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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.”

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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.

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Wisconsin would lose about $314 million in food assistance from the federal government under the massive budget bill passed by the U.S. House last week, according to an analysis of the proposed cuts by the Wisconsin Department of Health Services.

The legislation, which President Donald Trump refers to as the “big, beautiful bill,” would require states to start matching federal funds for the Supplemental Nutrition Assistance Program, or SNAP. It would also impose new work requirements on families with young children and older people, and it would require regular paperwork to prove exemptions from such requirements for some groups, such as families with special needs children.

Speaking to reporters Thursday, Wisconsin Medicaid Director Bill Hanna said those changes amount to new red tape that could cause 90,000 Wisconsinites to lose some or all assistance.

He said that would put new pressure on nonprofits like food pantries and have ripple effects at the retailers where people spend what’s commonly known as food stamps.

The proposal would push many costs onto the state, where lawmakers and the governor are in the process of deciding the next two-year budget.

“There’s going to be more demand to put state money into a program that has been 100 percent federally funded for really its entire existence, which will strain the state’s ability to put its state dollars towards other things like education, our health care system and other important aspects of what we do with our state dollars,” Hanna said.

Those state costs are calculated based on a given state’s error rates, which tend to occur when a person’s income or residence changes unexpectedly. Hanna said that Wisconsin has a low error rate but is lumped into a bracket with states with much higher error rates, and charged accordingly.

“These errors are not fraud,” DHS wrote in a statement. “For the first time ever, Congress is proposing an extreme, zero tolerance policy for payment errors harming states like Wisconsin that consistently keep error rates low.”

States would also be responsible for covering new administrative costs and for providing job training to people newly obligated to fulfill work requirements.

All six of Wisconsin’s Republican congressmen voted for the bill. Both of Wisconsin’s Democratic House members voted against it.

Over the weekend, U.S. Rep. Derrick Van Orden, R-Prairie du Chien, argued that anyone “legally receiving SNAP benefits should not see a single reduction in their SNAP.”

Hanna argued that’s because the federal government is “changing the definition of ‘legally receiving SNAP.’”

“They are adding additional red tape to folks to meet that by expanding those work requirements,” he said. “There certainly will be people who get caught up in the new red tape that they have to meet in order to achieve the benefits.”

Currently, about 700,000 Wisconsin residents — or an eighth of the state — receive SNAP.

This story was originally published by WPR.

Trump bill would cost Wisconsin $314 million in federal food aid 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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Since January, Milwaukee has been dealing with dangerous levels of lead dust in some public schools, resulting in nine school closures.

On Tuesday, U.S. Health and Human Services Secretary Robert F. Kennedy Jr. told a Senate committee there was a federal “team” in the city from the CDC’s Childhood Lead Poisoning Prevention Program — though the positions were cut in April.

“We are continuing to fund the program in Milwaukee, we have a team in Milwaukee, we’re giving laboratory support to the analytics in Milwaukee, and we’re working with the health department in Milwaukee,” Kennedy said when questioned by Sen. Jack Reed, a Rhode Island Democrat, during a hearing before the Senate Committee on Appropriations.

The Milwaukee Health Department disputed Kennedy’s statement.

“There is no team from HHS or CDC in Milwaukee assisting with the MPS lead hazard response,” department spokesperson Caroline Reinwald wrote in an email.

Kennedy has previously suggested the childhood lead program would be reinstated and told U.S. Sen. Tammy Baldwin last week that lead poisoning in children is an “extremely significant” concern. Reed had asked Kennedy about the program’s fate in light of those comments.

“If the secretary had information that hasn’t been proffered to myself or my team yet, I would welcome, again, continued support from the CDC,” said Milwaukee Health Commissioner Mike Totoraitis on Wednesday.

“Admittedly, I was wondering if they potentially got stuck in traffic in Chicago and didn’t make it to Milwaukee,” he said of Kennedy’s statements about a “team.”

Federal experts were part of Milwaukee’s lead crisis response

Childhood lead poisoning experts from the CDC communicated with the Milwaukee Health Department at the start of the city’s school lead crisis, Totoraitis told WPR.

“They validated our concerns about the testing results that we were finding in the schools,” he said.

He said federal experts recommended school closures as a response, which the city’s health department had originally avoided, not wanting to disrupt learning.

“But given the significant threat of permanent brain damage from lead poisoning, we had to rely on our federal partners to make that decision,” Totoraitis said.

In March, the city requested that a CDC Epi-Aid team come to Milwaukee, hoping to beef up the city’s school lead crisis response.

But in early April, Totoraitis learned that the experts who would’ve managed that team had been laid off. His request was denied.

The team would’ve expanded the city’s testing capacity, he said, and could’ve used its lead specialization to detect trends city officials wouldn’t catch.

But even without a special team, losing the ability to remotely consult CDC experts had an impact. Totoraitis said they had helped his department make investigation plans for lead-contaminated schools and do “epidemiological, long-term digging” into where kids are getting poisoned.

“Those are the parts that are really lacking now,” Totoraitis said.

After the layoffs, one CDC expert offered to help the city as a volunteer, he said.

Totoraitis said the city might contract with some of the laid-off staff members directly. “We’re really hopeful that I can secure the funding, through one of our grants, to bring some of these former CDC staff on in June,” he said.

But he stressed that his department already has a “really robust” lead poisoning program, handling about 1,000 cases a year.

“We’re continuing our work with or without federal resources,” the Milwaukee Health Department’s Reinwald said.

One CDC laboratory specialist visited Milwaukee

One of Kennedy’s claims was that “we’re giving laboratory support to the analytics in Milwaukee.”

In response to a question from WPR about Kennedy’s contention that a team is working on the issue in the city, a spokesperson from the Department of Health and Human Services said the CDC was assisting on laboratory testing.

“At the request of the Milwaukee Health Department Laboratory (MHDL), CDC is assisting with validating new lab instrumentation used for environmental lead testing. Staff from MHDL are focused on the lead response and other routine testing while CDC will assist with testing validation, laboratory quality management, and regulatory requirement documentation to onboard the new laboratory instrument,” the spokesperson said in an email.

According to Reinwald, a CDC laboratory specialist visited the city for two weeks in May to help the health department set up a new machine.

The machine processes lead samples from across the city — including those related to the school lead crisis.

But that visit was planned before the school lead crisis started, Totoraitis said. He said the city had already been expanding its lead-testing capacity before the crisis.

The lab specialist was “requested independently of the MPS situation,” Reinwald said, and served a “narrow technical role specific to onboarding the equipment.”

“It’s a single person,” Totoraitis said. “I know the secretary had said a team was in Milwaukee helping us, but I don’t know who he’s referring to.”

This story was originally published by WPR.

RFK Jr. claims federal ‘team’ is in Milwaukee for school lead crisis; city says there isn’t 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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Last week, our newsroom was intrigued by data in this Economist article showing that Wisconsin stands out nationally when it comes to its low vaccination rates for measles. It prompted a discussion about the many reasons for vaccine hesitancy and the complex challenges of maintaining trust in public health. 

One thing is clear: Measles is a very infectious disease, and it’s spreading nationwide. 

As of May 15 officials had confirmed 1,024 measles cases — including more than 100 hospitalizations — across 31 states, according to the U.S. Centers for Disease Control. 

Officials in 2025 have tracked almost as many measles outbreaks (defined as three or more related cases) as they did in all of 2024. Three deaths this year have been linked to measles. They included two unvaccinated school-aged children in Texas and an unvaccinated adult in New Mexico. 

The outbreaks come as vaccination rates decline nationwide, particularly in Wisconsin. The measles, mumps and rubella vaccine rate for Wisconsin kindergartners has plunged since 2019. But even before the COVID-19 pandemic, no county in Wisconsin had more than a 90% vaccination rate, which is traditionally associated with “herd immunity.” 

Wisconsin, The Economist article noted, “is among the most permissive states for vaccine exceptions in schools, allowing opt-out for personal-conviction reasons (along with medical and religious exemptions, which most states have); parents only have to submit a written note.”

Still, Wisconsin has yet to see a measles outbreak this year. As we consider how to report on this issue, let us know what you think. 

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. 

Help Wisconsin Watch report on measles prevention is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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This story was originally published by The 19th.

Jolene Baxter’s daughter, Marlee, has overcome immense challenges in her first eight years of life.

Marlee, who was born with a heart defect, has undergone four open-heart surgeries — suffering a stroke after the third. The stroke affected Marlee’s cognitive abilities — she’s in the second grade, but she cannot read yet. A mainstream class with neurotypical students felt overwhelming, so Marlee mostly attends classes with kids who also have disabilities. Her care includes physical, occupational and speech therapies.

For years, Baxter has relied on Medicaid to cover Marlee’s medical expenses while advocating for her daughter’s right to an equal education. Medicaid — which covers therapies, surgeries and medication for Marlee — and disability protections under the Department of Education have been a critical safety net for Baxter, a single mom in Oklahoma City. Now Baxter fears that proposed cuts to Medicaid and those already underway at the Department of Education, which President Donald Trump has effectively gutted, will have a disastrous impact on her daughter. 

As the Trump administration overhauls federal agencies with budget cuts, layoffs and inexperienced leadership, parents of children with complex medical needs and disabilities told The 19th they are navigating uncertainty over how the federal government plans to maintain key pillars of their kids’ lives.

Baxter, who fostered and, later, adopted Marlee, fought to give her life-saving medical treatment when the child was an infant. Since Marlee was both an abandoned child and is Kiowa, the officials overseeing her welfare weren’t invested in getting her the care she needed to survive, Baxter believes. Cuts to Medicaid would be yet another obstacle for the Baxters to overcome.  Just getting Marlee enrolled in local public schools that tried to turn her away was a battle, Baxter said. Now, the mom is gravely concerned that her daughter will be left behind due to the restructuring of the Department of Education.

“I’ll do everything I can at home, but she’ll just fall through all the cracks, and she won’t get the education that she deserves,” Baxter said.

In March, Trump signed an executive order to close the Department of Education. The Republican-controlled Congress is also considering massive funding cuts to Medicaid, the federal-state program that provides health insurance to millions of low-income Americans and is a key safety net for Americans with disabilities.

“It is 50 plus years of work to get these protections for people with disabilities that we could potentially see — maybe not fully diminished — but very deeply eroded, in a very short period of time,” said Robyn Linscott, director of education and family policy at The Arc, an organization that advocates for people with intellectual and developmental disabilities.

The Department of Education’s primary duty has been to ensure that all students have equal access to education, and it is equipped with an Office for Civil Rights to investigate schools accused of discrimination. In March, the Department of Education cut nearly half of its staff, with workers who enforce students’ civil rights hit particularly hard. Advocates worry how this could potentially impact students with disabilities, and a lawsuit filed in March began to paint a picture: newly closed regional offices, frozen investigations and new alleged politically based cases. 

The Trump administration claims that the nation’s most vulnerable will be spared from his plans for federal downsizing. 

The White House has tentative plans to assign oversight of special education to the Department of Health and Human Services. Conservative groups are calling for the Trump administration to refer civil rights complaints to the Department of Justice, an agency that has had an exodus of staff departures since Trump returned to office and changed its mission. 

Nicole Jorwic, chief program officer at Caring Across Generations, a national caregiver advocacy organization, said the Education Department’s Office for Civil Rights receives about 20,000 complaints annually. She worries about the impact of staffing cuts on handling these complaints on the families of children with disabilities.

“Some of those staff were the ones who were looking into those complaints,” she said.

It’s not just OCR complaints, she added. When she was a practicing special education attorney, Jorwic turned to reports and guidance issued by the agency. That helped local school districts, superintendents and special educators know how to implement different laws or changes.

“The lack of that federal agency to provide that clarity is also important, as well as something that we’re really worried about,” she said.

Parents and advocates are doubtful that students with disabilities won’t be impacted. Before the Department of Education was created in 1979, schools often denied these children a right to education with impunity. Dissolving it, families fear, could see a return to the period when states and schools failed to prioritize special education. 

Baxter’s daughter, Marlee, is guaranteed the right to free and appropriate schooling by the Individuals with Disabilities Education Act (IDEA) of 1975, which is enforced by the Department of Education. This federal law mandates that children like Marlee attend classes suited to their cognitive and physical abilities and that they get the services needed, such as speech, physical and occupational therapy, to attend school . Ninety-five percent of students with disabilities attend public schools, a higher share than the 90% of students overall who do — and that’s largely because of the services federal policy requires public schools to provide.

Kim Crawley, a mother to a teenager with medically complex needs, has a 25-year career as a special education teacher. As part of her training, she learned about the history of education, including how five decades ago, schools were not obligated to accommodate students’ special needs. The agency never took power away from the states, she said, but stepped in to ensure that they educated all students equitably. 

“We learn about this for a reason because we don’t want to repeat it,” Crawley said. “We don’t want to have to start over again. To think of losing everything we have gained through the Department of Education over these years is scaring not only parents but teachers. Teachers are scared because we don’t know where this is going to end up for those kids. And that’s why we go to work every day.”

Critics of closing the department and redirecting disabled children’s needs to other agencies say that it will create a bureaucratic nightmare for parents. Instead of one federal agency overseeing research on students with disabilities, state funding for special education or discrimination claims, multiple departments would be involved. Families might not know which agency to reach out to with questions and concerns.

As it is, families are sometimes unaware of the services legally available to them — a reality that has cost them time and energy in the past and could be even more complicated in the future.

Baxter, for one, pulled Marlee out of class for two years to homeschool her after the child’s kindergarten teacher retired and subsequent teachers did not know how to educate her properly, she said. It was not Baxter’s first choice to homeschool Marlee, an option unavailable to most working parents, but one she made after multiple public schools said they could not accommodate her child. 

“Our special needs are full,” Baxter said they told her. “We don’t have room for her.”

When an acquaintance told her that public schools could not lawfully refuse to enroll Marlee, Baxter finally got a local public school to admit her. But after her ordeal last year, she has no faith that the federal government will hold schools that discriminate against children with disabilities accountable if the education department is disbanded. 

“We have enough stuff to worry about (with) making sure that she gets taken care of as far as medical care,” Baxter said of parents like herself. “We don’t need to worry about what we’re going to do as far as their education.”

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For some families, the potential Medicaid cuts could unravel both a child’s well-being and their family’s finances.

In Philadelphia, Meghann Luczkowski has three kids with varying levels of specialized health care needs, including a 10-year-old son who spent his first year of life in a hospital intensive care unit.

“His ability to grow and thrive and be part of our family and part of this community is dependent upon significant health care support at home,” said the former special education teacher, who now works in public health.

Luczkowski said her husband has robust health insurance for the family, but it does not cover a lot of her son’s home-based medical needs — a reality for many families whose children are on Medicaid for care related to a disability. Private insurance never paid for his ventilator to breathe, or home health nurses who allow family caregivers to sleep at night.

“It doesn’t pay for the nurse to go to school with him, to make sure that he can be at school, accessing his education with his peers,” she said. “That’s all been provided through Medicaid.”

In the first months of his second term, Trump has mostly indicated support for Medicaid when asked about his budgetary plans for other popular programs like Social Security and Medicare. But the president has also said he supports cutting fraud and waste — a description that health policy experts warn could be used to defend more expansive cuts. Congress is considering hundreds of billions of dollars in Medicaid cuts, a dollar figure that goes way beyond known cases of fraud.   

Among the considerations are work requirements and a cap on Medicaid enrollee spending. Such restrictions could have ripple effects on state education budgets and subsequent reductions in services for students with disabilities. Medicaid is one of the largest providers of funds to public school districts. It is the responsibility of school districts and states to find funding if Medicaid reimbursements are insufficient. Trump has not addressed general concerns about how such spending cuts could impact disabled children and adults.

“We know that before 1975 and the passage of IDEA, 50% of kids with disabilities were not educated at all. So we know that this is a crucial piece of legislation, and that mandate to find funding for these is really important,” said Linscott, who previously worked as a special education teacher in New York City. “But we also recognize that school districts and state budgets are so limited, which is why we want Medicaid to be able to provide as robust funding and reimbursement as they possibly can for students and for these services.”

Jorwic said federal funding for special education services is crucial, and local governments cannot make up for the lost funds. The federal government currently spends more than $15 billion annually on special education services, and Medicaid funding accounts for about $7.5 billion annually in school-based services.

Jorwic said Medicaid cuts could also translate into higher taxes on a local or state level. This month, the Democratic Kansas governor said she had asked the state’s congressional lawmakers not to cut Medicaid in large part because of the ramifications on services. 

“There’s no state, even the wealthiest states, that could afford cuts to those programs, either when it comes to education or when it comes to providing home and community-based services,” Jorwic said.

Rachael Brown is the mom of a medically complex second grader in Washington, D.C., who receives special education services and multiple therapies at his public school. 

Brown’s son, who has autism and cerebral palsy, has a rare vascular anomaly in his brain that has required multiple surgeries. He receives extensive support from Medicaid and IDEA, which are crucial for his care and education. Brown is concerned about how cuts to Medicaid would impact her son’s care and her family’s personal finances. She noted that pediatric hospitals are heavily reliant on Medicaid. If the rate of that reimbursement is cut, those hospitals’ operational costs would be on the line — impacting everything from how many doctors and other health care providers are hired to what therapies are covered for her son.

“There’s just a ripple effect for our whole community,” she said, adding: “We are relatively privileged. There’s a lot of families who aren’t. It would be much worse for families for whom Medicaid is their only insurance.” 

Brown said she lives in fear and worry about what happens next, and it’s exhausting. While she and other advocates have some experience fighting for health care rights given previous political battles, “this time, everything feels a little more cruel.”

Luczkowski planned to travel to D.C. — taking a day off from work and rearranging child care needs — to advocate for Medicaid as part of a multi-organization advocacy day. She said parents of kids with medically complex needs and disabilities often aren’t able to get out and advocate as much as they would like to, in part because of the needs of their families.

“Despite the fact that it’s an incredible hardship on my family for me to be in D.C. talking to legislators and being at rallies on the Capitol steps, that’s what me and a great number of families are doing — because our kids’ lives depend on it,” she said. “We’re hopeful that our voices will be valued, and our children will be valued.”

This story was originally reported by Barbara Rodriguez and Nadra Nittle of The 19th. Meet Barbara and Nadra and read more of their reporting on gender, politics and policy.

‘She’ll fall through the cracks’: Parents of kids with disabilities brace for new reality 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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A Wisconsin-based research center focused on improving the health and safety of farmers and their children is under “existential threat” due to federal funding cuts.

The National Farm Medicine Center at the Marshfield Clinic Health System researches the causes of farm injuries and fatalities and provides education to rural communities both in Wisconsin and around the country. It’s also home to the National Children’s Center for Rural and Agricultural Health and Safety, one of 12 agricultural centers across the country funded by the National Institute for Occupational Safety and Health, or NIOSH.

NIOSH is one of the federal health agencies that were demolished by mass firings under the Trump administration in April. The agency is expected to lose more than 90 percent of its staff. 

The National Farm Medicine Center declined WPR’s interview request. But in a newsletter sent last month, director Casper Bendixsen said the cuts pose an “existential threat” to the program, which has relied on NIOSH funding and resources for decades.

“If these cuts hold, approximately three-quarters of the research and outreach carried out by the National Farm Medicine Center is at risk,” Bendixsen wrote in the email. “These potential losses threaten our communities on many fronts. Research, education and prevention of disease and injury in rural places cannot be ignored.”

John Shutske is an agricultural safety and health specialist at the University of Wisconsin-Madison who has been a longtime collaborator with the center in Marshfield. He said farming is a dangerous occupation, and new health issues continue to emerge as farms change, from exposure to gas from manure pits to injury risks from new farm machinery. That’s why he’s concerned about the uncertain future of grants through NIOSH and similar agencies.

“Without the continued research that’s made possible with federal funding, it would set us back,” Shutske said. “We’ve seen over the last several decades a pretty dramatic decrease overall in our farm fatality rate. And while I think (the number of deaths) would probably plateau, I don’t think we would be able to continue to make the kind of progress that we’ve had.”

Federal cuts threaten future of safety guidance for farm kids, families

Shutske said the National Farm Medicine Center is a significant resource for Wisconsin, helping to study the leading causes of farm fatalities in the state. But he said the center is known nationally for its work to create a safer environment for children on farms. 

The program first developed guidelines for age-appropriate farm jobs in the 1990s, and Shutske said they’ve been instrumental in helping rural families better understand a child’s limitations when pitching in around the farm.

“(Children) may be tall enough and strong enough and physically mature enough to operate some piece of equipment, but mentally and cognitively, from a decision-making perspective, they simply are not equipped,” he said. “That whole language piece, of talking about child development as it relates to farm safety, can really be traced back in its roots to the people in Marshfield.”

Mary Miller is a retired occupational health nurse practitioner for the state of Washington who spent her career focusing on protecting children in workplaces. She said the National Children’s Center is one of the only places in the country that focuses on protecting farm kids working for their parents or another family member.

“Historically, that’s been kind of the elephant in the room, frankly, that kids are allowed to do anything and everything on a so-called family farm,” she said.

Miller said researchers in Marshfield have been key leaders in getting guidance to farm parents even when regulations haven’t addressed the issue. She said losing that resource will put children and their families at risk.

Programs for rural firefighters also at risk

Jerry Minor, chief of the Pittsville Fire Department in rural Wood County, said his department has worked with the National Farm Medicine Center since it opened in 1981 to develop guidance for fire departments to respond safely on farms. 

“The type of call we get on a farm is usually a pretty high intensity type of call, you know entrapments, severe injuries, and we don’t go to those calls very often,” he said. “We’ve helped them develop programs on how to teach firefighters to enter silos and treat tractor rollovers.”

He said they’ve also created a training program for fire departments that want to proactively work with local farms on improving safety. Rural firefighters are trained to look for common hazards and to provide producers with information on how to safely store farm chemicals or what safety equipment is needed.

More than 170 first responders in 16 states and five Canadian provinces have gone through the training, according to the program’s website.

Minor said these programs are “vital” to both first responders and farm families. He’s worried there will be no one to continue the work if the center loses funding through NIOSH.

“I’m very fearful of what might happen,” he said. “I understand being fiscally responsible, but sometimes you’ve got to sit back and take a look at the bigger picture.”

This story was originally published by WPR.

Federal cuts threaten Wisconsin farm safety center for children, rural communities 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 state of Wisconsin is rescinding the Social Development Commission’s status as Milwaukee County’s community action agency, a move that puts the SDC’s ability to offer critical services to the community in jeopardy.

The anti-poverty agency has held that designation for over 60 years. Without the status, SDC is not eligible for key federal block grant funding for its services.

In a letter sent Friday to the SDC board, Wisconsin Department of Children and Families Secretary Jeff Pertl wrote that as of July 3, SDC’s status as Milwaukee County’s community action agency will end and that the agency will no longer be eligible for federal Community Services Block Grant funding.

“SDC has been a beloved institution in Milwaukee, positively impacting community members through a long history of programs and services,” Pertl said in a statement. “As such, the decision to de-designate them as a community action agency was not taken lightly, but it is clear that we must turn the page to resume these vital services.”

The decision comes after representatives of Milwaukee County said earlier this month that they planned to move from SDC as its community action agency.

However, SDC board members had seen maintaining the community action status as a vital part of keeping the agency open and resuming social services.

“The most important thing is to make sure that Milwaukee County residents are served, and this missive from DCF ensures that they will not be served,” said William Sulton, SDC’s attorney.

Now, the SDC board can request a review with the federal government within 30 days or choose to voluntarily de-designate.

The decision

The department decided to terminate SDC’s designation because it believes SDC has not been operating anti-poverty services since it abruptly shut down in April 2024, despite reopening in December.

According to the letter, SDC has not completed its federally required audit, verified sustainable funding sources, addressed outstanding financial obligations or corrected other deficiencies the department identified.

Board members and current and former employees of SDC advocated for the agency to keep its community action status at a hearing last month.

SDC was created by state, county and city governments but functions outside of them.

Pertl acknowledged the commitment of former staff members who performed unpaid service in support of SDC’s work and the board’s desire to restore SDC in his letter.

“There is also an array of community members and leaders who contend SDC is unable to carry out its vital mission in light of the financial mismanagement, pending foreclosures, outstanding debts, eroded infrastructure and lack of urgency in finding resolution to these practical service delivery challenges,” Pertl wrote in the letter.

SDC provided a range of services to help low-income residents, such as tax support, career advancement, senior companionship and rent assistance.

What happens next?

Going forward, SDC has the option to request a review by the secretary of the Department of Health and Human Services within 30 days.

It could also voluntarily relinquish its community action status, which would allow the department and Milwaukee County to more quickly find an interim service provider to use SDC’s allocated funds for the year.

The letter noted that President Donald Trump’s administration proposed eliminating block grant funding to community action agencies in his fiscal year 2026 budget, making the program’s future uncertain.

The Department of Children and Families can now start conversations with other eligible entities, but cannot take over the funds intended for SDC until SDC’s de-designation is effective, according to Gina Paige, communications director for the department.

Sulton said the board will have to meet to determine SDC’s next actions, but he is concerned that the state, Milwaukee County and the city will choose to stop funding anti-poverty services.

“Really what this act amounts to is a withdrawing of their commitment to pursue anti-poverty programming,” he said.

Board members could not be reached for comment.

SDC faces more funding upheaval after state removes its Milwaukee County community action status 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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Rennie Glasgow, who has served 15 years at the Social Security Administration, is seeing something new on the job: dead people.

They’re not really dead, of course. In four instances over the past few weeks, he told KFF Health News, his Schenectady, New York, office has seen people come in for whom “there is no information on the record, just that they are dead.” So employees have to “resurrect” them — affirm that they’re living, so they can receive their benefits.

Revivals were “sporadic” before, and there’s been an uptick in such cases across upstate New York, said Glasgow. He is also an official with the American Federation of Government Employees, the union that represented 42,000 Social Security employees just before the start of President Donald Trump’s second term.

Martin O’Malley, who led the Social Security Administration toward the end of the Joe Biden administration, said in an interview that he had heard similar stories during a recent town hall in Racine, Wisconsin. “In that room of 200 people, two people raised their hands and said they each had a friend who was wrongly marked as deceased when they’re very much alive,” he said.

It’s more than just an inconvenience because other institutions rely on Social Security numbers to do business, Glasgow said. Being declared dead “impacts their bank account. This impacts their insurance. This impacts their ability to work. This impacts their ability to get anything done in society.”

“They are terminating people’s financial lives,” O’Malley said.

Though it’s just one of the things advocates and lawyers worry about, these erroneous deaths come after a pair of initiatives from new leadership at the SSA to alter or update its databases of the living and the dead.

Holders of millions of Social Security numbers have been marked as deceased. Separately, according to The Washington Post and The New York Times, thousands of numbers belonging to immigrants have been purged, cutting them off from banks and commerce, in an effort to encourage these people to “self-deport.”

‘They are terminating people’s financial lives.’

Martin O’Malley, who led the Social Security Administration toward the end of the Joe Biden administration

Glasgow said SSA employees received an agency email in April about the purge, instructing them how to resurrect beneficiaries wrongly marked dead. “Why don’t you just do due diligence to make sure what you’re doing in the first place is correct?” he said.

The incorrectly marked deaths are just a piece of the Trump administration’s crash program purporting to root out fraud, modernize technology and secure the program’s future.

But KFF Health News’ interviews with more than a dozen beneficiaries, advocates, lawyers, current and former employees, and lawmakers suggest the overhaul is making the agency worse at its primary job: sending checks to seniors, orphans, widows, and those with disabilities.

Philadelphian Lisa Seda, who has cancer, has been struggling for weeks to sort out her 24-year-old niece’s difficulties with Social Security’s disability insurance program. There are two problems: first, trying to change her niece’s address; second, trying to figure out why the program is deducting roughly $400 a month for Medicare premiums, when her disability lawyer — whose firm has a policy against speaking on the record — believes they could be zero.

Since March, sometimes Social Security has direct-deposited payments to her niece’s bank account and other times mailed checks to her old address. Attempting to sort that out has been a morass of long phone calls on hold and in-person trips seeking an appointment.

Before 2025, getting the agency to process changes was usually straightforward, her lawyer said. Not anymore.

The need is dire. If the agency halts the niece’s disability payments, “then she will be homeless,” Seda recalled telling an agency employee. “I don’t know if I’m going to survive this cancer or not, but there is nobody else to help her.”

Some of the problems are technological. According to whistleblower information provided to Democrats on the House Oversight Committee, the agency’s efforts to process certain data have been failing more frequently. When that happens, “it can delay or even stop payments to Social Security recipients,” the committee recently told the agency’s inspector general.

While tech experts and former Social Security officials warn about the potential for a complete system crash, day-to-day decay can be an insidious and serious problem, said Kathleen Romig, formerly of the Social Security Administration and its advisory board and currently the director of Social Security and disability policy at the Center on Budget and Policy Priorities. Beneficiaries could struggle to get appointments or the money they’re owed, she said.

For its more than 70 million beneficiaries nationwide, Social Security is crucial. More than a third of recipients said they wouldn’t be able to afford necessities if the checks stopped coming, according to National Academy of Social Insurance survey results published in January.

Advocates and lawyers say lately Social Security is failing to deliver, to a degree that’s nearly unprecedented in their experience.

Carolyn Villers, executive director of the Massachusetts Senior Action Council, said two of her members’ March payments were several days late. “For one member that meant not being able to pay rent on time,” she said. “The delayed payment is not something I’ve heard in the last 20 years.”

When KFF Health News presented the agency with questions, Social Security officials passed them off to the White House. White House spokesperson Elizabeth Huston referred to Trump’s “resounding mandate” to make government more efficient.

“He has promised to protect social security, and every recipient will continue to receive their benefits,” Huston said in an email. She did not provide specific, on-the-record responses to questions.

Complaints about missed payments are mushrooming. The Arizona attorney general’s office had received approximately 40 complaints related to delayed or disrupted payments by early April, spokesperson Richie Taylor told KFF Health News.

A Connecticut agency assisting people on Medicare said complaints related to Social Security — which often helps administer payments and enroll patients in the government insurance program primarily for those over age 65 — had nearly doubled in March compared with last year.

Lawyers representing beneficiaries say that, while the historically underfunded agency has always had its share of errors and inefficiencies, it’s getting worse as experienced employees have been let go.

“We’re seeing more mistakes being made,” said James Ratchford, a lawyer in West Virginia with 17 years’ experience representing Social Security beneficiaries. “We’re seeing more things get dropped.”

What gets dropped, sometimes, are records of basic transactions. Kim Beavers of Independence, Missouri, tried to complete a periodic ritual in February: filling out a disability update form saying she remains unable to work. But her scheduled payments in March and April didn’t show.

She got an in-person appointment to untangle the problem — only to be told there was no record of her submission, despite her showing printouts of the relevant documents to the agency representative. Beavers has a new appointment scheduled for May, she said.

Social Security employees frequently cite missing records to explain their inability to solve problems when they meet with lawyers and beneficiaries. A disability lawyer whose firm’s policy does not allow them to be named had a particularly puzzling case: One client, a longtime Social Security disability recipient, had her benefits reassessed. After winning on appeal, the lawyer went back to the agency to have the payments restored — the recipient had been going without since February. But there was nothing there.

“To be told they’ve never been paid benefits before is just chaos, right? Unconditional chaos,” the lawyer said.

Researchers and lawyers say they have a suspicion about what’s behind the problems at Social Security: the Elon Musk-led effort to revamp the agency.

Some 7,000 SSA employees have reportedly been let go; O’Malley has estimated that 3,000 more would leave the agency. “As the workloads go up, the demoralization becomes deeper, and people burn out and leave,” he predicted in an April hearing held by House Democrats. “It’s going to mean that if you go to a field office, you’re going to see a heck of a lot more empty, closed windows.”

The departures have hit the agency’s regional payment centers hard. These centers help process and adjudicate some cases. It’s the type of behind-the-scenes work in which “the problems surface first,” Romig said. But if the staff doesn’t have enough time, “those things languish.”

Languishing can mean, in some cases, getting dropped by important programs like Medicare. Social Security often automatically deducts premiums, or otherwise administers payments, for the health program.

Lately, Melanie Lambert, a senior advocate at the Center for Medicare Advocacy, has seen an increasing number of cases in which the agency determines beneficiaries owe money to Medicare. The cash is sent to the payment centers, she said. And the checks “just sit there.”

Beneficiaries lose Medicare, and “those terminations also tend to happen sooner than they should, based on Social Security’s own rules,” putting people into a bureaucratic maze, Lambert said.

Employees’ technology is more often on the fritz. “There’s issues every single day with our system. Every day, at a certain time, our system would go down automatically,” said Glasgow, of Social Security’s Schenectady office. Those problems began in mid-March, he said.

The new problems leave Glasgow suspecting the worst. “It’s more work for less bodies, which will eventually hype up the inefficiency of our job and make us, make the agency, look as though it’s underperforming, and then a closer step to the privatization of the agency,” he said.

Jodie Fleischer of Cox Media Group contributed to this report.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — an independent source of health policy research, polling and journalism. Learn more about KFF.

This article first appeared on KFF Health News and is republished here under a Creative Commons license.

At Social Security, these are the days of the living dead 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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It appears that Milwaukee County is ready to work with the state to find a new community action agency to replace the Social Development Commission, the embattled agency that has provided anti-poverty services for more than 60 years.

In an email to NNS, a spokesperson from the press office of Milwaukee County Executive David Crowley stated: “Given the urgent need for supportive services in Milwaukee County, and in light of SDC’s ongoing challenges, we stand ready to work with the Wisconsin Department of Children and Families and other local partners to identify another eligible entity or entities who can receive (Community Services Block Grant) funds and provide needed services to county residents.”

The Social Development Commission, also known as the SDC, is eligible to receive these federal block grant funds administered by the state through its status as a community action agency, which the state is considering rescinding.

The email from the county was sent in response to a question about whether the Milwaukee County Board of Supervisors and the Milwaukee Common Council are required by state law to approve any decision to rescind SDC’s designation as a community action agency.

The background

The Wisconsin Department of Children and Families, or DCF, is scheduled to make a final decision on SDC’s community action status in the coming months.

DCF held a public hearing on April 4 to discuss SDC’s designation and future. At the meeting, some SDC board members and current and former employees testified about the crucial need to maintain the agency.

The department’s leadership said SDC has not created a realistic financial plan to restart services and perform its community action duties under the law, and it continues to have financial, programmatic, operational and service delivery concerns.

SDC reopened in a limited capacity in December after abruptly shutting down in April 2024, when problems included failing to pay employees and contractors on time and using grant dollars for one program to cover costs for another.

The agency has since missed state deadlines to pay employees their owed wages and also still owes some contractors for completed work.

 In addition, SDC’s property corporation, SD Properties Inc., is facing a foreclosure lawsuit and owes nearly $3 million in mortgage payments on its North Avenue buildings, according to court records.

Who’s responsible?

Jorge Franco, interim CEO of SDC and chair of its board, said Wisconsin law requires both the Common Council and County Board of Supervisors to approve a decision to de-designate SDC as a community action agency before the state can take that action. 

Franco is referring to Wisconsin Statute 49.265, which states the following: “The approval of a community action agency may be rescinded but only if there is good cause and if the decision to rescind is made by both the legislative body of the county, city, village or town that granted the approval and the secretary.”

According to the organization’s former website, SDC became a community action agency in 1964, shortly after the Economic Opportunity Act created the Community Action Program.

Because SDC was established through a collaboration that involved the city, county and other organizations, there is a lack of clarity over which legislative body actually granted SDC’s approval as a community action agency.

It’s also unclear which legislative body must weigh in on the commission’s potential de-designation based on state statute.

According to a spokesperson from the Milwaukee County Executive’s Office, a review of records found that the county board and the city of Milwaukee enacted an ordinance establishing SDC as a commission, but not specifically as a community action agency. 

“We have not found any records indicating that the County Board ever took any action relative to SDC’s status as a CAA,” an email from the Milwaukee County Executive Press Office said.

Because the county board did not approve SDC’s status as a community action agency, it does not have the authority to rescind that status, the Milwaukee County Executive Press Office’s email said. 

Jeff Fleming, a spokesperson for Mayor Cavalier Johnson, said the city’s responsibility in the potential de-designation of SDC as a community action agency has been a topic of discussion.

“The first impression from the city side is that it was the county that ‘granted the approval,’” Fleming said in an email, referring to SDC’s status as a community action agency. 

NNS also reached out to Milwaukee City Attorney Evan Goyke for comment on the issue, but he hasn’t responded. 

The Department of Children and Families was also questioned about which legislative body granted SDC approval to be a community action agency. 

“This is the first time the Department of Children and Families has sought to de-designate a community action agency,” said Gina Paige, communications director for DCF.  “As such, we are working closely with the federal Office of Community Services and Milwaukee County to determine what the process would need to be should we move forward with de-designating SDC.”

According to Franco, the state operates under a federal mandate to provide the types of anti-poverty services that SDC had provided for decades.

He said without SDC, those services could be delayed by several years.

“The bottom line point is that infrastructure is there. It must be activated immediately,” Franco said. 

Money, Franco said, is needed to help the agency climb out of debt and, more importantly, relaunch vital services to low-income residents in the county.

“SDC intends to pay every dollar it owes. First things first. Get anti-poverty services ready to go through SDC, which is ready to go today and that should not be delayed any further,” Franco said.

Some elected officials weigh in. Most stay silent.

State Sen. LaTonya Johnson said that she’d like to see SDC rebound from its troubles.

“SDC has been in the community for many years providing pivotal services for the community and this community can’t afford to lose those services,” she said.

Still, she said, given the significant mismanagement of funds at SDC, she understands that the Department of Children and Families will make a decision it feels is in the best interests of residents.

“Whatever decision they make, I’ll have to back it just like other elected officials will because we have to believe that they’re making the choice that’s best for taxpayers,” she said. “I’m hoping that the state will have a way to make sure that services will be provided, whether it’s SDC or not.”

Ald. Sharlen Moore also hopes to see SDC survive.

“They provide a critical need to our community, and so what I would hope is that they would find the necessary help or support that they need in order to get back on track,” Moore said. “It’s such a huge void.”

Like Johnson, she also acknowledges the challenges of providing funding to an organization with an uncertain future.

“It’s hard giving someone money without knowing how they are going to move forward,” she said.

Rep. Gwen Moore said it is important to center the people who have been majorly affected, like residents who lost services and former employees who are still owed pay.

“The serious concerns raised by the state must be addressed, and I hope the result of this process moves us closer to resuming these vital services to my constituents,” she said.

NNS reached out to more than 20 elected officials from the city, county and state government for comment on SDC’s future, including Common Council President Jose Perez and Milwaukee County Board Chairwoman Marcella Nicholson. Only three elected officials chose to speak.

What’s next?  

Despite the current challenges, Franco said that he is confident SDC will bounce back and that the history of the organization is proof of its effectiveness in fighting poverty.

“SDC has a legacy of generations of people who’ve been helped by SDC, and they still live in the community,” he said. “Whatever its issues were in recent times, the long-standing legacy and the number of people who have been helped must not be forgotten.”

Milwaukee County appears ready to find replacement for Social Development Commission 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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March marked three years since Paula Jolly opened Amanda’s House, a long-term, sober living home for women and their children in Green Bay. 

Within four days of the opening of the home she named to memorialize her daughter, its six bedrooms were full. For the last year and a half, 40 or more people have sat on a wait list, Jolly said. 

“It’s hard because a lot of times, they don’t have anywhere else to go,” Jolly said. “There’s other female sober living and male sober living (homes) in town but still not enough. They all have wait lists.” 

Jolly, who grew up in Niagara, Wisconsin, has called Green Bay home since the 1990s. She has two degrees from Northeast Wisconsin Technical College, where she studied medical office management and human services and substance use counseling. Jolly said she “could have gone to be a substance abuse counselor but I decided this was my path because I can help more people this way.”

The structure Jolly has built within Amanda’s House allowed her to escape what she described as rigid confines of typical counseling, where the state determines the terms of client services. She also made Amanda’s House a place where people could stay as long as they needed. While some may stay for just a couple of weeks, others have stayed for about two years. 

Staff at Amanda’s House provides them with life skills training, mental health support, substance use support and connections to community resources.

While working at another sober living home in Green Bay, Jolly saw the need for this type of program firsthand. She watched as women left treatment prematurely to reunite with their kids — only to fall back into their previous harmful cycles. 

“We’re trying to break the cycle,” she said.

Laurie Doxtator, 60, grew up west of Green Bay on the Oneida Reservation and returned to Wisconsin after living in California, where she said she used practically every drug you could think of and attempted suicide at one point. She said she began drinking alcohol at age 8 and experienced trauma over the decades, including the deaths of two of her children and a miscarriage. 

“But then I learned, you have a life and you have better things going for you,” Doxtator said. 

After 50 years of drinking, “it ain’t giving me nothing in life. It ain’t gonna bring my children back, it ain’t gonna bring my mom back,” she said. 

Doxtator previously spent four months in a 30-day rehabilitation program but knew she needed more structure and more time to learn how to heal. 

She has lived at Amanda’s House for more than two years.

After more than a year and a half of sobriety, aided by support from other women in the program and classes that help her heal, Doxtator said she feels safe there. “Me moving out from here into society, it’s scary for me,” Doxtator said. “I have to journey on one day but I have support here and support all over.” 

Jolly has told Doxtator: “You can stay here until the wheels fall off.”

Jolly believes such assurance would have helped her daughter.

Amanda Marcouiller was 13 months into recovery when she died in 2020 at age 37. She spent part of her final week at her mother’s house, where Jolly could tell something was wrong. 

“You’re acting like you did before, can I help you?” Jolly recalled asking her daughter, referring to Marcouiller’s previous period using substances. Marcouiller replied that she simply had a migraine. “So the last time I saw her was when she was probably under the influence, and I just couldn’t prove it or do anything about it,” Jolly recalled. 

Many people in the region and state face similar challenges. United Way of Wisconsin’s 211 helpline in the past year has fielded more requests from Brown County residents for housing and shelter and mental health and addiction resources than any other broad categories.

Before lightly declining in 2023, drug overdose deaths in Wisconsin increased each year since 2016, according to the Wisconsin Department of Health Services. 

Marcouiller helped Jolly launch the Mandolin Foundation, the nonprofit organization operating Amanda’s House, just a month before she died. “I wasn’t gonna continue on,” Jolly said. “But I felt like she would have wanted me to.”

The next step for Jolly and her small staff at Amanda’s House: fundraise for a renovation to add five bedrooms. Jolly secured federal funds in January that give her a good start on that expansion. 

“There’s a lot of states that are way ahead of us in recovery and substance use disorder type recovery, like eons,” Jolly said. “We have a lot of catching up to do.”

Honoring her daughter, Amanda’s House founder seeks to break addiction’s cycle in Green Bay 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

• The city and county of Eau Claire recently asked Attorney General Josh Kaul to weigh in on the legality of police officers dropping off homeless people outside their jurisdiction.

• Their request for an opinion cited several examples, including the Durand Police Department, which transported a woman in handcuffs to a city homeless shelter that has been over capacity and at risk of reducing beds.

• The story includes interviews with the Durand police chief and the mayor of Santa Cruz, California, which recently outlawed the dropping off of homeless people without prior communication and a plan for helping the person find a housing solution.

On Oct. 27, a Durand police officer responded to a suspicious person call. He made contact with a woman who had committed no crimes but had nowhere to stay on a cold night. 

She told the officer she was from Fargo, North Dakota, and waiting for a ride, but couldn’t explain how she arrived in Durand.

When that ride didn’t show, the officer asked if she had a credit card, which local hotels require homeless individuals to put down when using a motel voucher to stay overnight. She said she didn’t and didn’t know what to do. 

There are no homeless shelters in Durand or Pepin County.

The officer then suggested she go to Sojourner House, a shelter in Eau Claire about 40 minutes away. She agreed to be transported in handcuffs, in accordance with what the officer said was department policy. He called several other shelters in communities outside of Durand, all of which were full for the night. Sojourner House didn’t answer, but he offered the woman a ride there anyway. She asked if the shelter was open.

“It’s hard to say. Once I get you up there, they might not even have a bed for you to go,” the officer told her, according to body cam footage obtained by Wisconsin Watch. “Once you get up there, ask them for resources — see what else is available to you up there.” 

The officer dropped her off and left without contacting the shelter staff or Eau Claire city officials. 

According to Eau Claire County Corporation Counsel Sharon McIlquham and City Attorney Stephen Nick, the shelter was full, and Eau Claire city police later took the woman to a hospital. She then had a run-in with UW-Eau Claire police for indecent exposure. 

“They still found themselves homeless in an unfamiliar community and committed crimes — had to get medical attention,” Nick told Wisconsin Watch, referring to multiple people who have been dropped off in Eau Claire. “So not a good outcome for them or our community.” 

But what started as a conflict between local agencies is now a legal question being posed to Wisconsin Attorney General Josh Kaul: Should police departments in Wisconsin be allowed to transport someone experiencing homelessness out of their jurisdiction?

Nick said the problem has persisted for years in Eau Claire and extends far beyond the three examples cited in his January letter to the attorney general, asking his office to weigh in on the legality of these drop-offs.

“This is the first time we’ve received a communication along these lines, certainly since I’ve been attorney general,” Kaul told reporters at WQOW. “But I can say more broadly, some of the issues raised are ones that I think are true around the state.”

Democratic Gov. Tony Evers said the drop-offs display a need for more rural resources.

The letter pointed to instances of homeless individuals from neighboring counties being dropped off in Eau Claire by other agencies including the Menomonie Police Department and the St. Croix County Sheriff’s Office. McIlquham and Nick called it “a practice driven by a lack of good options,” but said the drop-offs are “unlawful at worst and unprofessional at best.” 

“None of the individuals we referenced actually received care, and that is the most common outcome from these sort of transports,” Nick said. 

Durand Police Chief Stanley Ridgeway said if his department is barred from carrying out these kinds of transports, the city’s human services department would have to pay other agencies or organizations to transport those in need of shelter. He added that rural communities like Durand lack rideshare services, public transportation or homeless shelters. 

“In the end, it will increase our cost,” Ridgeway said. “Our hands will be tied.” 

A statewide problem

The situation is not unique to Eau Claire. Police chiefs in Waukesha, Green Bay and Appleton told Wisconsin Watch they have dealt with a similar problem. 

“For as long as I can remember, we have struggled with people from outside the Fox Valley coming to this area to utilize this invaluable resource,” Appleton Police Chief Polly Olson said. “We know they … may be given rides by other, outside law enforcement, or they find out through word of mouth about the shelters and resources in this area.”

Green Bay Police Chief Chris Davis told Wisconsin Watch these drop-offs happen occasionally, but he has asked agencies outside the county not to transport people because it strains local resources and makes it difficult for the homeless to return to their city of origin.  

Drop-offs are also prevalent in Waukesha, with unhoused individuals coming from surrounding areas like Delafield, Hartland, Chenequa, Pewaukee and New Berlin. But Chief Daniel Thompson said the issue is complicated because the city is a hub for resources such as hospitals, mental health clinics, trauma centers, charitable organizations and shelters.

He said it makes sense that people experiencing homelessness in smaller, rural jurisdictions would come to Waukesha for services because their own communities often don’t have any.

But it’s a problem when other municipalities drop their homeless off in Waukesha simply because they don’t want to deal with them. This is particularly a problem at Waukesha Memorial Hospital, Thompson said.

In December, Wisconsin Watch reported that the state’s estimated homeless population has been rising since 2021, following national trends. It rose from 4,861 on a single night in 2023 to 5,037 in 2024. In rural Wisconsin, the increase was 9%, according to the annual homeless count. 

Despite accounting for over 60% of the state’s homeless population in 2023, every Wisconsin county besides Milwaukee, Dane and Racine collectively contained just 23% of the state’s long-term housing with on-site supportive services, which experts say is the best way to address chronic homelessness.

‘Only because we have such poor options’

Police departments in Durand and Menomonie quickly responded to the letter sent to the attorney general, emphasizing the transports were voluntary. Police footage from both departments confirms the officers didn’t coerce the individuals, but did suggest the destination. Neither individual knew where Eau Claire was. 

“They’re not looking to come here, they’re being asked if they want to come here,” Nick said. “When that’s being done by a uniformed police officer — that changes the circumstances quite a bit in terms of how voluntary that is.”

In the letter, McIlquham and Nick cited another example in which they say a woman who was a frequent source of contact for St. Croix County sheriff’s officers was dropped off at a gas station in Eau Claire without receiving any services. Eau Claire EMS, the county sheriff’s office and the city police department later responded to multiple complaints regarding the individual, who did not have ties to Eau Claire. 

St. Croix County Sheriff Scott Knudson described the incident to WEAU as a “courtesy ride.” He did not respond to Wisconsin Watch’s interview request. 

“I feel bad for Eau Claire that the facilities that we have available to us are in their jurisdiction, so sometimes they have to deal with the aftermath,” said Ridgeway, the Durand police chief. “But it happens a lot. That’s where the services are.”

Ridgeway told Wisconsin Watch the Durand Police Department will continue this practice as long as the attorney general allows it, adding that his department is not responsible for crimes these individuals may commit in Eau Claire. Asked how those individuals get back to where they came from, Ridgeway said that’s “out of our control.”

“These facilities receive funding from the federal government, state government, grants, donations — they’re not just receiving funding from Eau Claire County residents or city of Eau Claire residents,” Ridgeway said. “This is a service for all of western Wisconsin, and we’re going to take advantage of that service whenever we can.” 

He defended the decision to drop a woman off in front of a shelter that was either full or not open.

“You might not tonight have a place, but they can tell you what time they open tomorrow so you can be in line to get services,” Ridgeway said. “We’ll continue to call and try to get a bed verified as being available, but if a person wants to be dropped off there, we’ll do so.”

In a March 11 press release, Catholic Charities of the Diocese of La Crosse said it is facing a potential decision to reduce Sojourner House’s operations from year-round to just six months, citing a loss of funding and a shortage of volunteers.

On one night in January, Dale Karls of the Western Dairyland Economic Opportunity Council told WEAU, Sojourner House, which has a normal capacity of 53, opened overflow spaces and housed 77 people.

Nick said he doesn’t doubt the officers were trying to help these people, “but the message needs to get out that they weren’t helped.” There’s been a growing need for homeless services since the pandemic as temporary services and funding have been rolled back, he said. 

In the state’s 2023-25 biennial budget, the Republican-controlled Legislature rejected Evers’ recommendations to spend $24 million on emergency shelter and housing grants, as well as homeless case management services and rental assistance for unhoused veterans.

The Legislature also nixed $250 million Evers proposed for affordable workforce housing and home rehabilitation grants.

This year, Evers recommended another $24 million for homeless prevention programs in the 2025-27 state budget. Republican lawmakers who control the powerful budget committee vowed to throw out the governor’s budget and start from scratch this spring.

“The issue here is the disinvestment by the state and needed resources regionally,” Nick said. “It’s a law enforcement issue, but only because we have such poor options.” 

A California city has outlawed the practice

In 2024, the city of Santa Cruz, California, outlawed the practice of transporting homeless people into the city without authorization. Mayor Fred Keeley told Wisconsin Watch the local ordinance has pressured surrounding communities to ramp up their own resources for the homeless. 

The drop-off ban was sparked by an incident last summer when Hanford police drove a homeless woman with a disability nearly 200 miles to Santa Cruz — a city similar in size to Eau Claire — and left her outside a local shelter. 

“I know that for decades, other cities in our county bring people and dump them in the city of Santa Cruz,” Keeley said. “Nobody should do this to us because we would never do it to you without a prior conversation.” 

Keeley said these drop-offs almost never solve someone’s housing problem and instead shift the responsibility to another city. Santa Cruz is sympathetic to smaller municipalities with limited resources that are willing to coordinate with the city to arrange a transport, Keeley said, but that person should have some community ties. 

Keeley said the city’s investments in permanent supportive housing and other programs have reduced the city’s street homelessness by more than 50% in the last two years. 

Now, a bill has been introduced in the California Legislature that would ban local law enforcement agencies from transporting homeless individuals to another jurisdiction without first coordinating shelter or long-term housing for them. Keeley said he’s glad the issue is being taken up at the state level.

‘A practice driven by a lack of good options’: Homeless drop-offs in Eau Claire showcase need for state action 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: 10 minutes

Click here to read highlights from the story

• Wisconsin law generally requires trans people, including children, to publish their legal name changes in a newspaper. Some worry the requirement poses a higher risk with the Trump administration’s anti-trans policies.

• Lawyers working with trans people say Wisconsin’s publication requirements further endanger the trans community by creating a de facto dataset of people that some fear could be used for firing, harassment or violence.

• “We live just in constant terror of the wrong person finding out that we have an 11-year-old trans child. … All it takes is one wrong person getting that information, and what we could end up going through, becoming a target, is horrifying.”

• A Wisconsin law has dissuaded at least one transgender resident from going through with a legal name change. “It can put people at risk of violence and blatant discrimination simply because of who they are,” an ACLU lawyer said.

Update, April 18, 2025: After this story was published, the family of a transgender boy who changed his legal name at 15 years old learned a judge approved their request to retroactively seal his name-change documents. Wisconsin state Sen. Melissa Ratcliff and other Democrats have also introduced the bill that would eliminate the publication requirement for transgender people, so long as they can prove they’re not avoiding debt or a criminal record.

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In 2022, after living as a boy and going by a new name for several years, a 15-year-old from Madison, Wisconsin, wanted to make it official. Like most teenagers, he dreamed of getting his driver’s license, and his family wanted his government identification to reflect who he really was.

But Wisconsin law has a caveat: He would have to publish his old, feminine name and new name in the local newspaper for three weeks — essentially announcing to the world that he is transgender.

In many instances, if he had committed a crime, the law would afford him privacy as a minor. But not as a transgender teenager changing his name.

His parents worry the public notice now poses a risk as President Donald Trump has attacked transgender rights, asserted that U.S. policy recognizes only two sexes and described efforts to support transgender people as “child abuse.” The publication requirements endanger the community, lawyers working with trans people say, by creating a de facto dataset of likely transgender people that vigilantes and even the government could use for firing, harassment or violence.

Transgender people are over four times more likely to be victims of violence, research shows. Most transgender people and their families agreed to be interviewed for this story only if they weren’t named, citing safety concerns.

“Publication requirements really leave folks open and vulnerable to discrimination and to harassment more than they already are,” said Arli Christian, senior policy counsel at the American Civil Liberties Union. “It can put people at risk of violence and blatant discrimination simply because of who they are.”

Wisconsin’s legal process stems from a 167-year-old law, one of many statutes across the country that Christian said were intended to keep people from escaping debts or criminal records. Changing one’s name through marriage is a separate process that does not require publication in a paper.

Although the right to change one’s legal name exists in every state, the effort and risk required to exercise it vary. Less than half of states require people to publicize their name changes in some or all cases, according to the Movement Advancement Project, a think tank that tracks voting and LGBTQ+ rights. 

Wisconsin law grants confidentiality only if a person can prove it’s more likely than not that publication “could endanger” them. But the statute does not define what that means. For years, some judges interpreted that to include psychological abuse or bullying, or they accepted statistics documenting discrimination and violence against transgender people nationwide. 

In 2023, however, a state appeals court set a stricter standard after a trans teenager was denied a confidential name change in Brown County, home to Green Bay. The teen said he had endured years of bullying, in which peers called him slurs and beat him up. Court records show the Brown County judge asserted that publishing the teen’s name wouldn’t expose him to further harm because his harassers already knew he was transgender. 

The teen argued that a public process would create a record available to people he met in the future. While the appeals court conceded a “reasonable judge” could agree, it found the Brown County judge had not improperly exercised her discretion in denying the request. Crucially, the appeals court determined that “endanger” meant only physical harm. The case wasn’t appealed to the Wisconsin Supreme Court.

The combination of Wisconsin’s public requirement, the restrictive ruling and the Trump administration’s anti-trans policies has dissuaded at least one person from going through with a name change.

J.J Koechell, a 20-year-old LGBTQ+ advocate from suburban Milwaukee, tried to change his name in November but decided against it after a judge denied his request for confidentiality, ordering him to publish his change in the local paper and create a public court record if he wanted to proceed. 

“That’s already dangerous,” Koechell said of a public process, “given our political atmosphere, with an administration that’s trying to erase trans people from existence completely, or saying that they don’t exist, or that there’s something wrong with them.”

At the end of March, Wisconsin Democrats announced plans to introduce a bill that would eliminate the publication requirement for transgender people, so long as they can prove they’re not avoiding debt or a criminal record. Republicans, who control the Legislature, will decide whether it will receive a hearing or vote. 

There has been a push in some states to make it easier and safer for transgender people to update their legal documents. Michigan and Illinois laws removing publication requirements took effect earlier this year. And a California lawmaker introduced a bill that would retroactively seal all transition-related court records.

Assembly Speaker Robin Vos, R-Rochester, did not respond to emails and a phone call to his office seeking comment. Wisconsin Watch and ProPublica sought comment from four other Republican leaders in the Assembly and Senate. Of the two whose offices responded, a staffer for Assembly Majority Leader Tyler August, R-Walworth, said, “It doesn’t look like something we’d consider a priority,” and a staffer for Senate Assistant Majority Leader Dan Feyen, R-Fond du Lac, said he was not available for comment.

Asked about the safety concerns people raised, a White House spokesperson said, “President Trump has vowed to defend women from gender ideology extremism and restore biological truth to the federal government.”

No exceptions for minors

Wisconsin’s law requires a transgender person to publish the details of their identity to change their name whether they are an adult or a child. The notice requirement makes no distinction based on age.

This is less privacy than the legal system typically affords young people, confirmed Cary Bloodworth, who directs a family law clinic at the University of Wisconsin Law School. Bloodworth said both child welfare and juvenile courts tend to keep records confidential for a number of reasons, including that what happens in a person’s youth will follow them for a lifetime. 

“I certainly think having a higher level of privacy for kids is a good thing,” Bloodworth said, adding that she thinks the publication requirement is unnecessary for people of any age.

A mom living near the Wisconsin-Illinois border whose 11-year-old daughter recently went through the name-change process said these proceedings should automatically be private for children.

“The fact that we still have to fight to get something as simple as a confidential name change for a minor who is obviously not running away from criminal or debt charges is just so frustrating and overwhelming,” she said. 

The judge deciding their case seemed reluctant to grant confidentiality at first, questioning whether her daughter was being threatened physically, she said. The judge granted the confidential change. But the family remains shaken. 

“We live just in constant terror of the wrong person finding out that we have an 11-year-old trans child,” she said. “All it takes is one wrong person getting that information, and what we could end up going through, becoming a target, is horrifying.” 

Right before the pandemic, a teenager told her parents she was transgender. She spent much of that first year of her transition at home, attending virtual school like the rest of her peers in the Madison school district. She came out to only a few friends and wanted to keep her gender identity private, so she kept her camera off and skipped her high school graduation. 

When she decided to legally change her name, the prospect of publicizing her transition terrified her, according to her mom.

“I explained to her that it’s in tiny, tiny print, and it’s in some page of the paper that no one is going to read,” her mom said. “But it felt to her like she was just standing out there in public with a ‘TRANS’ sign on her.”

While fewer people read physical newspapers these days, much of their content gets published online and is easily searchable. The court case, too, becomes a public record that is stored online and sometimes aggregated by other websites that show up at the top of search results. 

The parents of the then-15-year-old boy who changed his name before getting his driver’s license discovered that happened to their son. When anyone — say, a prospective employer — searches the young man’s name, one of the first results shows his old name and outs him as trans.

“This is what somebody would use as their first judgment of him,” his mom said. “We certainly don’t want that to be something that people would use to rule him out for a job, or whatever it is he might be doing.” 

Like many other states, Wisconsin does not have laws that ban discrimination against transgender people in credit and lending practices or in public spaces like stores, restaurants, parks, doctor’s offices and hotels. However, Gov. Tony Evers, a Democrat, issued an executive order in 2019 banning transgender discrimination in state employment, contracting and public services.

After Trump took office again and began issuing executive orders attacking trans rights, the boy’s family started to investigate how they could retroactively seal the court records related to the name change. It wouldn’t change what was in the newspaper, but it could help them remove the online records. The court records also contain sensitive information like their home address that someone could use to harass them.

A friend who was a retired attorney helped their son craft an affidavit describing his experiences. His mom read from it during an interview. “‘Because of recent political events, I fear violence —’” she said before breaking off. “Oh God, I hate even reading this. ‘I fear violence, harassment, retribution because of my status as a transgender person.’”

Her son, who is now 18, shared a statement over email. 

“At this moment in time I’m probably more scared about being a trans person than I ever have been before, with the public record if you have my first and last name you can easily find my deadname and therefore find out I’m trans,” he said. “I would love to say that I feel safe and valued in our society but unfortunately I can’t, at times I feel that my personhood is being stripped away under this government.”

Anne Daugherty-Leiter, who has guided transgender clients and their families through the name-change process as board president of Trans Law Help Wisconsin, said where a person lives in Wisconsin, and therefore what court they must petition, affects their likelihood of getting a confidential change.

Confidentiality is important, she said, because of how the state handles changes to birth certificates. Wisconsin birth certificates that are issued through a confidential name change show only the new name. But if a person has to announce their name change publicly, birth certificates are amended to list both the person’s old and new names. Any time the person has to use that document, at the DMV or while getting a loan, it outs them, she said.

‘This is not who I am’

Koechell, a trans man and LGBTQ+ activist, was unwilling to go through with the name-change process after being denied confidentiality by a judge late last year.

Koechell lives in Waukesha County, a Republican stronghold where multiple schools have enacted policies critics have called anti-LGBTQ+. 

In a letter to the judge, Koechell wrote that people had sent him multiple threats and posted his family members’ addresses online, all for “being an advocate and being transgender openly in my community.” 

“I do not want to publish my deadname for people to use against me,” he said in an interview, using a term common among transgender people to refer to their birth names. “I don’t see a reason why people who are not particularly fond of me wouldn’t show up at a hearing like that and try and cause trouble.” 

Court records show the judge denied Koechell’s confidentiality request and his request to reconsider. The judge’s order referred to Koechell, a trans man with a masculine voice and beard, as “she” and “her.”

Koechell decided the public process wasn’t worth the risk. But it’s hard, he said, to move through life with his old identification.

“When I go to a new doctor or new appointment or something, then that’s the name on my chart, and then I get called that in a waiting room full of people, and it’s super uncomfortable. I just want to disappear,” Koechell said. “Then eventually, I have to correct the doctors, and I’m like, ‘Hey, just to let you know, I don’t go by that name. This is not who I am.’”

Data from the latest U.S. Transgender Survey found that 22% of people who had to show an ID that did not match their identity experienced some form of negative consequence, including verbal harassment, discrimination or physical violence. 

If the U.S. Senate passes the SAVE Act, which would require voters to prove citizenship with a passport or birth certificate, those consequences could include disenfranchisement. Transgender people who can’t change the name on their birth certificate or passport would be ineligible to vote, according to the liberal think tank Center for American Progress.

U.S. Rep. Chip Roy, a Texas Republican and chief sponsor of the bill, has said the legislation directs states to create a process for citizens with a “name discrepancy” to register. “No one will be unable to vote because of a name change,” he said.

After Trump won in November, Trace Schlax, a 40-year-old IT project manager, decided to expedite changing his gender marker on his passport, figuring he could update his name later in state court. 

“It matters,” Schlax said. He loves to travel but has encountered extra scrutiny from airport security with outdated documents. “I get comments from TSA when I go through to travel domestically, about my hair, about how I look. I get extra pat-downs.”

He sent his application in early December and crossed his fingers. He received it back in February, rejected. By that time, Trump had issued an executive order banning trans people from changing the gender markers on their passports. 

Schlax decided to continue updating what records he could, like his birth certificate and driver’s license. He worries about having conflicting documents. Will he get accused of fraud? Will he have trouble flying? 

But in the end, he decided it was still important to change his name and update his license to improve his day-to-day experience. 

And he decided to go about it publicly. It felt less painful, he said, to accept the risks rather than detail his personal, traumatic experiences to a judge only to have them decide he hadn’t endured sufficient danger. 

“Me changing my name and my gender marker affects absolutely no one but me,” said Schlax, who has a court date to change his name in late April. “Why does this have to be so hard? Why do I have to prove myself so hard?”

This article was produced for ProPublica’s Local Reporting Network in partnership with Wisconsin Watch. Sign up for Dispatches to get stories like this one as soon as they are published. 

Wisconsin’s name-change law raises safety risks for transgender people 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.