconsin hospital systems are quietly removing diversity language is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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The percentage of Wisconsin schoolchildren not receiving state-mandated vaccinations because of their parents’ personal beliefs is four times higher than it was a generation ago.

That rise in personal conviction waivers has driven a decrease in all immunizations among Wisconsin children ahead of new measles outbreaks hitting the U.S. that are linked to three deaths.

Wisconsin’s measles vaccination rate among kindergartners was the third-lowest in the nation in the 2023-24 school year, behind Idaho and Alaska. (Montana didn’t report data.)

Here’s a look at how we got here.

Vaccine laws in all 50 states

Immunizations are so common that all 50 states have laws requiring them for schoolchildren. Wisconsin was among the first, in 1882.

In the 1950s, the child mortality rate was 4.35%, largely due to childhood diseases. That rate dropped to 0.77% by 2022, according to the nonpartisan Wisconsin Legislative Fiscal Bureau.

“Vaccines have brought about one of the largest improvements in public health in human history, making diseases that once caused widespread illness and many deaths, such as measles, mumps, and rubella, rare in the United States,” the agency reported.

For the 2024-25 school year, Wisconsin required seven immunizations (18 doses) for children to enter school. That included shots for measles (MMR), polio and hepatitis B. COVID-19 and influenza vaccines are not included.

Overall, the vast majority of Wisconsin students, 89.2%, met the minimum immunization requirements in the 2023–24 school year, according to the state’s latest annual report. 

That’s essentially unchanged from the previous two school years. 

But it’s down more than three percentage points from 92.3% in 2017-18.

For highly communicable diseases such as measles, a threshold above 95% is needed to protect most people through “herd immunity.”

More parents refusing to get kids vaccinated

Wisconsin had been a national leader in childhood immunizations. 

But increasingly, Wisconsin parents are opting out:

• For all childhood immunizations, vaccination rates statewide were lower in almost every quarter from 2020 through 2024, in comparison with the average rate in the three years before COVID-19.

• Wisconsin was one of the states with the largest drops in the measles vaccination rate for kindergartners between the 2022-23 and 2023-24 school years, and no county had an MMR vaccination rate above 85%, The Economist reported.

• By a different measure, the measles vaccination rate for 2-year-olds in 2024 was as low as 44% in Vernon County and under 70% in 14 other counties.

On exemptions, Wisconsin differs from most states

All states have exemptions that allow parents not to have their children vaccinated. Medical and religious reasons are the most common. 

In Wisconsin, there’s also a third waiver.

Wisconsin regulations say the Wisconsin Department of Health Services shall provide a waiver for health reasons if a physician certifies that an immunization “is or may be harmful to the health of a student”; or, if the parent of a minor student, or an adult student, submits a signed statement that “declares an objection to immunization on religious or personal conviction grounds.”

That philosophical exemption, based on personal beliefs, exists only in 15 states, including Wisconsin, Michigan and Minnesota.   

“The bottom line is: If you don’t want your child vaccinated, you don’t have to,” said Kia Kjensrud, interim director of Immunize Wisconsin, which supports vaccination organizations.

In 2023-24, 6.1% of Wisconsin students used a waiver. 

That includes 5.2% who had a personal conviction waiver — a rate more than four times higher than the 1.2% in 1997-98.

Waiver use has increased because the number of required vaccines and the legal protections given to vaccine manufacturers have “fueled skepticism about vaccine safety and testing rigor,” Wisconsin United for Freedom said in an email. The De Pere-based group works to protect “rights to medical freedom” and promotes vaccine skepticism. 

Rep. Lisa Subeck, D-Madison, one of the lawmakers who introduced legislation in 2023 to repeal the personal conviction waiver, said she believes some parents have genuine convictions against vaccinations. But “many of the folks who are choosing this exemption are doing it because of misinformation” claiming that vaccines are dangerous, she said.

Groups that registered to lobby in favor of Subeck’s bill included associations of physicians, nurses and local health departments. Wisconsin Family Action, which works to advance Judeo-Christian values, opposed it. The bill did not pass.

Kjensrud also blamed Wisconsin’s declining immunization rates on misinformation. But she said that rather than legislation, her group wants to improve “messaging the safety, efficacy and lifesaving importance of vaccines, and increasing vaccination rates however we can.” 

Bipartisan support for personal exemption

Wisconsin’s modern student immunization law was passed in 1975 with only the medical and religious waivers. In 1980, the Legislature added the personal conviction waiver. 

The waiver was included in a broader amendment proposed by 10 Democratic members and 11 Republican members of the Assembly.

The lead sponsor was the late Richard Flintrop, who represented Oshkosh and was known as a child welfare advocate. He also was a former staff member to maverick Democratic U.S. Sen. William Proxmire.

Wisconsin United For Freedom said the recent measles outbreaks “raise valid concerns,” but that “the focus should be on balanced public health strategies that prioritize sanitation, nutrition, and informed choice alongside vaccination, rather than relying solely on mandates.”

Wisconsin Watch wants to hear your perspective on vaccinations. Do you have questions about measles, its vaccine or how to keep your family safe? Or do you have perspectives to share about prevention efforts in your community?

If so, fill out this brief form. Your submissions will shape the direction of our reporting and will not be shared publicly.

Wisconsin, once a leader in childhood vaccinations, now a leader in vaccine skepticism is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.