Concerns about brain cancer cases in Piatt County grow, but Illinois public health agency yet to investigate
Lessie Ann Patterson lived in Monticello, Illinois, for 25 years before dying in 2015 from glioblastoma, a rapidly advancing brain cancer with an average survival time of 12 to 18 months.
Belinda Barnhart, Patterson’s stepdaughter, witnessed firsthand the effects of glioblastoma in her family.
“There was no clear reason why she ended up with it,” Barnhart said in an interview. “And then when you hear about so many of them in the Monticello area, you just think about all the devastation it has caused, and it does make you want to say, ‘Why is this one area so rife with glioblastoma specifically?’”
Patterson was one of many victims of brain cancer in Piatt County that have been identified by a local researcher and health professional, Caitlin McClain.
Concerns about the number of cases came to light last year when McClain started researching and gathering information on glioblastoma cases in Monticello and Piatt County following the death of her father-in-law from the disease in 2022.
Caitlin McClain by a farm field on the south side of Monticello, IL on Friday, June 14, 2024. photo by Darrell Hoemann, for C-U Citizen Access
As of last fall, she said she had collected information on at least 30 cases from the past 20 years — with at least 14 deaths from the cancer in just the last five years. McClain collected her data through obituaries, surveys and speaking with residents.
She said she has had to investigate on her own because public health data lags years behind and sometimes is suppressed — that is, not disclosed — for smaller counties that would allow individuals to be identified. Piatt County’s population is about 16,700, of which just over 6,000 people live in Monticello, according the latest census data.
McClain took her findings to the Illinois Department of Public Health several times in 2024, but she said department officials did not follow the federal health guidelines for investigating possible cancer clusters and dismissed her concerns, saying the numbers did not indicate a cancer cluster.
But there is a protocol from the Centers for Disease Control and Prevention (CDC) and the American Cancer Society, on how an agency should respond. The CDC has guidelines for responding to reports of suspicious numbers of cancer cases and calls for public health agencies to talk to citizens and visit the community.
Glioblastoma has an incidence rate of about 3.2 cases per 100,000 people according to a 2017 study available at the National Library of Medicine. For Piatt County, the rate of brain cancer, which includes glioblastoma, from 2017 to 2021 was 9.1 for males on average. The registry counted 5 male cases during that time. It was only a 1.2 rate for females and the registry reported one case.
Yet McClain’s data shows five women living in or primarily from Monticello died of glioblastoma between 2017 and 2021 including Tina M. Purcell, a resident of Monticello since she married in 1990, and lifelong resident Connie Jean Hendrix.
“I have spoken to so many people at this point it is difficult to keep track of everything,” McClain said in October.
Thirty cases of glioblastoma were identified in and around Piatt County by a local researcher and health professional concerned about the possibility of a cancer cluster. Cases are mapped by general proximity to protect privacy.
Citing McClain’s data and information, Barnhart, whose stepmother died, said the state department’s response has been disappointing.
“It’s incredibly disappointing that your local public health office won’t even entertain the idea that something could be going on specifically in that area, that there could be a cancer cluster,” she said.
After numerous calls from CU-CitizenAccess, Michael Claffey, the public health department spokesperson, responded in December 2024.
“I will try to find out more about this,” Claffey wrote in an email.
But with federal funding for public health under siege, Claffey said in February:
“Sorry for the slow response to this. We have really been swamped recently given all the federal changes and everything else that is going on. I don’t have anything for you at this point.”
McClain said Chief Medical Officer Arti Barnes at the state public health department asked for an update from her in early February this year, but “there has been zero communication from IDPH otherwise.”
University researchers said cases are concerning
Molly HughesResearchers at Beckman Institute (405 N Mathews Ave., Urbana) at the University of Illinois Urbana-Champaign said they were concerned about reports of glioblastoma in Monticello in Piatt County. photo by Molly Hughes, for C-U Citizen Access
Biomedical researchers at the University of Illinois Urbana-Champaign said they are concerned about the reports of glioblastoma in Monticello.
Professor Catherine Alicia Best-Popescu, a biomedical researcher at the University of Illinois whose focus is molecular, cellular and tissue engineering, said in December that Monticello’s glioblastoma rates are worth investigating, calling the pattern a “huge cluster.” Glioblastoma, she explained, is notoriously challenging to treat due to its aggressive nature.
“It’s a really impossible cancer to treat because it can evade your immune system, evade radiation therapy,” Popescu said. “We give it a superpower in a way.”
The CDC sets clear guidelines for investigating cancer clusters, which prioritize cases with higher-than-expected numbers of rare cancers like glioblastoma. The investigations require experts to study the cancer data to establish if there is a concerning rate.
Under those guidelines, health departments’ partners and officials are expected to review data from cancer registries and other databases to monitor the estimated rates of cancer incidents routinely. The guidelines note that state resources and small populations can restrict state health departments from proactively reviewing or monitoring cancer data.
The CDC also said a cancer cluster must have one of these traits:
There is a greater-than-expected number of a specific type of cancer (or types of cancer that are known to have a common cause).
There are several cases of a rare type of cancer.
The cancers are a type that is not usually seen in a certain group of people (for example, children getting cancer usually seen in adults).
For rural Illinois residents, accessing information about the occurrence of cancer in their area is difficult because cancer data are sometimes suppressed in rural areas due to concerns of confidentiality and small populations.
Suppressed means the number of cases do not show up on state maps and data.
While the goal of the U.S. Census Bureau’s privacy protection system is to protect individual identities by injecting statistical noise into aggregate population data, a study by the National Library of Medicine found discrepancies increase dramatically in rural areas, raising concerns that the new system may misrepresent population trends and demographic changes.
“Whenever we talk about it, they say, ‘Try not to be alarmed.’ We are very alarmed. We’re very upset about it. It’s absolutely unacceptable.” Popescu said.
Severity of cases questioned by public health
Thirty cases of glioblastoma were identified by a local health professional in and around Piatt County, many of which are in Monticello. Cases are mapped by general proximity to protect privacy.
Last year, McClain said multiple state officials questioned whether her data indicates a cancer cluster, including those from the Illinois Cancer Registry, the state public health department and state representatives.
The Illinois Department of Public Health — tasked with protecting public health and the environment — said the number of cases was not alarming and there was no need or resources to look into the cases. Officials said McClain’s data did not indicate evidence of a cancer cluster because the rate of the cases was insufficient.
When McClain first contacted health officials in early 2024 she had documented 19 cases of glioblastoma since 2004. By October, she identified 30 cases total since 2004 — with seven cases within 2.3 square miles in Monticello.
Under cancer cluster investigation guidelines, the Illinois Department of Public Health is expected to review data available from cancer registries and other databases to monitor the estimated rates for cancer incidents.
But databases and cancer registries are outdated. According to the CDC, the latest cancer incidence data available are from 2021, four years ago, and recent cancer death data are from 2022. Illinois’s cancer incidence data is from 2021.
McClain said she found at least 11 people with glioblastoma died between 2017 and 2021, of which 6 were men and 5 were women.
In response to a Freedom of Information Act (FOIA) request to the state public health department in November, a FOIA officer said “the Department follows CDC guidelines when determining whether and how to investigate or assess a cancer cluster.”
As of February this year, no additional investigation by the Illinois Department of Public Health had been done.
Cause of glioblastoma unclear, linked to pesticides
While glioblastoma’s exact causes remain unclear, exposure to carcinogens, radiation and agricultural chemicals has been linked to DNA mutations that drive the disease.
“It is my opinion that Illinois as a whole refuses to accept that agricultural chemicals pose risk to human life,” McClain said in October. “They seem to be behind in research and correspondence with the public compared to other rural states … Some farmers have left more space between their crops and the homes and schools this year once I brought the risk to their attention.”
In response to McClain asking for the city of Monticello to test the water, officials did so and saw nothing worrisome in the results, which showed no violations for disinfectants or inorganic contaminants.
Water test reports from 2023, obtained in an email from Monticello Public Works, show most regulated contaminants are within acceptable levels.
“Any time Caitlin has brought something to our attention, we’ve expeditiously looked into it and gone from there,” Monticello City Administrator Terry Summers said in an interview in November 2024.
Summers initiated water tests of the county’s water supply and found the nitrate levels were almost undetectable. He said there was no sign that the public water supply was behind the number of brain cancers.
According to the American Cancer Society, more than 1,000 suspected cancer clusters are reported to state health departments in the United States each year.
The stakes are high for those diagnosed with glioblastoma: the average survival time is just 12 to 18 months, even with aggressive treatment.
Gita Kwatra, CEO of the Glioblastoma Foundation Inc, a non-profit organization in Durham, North Carolina, said glioblastoma is the most common malignant brain tumor, with slim survival rates.
“The disease is incredibly fast, incredibly lethal cancer. There isn’t enough research funding that goes to this cancer. There isn’t enough awareness,” Kwatra said in a phone interview. “Five to seven percent of people who are diagnosed will survive to five years, and five years is important in the medical community, five years is used as a surrogate marker for beating the disease.”
How Oklahoma’s superintendent set off a holy war in classrooms
NORMAN, Okla. — Sometimes, Jakob Topper teaches his Christian faith to his six-year-old daughter using children’s Bible stories illustrated with teddy bears. Other days, he might use her kid-friendly Bible featuring Precious Moments figures as characters. One thing he knows for sure: The King James version is not on the reading list, given some of its adult themes of sexual assault and incest.
As a parent and a Baptist pastor, Topper opposes Oklahoma’s state superintendent of public instruction’s mandate to put a King James Version Bible in every grade 5–12 classroom. The father of three is also not keen on the state’s newly proposed social studies standards that would require biblical lessons starting in first grade.
“I want the Bible taught to my daughter, and I want to be the one who chooses how that’s done,” said Topper, who also has a one-year-old and a three-year-old and is pastor of NorthHaven Church in Norman, a university town. “If we’re talking about parental choice, that’s my choice. I don’t want it to be farmed out to anyone else.”
Norman, a central Oklahoman city of about 130,000, is an epicenter of resistance to the Bible mandate that the state superintendent of public instruction, Ryan Walters, announced last June. Opposition here has come from pastors, religion professors, students, parents, teachers, school board members and the school district superintendent, among others. The prevailing philosophy among Norman residents, who are predominantly Christian, is that they do not want the state — and namely, Walters — mandating how children should be taught scriptures. They want their children to learn from holy books at home or in church.
Pastor Jakob Topper, of NorthHaven Church, says he prefers to teach his children about the Bible rather than placing that responsibility on teachers. Credit: Mike Simmons for The Hechinger Report
Many residents see Walters’s pitch as a play for national attention, given his abundance of social media posts praising Donald Trump, who campaigned on returning prayer to schools and as president has established a White House Faith Office and a task force to root out “anti-Christian bias.” In September, Walters proposed spending $3 million to buy 55,000 copies of the Bible that has been endorsed by the president and for which he receives royalties. More recently, Walters — who in February clashed with his state’s governor for proposing that public schools track students’ immigration statuses — made media lists as a possible candidate for Trump’s education secretary. He was not picked.
But beyond Walter’s national aspirations, the Bible mandate also seems like an attempt at one-upmanship, with other states angling to infuse Christianity into public schools. Louisiana, for instance, is in a court battle over its push for Ten Commandments posters in schools. Texas fought off Democratic opposition to approve an optional Bible-infused curriculum and financial incentives for school districts that use the materials. A slew of states have passed or promoted similar measures, including ones allowing chaplains to act as counselors in schools. Unsurprisingly, Walters, too, has advocated for displaying the Ten Commandments in every classroom and also has backed the conversion of a private virtual Catholic school into a charter school; the Supreme Court plans to hear oral arguments on the case on April 30.
It goes without saying that Walters’s crusade is multifaceted. But fundamentally, all of his efforts amount to teaching the Bible “in inappropriate ways in public schools,” said Amanda Tyler, author of “How to End Christian Nationalism” and executive director of the Baptist Joint Committee for Religious Liberty, a Washington, DC–based organization of attorneys, ministers, and others who advocate for religious freedom. “He’s saying you can’t be a good American citizen if you don’t understand the Bible,” she added. “It’s this merger of American and Christian identities, the idea that only Christians are true Americans.”
On March 10, the Oklahoma Supreme Court dealt a blow to Walters’s plans: It issued a temporary stay prohibiting the state’s department of education from purchasing 55,000 Bibles with certain characteristics and from buying Bible-infused lessons and material for elementary schools.
The stay stems from a lawsuit led by Americans United for Separation of Church and State on behalf of 32 plaintiffs, including parents, clergy, students and teachers. The group, which is suing Walters, claims the Bible mandate violated the state’s prohibition against using state funds for religious purposes and the state’s own statutes allowing local district control over curriculum.
As of now, until the court issues a final ruling, its decision marks a victory in Americans United’s attempt to stop Walters, said Alex Luchenitser, the organization’s associate legal director: “It protects the separation of church and state. It protects the religious freedom of students.” Speaking about the court’s stay, Walters, through spokeswoman Grace Kim, said in a statement: “The Bible has been a cornerstone of our nation’s history and education for generations. We will continue fighting to ensure students have access to this foundational text in the classroom.”
Oklahoma Supreme Court, pictured in the state Capitol building, in March issued a stay that would prohibit the state education department from purchasing Bibles and Bible-infused lessons for elementary students. Credit: Sue Ogrocki/ Associated Press
Meanwhile, Walters was also sued separately last summer by a parent in Locust Grove who contended the mandate violated the state and federal constitutions. The state education department has denied the claims of both suits and contended in legal briefs that using the Bible for its secular value does not violate the state’s constitution.
Walters’s mandate has also sparked concern because of the proposed social studies standards that followed. The standards, which were initially released in December and would require legislative approval, mention the Bible and its historical impact more than 40 times. Several of the standards attempt to erroneously frame the Bible, and specifically the Ten Commandments, as the foundation of American law. Biblical scholars from the University of Oklahoma and elsewhere believe these standards promote the long-standing trope of Christian nationalism, which is premised in part on the false idea that the nation’s founding documents stemmed from the Bible. (The founders were Bible readers, but not necessarily fans of the same versions or holy texts in general. In fact, Thomas Jefferson cut up pages of the Bible to remove mention of miracles or the supernatural.)
For example, Walters’s standards would require students in first grade to learn about David and Goliath, as well as Moses and the Ten Commandments, because the standards cite them as influences on the American colonists and others. Second graders would be asked to “identify stories from Christianity that influenced the American colonists, Founders, and culture, including the teachings of Jesus the Nazareth (e.g. the ‘Golden Rule,’ the Sermon on the Mount).”
“These new standards,” said a news release from the state department of education, “reflect what the people of Oklahoma — and all across America — have long been demanding of their public schools: a return to education curricula that upholds pro-family, pro-American values.” (Walters’s press office, despite repeated requests, did not make the state superintendent available for an interview.)
Critics in Oklahoma and elsewhere see Walters’s Bible mandate as part of a broader Christian nationalist movement. “I think Oklahoma is the test case for the nation,” said Dawn Brockman,a Norman school board member.
Walters, though, has been steadfast in his belief that the mandate is legal and critical for the education of Oklahomans. In the fall, after Americans United sued, Walters wrote on X: “The simple fact is that understanding how the Bible has impacted our nation, in its proper historical and literary context, was the norm in America until the 1960s and its removal has coincided with a precipitous decline in American schools.”
But nothing is simple about the history of the Bible in America’s schools. When public schools started to open in the 1800s, some required regular Bible readings. From the beginning, that practice was controversial: Schools typically favored the King James Version, pitting Protestants against Catholics, and riots over school Bible readings broke out from the 1840s into the 1870s, said Mark Chancey, a professor of religious studies at Southern Methodist University in Dallas. By 1930, 36 states allowed Bible reading to be a requirement or an option, but another dozen banned such activities.
A few decades later, a Pennsylvania family sued their school district for heeding the state’s 1949 law requiring the reading of 10 Bible verses and the recitation of prayers at the start of each school day. In 1963, just a year after a similar opinion, the Supreme Court ruled that requiring in-school Bible readings and prayers was unconstitutional. After those rulings, daily teaching from the Bible, for the most part, was halted, Chancey said, but backlash continued, with critics charging that removing prayer and Bible readings from schools had led to a decline in the morality of schoolchildren.
In subsequent decades, the Supreme Court ruled against clergy-led prayer and prayer over the loudspeakers at football games in several school-related cases. But in a seeming reversal, in 2022, the high court ruled in favor of allowing a football coach to conduct midfield, postgame prayers, shifting the legal landscape. The majority’s opinion on the football coach’s prayer has prompted politicians and states to further test the limits of the separation of church and state. In February, lawmakers in Idaho and Texas even proposed measures to allow daily Bible readings in public schools again.
Darcy Pippins, who teaches Spanish at Norman High School, said she doesn’t feel qualified to teach about the Bible. Credit: Mike Simmons for The Hechinger Report
In Norman, many teachers reacted to news of the Bible mandate with concern and fear. Spanish teacher Darcy Pippins,who is in her 27th year at Norman High, said she sometimes teaches about Catholicism because it is the religion of the Spanish-speaking world. But putting a Bible in every classroom and teaching from it is different. “I just don’t feel comfortable,” said Pippins, also a parent. “I’m not qualified to teach and to incorporate the Bible into what I teach.’’
Other teachers, said Brockman, the school board member, worried about professional repercussions were they not to follow the mandate, given that Walters had already targeted at least one Norman teacher in the past for objecting to bans on particular books.
Nick Migliorino, the public school system’s superintendent since 2017, was the first superintendent in the state to publicly oppose the Bible mandate. When asked about it in a July interview with a local paper, he responded: “I’m just going to cut to the chase on that. Norman Public Schools is not going to have Bibles in our classrooms, and we are not going to require our teachers to teach from the Bible.”
Other superintendents followed, and by late July, at least 17 school district leaders said they had no plans to change curriculum in response to the Bible mandate, according to a report by StateImpact Oklahoma.
In an interview at his district’s headquarters, Migliorino emphasized that his school system already teaches how different religions affect history. Bibles, he noted, are accessible to students through the library. Migliorino added that the state superintendent had no authority to make school districts follow the mandate and that it would result in pushing Christianity on students.
“It’s a captive audience, and that is not our role to push things onto kids,” he said. “Our role is to educate them and to create thinkers.”
Oklahoma already has a 2010 measure allowing school districts to offer elective Bible classes and to give students the latitude to pick the biblical text they prefer to use. But unlike Walters’s mandate, it allows for different biblical perspectives, said Alan Levenson, chair of Judaic history at the University of Oklahoma and a biblical scholar. Even still, there has never been widespread interest in a Bible elective in Norman, said Jane Purcell, the school system’s social studies coordinator. Nor was there much interest in such a class when she taught in Florida. Since 2006, at least a dozen states have passed laws promoting elective Bible classes.
This may be, in part, because educators worry about potential issues with teaching Bible courses, said Purcell: “It’s very easy for it to appear to be proselytizing.”
Walters, for his part, has not taken any of this pushback in stride. At a July 31 state board of education meeting, he lashed out against “rogue administrators” who opposed him, saying of the left: “They might be offended by it, but they cannot rewrite our history and lie to our kids.”
After the public schools superintendent publicly rejected Walters’s mandate, community members and teachers in Norman expressed relief. Meg Moulton, a realtor and mother of three, came to a July board meeting to thank the superintendent in person. “I’m a Christian mama,” she said. “I love teaching my kids about God. I love going to church.”
But, she added, “Ryan Walters’s mandate makes it so that teachers and students who may not be Christians…[or] who may believe something different, are going to be essentially forced to learn something that they may not believe in.”
Students and others I met with at a popular Norman coffee shop said they were concerned about how Walters’s mandate could affect religious minorities, women, and members of the LGBTQ+ community. “What Ryan Walters is trying to push goes in line with a lot of trends of kind of pushing back against LGBTQ,” said Isandro Moreno,a 17-year-old senior at Norman High.
Phoebe Risch, a 17-year-old senior at Norman North, the town’s other public high school, said Walters’s mandate was part of what motivated her to restart her high school’s Young Democrats club and recruit roughly 30 members. Risch, already upset about her state’s readiness to ban abortion following the Supreme Court’s overturn of Roe v. Wade, fears that requiring Bible-based instruction could lead to the promotion of the idea that women are submissive. “As a young woman, the implications of implementing religion into our schools is a little scary,” she said, “especially because Oklahoma is already a very conservative state.”
Among the half dozen teens attending a confirmation class in December at Oklahoma City Reform temple B’nai Israel, most opposed the mandate, except for one. She said she supported it as long as the classroom teacher was careful and encouraged critical thinking.
One teen recounted tearily how, during class the previous week, a friend had drawn a swastika on her paper as a taunt. “Stuff like that is so normalized,” she said. “It’s antisemitism. If that’s so normalized, normalizing Christianity further, it’s just worse.”
Imad Enchassi, an imam who oversees an Oklahoma City mosque and also chairs the Islamic Studies department at Oklahoma City University, said he worries that Superintendent Ryan Walter’s policies will further isolate Muslim children. Credit: Mike Simmons for The Hechinger Report
Imad Enchassi, an imam who oversees an Oklahoma City mosque and serves as chair of Islamic studies at Oklahoma City University, echoed similar fears for the Muslim community. “We’re already experiencing Islamophobia. Muslim kids who wear the headscarf already have been told they’re going to hell because they don’t believe in the Bible or they don’t believe in Jesus,” he said. “When curriculum mandates one religion over the other, that will further isolate our children.”
Some Oklahomans, though, do support the mandate. And at one of the state board of education meetings where Walters touted it, three residents expressed support for the idea — during public comment — as did at least one board member. That board member said he thought biblical literacy was important, while other supporters see the Bible mandate as a way to instill morality in the public schools. Ann Jayne,a 62-year-old resident of Edmond, about 15 miles north of Oklahoma City, makes a point of letting Walters know on his Facebook page that she’s praying for him, because she believes public schools need to instill Christian values. “I think we need church in the state,” she said. “I don’t see a problem with God being back in the school. Nobody is forcing them to become a Christian.”
Since last summer, Walters’s efforts to push Christianity have only become bolder. In mid-November, he announced the opening of the Office of Religious Liberty and Patriotism, which would, among other things, investigate alleged abuses against religious freedom and patriotic displays. Two days later, he announced that he was sending 500 Bibles to Advanced Placement government classes. He also emailed superintendents around the state with the order to show their students a one-minute-and-24-second video announcing the religious liberty office and praying for newly elected President Trump.
At a Christmas parade in Norman in early December, some residents called the video embarrassing, with many superintendents, including Norman’s, having declined to show it. However, while many residents seem to abhor the Bible mandate, they do not agree on how religion should be handled in public life. Despite some religious diversity and some liberal leanings common in a university town, Norman skews religiously conservative. That dichotomy means many residents see the Bible as so sacrosanct that they don’t want it taught in schools, yet they see no problem with other Christian-oriented school activities.
In some cases, residents like school board member Brockman, who is also a former teacher and lawyer with training on the First Amendment, have objected to school promotion of the religious aspects of Christmas. When she was a teacher at one of Norman’s two high schools, she asked to stop the playing of overtly religious Christmas songs in the halls during passing periods. She saw it as a “gentle reminder that the Supreme Court says we need to remain neutral on religion.” Her wish was granted. “They took it down with some consternation and played the Grinch in my honor.”
Residents have also quibbled over what to call the parade featuring Santa each December. Should it be called the Norman holiday or Christmas parade? It’s now known as the Norman Christmas Holiday Parade. In early December, the city’s mix of liberal and conservative influences shone through the glitz during the parade. The Knights of Columbus float had a sign that said “Merry CHRISTmas.” Norman’s Pride organization participated, with its human angels wearing wings lit up in rainbow colors.
Tracey Langford, watching the parade from the back of her SUV, was dressed in a red stocking cap and a red sweatshirt that read “Santa, define good,” a jab at the fact that she is a lawyer who cares about legal definitions. To her, the Bible mandate is a clear violation of separation of church and state.“Every home here has a Bible…. We don’t need to spend a dollar to get a Bible in every classroom,” said Langford, a lawyer at the University of Oklahoma and a parent of a first grader in Norman schools and a 15-year-old in a private school.
Traci Jones, a parent of both a Norman sixth grader and fifth grader, likewise asked, “Who’s supposed to be teaching these kids the Bible? Is it just a random person? What if it’s an atheist or someone who has totally different beliefs than me?” As a nondenominational Christian, she added, “I think it’s wack to ask these poor teachers to teach that.”
What happens next may ultimately be decided in a courtroom. There is no sign yet when final opinions may be issued in either lawsuit.
State lawmakers at recent appropriation hearings said they were worried about the directive’s constitutionality, and in fact, in March, the Senate Appropriations’ Education Subcommittee said it did not consider Walters’s $3 million request to purchase Bibles. The next day Walters announced he was launching a national campaign with a country singer to get Bibles donated to Oklahoma schools. (The legislature gets the final word on the Bible purchases, a line item in the education budget, and the standards, which the state board of education approved in late February.) Meanwhile, the fate of religion’s place in public schools on a national level likely will rest with the Supreme Court, with various lawsuits against state measures promoting Christianity making their way through the court system.
A Ten Commandments monument that sat on Oklahoma State Capitol grounds until the state Supreme Court ruled its presence violated the separation of church and state. It now is at the headquarters of a conservative lobbying group. Credit: Linda K. Wertheimer for The Hechinger Report
In Norman, Jakob Topper, Kyle Tubbs and other Baptist pastors I met with at the headquarters of a statewide Baptist church organization were increasingly aghast at Walters’s mixing of religion and politics. Rick Anthony, pastor of Grace Fellowship, a Baptist church, centered his November 17 sermon on such concerns. “Almost comically, we’ve heard this week about a video made that was ordered to be shown to all children in the public schools and then sent to their parents,” he said. “Our question is…where are our voices as our political leaders cozy up to faith leaders, all the while destroying our faith institutions?”
Kaily Tubbs, Tubbs’s wife and a fifth grade teacher in Norman schools, said the mandate conflicts with her personal belief on how faith should be handled in schools. She spoke also as a mother of a kindergartener and a third grader, both in Norman schools. “Our faith is really important to us,” she said. “I don’t want it to be used as a prop in a classroom.”
Topper said that at his church, the majority of his congregation believes in separation of church and state. He said he is aware of the religious diversity that exists in his town, too, and has both Muslim and Jewish neighbors. Like Anthony, he spoke with his congregation about Walters’s mandate, though in an informal weeknight meeting at his church, rather than as part of a formal sermon. “I wish,” he said, “that Jesus was left out of schools and left for the religious realm.”
Contact editor Caroline Preston at 212-870-8965, via Signal at CarolineP.83 or on email at preston@hechingerreport.org.
GOP Cuts to Medicaid Could Threaten Rural Hospitals
Southwest Memorial Hospital in Cortez, Colorado, received more than 59,000 patient visits last year. That’s enough to treat everyone in Cortez and surrounding Montezuma County twice.
Staff call the small hospital a bedrock of both medical care and the local economy.
But warnings that the Republican-controlled federal government might cut Medicaid funding have community members worried about the facility’s future.
They are not alone. Nationally, health policy experts warn that any cuts to Medicaid are likely to cause more trouble for rural hospitals than urban ones. That’s due in part because rural residents are more likely to be enrolled in Medicaid
In Montezuma County, 36% of the population is enrolled in Medicaid, which is publicly supported medical insurance for lower-income Americans. Southwest Memorial Hospital, a nonprofit hospital, expects about $20.5 million to come from the Medicaid reimbursements in 2025. That’s nearly a quarter of their expected revenue for the year, according to CEO Joe Theine.
If that revenue is threatened, the healthcare system would have a hard time adjusting without affecting the services they can offer.
Theine said that the hospital is planning for growth in 2025. But if Medicaid is cut, the hospital would have to consider their level of services, the same way a family would have to revise its spending if it lost a big part of its income.
“If [you] had a 25% reduction in household income, you have to make some different decisions other than just around the edges,” Theine said.
Any such changes could affect the community’s level of health services and the local economy.
The hospital employs nearly 500 locals, including employees with young families that support Cortez’s public schools, Theine said. “The ripples of a hospital in a rural community are many beyond just the health and wellbeing of the people we serve directly,” he said.
Medicaid reimbursement is a crucial part of Southwest Memorial’s funding, despite reimbursing less at lower rates than private insurance.
“If a patient comes in and has Medicaid as a pay source, even though it may pay less than the average cost for that service, it still is contributing to paying for that fixed cost of having the emergency room open,” said Theine, “If that same patient no longer has insurance and is unable to pay, we still take care of them. But now there’s nothing coming in that’s contributing to keeping all of those services available.”
GOP Legislation Could Threaten Rural Healthcare Systems
A March 5 letter from the Congressional Budget Office to two Democratic representatives said that House Republicans won’t be able to meet their budget target of $1.5 trillion in cuts without slashing Medicaid and Medicare.
Speaker of the House Mike Johnson said Medicaid was safe under Republican lawmakers, but the math doesn’t add up with Trump’s determination to drop the national deficit by more than $1 trillion, according to Democrats.
“There have been proposals around reducing or eliminating that federal match for [Medicaid] expansion populations,” said Carrie Cochran-McClain, chief policy officer of the National Rural Health Association.
That match was part of the 2010 Affordable Care Act, which provides federal funds to states to expand eligibility for Medicaid to families that earn up to 38% above the federal poverty line. A later Supreme Court ruling made Medicaid expansion optional. Currently, all but 10 states have accepted federal funding and expanded Medicaid.
In Colorado and California, for example, the federal government issues a reimbursement rate of 50% of total Medicaid costs. But in states that have expanded Medicaid under the ACA, the federal government also reimburses them for 90% of the Medicaid costs of the expansion population. Colorado, along with 40 other states (including the District of Columbia), have expanded Medicaid under the ACA legislation.
According to a 2023 report from the Medicaid and CHIP Payment and Access Commission (MACPAC), an organization that advises Congress on healthcare policy, hospitals in states that expanded Medicaid under the ACA don’t have as many uninsured patients as those that didn’t adopt expansion. Medicaid expansion can save hospitals money by increasing the share of its patients who are covered under some form of insurance.
An analysis of 600 research papers on Medicaid found that expansion led to drops in the uninsured population and economic improvements for both states and healthcare providers. In the fiscal year 2020, the cost of uninsured care represented 2.7% of the total operating expenses in states that expanded Medicaid, compared to 7.3% in states that haven’t expanded.
Medicaid expansion under the ACA also means states can spend less money on mental health and substance use treatments because federal matches help pay for them.
“States can come up with a number of different ways that they finance their Medicaid programs, and it varies across the board,” Cochran-McClain said. “They can use specific kinds of fees or taxes to help support the Medicaid program.”
Reducing or eliminating that federal match would leave states with the option to either reduce the number of Medicaid enrollees, or to come up with another method of funding care for the expansion population. But some states might not be able to make up the funds.
Rural Residents Are More Likely to Receive Medicaid
The loss of that federal money would be especially hard on rural health-care providers, Cochran-McLain said. That’s because a greater share of the rural population relies on Medicaid compared to urban and suburban areas.
Nonmetropolitan, or rural, counties have slightly higher Medicaid enrollment rates than metropolitan counties. Nationwide, 24% of residents in rural counties received Medicaid either alone or in combination with another health insurance method in 2023, compared to about 20% of the metropolitan population that year.
In Colorado, 23% of the nonmetropolitan population and 18% of the metropolitan population received Medicaid in 2023, according to a Daily Yonder analysis of Census data.
Of the 47 states that have nonmetropolitan counties, 43 of them have higher Medicaid enrollment rates in rural areas compared to metro ones.
“There is a really direct and strong relationship between Medicaid coverage levels and the financial viability of rural hospitals,” Cochran-McClain said. “In states that have expanded Medicaid, we saw an improved hospital performance, rural hospital performance and smaller rates of vulnerability for rural hospitals.”
Expanding Medicaid to include more low-income individuals saves states money by reducing the cost of providing care to the uninsured.
States that have not expanded Medicaid leave their rural healthcare systems more vulnerable to financial crises.
“Whether it’s Medicare or Medicaid, it’s a really important revenue source and source of coverage,” said Cochran-McClain.
How Does Medicaid Work in Colorado?
Colorado lawmakers voted to expand Medicaid coverage in 2009, ahead of implementation of ACA. The state simultaneously created a hospital provider fee program that funds the state’s portion of Medicaid. In Colorado, the federal match rate comes to 63.6%. The hospital provider fees pay the rest..
Many states use provider taxes or fees to fund Medicaid programs at the state level. Colorado taxes hospitals and healthcare providers 5.5% of revenue (the fee cannot exceed 6%) with a program called the Colorado Healthcare Affordability and Sustainability Enterprise (CHASE). That money is then matched by the federal government at 90%, as long as the population falls under the ACA expansion eligibility.
Colorado’s CHASE funds go to offsetting the difference between Medicaid reimbursement and the actual cost of a service. Medicaid typically reimburses a provider around 50% of cost, said Tom Rennell, senior vice president of financial policy and data analytics for Colorado Hospital Association.
Rennell said that CHASE “helps out our rural hospitals more than our urban hospitals. Our rural hospitals pay in less fees and our rural hospitals receive more of the distribution.”
Increasing taxes and fees from healthcare providers are one funding source that could help bridge the gap if federal funding is cut, said Rennell.
In Colorado, the state legislature has a constitutional requirement to have a balanced budget. That budget is currently facing a $1.2 billion deficit, some of which is caused by rising Medicaid costs. Colorado’s Taxpayer Bill of Rights (TABOR) restricts government spending to population growth plus inflation, meaning that any additional tax revenue over that formula is returned to taxpayers.
This means that even if the state has the revenue to balance the budget, it’s incredibly difficult to reallocate those funds to other programs, like Medicaid. Colorado voters have historically been very protective of TABOR refunds. Raising taxes to fund Medicaid is also not an option in Colorado under TABOR.
“The state’s already wrestling with a billion dollar shortfall in our upcoming year, and then add onto that potential additional shortfall from this federal funding. And those really start to add up to some real sizable impacts that the state is going to have to deal with,” said Rennell.
Rennell sees the potential cuts affecting rural hospitals disproportionately. “This funding from the federal government is their lifeline. It is what keeps those rural hospitals operating. And if you cut the lifeline, they will have to make difficult choices.”
As birthing units continue to close, potential solutions emerge
Editor’s Note: This story is the third in a series exploring maternity care in Maine.
In the United States and across the world, birth rates are falling.
Fertility rates in the United States reached a historic low in 2023, and have dropped more than twenty percent in the past three decades, to 1.6 births per woman of reproductive age. In Maine, where fertility rates have long been lower than the national average, that figure was 1.47 births per woman in 2022.
The reasons are complex, driven in part by dramatic reductions in teen pregnancies and fewer unplanned pregnancies. But the change — coupled with a nationwide shortage of physicians, low reimbursement rates for care and people entering pregnancy with more complex medical needs — is the primary force behind a cascade of birthing unit closures in Maine and across the nation.
Fewer babies being born means it is difficult for providers to maintain their skills and harder to sustain services financially; once a unit closes, it becomes more difficult to attract young families to an area, pushing fertility rates into a downward spiral.
As birthing units shutter and some rural hospitals close their doors entirely, providers around the state are looking to make it easier to train physicians in rural areas, cross-train staff who are already in rural hospitals in obstetrics and make better use of highly-trained nursing staff and other providers to lessen the burden on physicians and prop up the birthing units that remain.
The state already has a range of services in place designed to support families, including services for parents struggling with substance use disorder, telehealth programs for patients to access mental health care and remote blood pressure monitoring, which allows patients in rural areas to avoid frequent office visits.
“The state is taking this seriously,” Anne Marie van Hengel, a retired obstetrician from Portland, told The Maine Monitor in early March. “No one is looking at this and saying, ‘oh, no big deal.’ These birthing unit closures, they are really an issue.”
Leveraging existing providers
One of the most approachable solutions to the rural health care crisis, said several experts, and one that can be implemented immediately, is making better use of providers who are already part of the community.
That’s what hospital administrators did in Washington County. Two years ago, faced with a nearly $1.5 million gap between projected costs and nursing staffing charges, a declining number of births and the very real prospect of closing the sole remaining maternity unit in the county, hospital administrators at Down East Community Hospital in Machias decided to cross-train nurses from the medical/surgical department in obstetrics.
Med/surg nurses were trained in resuscitating newborns. Staffing shifted slightly to have just a single dedicated obstetric nurse on shift rather than two, allowing the hospital to reduce its reliance on costly traveling providers. A labor-trained medical-surgical nurse fills in the staffing gaps, and a multi-disciplinary team, including emergency department staff, anesthesiologists, a pediatrician, a nursing supervisor and a respiratory therapist, are on call.
The transition was not seamless. Some nurses, uncomfortable working with highly specialized obstetrics cases, reportedly left the hospital, according to nursing union representative Roberta Alley, who told The Monitor last year that the decision to cross-train nurses was “highly unusual.”
In an email this February, DECH spokesperson Julie Hixon said the flex arrangement was still in place and “has helped considerably with closing the gap. Even though our births were down in 2023, we feel good about the future of our OB program because we believe our flex approach will only improve over time.”
Surgeons trained to perform C-sections can also provide care in places where a dedicated obstetrician is not available.
That was once the case at Mount Desert Island Hospital in Bar Harbor, where Linda Robinson, a certified nurse midwife, worked for decades.
“Midwives used to provide all of these services. It was never an issue,” said Robinson, who recently taught a class on the history of midwifery in the U.S. at the College of the Atlantic. “The one thing [hospitals] absolutely need an OB/GYN for is a C-section, which can be done by a general surgeon.”
With low birth rates making it financially unsustainable to retain obstetricians in certain areas and challenging to keep them trained, Robinson advocates for hospitals training surgeons to perform complex births while nurse-midwives assist or, in some cases, take the lead during deliveries.
“There’s a younger generation of doctors coming forward [and] many of them have been trained by midwives, so they appreciate our skill,” said Robinson.
Allowing specially-trained nurses to take first call, bringing in a physician only if a case becomes complex or requires a C-section, can also help alleviate the burden of being constantly on call, said several providers. Sharing personnel across hospitals within a system can also reduce the strain.
Cross-training family medicine physicians, who outnumber obstetricians more than ten to one, has also been proposed as a way to boost obstetric care in Maine.
According to a 2024 paper published by the Maine Rural Graduate Medical Education Collaborative, Maine graduates about four obstetric residents annually, all out of Maine Medical Center in Portland. By contrast, the state graduates around 35 family medicine residents each year out of programs in Portland, Lewiston, Augusta and Bangor.
The authors suggested that Maine explore establishing a family medicine obstetrics fellowship to train family medicine physicians in obstetrics. Twenty-eight states offer such fellowships, including Massachusetts.
“In Maine, where Family Medicine physicians are more widespread through the State, it would be beneficial to cross-train rather than rely on recruitment,” the authors wrote.
Cross-training providers who are already part of the community is often much easier than hiring those who have few or no connections to a place.
“No question about it, recruitment is extremely challenging,” said Mike Towey, a speech pathologist who recently retired from Waldo Hospital. “It’s all about… developing a sense of community to attract and recruit people.”
Rural hospitals in Maine face significant challenges with recruitment due to scheduling, fluctuating patient numbers and internal hospital dynamics, according to a 2024 Roux Institute report.
But, according to the same report, rural hospitals in Maine see “high retention of employees from the community,” and solid partnerships and communications with other providers, such as EMTs, community midwives, and other types of community-based care and services.
“When they’re trying to recruit medical professionals for these rural areas, nobody wants to move there, nobody wants to put their kids in the schools, and they don’t make enough money,” said Robinson. “These people are already part of the community.”
Incorporating midwives, doulas, training EMS
Hospitals in Maine are also incorporating more nurse-midwives — registered nurses with a master’s degree in nurse-midwifery — into their practices.
Maine’s largest hospital systems, MaineHealth and Northern Light Health, offer midwifery services at several hospitals. Nurse-midwives are licensed to attend births in hospital settings as well as at birth centers and at home, although the vast majority practicing in Maine are affiliated with larger providers.
A nationwide blueprint published by the Biden Administration for addressing the maternal health crisis calls in part for expanding access to licensed midwives, doulas, and freestanding birth centers and encouraging insurance companies to improve reimbursement for and coverage of nurse-midwives and perinatal supports, such as doulas and nurse home visits.
Other countries rely far more heavily on midwives than the United States — in most countries, midwives far outnumber obstetricians. In some cases, research has suggested that midwifery-led care models provide care that is comparable or better than obstetrician-led care, according to the CommonWealth Fund.
“Outside the U.S., midwives are often considered the backbone of the reproductive health system,” wrote the authors.
But midwifery training in many of those countries is far more standardized than it is in the United States. It is also often far more integrated into the health care system, with greater coordination and support for midwifery-led care teams, said several midwives.
“Midwives are the answer to maternity care in America. But just putting that burden onto us without giving us the infrastructure to do it is not sustainable and does not actually create a better care structure,” said Ariel Bernstein, a certified professional midwife who recently graduated from Harvard with a master’s in public health.
According to the National Academy for State Health Policy, 18 states and Washington, D.C., reimburse non-nurse midwives (whose titles and certification vary) under Medicaid; nurse-midwives are covered under Medicaid in all jurisdictions. MaineCare, Maine’s version of Medicaid, covers nurse-midwives but does not reimburse for services by midwives without a nursing degree.
Hospital administrators and state officials interviewed by The Maine Monitor said they had no plans to incorporate independent midwives (those who are not trained as nurses but instead licensed as certified professional midwives) into their practices, in part for liability reasons.
Some in Maine are pushing for increased access to doulas, non-clinical providers who provide educational, physical and emotional support to families and people who are pregnant and postpartum. A bill sponsored by Sen. Denise Tepler (D-Dresden), would require MaineCare to cover doula services.
The bill, however, faces an uphill battle, as lawmakers in Augusta fight over a supplemental budget and a budget shortfall for MaineCare, the state’s insurance program for low-income residents. MaineCare covers roughly 37 percent of all births in Maine.
A recent grant awarded to the Maine Department of Health and Human Services, however, requires the state to cover doula services within the first three years, according to previous reporting by The Monitor.
A dozen states and Washington, D.C., have implemented Medicaid coverage for doula services, according to the National Health Law Program.
Rural emergency medical service providers are also increasing training for their staff, who are being called upon more frequently to handle out-of-hospital births and newborns.
“We’ve also seen a tremendous increase in the number of births that happen outside of the hospital, triple the numbers from prior to the COVID pandemic,” said Mark Minkler, program manager of EMS for Children, speaking to Maine Public in late February.
“If [a nearby hospital doesn’t] have the internal capacity to admit patients that are having complications, EMS is the workforce that moves those patients to other locations, and that can put a tremendous strain on both systems,” said Minkler, “and on the patients that have to be transported and their connection with their families and homes.”
Maine also has CradleME, a free program that began in 2017 in which public health nurses make home visits to anyone who is pregnant or postpartum, or anyone caring for an infant, to help with parenting, breastfeeding, nutrition and any other concerns.
Decades of research have shown that sending nurses into people’s homes is one of the most effective ways to reduce pregnancy complications, pre-term births, infant deaths, child abuse and injury, violent crimes and substance abuse.
“You do not have to have a problem,” said van Hengel, who likened the program to support offered in much of Europe, where “Someone comes by and says, ‘so, how’s it going? What’s up?’”
But CradleME has struggled for years to reach as many families as the state has hoped. Many patients and providers are unaware the program exists, or may offer information as families are leaving the hospital after giving birth, as parents are overwhelmed and exhausted.
The Monitor was unable to reach CradleME representatives before press time.
“For a lot of people, including myself as a provider, I did not really realize that that was something that was accessible for anyone,” said van Hengel. “The context really needs to be ingrained early, so that providers or women or families know about it ahead of time.”
Training future providers in rural areas
Residency programs, where physicians spend time training in various specialties after medical school, are mostly hosted in largely medical centers, where doctors-in-training have access to a host of specialist attending physicians and exposure to a variety of cases.
While that’s valuable, said Dr. Jane Carreiro, dean of the University of New England College of Osteopathic Medicine, Maine’s only medical school, it doesn’t reflect the environment that rural physicians end up practicing in, one with limited specialist access where complex cases will be transferred to larger facilities.
Starting a new residency program is nearly impossible for small hospitals, said Dr. Carreiro, because it requires not only funding but also access to highly specialized staff certified in a range of fields, including maternal-fetal medicine, urogynecology and reconstructive pelvic surgery, gynecologic oncology, and reproductive endocrinology and infertility.
Criteria for residency programs are set by the Accreditation Council for Graduate Medical Education, she said, “which is biased towards large academic medical centers.”
But most doctors in community hospitals won’t ever need or have access to that level of care once they’ve started their careers.
“It’s throwing the baby out with the bathwater,” said Dr. Carreiro of the requirements for starting new residency programs. “You want this high, high standard, but 90 percent of people don’t need that. And so you eliminate the opportunity for those 90 percent of people to have any care because you’ve created so many obstacles.”
MaineHealth currently operates the state’s only obstetrics residency program, at Maine Medical Center in Portland.
While establishing dedicated obstetric residency programs in small rural hospitals may be a significant lift, hospitals are working together to expose more doctors-in-training to rural obstetric medicine, in the hope that they’ll stay in the area after graduation.
The Maine Rural Graduate Medical Education Collaborative recently received a three-year, $667,330 federal grant aimed at developing obstetrics education programs focused on rural community needs.
The program has been in place for several years in a range of other specialty areas, allowing budding physicians to train at partner hospitals around the state, and offering housing stipends to eligible residents. Of the ten residents who graduated in 2024, six chose to practice in rural settings, two of them in Maine, according to a paper published earlier this year in the Journal of Maine Medical Center.
“It creates an opportunity for students in rural residency rotations to learn important skills to support pregnant patients and their families,” said Dr. Kalli Varaklis, designated institutional official at MaineHealth, in a statement in January announcing the collaboration.
Financial reforms
Experts The Monitor spoke to said one of the most impactful ways to support rural birthing hospitals would be for MaineCare to pay more for their services. Thirty-seven percent of all births in the state are covered by MaineCare, and Maine recently expanded postpartum coverage to 12 months after the end of pregnancy, which research has shown is the deadliest time for new mothers.
On average, private insurance reimburses providers in Maine $23,595 for a C-section and $14,630 for a vaginal delivery, according to research by the Health Care Cost Institute. MaineCare, however, reimburses providers just a fraction of the cost of providing care — $4,607 for a vaginal birth and $6,847 for a C-section.
Significant reimbursement reforms are unlikely in the current budgeting environment, however. The program is facing a $118 million budget shortfall; the state began temporarily holding payments to some participating providers on March 12.
Maine is examining the payment model for maternity services under MaineCare as part of a $17 million, ten-year grant announced earlier this year, said Dr. Amy Belisle, chief child health officer for the Maine Department of Health and Human Services. A plan for the grant calls for the state to implement a new “value-based” payment model by 2028.
Under that model, payments would be tied in part to the implementation of evidence-based best practices that address issues like mental health, hypertension and sepsis in pregnant people.
“How do we make sure that we’re getting good outcomes? So we’re not just paying for care, but we’re paying for quality care,” said Dr. Belisle.
The $17 million grant also has funding to support birthing units at risk of closing, said Dr. Belisle, although those funds do not kick in for several years. The first three years of the grant are focused on planning; the remainder are for implementation.
Whether the grant will survive the cuts being made by the Trump Administration is hard to tell.
“We’re actively monitoring what the situation is and if things change then we’ll think through that at that time,” said DHHS spokesperson Lindsay Hammes. “But given that there’s not been an indication that that funding is going to be frozen, the work continues.”
Nueva clínica ofrecerá atención médica y apoyo legal a migrantes en el oeste de Carolina del Norte
Con el objetivo de responder a la falta de acceso a servicios de salud, la organización Vecinos en el oeste de Carolina del Norte inaugurará una clínica que brindará atención médica gratuita para personas de bajos recursos y sin importar el estatus migratorio.
A U.S. District Court judge ruled Thursday that federal agencies illegally fired tens of thousands of employees over President’s Day weekend.
At the end of a March 13 hearing of American Federal of Government Employees v. U.S. Office of Personnel Management (AFGE v. OPM), Judge William Alsup placed a preliminary injunction on federal agencies, ordering them to immediately reinstate the employees that were fired per an OPM directive from President Donald Trump in February. The defendants swiftly filed an appeal, but unless another judge intervenes, Alsup’s ruling stands as the default.
The basis of his ruling, Alsup declared in scathing language, was that the government deliberately went after the workers with the least amount of appeal power, making them the easy targets of an unfair and arbitrary government slash.
“I got goosebumps,” said Don Neubacher after the judge issued his decision. He’s a former superintendent of Yosemite National Park and a board member of the Coalition to Protect America’s National Parks, one of the plaintiffs in the case. “We’re very happy with the ruling. We’re going to celebrate it.”
Alsup’s order rang like a takedown of the federal government. It came from his review of the evidence: On Jan. 20, the OPM instructed federal agencies to compile a list of all their workers who had been hired within the past two years or had recently received a promotion, officially called probationary workers. Then, on Feb. 13 and over President’s Day weekend, the OPM ordered agencies to fire that group. In a template email, the OPM cited the employees’ poor work performance, even though many of the workers had earned stellar performance reviews.
Labor unions, including the AFGE, quickly challenged the OPM. At the first hearing of AFGE v. OPM on Feb. 27, Alsup granted a temporary restraining order and said the federal government’s efforts to expunge its employees were “unlawful, invalid, and must be stopped and rescinded.”
Elizabeth Turner-Nichols, center, president of the American Federation of Government Employees Local 2110, is interviewed outside the federal courthouse in San Francisco in late February, where Judge William Alsup granted labor unions an emergency injunction blocking mass federal firings. Credit: Jeff Chiu/AP Photo
Alsup used nearly the same language Thursday morning. Ahead of the hearing, the plaintiffs had sought an injunction against an expanded list of defendants that included all 23 federal agencies that dismissed probationary staff. Alsup applied his ruling to the departments of Veteran Affairs, Agriculture, Defense, Interior and the Treasury, where the record of the unlawful OPM action “was the strongest,” he said. But he invited the plaintiffs to submit briefs making the case for tacking on other agencies.
“It’s a very conservative ruling, and a very strongly worded ruling by the judge,” said Peter Jenkins, a senior counsel for the nonprofit Public Employees for Environmental Responsibility who wasn’t involved in the case. “It was a great ruling.”
The lawsuit is arguably the most successful one so far among the suits that labor unions, nonprofits and states have hurled at the OPM. In one lawsuit filed in the District of Columbia, a judge decreed that fired workers should direct their complaints to internal labor committees, such as the Merit System Protection Board (MSPB), rather than resolve their grievances in court. In a legal challenge against another OPM initiative, a program that incentivized resignations, a Massachusetts judge ruled against the unions that brought the suit, declaring that they were not directly impacted by the OPM actions and thus did not have standing.
During the Thursday hearing, the federal government’s lawyers repeated their arguments, insisting that the plaintiffs’ case lacked standing. As part of its defense, the OPM also asserted that the agencies’ leadership had called the shots rather than simply obeying the OPM’s orders to lay off their probationary employees. The OPM revised its initial memoafter Alsup’s restraining order, adding a disclaimer that OPM was “not directing agencies” to terminate employees. But during the second hearing, Alsup rejected the defendant’s claim. “It’s illustrative of the manipulation by the OPM to orchestrate this government lie,” he said.
At first, Alsup concurred with the rulings in previous lawsuits that he lacked the jurisdiction to hear the unions’ case, because fired workers should seek relief from their oversight boards rather than go through court.
But in the March 13 hearing, new arguments presented by the plaintiffs on how Trump has dismantled those independent groups made him reconsider.
Alsup called the top-down firings a “watchdog cannibalization” during the hearing. “I have a feeling that’s where we’re headed now, that there’s no relief” for fired employees, he said.
“It is a sad, sad day, when our government would fire some good employees and say that it was based on performance. Well, that’s a lie.”
In addition, the plaintiffs in AFGE v. OPM include organizations other than unions, such as the Coalition to Protect America’s National Parks, Western Watersheds and the state of Washington, to name a few. Since the first hearing, Alsup has concurred with those organizations that they have suffered concrete injury from the sweeping dismissals, to the point where they could no longer carry out their organizations’ missions.
The vast public outcry against the federal firings has already sparked some reversals. The National Park Service, National Science Foundation, Environmental Protection Agency and other agencies have rehired some of their terminated staff members. Three weeks after the Department of Agriculture dismissed nearly 6,000 probationary workers — including some 3,400 Forest Service employees, per AFGE’s recent legal filings — the MSPB issued an order to reinstate all terminated staff members for 45 days following Alsup’s Feb. 28 memorandum opinion. But as of March 13, many fired workers were still awaiting word from their supervisors about their employment.
Meanwhile, the MSPB is wading through the thousands of new complaints that have been filed each week — as much as a 21-fold jump since Trump took office — from federal workers who believe they were terminated unjustly.
Even after Alsup’s ruling, the judicial jousting between Trump’s government and federal workers continues. Following the government’s notice to appeal the federal court order, the case will now go to the 9th Circuit Appellate Court for further adjudication. “The bottom line is, there’s a lot of litigating still to be done here,” said Dave Owen, a law professor at the University of California Law San Francisco.
AS A CHILD, Riley Rackliffe dressed as a park ranger for Halloween. He carried his interest in the National Park Service into adulthood, giving up a university teaching position to become an aquatic biologist at Nevada’s Lake Mead National Recreation Area last year. Now, Rackliffe is on the job market once more, his dream job snatched away even before the afterglow of landing it wore off.
Rackliffe is one of the thousand National Park Service workers in the OPM’s crosshairs. But since the court rulings, he and his supervisor are still in the dark about whether Lake Mead’s sole aquatic biologist can get back to doing the work he loved.
A Protect Our Parks rally at Lake Mead National Recreation Area near Boulder City, Nevada, March 1 in support of fired National Park Service employees. Credit: Steve Marcus/Las Vegas Sun via AP
“I am definitely still holding onto hope,” he said. But he can’t afford to wait, he said: “I’ve got a mortgage and two kids and bills to pay, so hope isn’t a good financial strategy.” As he hunts for a new job, he’s not banking on landing another aquatic ecologist position in a state that receives only 4 inches of rain annually. “I got fired from the one lake in town,” he said.
More than just individuals’ lives and livelihoods turned upside down, a severely culled staff — not to mention a demoralized one — will challenge the ability of federal agencies to provide the crucial public services they are mandated to perform. In the case of the departments of Interior and Agriculture, the mass firings threaten the management of public lands, both now and in the future. Experts already predict a chaotic recreational season ahead, filled with unkempt campgrounds, heightened wildfire risk and unsafe trail conditions.
“Visitations are going up, but staffing and budgets are going down,” Neubacher said. “At some point something has to give, and we’re pretty close to that.”
Even if agencies comply immediately with the March 13 ruling, that might not be enough to prevent looming damage to public lands and more. Alsup acknowledged that the government could still legally pursue other mechanisms to pare back the workforce, to similar effect. For example, it could undertake a reduction in force, an official process to reorganize and reduce the number of federal employees. In fact, the Trump administration has already repeatedly promised to do so. March 13 is also the deadline that Trump set for agencies to submit plans for drastic downsizing, with another round to come in April.
Still, the Trump administration may not need to win in court to get its way. Legal experts suspect that it’s gambling on stirring up so much uncertainty that federal employees will simply choose to leave. Even if Rackliffe is reinstated, he said, the prospect of future cuts and the turbulent political climate might not make it worth returning.
And while Alsup’s latest court order halts what he concluded to be a hasty reduction in force in disguise, and an illegal one at that, there may be little to celebrate in the long run. “It is a sad, sad day, when our government would fire some good employees and say that it was based on performance. Well, that’s a lie,” Alsup said. “That should not have been done in our country.”
How to combat misinformation and fact-check ICE sightings in Mendocino County
MENDOCINO CO., 3/14/25 – On Tuesday, swarms of social media posts indicated that U.S. Immigration and Customs Enforcement agents were seen near the Holiday Inn and the Costco on Airport Park Boulevard in Ukiah.
However, according to Mendocino County Sheriff Matt Kendall, there have been no reports of ICE agents enacting raids in the county, but he can confirm that federal agents were in town for a separate investigation.
In a statement to The Mendocino Voice, Kendall noted that federal agents did use the interview room at the Sheriff’s Office to investigate a crime, but it was not related to immigration.
“People were here from a federal agency to use our offices,” Kendall said. “But I checked with the agents to make sure it had nothing to do with immigration.”
He also noted that Senate Bill 54, known as the California Values Act, prohibits law enforcement and public institutions in the state from sharing information or coordinating with ICE agents on deportations.
Before Kendall verified and informed the public that there were no ICE agents organizing deportations, several social media posts were published by community members, inciting fear and anxiety in the local immigrant community.
Even though federal agents were conducting an investigation in the county, both the Ukiah Police Department and the Mendocino County Sheriff’s Office said there have been no reports of ICE agents conducting raids. The agents, according to Kendall, were part of a special response team investigation and were not involved in immigration enforcement.
According to Richard Beam, a communications officer for ICE’s Los Angeles office, although SRT agents operate under ICE’s jurisdiction, they often handle investigations involving criminal records, drug cartels, or other gang activity. SRT agents must have specific search warrants to conduct investigations. These specialized teams rarely enter communities to carry out immigration enforcement without a warrant or a specific criminal history tied to an individual or group.
The confusion and surge of social media posts about immigration raids have been common since President Donald Trump issued executive orders to increase deportations across the U.S., and the spread of misinformation has been increasing in California.
According to Berkeley immigration attorney Cara Jobson, while the information can be confusing, there are key indicators to consider before assuming an ICE agent is in the area.
“Usually their uniforms will say ‘ICE police’ or something like that,” Jobson said in an interview. “The vehicles will usually have a federal government logo and be white with a large blue stripe.”
Jobson said that before jumping to conclusions, people should contact local authorities or the nearest rapid response network, which is an organization of volunteers that assist in verifying the presence of ICE agents in local communities. These organizations can also assist with legal questions and educating immigrants about their rights. Before immediately posting on social media that ICE agents are in town, Jobson recommends that you contact one of these networks.
“You don’t want to create unnecessary panic, but you want people to have good information,” Jobson said. “It doesn’t hurt to call a couple places like a rapid response network and say I’m on this street and I see a bunch of ICE trucks or vans. That is reasonable.”
Jobson also said it’s crucial to know your rights if you encounter an ICE agent and find yourself in a difficult situation. She emphasized that, whether you’re an immigrant with or without legal status, you should carry a “red card” describing your rights, which can be downloaded and printed online.
“These cards are available to citizens and non-citizens alike, you’re not outing yourself as having any particular status by presenting the card,” she said. “Many people are ordering them and they’re in lots of different languages like English and Spanish. The importance of the card is so if someone gets stopped by ICE or approached on the street or wherever the location is they know exactly what to do.”
If you or someone you know has seen or heard that there is an ICE agent in your county, several organizations in Northern California can help verify the information before you report it to your local community.
Here is a list of places you can contact to verify if there are ICE agents in your area:
The North Bay Rapid Response Network, though centered in Napa, Sonoma and Solano counties, can still help verify information and review photos or videos to determine whether they show ICE agents or other federal officials. You can contact them at (707) 800-4544.
Catholic Charities of Santa Rosa has an immigration department that can be contacted if you believe ICE agents are in your area. You can reach them at (707) 578-6000.
You can also contact Nuestra Alianza de Willits, located in Willits, to report any possible sightings of ICE agents and ask them to help verify your photos or videos. Reach them at (707) 456-9418.
Legal Services of Northern California, which has an office in Ukiah, can assist with immigration paperwork and explain your rights as an immigrant. You can contact them if you have questions about what to do if you see an ICE agent in your area. Reach them at (707) 462-1471.
Wyomingites both fear and cheer EPA move to slash fossil fuel, climate regulations
Following the world’s hottest year on record and a series of increasingly intense and damaging environmental disasters, including a historically bad year for wildfires in Wyoming, the U.S. Environmental Protection Agency announced Wednesday it is rolling back dozens of climate rules and fossil fuel regulations in an effort to “usher in the golden age of American success.”
The agency, as part of President Donald Trump’s “Unleashing American Energy” initiative, will eliminate or otherwise “reconsider” the Clean Power Plan, along with the landmark 2009 “endangerment finding” that greenhouse gases cause harm. Also on the chopping block are “Mercury and Air Toxics Standards” for coal-fired power plants, regulatory greenhouse gas reporting, a risk management program for oil and gas refineries and dozens of other federal pollution control measures.
“Today is the greatest day of deregulation our nation has seen,” EPA Administrator Lee Zeldin said in a prepared statement that was accompanied by a video message. “We are driving a dagger straight into the heart of the climate change religion to drive down cost of living for American families, unleash American energy, bring auto jobs back to the U.S. and more.”
The actions have major implications in Wyoming, where both fossil fuel extraction and a large federal land footprint play major economic roles and touch almost every aspect of life in the state.
An oil well in Campbell County flares methane, adding to atmospheric pollution and wasting a valuable public resource. (Courtesy Powder River Basin Resource Council)
Many industry officials, conservation groups and politicos in Wyoming were still absorbing the possible implications Thursday, noting the sprawling actions trigger myriad legal and logistical questions.
Compounding those questions is general uncertainty and chaos surrounding the Elon Musk-led federal employee purge, Trump’s freeze on federal funding and grant programs, as well as an ever-evolving tariff war. Further complicating the EPA’s regulatory rollback: How Wyoming, which maintains primacy over many federal emissions programs and sometimes implements more stringent requirements, might respond to the new initiatives.
From Zeldin’s perspective, the EPA’s efforts to undo “flawed” and “suffocating rules” implemented under past Democratic administrations that “restrict nearly every sector of our economy and cost Americans trillions of dollars” will make it “more affordable to purchase a car, heat homes, and operate a business.”
Asked whether oil and gas companies in Wyoming might respond by relaxing environmental mitigation efforts, Petroleum Association of Wyoming Vice President and Director of Communications Ryan McConnaughey said that’s not the intention of industry.
“If you look at the announcements that were made [this week] from their leadership, they did not say a word about the environment or protection of air or water or waste — nothing.”
John Burrows, Wyoming Outdoor Council
“Wyoming’s natural gas and oil producers have long been leaders in emissions reductions, and we have no intention of backing away from that commitment,” McConnaughey told WyoFile via email. “Throughout the Biden administration, PAW consistently sought to engage with the EPA, offering constructive feedback and voicing concerns that the regulatory approach could lead to unnecessary closures and significant increases in energy costs for American consumers.
“Unfortunately,” McConnaughey continued, “these concerns were repeatedly ignored. By ensuring regulations align with on-the-ground technological and economic realities, we can achieve emissions goals in a cost-effective and practical manner without imposing undue burdens on American businesses or households.”
Whatever the intention, the EPA’s regulatory rollbacks are sure to have negative impacts regarding the climate, as well as the health of Wyoming landscapes and wildlife, and “on people, ultimately,” Wyoming Outdoor Council Energy and Climate Policy Director John Burrows told WyoFile.
Zeldin’s announcement, Burrows said, appears to reveal a fundamental shift in mission at EPA, he added.
“The mission of the EPA is to protect human health and the environment — that is their mission,” Burrows said. “If you look at the announcements that were made [this week] from their leadership, they did not say a word about the environment or protection of air or water or waste — nothing.”
Reached for comment, Gov. Mark Gordon’s Communications Director Michael Pearlman lauded the rollback effort. Gordon has repeatedly sued the Biden administration over policies tied to the energy industry and climate change.
“These are highly impactful actions, particularly the endangerment finding, that could be extremely beneficial to Wyoming energy producers,” Pearlman said. “This is yet another step that the Trump administration has taken to relieve the stranglehold on industry created by the Biden administration’s regulations.”
Vermont agriculture community reels from federal funding changes
Bear Roots Farm. Photo courtesy of Paul E. Richardson
Funding aimed at making a struggling Williamstown farm more resilient has been paused. A program that distributes local, free food has been canceled. The Department of Environmental Conservation is missing $10.7 million for clean water quality projects.
In the last few months, the new administration of President Donald Trump has pulled back federal funding related to diversity, equity and inclusion initiatives, climate change and the Inflation Reduction Act, signed in 2022 by his predecessor Joe Biden.
Around Vermont, those funding changes are affecting farmers and the organizations that support them, prompting alarm and confusion. Altogether, the federal government has paused or canceled tens of millions of dollars in funding for agricultural programs across the state.
“Farmers thrive on predictability,” said Anson Tebbetts, secretary of the Agency of Agriculture, Food and Markets. “But we’re not in that space right now. So I think everyone is taking it day to day.”
The most recent axe fell last Friday on two U.S. Department of Agriculture programs that support local farms by paying them to provide food for specific local markets.
One supported 80 local farms, which in turn produced food that was distributed to people experiencing poverty in 13 Vermont counties through free CSA programs, pop-up markets and food shelves, according to the Vermont Agency of Agriculture. The other focused on getting more local food into schools and child care centers.
The state agency learned on March 7 that the two programs — the Local Food Purchase Assistance Program and the Local Food for Schools and Child Care Cooperative Agreement, respectively — would be canceled in 60 days.
Nationally, the programs cost about $1 billion, and in Vermont, the USDA will no longer award roughly $1.7 million that it had previously pledged, the agency said.
“It was a successful program, because it was essentially doing two things,” Tebbetts said. “It was supporting farmers. They were growing or producing something, and that was being distributed to cafeterias, homes, etc. So it was a great program because it was helping our farmers, but it was also getting that local product to a bigger audience.”
The Intervale Center in Burlington distributed about $45,000 of the Local Food Purchase Assistance Program funding to around 700 families, according to Kristen McDowell, food hub manager at the Intervale.
The people who receive the benefits are often Black, Indigenous, people of color, single-family households and elderly people who “don’t have access to federal benefits, like Snap or EBT, so they’re technically on the benefits cliff,” she said.
While the organization already distributed free food for people in need before the assistance program started, the federal funding allowed them to continue it in the winter months. Without the funding, the program will likely be restricted to only summer months, McDowell said.
Kayla Strom, the Farm to School Program manager at Northeast Organic Farming Association of Vermont, or NOFA, said in an email the organization was “devastated” to hear that the Local Food for Schools and Child Care program was canceled. Vermont had worked to convene “dozens of partners to determine the most effective use of these funds.”
The cancellation comes at a time “when food costs are expected to rise, and the funding would have expanded local purchasing, supported Vermont farmers, and strengthened our farm to school programs,” Strom said.
Vermont Secretary of Agriculture Anson Tebbetts speaks during a ceremony to mark the startup of the largest anaerobic digester in the Northeast at the Goodrich Farm in Salisbury on July 21, 2021. Photo by Glenn Russell/VTDigger
Plug pulled
After Bear Roots Farm, located in Williamstown and Barre, experienced floods and prolonged wet weather in 2023, farmers Jon Wagner and Karin Bellemare were looking for financial resources to recover.
Before the flood, they had borrowed money to grow crops, only to have those crops wiped out by a torrent of water. The pandemic, flooding and rising expenses have contributed to unmanageable costs for the farm, and debt that’s becoming increasingly unwieldy.
“Almost every year there’s some extreme thing that’s going on,” Wagner said.
Last spring, the farmers sat down with staff at NOFA to develop a new business model “that would help us rebuild, and sustain us through future environmental impacts, like flooding,” Wagner said in an interview.
They planned to construct a nursery, which would be more weather resilient, and put up a fence to keep deer out.
After helping the farmers think through big-picture questions about the future of their business, NOFA assisted in putting Bear Roots Farm on a path to receive roughly $60,000 through a program called Climate Smart Farming and Marketing.
The program is funded directly through the federal Inflation Reduction Act and distributed through the Agricultural Marketing Service, which is part of the United States Department of Agriculture.
The program was intended to help “farms mitigate the risks of climate change” and “analyze the vulnerabilities in their business,” said Eric Boatti, who manages the program for NOFA.
“The verbal communication was, ‘We don’t have the funds until April 1. They need to be signed off on.’ But the plants are all on sale in the winter. You have to buy them now,” Wagner said.
They bought the plants, which put the farm in a tight financial position. They expected to be reimbursed, and they needed the money.
Then, Wagner received notice from Pasa — an organization that doles out the funds to farms from Maine to South Carolina — that the federal government had paused the program. While there hasn’t explicitly been a stop-work order, Pasa has been filing reimbursement requests that haven’t been fulfilled.
“I’ve got a long list of expenses coming up, and I’m kind of scratching my head and saying, ‘Well, I guess I can put it on a credit card,’” Wagner said.
Some contracts with Vermont farms had already been finalized when the freeze started, and those farmers have been able to move forward with projects, Boatti said. But around 40 to 50 farms needed an environmental review, a process that takes more time, and now they’re stuck in limbo, he said. In addition, the federal government has terminated a contract with the company that performed the environmental reviews, the Clark Group.
According to Pasa, 12 Vermont farmers have already received almost $117,00 in funding through the program. Over the next three years, the organization estimates that almost $1.5 million would be available through the program to Vermont farmers, the organization’s director, Hannah Smith-Brubaker, said in a memo about the funding freeze.
The technical assistance and business planning side of the Climate Smart Farming and Marketing program can still exist without the funding, Boatti said, but it won’t offer farms the same opportunities.
“We can go out and do risk assessments and help farms make adaptation plans, but this funding was allowing us to then pay them for the implementation of those adaptation practices, and that is now no longer an option, with this funding being pulled,” he said.
That has left Bear Roots Farm facing an even more precarious financial future.
If the grant hadn’t been available in the first place, Wagner said, the farmers would have figured something else out, or pointed their business in a different direction.
“But to set us up and then pull the plug, that’s put us in a much worse situation,” he said.
Support for farms
The state’s Department of Environmental Conservation, too, recently received notice that a $10.7 million grant to assist farmers with installing often-expensive water quality projects, has been paused. It was also funded through the Inflation Reduction Act.
The program was set to deliver $8 million directly to farmers for water quality and flood resilience projects ranging from no-till practices to stream restoration to forest management plans that can help stop soil erosion, according to Marli Rupe, the agricultural water quality section chief at the Department of Environmental Conservation. Another $2.7 million was going to be directed toward technical assistance programs for the farmers.
While farmers had already applied for the funding, the money had not yet been awarded, Rupe said.
The projects are “also really good for their farm sustainability and their ability to be financially sound,” Rupe said. “Not having these funds is definitely going to have an impact on what they can do.”
The agriculture industry is the largest contributor to Lake Champlain’s water quality problems, but farmers have also been responsible for more success in water quality restoration than any other sector, according to a recent performance report from the Department of Environmental Conservation. Farmers are required to adhere to certain statewide water quality practices, and the resulting projects are often expensive and difficult for farmers to take on without financial assistance.
“The (loss of the) Inflation Reduction Act money is going to start seriously impacting the ability of organizations like Vermont Association of Conservation Districts, like the Department of Environmental Conservation, to actually help farmers get practices on the ground that protect water quality and that do this work,” said Michelle Monroe, executive director of the Vermont Association of Conservation Districts.
Her organization, too, is waiting for $500,000 in already-awarded funding through the Natural Resources Conservation Service, a federal program that funds water quality projects on farms. That money, which partially comes from the Inflation Reduction Act, funds salaries for several Natural Resources Conservation Service employees whose responsibilities span both organizations, she said.
Previously paused
The federal government previously froze some money that is now thawed and flowing to farmers and supporting organizations.
Some money that was already contracted to farms through the Natural Resources Conservation Service for on-farm conservation programs was stopped, but is now flowing again, according to Monroe.
Some farms had invested “a lot of money” to employ practices on their farms that are “good for the environment and good for their farm,” Monroe said, while expecting to be reimbursed.
“For some farms that did a lot of projects, it was a real financial burden to have this money frozen,” she said. But now that the money is flowing again, the Natural Resources Conservation Service “has been approving those (reimbursement requests) as quickly as they can,” she said.
Separately, federal funding going to the Northeast Dairy Business Innovation Center — which pays for all six of the center’s staff members, along with their programs and contracts — had been paused, according to Laura Ginsburg, who leads the center. The paused money totaled more than $9.5 million, she said.
The center is funded through the USDA, and it stopped processing payments after Jan. 19, Ginsburg said. The center’s staff never received any communication from the federal government “about the funds being unavailable or frozen,” Ginsburg said.
“The only response we would get when we asked for a status update was, ‘We are awaiting further guidance,’” she said.
Four similar organizations exist across the country, all funded through the farm bill. They each represent a region, and though they all operate a bit differently, “the core” of the programming “is to provide grant funds to dairy businesses, and for us, that means farmers, processors and technical assistance providers,” Ginsburg said.
“We do lots of different kinds of grants, from processor expansion and modernization to food safety and marketing and branding to farm focused grants for farm modernization, for milk handling and storage and for technical assistance and research as well,” she said.
In early March, the center learned that the funding was unfrozen.
During the time the center could not access the funding, Ginsburg said farmers experienced “a lot of anxiety” and “a lot of uncertainty.”
“There were a few teary phone calls that we had with recipients who just didn’t know what they should do,” she said.
For many farmers, she said, this specific uncertainty came on top of many others: paused Natural Resources Conservation Service funding, a lack of communication from local USDA offices, questions about potential tariffs and the increased prices or supply chain issues that might arise as a result.
“It’s just a lot for one person to try to figure out how to navigate, especially when they have tens to hundreds of thousands of dollars on the line,” she said.