Damakant Jayshi Over objections from licensed child care providers, a Marathon County committee on Thursday passed a resolution that aims to cut child care support and also weaken oversight of small in-home child care providers by reducing regulations. The resolution, approved by the Extension, Education, and Economic Development Committee, not only seeks to prohibit using […]

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Reading Time: 7 minutes

Story highlights

• Telehealth is increasingly connecting Wisconsinites living in remote areas to health resources.
• Helping fuel that growth was the federal government’s COVID-19 Public Health Emergency declaration, which eased regulatory barriers that previously blocked telehealth access.
• The federal government ended its emergency declaration in May, leaving questions about how long some telehealth flexibilities will last.
• Gaps in broadband access continue to limit services in many rural communities.

This story is part of our series Unhealthy Wisconsin, which examines areas where Wisconsin falls short in well-being.

Marshfield Medical Center family nurse practitioner Brianna Czaikowski says telehealth appointments are a game-changer for some patients. But in serving a mostly rural community, Czaikowski often fights spotty connections and miscommunication when providing virtual care.

“They feel a lot that I’m talking over them, which sometimes I probably am because (of) the delay,” said Czaikowski, a doctor of nursing practice and pediatric urology specialist who sees patients as far away as Michigan’s Upper Peninsula. “You’re not getting that full connection.”

Fresh off a COVID-19 pandemic boom, telehealth is increasingly connecting Wisconsinites living in remote areas to a web of health resources. Telehealth claims in 2020 swelled to a 6.3% share of total claims in Wisconsin — an increase of more than 2,400% from the previous year, according to a report from the Wisconsin Health Information Organization. Some northern counties reported high gains compared with the rest of the state.

Helping fuel that growth is the federal government’s COVID-19 Public Health Emergency declaration, which eased regulatory barriers that previously blocked telehealth access. That included relaxing rules for certain prescriptions and changing regulations pertaining to appointments and reimbursement for those on Medicare or Medicaid.

But lingering gaps in broadband access continue to limit services in many rural communities, where telehealth use lags behind better-connected urban communities.

Meanwhile, the federal government ended its emergency declaration in May, leaving questions about how long some telehealth flexibilities will last. Legislation made some changes permanent, but others are set to expire by the end of 2024 or before.

Without action, some of the state’s most vulnerable patients could lose telehealth options they gained during the pandemic.

Pandemic actions expanded telehealth services 

After the COVID-19 pandemic struck in March 2020, the Biden administration announced initial telehealth flexibilities that Congress further expanded temporarily — igniting a 63-fold increase in Medicare patients seeking telehealth services that year, according to a federal Department of Health and Human Services report.

Pandemic-era changes, for instance, allowed all eligible Medicare providers to deliver telehealth services that patients could access in their home and outside of previously designated rural areas. The changes waived geographic restrictions on telehealth services and increased options to receive them.

The changes cleared a “huge hurdle” that previously blocked telehealth growth, said Mary DeVany, associate director for the Great Plains Telehealth Resource and Assistance Center.

The pandemic ushered in significant growth for telehealth services for behavioral and mental health. And it has also increased options for certain types of primary care, DeVany said. Remote patient monitoring software, for instance, allows doctors to keep tabs on weight, blood pressure and other vital signs for patients with chronic health conditions, meaning patients with chronic conditions need less frequent hospital or clinic visits.

Telehealth has its limitations. “We can’t see certain things that we could see in the office,” Czaikowski said. That could include immediately spotting signs of child abuse or diagnosing ailments that might not be on a patient’s radar.

But expanded telehealth options have proved “really beneficial” for Czaikowski’s patients in many ways. Although most of her patients still use in-person visits, she said, telehealth visits allow families to check in more often or get simple diagnoses without having to pull their kids out of school and drive long distances for a short in-person visit.

“I see people from Michigan,” Czaikowski said. “They have to drive six hours just to see me. And then to have a 10-minute visit and tell them that their kid is just constipated? Or that they wet the bed — okay, here’s your medicine. That’s a lot for the families to have to give up.”

Health care by phone and Zoom 

But not all telehealth options are equal — or accessible to all.

Czaikowski conducts telehealth appointments over video or phone. She prefers video appointments when possible, allowing her to see patients and keep their attention. But she said the majority of telehealth patients she treats rely only on phone calls. That’s in line with national trends among rural patients.

“People will call you from work or when they’re driving and not really give you their full attention,” Czaikowski said. “You have to be really talented in what questions you ask as a provider.”

While phone visits work well for those with less tech literacy or working parents with multiple kids at home, they reduce opportunities for children to communicate health information that parents might not think or want to mention, Czaikowski said.

“The kids tell the truth. When we’re on the (phone) visit, you don’t really hear the kids, it’s more the parent.”

Rural broadband access lags

Poor internet service ranks among the top reasons Czaikowski’s patients choose phone appointments over video, which generally should work at download speeds of 25 megabits per second and upload speeds of 3 Mbps — the federal standard for broadband access.

Nearly 22% of rural Wisconsinites lack adequate broadband services — a rate far above the rest of the state, according to a 2021 Federal Communications Commission report. And data from the U.S. Census Bureau’s American Community Survey show 38% of low-income households in Wisconsin lack an internet subscription.

State leaders are working on solutions.

In 2020 Democratic Gov. Tony Evers established the Governor’s Task Force on Broadband Access, which assists rural communities, many with older populations that want high-quality internet but don’t know where to start.

“They didn’t mind not having broadband, maybe they didn’t see the importance of it,” task force chair Chris Meyer said. “But as their communities age, telehealth suddenly becomes a reason.”

Telecommunications companies find it more lucrative to provide broadband to densely populated urban areas. For-profit businesses happily make the initial, and often heavy, infrastructure investment because they expect to have a large customer base.

But sparsely populated areas are less enticing for private companies. The cost of burying miles of fiber optic cables — one of the fastest and most reliable ways to deliver the internet — can be prohibitive. While a mile of internet service could serve hundreds of homes in a metropolitan area, it would cover only a few homes in northern Wisconsin, Meyer said.

Wisconsin has directed at least $340 million to broadband expansion and connected about 390,000 people to the internet since Evers launched the task force, Meyer said. The state had previously spent about $20 million.

Despite the task force’s increase in spending, Meyer said many people, especially those in northern Wisconsin, have yet to gain high-speed service.

Without broadband access, telehealth is “not a cure-all,” said Kirk Moore, Covering Wisconsin’s navigator who connects northern Wisconsinites to health insurance.

“Just to be able to take on the task of telehealth is a barrier.”

Meanwhile, low-income rural Wisconsinites may not make full use of the internet even after fiber optic cables arrive in their communities.

Rural households tend to earn less than urban households in Wisconsin, federal data show. And while a growing share of rural Wisconsinites own a computer, Moore said, “they have a computer but they don’t have the broadband access to be able to hook up to a physician or a behavioral health person through a video.”

Some telehealth flexibilities are temporary 

The federal government made some telehealth flexibilities permanent before the emergency declaration ended, particularly for those related to behavioral and mental health. Federally Qualified Health Centers and Rural Health Clinics, for instance, may continue providing such services to Medicare patients without previous geographic restrictions — including over audio-only platforms.

The government has extended similar flexibilities for issues unrelated to behavioral and mental health through only Dec. 31, 2024.

The Drug Enforcement Administration and the Substance Abuse and Mental Health Services Administration additionally extended flexibilities for remote prescriptions of controlled medications, such as treatments for opioid use disorder, through Nov. 11, 2023. The deadline will extend an additional year for new practitioner-patient telemedicine relationships.

Financial incentives affected

The pandemic also affected how hospitals were reimbursed — and financially incentivized — to offer telehealth services.

Under the federal emergency declaration, Medicare and Medicaid in Wisconsin and most other states began reimbursing hospitals for telehealth visits at the same rate as in-person visits.

“That means if you are seen … for something that you would have had covered in person, you are seen for that through telehealth,” DeVany said.

The Wisconsin Department of Health Services in March announced it would permanently reimburse hospitals for most video and audio telehealth services offered to the more than 1 million Wisconsinites on Medicaid — as long as the quality of virtual appointments matched in-person services.

The long-term future of reimbursements for telehealth services through Medicare remains less certain. Without further action, the equal treatment of telehealth and in-person services for billing will expire at the end of 2024.

At that point, Medicare could pay a lower rate for telehealth appointments — excluding the costs of items associated with in-person visits. That would require health care providers to absorb additional costs — or even eliminate services they can’t afford, DeVany said, adding that a similar result could happen with the private insurance market, which often follows Medicare’s lead.

“Once again, the patient would have to come and figure out how to come in,” DeVany said. “It’s a dual-edged sword, in that the patient gets the short end of that deal.”

A bipartisan group of dozens of lawmakers in Congress are pushing to make a range of pandemic-era telehealth flexibilities permanent.

“While telehealth use has skyrocketed these last few years, our laws have not kept up,” U.S. Sen. Brian Schatz, D-Hawaii, said in a June statement. “Telehealth is helping people in every part of the country get the care they need, and it’s here to stay.”

Czaikowski hopes Medicare continues covering telehealth appointments for specialists, which she said are in short supply across Wisconsin. She is among just six nurse practitioners statewide certified in urology, she said.

“They can’t just go to the doctor an hour away. They are traveling six hours,” Czaikowski said about some of her rural patients in Upper Michigan. “I really hope Medicare doesn’t ever take that away because it’s really going to hurt us.”

The nonprofit Wisconsin Watch (www.WisconsinWatch.org) collaborates with WPR, PBS Wisconsin, other news media and the University of Wisconsin-Madison School of Journalism and Mass Communication. All works created, published, posted or disseminated by Wisconsin Watch do not necessarily reflect the views or opinions of UW-Madison or any of its affiliates.

Pandemic brings telehealth boom to rural Wisconsin, but barriers linger is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Reading Time: 6 minutes

Story highlights

• Black infants in Wisconsin are three times more likely to die than white infants. The state has one of the highest mortality rates for Black infants in the country.
• Stress felt from poverty, lack of health care and racism can impede a baby’s growth during a pregnancy, research suggests. Addressing such societal factors may improve pregnancy outcomes.
• Boosting access to information during a pregnancy and support from doulas could also help.

This story is part of our series Unhealthy Wisconsin, which examines areas where Wisconsin falls short in well-being.

When her daughter was born weighing just 1 ½ pounds, Dr. Jasmine Zapata experienced firsthand the danger she now spends her professional life battling: Wisconsin’s stubbornly high rate of preterm birth and mortality, especially among Black babies.

Zapata works at the University of Wisconsin School of Medicine and Public Health as a pediatrician and public health researcher. For the last two years, she also has served as the state epidemiologist for maternal and child health and chronic diseases at the Wisconsin Department of Health Services (DHS).

Her second child, born prematurely at just 25 weeks of gestation, faced several life-threatening illnesses in the neonatal intensive care unit. As Zapata knows better than most, complications caused by prematurity are the leading cause of Black infant mortality in Wisconsin.

“She was almost a statistic,” Zapata said. “I was a statistic with my birth outcome … the one about college-educated Black women having higher rates of preterm birth compared to white women who don’t finish college.”

Her daughter is now 13 years old and “thriving,” but the experience still fuels her passion for combating inequities in maternal and child health.

Wisconsin has one of the highest mortality rates for Black infants in the United States. The two main causes of death within the first year of life for Black infants are low birthweight and sudden unexpected infant death, according to a 2023 DHS report.

The report calls for more parental education around safe sleeping habits (babies alone on a surface on their backs, free from soft objects and loose bedding), prioritizing breastfeeding when possible and better access to prenatal and postpartum care.

Research, including at the University of Wisconsin, has highlighted societal factors — including stress caused by poverty and racism — as major causes of negative outcomes for Black babies.  Wisconsin is home to outsized Black-white disparities across society, including in education, wealth, health, housing and the justice system.

Mortality rate remains high

In 1990, Black infants in Wisconsin were 2.7 times more likely to die within a year of birth than white infants in the first year of life, according to DHS. Three decades later, Black infants in the state are three times more likely to die than white infants.

“This isn’t new news,” said Theresa Duello, a reproductive cell and molecular biologist who researches misconceptions of race, a social construct, in genetic studies.

The overall rate at which infants die during the first year of life in Wisconsin in 1990 was 8.4 deaths per 1,000 live births. By 2021, that number dropped to 5.3 deaths per 1,000 live births, similar to the national rate.

Negative birthing outcomes for Black infants have not improved as quickly as those for white babies.

Among white infants, the rate dropped from 7.2 to 4.4 deaths per 1,000 births between 1990 and the 2019-2021 period — a 39% decrease. Among Black infants, the rate dropped from 19.7 to 13.2 deaths per 1,000 live births over the same period, a 33% drop and still triple the rate for white infants.

“I think we should reexamine how we take responsibility for this,” Duello said.

Preterm birth is top cause of infant deaths

Preterm birth, those occurring before 37 weeks of pregnancy, is the leading cause of newborn mortality.

Wisconsin’s rate of neonatal deaths due to preterm birth was 21% above the national average in 2018. That year, 15.6% of Black births were premature, compared to 9% of white births.

Low birth weight — infants less than 5 pounds, 8 ounces — and prematurity are both associated with infant mortality, Duello noted.

Low birth weight is often associated with intrauterine growth retardation (IUGR), when the fetus is smaller than expected for the number of weeks of pregnancy. Researchers hypothesize that an increase in the hormone cortisol during pregnancy may harm blood flow to the placenta, compromising access to nutrients and impairing fetal growth.

When low birth weight babies are born in consecutive generations, some may incorrectly assume the issue is genetic, Duello said. But if pregnant women in the same family face great stress over the generations, such as poverty, lack of health care and racism, they will more likely have high cortisol levels — and likely deliver a small baby. Addressing such stressors could improve pregnancy outcomes, research shows.

Stress blamed for racial disparities

Mothers of color disproportionately live in areas with fewer resources and thus may face greater stresses that increase the odds of negative birth outcomes, DHS says in a 2018 report.

“The Black-white difference in infant death is considered an inequity because its causes are systemic, avoidable and unfair,” the report says.

While poverty affects stress levels, a California-based study suggests racism can play an even bigger role in infant mortality disparities than wealth. In California, the wealthiest Black parents lost more babies on average — 437 per 100,000 births — than the poorest white parents: 350 per 100,000 births.

“We know what to do. We lack sufficient intent,” Duello said. “And that doesn’t mean there aren’t good people working really hard.”

Infant mortality in Wisconsin’s state budget

The federal American Rescue Plan Act (ARPA) and the Title V Maternal and Child Block Grant program provide key resources for reducing maternal and infant mortality rates in Wisconsin, according to DHS.

Thirty community organizations — eight of which are based in Milwaukee County — have received grants to reduce infant and maternal mortality rates in Wisconsin.

But ARPA funds are not permanent.

In his 2023-2025 budget, Wisconsin Gov. Tony Evers proposed $5.7 million over two years in grants for community organizations working to lower maternal and infant mortality. The funding would have also supported fetal and infant mortality review teams and grief and bereavement efforts.

Evers’ proposal would have helped community-based grants stretch beyond the time frame of ARPA and built on the work started with the ARPA-funded community grants, according to Elizabeth Goodsitt, a DHS spokesperson.

But the Wisconsin Legislature’s Republican-controlled Joint Committee on Finance removed the provisions along with hundreds of others before Evers ultimately signed the budget in July. The final budget allocated $222,700 per year for “reducing fetal and infant mortality and morbidity” — the same level DHS has received for more than a decade.

Doulas seen as a solution for improving pregnancy outcomes

A 2014 study found better birth outcomes for Black and white mothers who participated in Healthy Start, a community-based federal program involving home visits, health information and access to medical and community services.

Another approach is the use of doulas: support people during pregnancy, labor and birth. Hanan Jabril, a community doula and sexual and reproductive health and rights educator in Madison, said a doula’s role is to support and empower the patient to facilitate a safe pregnancy and birth.

“We don’t speak on behalf of the patient, but we can help facilitate conversations between the patient and the provider,” Jabril said.

One goal is to reduce “obstetric violence,” which refers to harm inflicted during or in relation to pregnancy, labor and the postpartum period, sometimes by providers who hold implicit biases against people of color.

One example Jabril observed: a patient who was denied pain medication in the hours after a cesarean section after a provider suspected “drug-seeking behavior” — contrary to what some of the patient’s nurses thought. Although the patient advocated for herself, the experience showed the potential harm of implicit bias and the need for doulas, Jabril said.

The presence of doulas can improve birth outcomes. Doulas have been shown to decrease cesarean sections — surgical procedures with higher risks than nonsurgical births — by anywhere from 28% to 56%, according to DONA International, the largest doula-certifying organization.

People partnered with doulas often forgo epidurals or other pain medication, and they are four times less likely to deliver a baby with a low weight, according to a 2013 study.

The price of doulas ranges widely depending on the type — for instance their availability before or after a birth. Although most insurance companies do not cover a doula’s full cost, Jabril considers them “always worth it.”

Patients in need of financial help have options. The city of Milwaukee, for instance, since 2019 has matched residents with free doulas through its Birth Outcomes Made Better program.

Some doulas-in-training or volunteer doulas are willing to work for free. Jabril provides free services.

Wisconsin DHS recently disbursed almost $1 million to four community organizations that train doulas or provide doula services. Two of those organizations — both based in Milwaukee — received more than $700,000 for doula workforce development. They include the WeRISE Community Doula Program, which provides free services.

Zapata admits her work to improve birth outcomes often is “daunting” and “discouraging,” but it’s also important.

“And it’s important for us to remember that behind all of the statistics and numbers these are real lives and real families that are forever impacted,” she said.

The nonprofit Wisconsin Watch (www.WisconsinWatch.org)  collaborates with WPR, PBS Wisconsin, other news media and the University of Wisconsin-Madison School of Journalism and Mass Communication. All works created, published, posted or disseminated by Wisconsin Watch do not necessarily reflect the views or opinions of UW-Madison or any of its affiliates.

Wisconsin’s Black infants have some of the country’s highest mortality rates. These solutions could help. is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Juan Peña, 29, has worked in the fields since childhood, often exposing his body to extreme heat like the wave hitting the Midwest this week.

The heat can cause such deep pain in his whole body that he just wants to lie down, he said, as his body tells him he can’t take another day on the job. On those days, his only motivation to get out of bed is to earn dollars to send to his 10-month-old baby in Mexico.

Farmworkers, such as Peña and the crew he leads in Iowa, are unprotected against heat-related illnesses. They are 35 times more likely to die from heat exposure than workers in other sectors, according to the National Institutes of Health, and the absence of a federal heat regulation that guarantees their safety and life – when scientists have warned that global warming will continue – increases that risk.

Over a six-year period, 121 workers lost their lives due to exposure to severe environmental heat. One-fifth of these fatalities were individuals employed in the agricultural sector, according to an Investigate Midwest analysis of Occupational Safety and Health Administration (OSHA) data.

One such case involved a Nebraska farmworker who suffered heat stroke alone and died on a farm in the early summer of 2018. A search party found his body the next day.

In early July 2020, a worker detasseling corn in Indiana experienced dizziness after working for about five hours. His coworkers provided him shade and fluids before they resumed work. The farmworker was found lying on the floor of the company bus about 10 minutes later. He was pronounced dead at the hospital due to cardiac arrest.

“As a physician, I believe that these deaths are almost completely preventable,” said Bill Kinsey, a physician and professor at the University of Wisconsin-Madison. “Until we determine as a society the importance of a human right for people to work in healthy situations, we are going to see continued illness and death in this population.”

Peña harvests fields in Texas and Iowa. This summer, he’s overseen five Mexican seasonal workers picking vegetables and fruits in Louisa County, Iowa. With its high humidity and heat, Iowa’s climate causes the boys, as he affectionately refers to them, to end their day completely wet, as if they had taken “a shower with their clothes on,” he said. They work up to 60 or 70 hours a week to meet their contractual obligations.

“I’m lucky because my bosses are considerate (when it’s hot),” he said in Spanish, recalling that he managed to endure temperatures as high as 105 degrees in Texas. “I’ve had bosses who, if they see you resting for a few minutes under a tree to recover yourself, think you’re wasting your time and send you home without pay.”

Some of his friends have been less fortunate, and a few minutes of rest have been cause for dismissal, he said.

The fatalities scratch the surface of what is a more extensive issue, according to health experts, academics and advocacy groups, who say the data on heat illnesses and death is inadequate.

“There is a massive undercount,” said Elizabeth Strater, director of strategic campaigns for United Farm Workers.

She said it is common for the death of a person who died after a heat stroke to be classified as caused by a heart attack on an autopsy.

Strater said it’s difficult to quantify issues that face farmworkers because those that are undocumented tend to shy away from authorities and, in general, the population moves around a lot and lives in secluded areas. “Everything to do with farmworkers is particularly difficult because we don’t know,” she said.

An estimated 2.4 million people work on farms and ranches nationwide, according to the U.S. Department of Agriculture’s census of agriculture. This population, mostly Latino, is roughly equal to the population of Chicago. More than one-third are undocumented.

A possible federal standard

Although employers are generally responsible for ensuring a safe working environment that protects their employees’ well-being and lives, no federal regulation stipulates a specific temperature threshold that mandates protective measures.

Nearly four in 10 farmworkers are unwilling to file a complaint against their employer for noncompliance in the workplace, mostly out of fear of retaliation or losing their job, according to survey data of California farmworkers conducted by researchers at the University of California Merced Community and Labor Center.

Only four states have adopted outdoor workplace heat-stress standards, and none of them are in the Midwest. California was the first to implement such standards, followed by Oregon, Washington, and Colorado.

This leaves the protection of agricultural workers from heat stress at the discretion of their employers in most states.

OSHA has been working on a heat-stress rule since 2021 that will require employers to provide adequate water and rest breaks for outdoor workers, as well as medical services and training to treat the signs and symptoms of heat-related illnesses. However, according to a U.S. Government Accountability Office report, this process can take from 15 months to 19 years.

OSHA officials would not comment on the pending federal heat standard.

Last year, the Asuncion Valdivia Heat Stress Injury, Illness, and Death Prevention Act, which would force OSHA to issue a heat standard much faster than the normal process, failed to get the votes on the floor.

The bill was named in honor of Asuncion Valdivia, who died in 2004 after picking grapes for 10 hours nonstop in 105-degree heat. Valdivia collapsed unconscious and, instead of calling an ambulance, his employer told his son to take his father home. On the way home, he died of heat stroke at 53.

A group of Democratic lawmakers reintroduced the bill last month.

“There is definitely a political decision to be made by members of Congress, in both the House and the Senate, because they have the power to pass legislation to tell OSHA to issue a standard more quickly,” said Mayra Reiter, project director of occupational safety and health at the advocacy group Farmworker Justice.

Reiter added that the legislation would also help shield that standard from future legal challenges in court.

As in several recent years, the summer of 2023 has broken records for heat.

In response, President Joe Biden announced new measures to protect workers — including a hazard alert notifying employers and employees of ways to stay safe from extreme heat — as well as steps to improve weather forecasting and make drinking water more accessible.

But farmworker advocacy groups are calling on the administration to speed up OSHA’s issuance of a rule protecting workers. They are also pushing for the 2023 farm bill to include farmworker heat protections.

“Farmer organizations and many other worker advocacy groups are hoping that there’ll be a federal regulation,” Reiter said, “because, going state by state, we have seen that there isn’t that urgency to develop these rules.”

Long way to a new rule

Creating a new rule to protect workers from heat must overcome several hurdles, from bureaucratic procedures to lobbying industries, including the agricultural industry.

“OSHA is uniquely slow,” said Jordan Barab, who served as OSHA’s deputy assistant secretary of labor during the Obama administration.

He said the 1970 act that created OSHA imposes many requirements on the rulemaking process. The agency has to determine the current problem and whether the new standard will reduce risk. OSHA must also ensure that the new standard is economically, technically and technologically feasible in all industries.

The road to regulations to protect workers from the heat also has to overcome industry lobbying, including big agricultural and construction groups. One group that has expressed hesitancy to new federal rules is the American Farm Bureau Federation, which has spent on average about $2.3 million on lobbying over the past two years, according to OpenSecrets.

“Considering the variances in agricultural work and climate, (the Farm Bureau) questions whether the department can develop additional heat illness regulations without imposing new, onerous burdens on farmers and ranchers that will lead to economic losses,” Sam Kieffer, vice president of public policy at American Farm Bureau Federation, said in a statement.

Vulnerable populations

To make a living, Jaime Salinas fills 32 sacks of apples each day in Missouri. His daily quota is one ton, or about 3,200 apples. His wife used to walk 11 miles a day to harvest fruits and vegetables when she worked in the field.

He said when he gets too hot, he sits in the shade to drink water but feels pressured to keep working due to the method of payment, which depends on the amount harvested.

Strater, with Farmworker Justice, believes that the way farmworkers are paid is one of the main obstacles that must be overcome to ensure their safety because it often incentivizes volume, forcing them to expose themselves to continued work without regard to the signs of heat-related illness.

Kinsey, the University of Wisconsin professor and the director of a mobile clinic, said the demographic has a higher incidence of diabetes, hypertension, and chronic kidney disease.

“Climate stress,” he said, “has introduced an additional layer of complexity to these existing challenges.”

Seasonal visa workers are especially vulnerable because they depend completely on whoever hires them: from the house they live in to the food they eat.

“You’re going to endure as much as you can with the hopes of continuing to provide for your family,” Strater said. “The thing is the endpoint for that is death.”

In Tama County, Iowa, David Hinegardner owns a small farm called Hinegardner’s Orchard, where he grows apples, strawberries, corn and soybeans. He sells his crop to supermarkets, farmers’ markets, schools, and colleges.

The farmworkers are immigrants from Latin America who reside in the surrounding area, and some of them have been working on his farm for decades. One of the measures he takes during the summer to avoid risks to his workers is to change the work schedules to avoid the hottest part of the day.

“I think they do a much better job when they’re treated with respect and taken good care of,” he said.

This story is a product of Harvest Public Media, Investigate Midwest and the Mississippi River Basin Ag & Water Desk as part of the series A Changing Basin. News outlets can sign up to republish stories like this one for free. 

The post Poor regulatory safeguards leave farmworkers suffocating in the face of increasing heat waves appeared first on Investigate Midwest.

Reading Time: 12 minutes

Wisconsin Watch is a nonprofit and nonpartisan newsroom. Subscribe to our newsletter to get our investigative stories and Friday news roundup.

Here are highlights from the story:

• Moms for Liberty chapters have spread to 11 counties in Wisconsin and members say their ranks have grown since the Southern Poverty Law Center labeled them an anti-government extremist group.
• Much of the growth comes from previous local organizations that formed to oppose COVID-19 school closures and mask requirements re-organizing as part of the well-funded national group.
• Members plan to be active in upcoming school board and state superintendent elections, to remove books they find objectionable from school libraries and to support anti-LGBTQ legislation. Eight of the 27 school board candidates the group endorsed won elections in April, mostly in Ozaukee County.

At July’s Wood County chapter meeting of Moms for Liberty — a growing, national conservative organization that has drawn scrutiny for its extreme rhetoric on hot-button issues — the discussion turned to a topic that had been decided 30 years ago: whether the local high school should have a valedictorian.

The Marshfield School District discontinued the practice in 1993 on a 4-3 vote partly due to concerns that it put too much pressure on students. Since 2010 the district has recognized the top 5% of graduating seniors, but has stopped publicly ranking students by GPA.

For some parents, it was a reminder that school policies didn’t reflect their values.

“The pushback on it is that whole ‘Well, we don’t want to exclude someone,’ ” said Mary Schueller, the Wood County Moms for Liberty chair who graduated from Marshfield High School in 1995. “Well, not everybody gets a participation ribbon for valedictorian and salutatorian. They worked really hard for that.”

“That’s the sort of stuff we’re fighting,” she added.

Moms for Liberty has attracted condemnation for their promotion of anti-LGBTQ+ rhetoric, opposition to race-focused history lessons and calls to ban books they deem inappropriate for children.

But in Wisconsin and elsewhere their ranks are growing, bolstered by the concerns of parents like Schueller who got a look under the hood of their local schools during COVID and now want a more direct role in their children’s education. That includes removing books from school libraries members deem offensive or inappropriate for children.

The group in June was categorized as an anti-government extremist group in the Southern Poverty Law Center’s 2022 Year in Hate & Extremism report, which stated that the group’s “primary goals are to fuel right-wing hysteria and to make the world a less comfortable or safe place for certain students — primarily those who are Black, LGBTQ or who come from LGBTQ families.”

At the Wood County chapter meeting, Marie Rogerson, national executive director of program development, said the group experienced a large membership spike shortly after the SPLC report.

Since it started in January 2021 Moms for Liberty says it has expanded to 285 chapters in 46 states with over 125,000 members. In Wisconsin, chapters in Kenosha, Marathon, Milwaukee, Ozaukee, Polk, Rock, St. Croix, Vilas, Washington, Winnebago and Wood County have popped up over the past two years.

It’s hard to pinpoint how many members are active in Wisconsin — the Wood County and Ozaukee County chapters estimated that there are 400 and 6,000 members in their groups, respectively. A national spokesperson said they do not have updated state membership numbers.

The national group has remained unapologetic in the face of criticism. At the group’s second summit in Philadelphia co-founder Tiffany Justice defended an Indiana chapter that quoted Adolf Hitler in its newsletter and later apologized.

“One of our moms in a newsletter quotes Hitler. I stand with that mom,” she said to applause.

“If @Moms4Liberty is a ‘hate group,’ add me to the list,” GOP presidential candidate and former United Nations Ambassador Nikki Haley tweeted a few days later.

The group planned to visit Milwaukee ahead of the first Republican presidential debate on Aug. 23. Moms for Liberty is hosting a discussion titled “Giving Parents a Voice” with U.S. Sen. Ron Johnson. They initially planned to host a candidate town hall event but pivoted after they said the venue, the Italian Community Center, canceled the event.

Membership is spreading from Southeast Wisconsin throughout the state

Moms for Liberty first made headlines in Wisconsin two years ago amid mask mandates and social distancing measures, when members in Kenosha shut down a school board meeting holding signs that said “We do not Co-Parent with the Government.”

One of the Kenosha members, State Rep. Amanda Nedweski, R-Pleasant Prairie, went on to run for county board and state Assembly. Nedweski helped lead an unsuccessful September 2021 recall petition against Kenosha School Board President Yolanda Santos Adams, which boosted her profile ahead of her county board election.

“Is this losing steam? Is this going to stop? No, it’s only going to gain momentum as we move forward,” Nedweski told the Milwaukee Journal Sentinel in December 2021 following the failed recall, adding that one of her goals is “to have a Moms for Liberty T-shirt in every school board meeting across the country.”

In Ozaukee County, a recall effort led by Scarlett Johnson and Amber Schroeder against four Mequon-Thiensville School Board members in November 2021 raised nearly $50,000, with Republican donor Richard Uihlein donating to the campaign and Former Lt. Gov. Rebecca Kleefisch helping organize outreach.

The effort didn’t unseat any incumbents but the group morphed into Moms for Liberty when Johnson and Schroeder formed an Ozaukee chapter in July 2022. Johnson serves as the Republican Party of Ozaukee County’s second vice chair and Schroeder is a member at large.

Johnson this past spring lost a bid for the Mequon-Thiensville School Board, receiving 21% of the vote.

Sitting at a bench behind the Frank L. Weyenberg Library in Mequon, where Johnson and Schroeder spent summer 2021 collecting recall signatures, they reflected on the chapter’s growth.

“A lot of families do go to church around here and a lot of families do have very freedom-loving, patriotic, constitution-loving values, and if you’re going to come and start taking those away from people, you’re going to tick off a lot of people,” Schroeder said.

Schroeder and Johnson were both previously stay-at-home moms, and Schroeder pulled her younger kids out of public school during the pandemic. Most Moms for Liberty members “weren’t paying attention 10 years ago or five years ago,” Schroeder said. “COVID-19 really helped open everybody’s eyes because our students started struggling.”

Wisconsin strategy mirrors national movement

Moms for Liberty was founded in Florida by former school board members Justice and Tina Descovich, as well as Bridget Ziegler, a current Sarasota County school board member. The group started as a way to fight against COVID-19 safety protocols in schools and gained wider attention with their appearance on the Rush Limbaugh Show in January 2021.

Similarly in Wisconsin, a surge of conservative groups that initially organized amid pandemic mask mandates and distancing restrictions formed the basis for Moms for Liberty. The Kenosha chapter of Moms for Liberty was one of 73 groups that signed onto an August 2021 Wisconsin United For Freedom open letter against mandatory COVID-19 vaccines. Members across those groups, as well as members of MTSD Parents for Moving School Forward in Mequon and Concerned Citizens of Marshfield, have funneled into Moms for Liberty, according to Johnson, Schroeder and Scheuller.

Johnson added that conservative media, such as Wisconsin Right Now, the Vicki McKenna Show on 1310 WIBA and 1130 WISN and the Meg Ellefson Show on the WSAU Wisconsin Morning News, helped give the group a platform to grow.

In Marshfield, the valedictorian issue was first brought to Tara Tremelling, a Moms for Liberty-endorsed board member who graduated in 2003, by Dillon Scheuer, a Northwestern University freshman who graduated in May from Marshfield High School.

“He was feeling like he had nowhere to really take the topic,” Tremelling said.

In an interview, Scheuer pointed to Moms for Liberty’s national Constitution challenge and to the Marshfield group’s partnering with The 917 Society to provide pocketbook constitutions for students as an example of what he believes is positive work. Constitution day on Sept. 17 has been a public school observance day in Wisconsin since 1987.

“If someone thinks Moms for Liberty, what they jump to right away is ‘Oh, book burnings, and they hate the LGBTQ community,’ ” Scheuer said. “I think that’s something that gets a lot of press attention because it gets people fired up. … It’s less sexy to say ‘Hey, these people want school board accountability and these people want everyone to understand the Constitution.’ ”

Community members have voiced their concerns about the chapter’s growing presence in Marshfield. At their June school board meeting, one parent speaking about Moms for Liberty said she was worried that community members didn’t know the group’s background and cited the SPLC report.

“I want us all to be aware of the possible motivation that could be behind some of the things right here in Marshfield schools,” said Nicole Johnson, who is a member of LGBTQ+ advocacy group PFLAG Marshfield. “Just because they may say they are doing these things because of parents’ rights, and they find buzzwords that can make the public think things are happening in the schools that are not does not mean they’re speaking for all parents.”

“Just because you are loud and angry doesn’t make you correct,” she added.

Looking ahead to elections and shaping public policy

In 2022 more than half of the 500 candidates the group endorsed in school board elections were elected to seats across the country, according to the Associated Press. This past April cycle in Wisconsin, eight of the 27 candidates it endorsed were elected, seven of whom were to Ozaukee County school boards.

At the group’s second summit held June 29 through July 2, the fight against “woke” rhetoric took center stage and served as a platform for 2024 GOP hopefuls to champion their values. Speakers included Haley, former President Donald Trump, Florida Gov. Ron DeSantis, former Arkansas Gov. Asa Hutchinson and entrepreneur Vivek Ramaswamy.

“I think parents are going to help decide this next election more than ever. And I think that’s why at the Moms for Liberty summit in Philadelphia, we had every single (Republican) candidate speak,” Johnson said. “They know that they need to come talk to the mama bears.”

The summit provided training on how to win school board elections and included sessions on topics like “Comprehensive Sex Education: Sex Ed or Sexualization” and “Protecting Kids from Gender Ideology,” according to SPLC.

During the conference, Justice told the AP that Moms for Liberty will use its political action committee to endorse candidates for state education boards, state superintendents and local school board races across the country.

The group in Wisconsin is in the candidate recruitment process for the spring 2024 school board elections and spring 2025 Wisconsin State Superintendent of Public Instruction election. They have worked with the conservative Leadership Institute on candidate and recruitment training, Johnson said.

Asked what solutions Moms for Liberty supports for closing Wisconsin’s huge racial disparities in education outcomes, Johnson, who is Hispanic and grew up in a poor area of Milwaukee, said the state needs less diversity coordinators and more reading and math specialists.

“Since we’ve started to focus on equity and not excellence, we have seen that gap grow because we’re not giving kids what they need,” Johnson said. “We are focused too much on virtue signaling and not actually doing the virtuous thing, which is educating children.”

The most recent National Assessment of Educational Progress showed Wisconsin had the largest gap among the states between white and Black student test scores, though those disparities have existed for decades.

Johnson and Schroeder said one of Moms for Liberty’s primary goals in Wisconsin is shaping public policy. They recently formed a Moms for Liberty state legislative committee, which Johnson chairs, that will help them prepare to support legislation this fall.

They plan to testify in support of legislation that would prohibit puberty blockers for minors and ban transgender athletes from participating in athletic teams designated for females and require schools to designate teams as falling into male, female, or co-ed categories. Democratic Gov. Tony Evers has vowed to veto it.

Johnson, Schroeder and Nedweski were among those who testified in support of a Republican-supported Parent Bill of Rights that Evers vetoed last year. Provisions requiring students to have parental authorization to use different names and pronouns in school have since been added to school board district policies in Kettle Moraine, Arrowhead, Waukesha, Germantown and Muskego-Norway.

On July 12, the Waukesha School District fired first grade teacher Melissa Tempel in the months after she publicly criticized the district’s request that she remove from a school concert the song “Rainbowland,” The song celebrates diversity and encourages everyone to “dig down deep inside (and) brush the judgment and fear aside.” The district said it “could be perceived as controversial.”

That morning, Johnson and Schroeder lined up outside of the district’s offices to oppose a silent protest of the firing organized by the Alliance for Education Waukesha.

“There are only two genders,” read a sign that Johnson posted a photo of on Twitter alongside a selfie of her and Schroeder with the caption: “supporting the Waukesha School District as they work to keep ideology and politics out of first-grade classrooms.”

John Norcross, a parent and community organizer in the Arrowhead School District​​, was there to support Tempel. He has tracked connections between school board policies and political organizations since the pandemic and said Moms for Liberty has more national strategy and resources behind it than most organizations.

“There’s no equivalent from a party perspective,” Norcross said.“Democrats aren’t doing it, whether because they don’t want to or can’t. … But what’s countering it is what I call a communitarian response.”

Book removals in the works

Earlier this year, a 111-page Moms for Liberty document identified several books, many dealing with gender identity and race, that they deemed inappropriate in schools. Among others, the list included Maia Kobabe’s “Gender Queer,” Toni Morrison’s “The Bluest Eye” and Margaret Atwood’s “The Handmaid’s Tale.”

The nonprofit freedom of expression organization PEN America’s Index of School Book Bans found 1,477 instances of individual books banned in fall of 2022 and connected Moms for Liberty to 58% of all advocacy-led book bans around the country. Despite their growing efforts, a 2022 poll found that nearly three-quarters of parents oppose book banning. Critics have raised concerns that banning books that explore gender and sexuality sends a harmful message to kids struggling with their identity.

Moms for Liberty members say they are “curating” books in school libraries, not banning them. But groups like the American Civil Liberties Union, the American Library Association and PEN describe the removal of those books as a ban.

So far in Wisconsin removing books from schools hasn’t been at the forefront of Moms for Liberty’s goals, but chapters are looking to remove books they deem inappropriate for schools in the future.

In Marshfield, Schueller in May 2022 sent a request to remove four books — “Lucky,” “Push,” “Sold” and “Tricks” — from Marshfield High School’s library but did not respond to the school’s response that outlined the process for moving forward with the complaint. She said she plans to wait until more group members can actively review the district’s books.

Tremelling hopes to eventually remove from Marshfield’s school libraries several titles dealing with violence, sexual nudity, child rape and profanity, including “Push,” “Sold,” “Tricks,” “Damsel,” “A Court of Mist and Fury,” “A Court of Frost and Starlight,” “A Court of Wings and Ruin,” “Crank” and  “Infandous.”

Half a dozen scholarly historian groups criticized the Museum of the American Revolution in Philadelphia for renting space to the group ahead of the national summit. The American Historical Association wrote in a letter that Moms for Liberty “has vigorously advocated censorship and harassment of history teachers, banning history books from libraries and classrooms, and legislation that renders it impossible for historians to teach with professional integrity without risking job loss and other penalties.”

Johnson, who attended the national summit, said protesters there told her that she deserved to be raped and murdered and that they wanted to kill her children. She called it the “most vile, horrific thing” she had ever witnessed.

“Basically, if you’re not on the left, you’re a hate group,” Johnson said of the criticism the group receives. “You’re akin to a very extreme, something horrific like the KKK, just because you’re a Republican. And that’s wrong. And that is demoralizing, and it’s also dehumanizing. And that’s where we have to be careful. We should not dehumanize people that we don’t agree with.”

‘Proxies for a national culture war’ 

Liberal groups, including Stop Moms for Liberty, Defense of Democracy and Red Wine & Blue, have formed to counter Moms for Liberty, mobilizing suburban, Democratic voters at the school board level and starting campaigns related to racial equity and stopping book bans.

Critics say the politicization of school boards is creating a hostile environment for marginalized students. Elisabeth Lambert, founder and principal of the Wisconsin Education Law and Policy Hub, has represented students in discrimination cases against school districts across the state, including in Chippewa Falls, Cedarburg and Burlington. She said her clients often receive “astounding harassment” that reduces what they’re experiencing to a “culture war narrative,” with those who speak out labeled as “anti-American” or a “corrupting influence.”

“They’re sort of viewing these local peoples as proxies for a national culture war and so it’s really not about problem-solving at all,” Lambert said. “It’s just about feeling like part of whatever team you happen to identify with, and using these other folks in your community and the fact that you share a public school system as an opportunity to perform your allegiance to that national agenda.”

Melissa Deckman, a political scientist who studies gender, religion and the role of women in conservative politics, said that Moms for Liberty’s growth is a response to the country’s growing diversity in terms of race, ethnicity and gender, specifically citing that one in five Gen Z adults identify as LGBT.

“Those sorts of things are challenging to the worldview of conservative Christian women who don’t like these changes in society,” Deckman said, noting how they’ve utilized the unique historical position of the pandemic to their advantage. “It really has allowed them to organize and pretty effectively tap into a lot of parents who were unhappy about COVID and those restrictions, but now, of course, it has spread to concerns about critical race theory or transgender policies or LGBT policies.”

Ahead of the 2024 election cycle, Norcross said he’s concerned about the group gaining more funding and getting more active throughout Wisconsin and is worried their anti-LGBTQ rhetoric will negatively impact vulnerable groups. With the suburban Milwaukee counties growing increasingly Democratic, he sees conservatives “driven by a fear that their local area is changing.”

“They’re losing Republican suburbs because of the demographic changes,” Norcross said. “They don’t want to lose that and they’ve seen this as a play to get it.”

Looking ahead, Johnson said the group is focused on growing its membership in northern Wisconsin and believes there will be a burst of membership over the next year.

“With all of the national attention that’s going to be on Wisconsin because we are having the Republican convention here, by the summer, I would think that we’re going to see huge growth in Moms for Liberty,” Johnson said.

The nonprofit Wisconsin Watch (www.WisconsinWatch.org) collaborates with WPR, PBS Wisconsin, other news media and the University of Wisconsin-Madison School of Journalism and Mass Communication. All works created, published, posted or disseminated by Wisconsin Watch do not necessarily reflect the views or opinions of UW-Madison or any of its affiliates.

Moms for Liberty is growing in Wisconsin as critics call them extremists is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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Parents have a lot to worry about when preparing for a baby: their health, hospital bills, whether or not the delivery goes smoothly — the list goes on and on. But another concern is becoming more prominent.

“(Child care) has literally been the biggest stress of my entire pregnancy — not knowing exactly where our baby is going to go, if they’re going to be safe, and just knowing the waitlists are so long and the astronomical prices,” said Menasha’s Hannah Wainio, who’s expecting her first child in late July.

Hannah and her husband, Grant, started their child care search as soon as they learned she was pregnant at five weeks. When Hannah spoke to USA TODAY NETWORK-Wisconsin in June, the family still had not found care.

Their story isn’t unique. In Outagamie County, there are over 1,200 children younger than 2 on regulated child care waitlists, according to data recently compiled by Child Care Resource & Referral Fox Valley. In Winnebago County, there are nearly 550.

In Family and Child Care Resources of Northeast Wisconsin’s service area, infant waitlists can span one to two years, said executive director Paula Breese. CCR&R Fox Valley’s executive director, Candy Hall, said wait times can be over five years.

Because of this, it’s increasingly common for parents to get on wait lists even before they conceive. Six months before Ripon’s Ashley Giese found out she was expecting her fourth child, she told her child care provider she was trying to get pregnant. In New Glarus, Abby Funseth timed the conception of her second child around a child care opening.

“People plan all of the things they need and the logistics of waking up at night (to feed their infant), those are things you expect as a new parent. But you don’t always expect an 18-month waiting list for daycare,” Giese said.

Why is care for infants, specifically, so difficult to find?

The financial model most child care programs in Wisconsin operate within is flawed, said Kelly Matthews, co-director of Wisconsin Early Childhood Association’s shared services network.

Aside from funds from Child Care Counts, the state’s monthly stabilization payment program, which is set to expire in early 2024, the price parents pay for care is often the only revenue centers see, Matthews said. This has to cover myriad costs, including utilities, rent or mortgage, insurance, personnel costs and more.

Providers often charge parents less than the actual cost of care — all costs of running the child care facility, from bills to livable wages and benefits for the educators — in an attempt to keep prices manageable. And that’s with child care workers being notoriously underpaid compared to those with similar credentials in other fields.

Child care businesses are left to survive on thin profit margins — typically 1% to 2%, while most businesses’ profit margins span 10% to 20%, according to research compiled by the Greater Fox Valley Child Care Alliance.

Licensed child care programs in Wisconsin are also subject to regulations aimed at ensuring infants get age-appropriate care, Matthews said.

In a licensed family child care setting — a child care business based in the provider’s home — the number of children younger than age 2 present often limits the total number of children it can serve full time, which also limits its revenue.

In group centers, staff-to-child ratios allow for more children per staff member as children get older. For example, one staff member can either supervise four children younger than 2, or six children ages 2 to 2½.

“Without (funding) based on the true cost of care, it is a better financial decision for child care programs to take children 2 and older than it is for them to take infants, which (leaves) both programs and families struggling,” Matthews said. “The issue is the (lack) of revenue coming in, not the ratios.”

Caring for infants is often more labor-intensive than caring for older children, as infants typically require more one-on-one interaction, according to First 5 Fox Valley Director Barb Tengesdal. It’s also harder on providers’ bodies, with all of the bending and lifting, according to Corrine Hendrickson, a licensed family child care provider in New Glarus.

As a result, there’s often high turnover among infant teachers.

What happens when families can’t find care?

Even searching for care well before their infant is due doesn’t always guarantee families a spot — let alone one they can afford. According to Child Care Aware of America, the average cost of center-based infant care in Wisconsin in 2022 was $13,572, and the average price of infant care for in a family child care was $10,400. Both surpass the cost of a year of in-state tuition at University of Wisconsin-Madison.

As soon as she knew her pregnancy was viable, Allyssa Thomas, a Milwaukee-area teacher, began contacting centers, many of which required nonrefundable waitlist fees. Based on the responses, she doesn’t expect a slot will open by the time her maternity leave ends.

While Thomas is confident she can piece together care for a few months if needed, she said if it takes too long, she might need to leave her job.

“I’d imagine that either myself or my husband would need to choose not to work, at least for a year while our child is still an infant, which would be hard,” Thomas said. “Child care is expensive, but paying for child care with two incomes is (more feasible) than going down to one income.”

Parents may also turn to their own parents when they cannot find an opening. Carolyn Nelson’s mother drives five hours each week between her home in Beloit and Nelson’s home in Appleton to care for Nelson’s 6-month-old daughter, Emma.

This allows Nelson to continue working as a Help Me Grow navigator with ThedaCare, helping connect families with early childhood resources and information — for now. Nelson worries about what will happen if a spot doesn’t open before winter, when ice and snow may prevent her mother from traveling.

“If there’s still no child care, where do I put Emma every day?” Nelson asked. “Can I work through her nap times and have her home with me? To be quite honest, that sounds like I will be burnt out in two months. Would I be able to (leave work temporarily) and return once I get child care? Would that even be an option?”

On one hand, Nelson said she can’t help but wish she looked sooner, starting months before Emma was born. At the same time, she knows doing so could’ve had unforeseen drawbacks.

“I would have been pretty crushed to get a phone call saying that there’s a spot opening on a waitlist if I was no longer pregnant (due to medical complications),” Nelson said.

When parents can’t find an infant opening at a high-quality child care, they may be forced to leave the workforce, turn to lower-quality options or patch care together from a variety of sources.

Tammy Dannhoff, a licensed family child care provider in Oshkosh, said consistency is key for a young child’s development, and the early months and years are the prime time for children to develop secure relationships with caregivers.

This led Dannhoff to bend the rules a few summers ago to add a second child younger than 2 to her program. Under licensing regulations, she was supposed to care for only one child younger than 2 if she wanted eight slots, the maximum number a licensed family provider can have.

“When I was talking with his mom, I found out he was going to be going to three or four different places every week in the summer because she had to piece together care for him,” Dannhoff said. “At the time, he was 22 months, and I thought, ‘It’s going to be more detrimental for him to go to three or four different places for child care, so I’m going to take the risk and just take him.’”

Dannhoff was able to get an exception so she remained in compliance. Department of Children and Families Communications Director Gina Paige said there’s a flow chart of sorts that helps determine when exceptions should be granted, but some family child care providers said they feel these exceptions are granted inconsistently.

What can be done?

The solution to the care shortage for children up to age 2 doesn’t lie in doing away with regulations or increasing staff-to-child ratios.

“That, I believe, would be the fastest way to close down more of the under-2 rooms,” said Brooke Skidmore, co-owner and director of The Growing Tree, a child care center in New Glarus. “You will not find teachers that want to have five babies under their care, and it still will not make it profitable.”

Matthews thinks the solution to the infant care crisis lies in funding child care businesses based on the true cost of care.

“If we had true cost of care for payment amounts … it would still get the bills paid and not be a loss for the program,” Matthews said.

Increasing tuition rates often comes with the risk of making child care unattainable for families. Matthews said finding a path forward will require collaboration between communities, employers, families and the government.

Angel Berry, the executive director of the nonprofit A Million Dreamz child care in Sheboygan, said solutions lie in creative funding models. For example, she said, child care businesses could make infant care sustainable by operating under a nonprofit model and seeking funding support from the community.

However, in the meantime, some say slight alterations to state licensing requirements could help.

After Dannhoff investigated ways to change family child care requirements for a college capstone project in 2021, she said she supports employing a “weighted” system that distinguishes between young infants and children 18 months and older. The younger children would have a higher “weight” than the older children, essentially making a spot at a family child care available for another child once an infant turns 18-months-old instead of 2 years.

Hendrickson, who also supports this change, explained that by 18 months, children are typically more mobile and better able to verbalize their needs. The Wisconsin Family Child Care Association has long discussed the exact weights each particular age group would be assigned. As of now, however, WFCCA has not brought any formal proposals to DCF.

While Hendrickson said this change could help get families off waitlists and into consistent care more quickly, she said it alone cannot rectify Wisconsin’s infant care shortage.

“It’s definitely not a solution, per se, for the crisis because it’s not going to even come close to fixing the problem, but it would be one potential way to alleviate some of the pressure,” Hendrickson said.

Employers have a role to play, too. Providing and extending paid family leave gives parents essential time to bond with their infant as well as more time to search for child care, Tengesdal said. For industries in which flexible scheduling is possible, allowing parents to work from home, bring their child to work when needed, and reduced hours after birth helps both parents and babies adjust, she said.

Many of the potential solutions advocates say could bolster Wisconsin’s child care sector in general would, by extension, help solve the infant care crisis, Hendrickson said. These range from significant state and federal investments to shifting the way society views child care.

“If there is no infant care, the likelihood of a mother returning to work is significantly reduced,” Hendrickson said. “This impacts her family’s financial wellbeing, her career trajectory, her mental health and the growth and development of her child.”

Can’t find child care for your infant in Wisconsin? You’re not alone. Industry experts break down why it’s so difficult. is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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This story is a product of the Mississippi River Basin Ag & Water Desk, an editorially independent reporting network based at the University of Missouri School of Journalism in partnership with Report For America and funded by the Walton Family Foundation. Wisconsin Watch is a member of the network. Sign up for our newsletter to get our news straight to your inbox.

After a developer began eyeing rural northwest Wisconsin for a large swine farm, five small towns enacted ordinances aimed at curbing environmental and health impacts.

Then, the state’s biggest business and agricultural interest groups fought back. They engaged disaffected residents. Some locals sued. Others ran for political office. New leaders in one Polk County town rescinded regulations on concentrated animal feeding operations, or CAFOs.

Now, officials in the remaining towns with livestock regulations wonder whether they, too, are in legal crosshairs. 

The Wisconsin Farm Bureau Federation and Wisconsin Dairy Alliance have filed a far-reaching public records request for documents from an advisory group that shaped the municipalities’ CAFO rules.

In 2019, a developer proposed an operation, known as Cumberland LLC, that would have housed up to 26,350 pigs — the region’s first swine CAFO and what would be the largest in Wisconsin. Residents later formed the advisory group, believing that state livestock laws insufficiently protect health and quality of life.

In October, two farm families, represented by WMC Litigation Center, sued one municipality in the advisory group: Laketown, population 1,024. The town’s livestock, crop and specialty farms make up almost two-thirds of the landscape.

The plaintiffs, later joined by the Farm Bureau, argued that Laketown’s ordinance diminished property values and prospects for future expansion, a government overreach that could “essentially outlaw mid-to-large sized livestock farms.”

Scott Rosenow, the Litigation Center’s executive director, did not respond to multiple requests for an interview.

The records request follows the dismissal of that lawsuit, but some residents wonder if the lobbying organizations are “fishing” for another case, the latest effort to prevent local governments from regulating farming in America’s Dairyland.

Pig farm proposal roils northwest Wisconsin 

Cumberland’s proposal sparked heated public meetings, dozens of letters to newspapers and the formation of a nonprofit opposition organization.

The CAFO would be constructed in Trade Lake, north of Laketown in neighboring Burnett County. Sows would be bred and piglets trucked elsewhere after weaning, where they would grow until slaughter.

The Wisconsin Department of Natural Resources rejected Cumberland’s application in March. The developer recently pitched a scaled-down project that would house 19,800 swine.

CAFO opponents in Laketown include back-to-the-landers, who view such farms as inhumane to animals. Others fear the health impacts of the millions of gallons of manure facilities generate annually, to be spread on farm fields.

About 90% of all nitrate groundwater pollution in Wisconsin comes from fertilizer and manure application, according to the DNR. The naturally occurring nutrient helps crops grow, but scientists associate exposure in drinking water with birth defects, thyroid disease and increased risk of developing certain cancers.

Other concerns are rooted in economics. Some Laketown farmers say CAFOs threaten smaller operations; others fear shrinking property values.

“It’s nothing more than big corporations getting together with the government and putting the screws to the little people,” said Vietnam Army veteran and recently ousted Laketown supervisor, Bruce Paulsen, who, like many opponents, speculates that the pork will be exported to China.

Laketown’s ordinance explained 

The town ordinances regulate not where, but how CAFOs operate.

Laketown’s rules applied to new operations housing at least 700 “animal units,” the equivalent of 1,750 swine or 500 dairy cows, and required applicants to submit plans for preventing infectious diseases, air pollution and odor; managing waste and handling dead animals.

It also mandated traffic and property value impact studies, a surety for clean-ups and decommissioning and an annual $1-per-animal-unit permit fee — atop costs to review the application and enforce the terms of the permit.

The ordinance did not affect existing livestock facilities as long as the farms did not change owners, alter their animal species or expand beyond 1,000 animal units. But several residents believed the strict requirements amounted to a CAFO ban that would bar existing farms from growing.

Others protested government spending on the advisory group. Some said the smell of manure comes with living in a rural area.

Polk County Supervisor Brad Olson asked why farming gets blamed when excessive road salt and wastewater treatment plant overflows also taint water.

“I don’t think anybody denies that agriculture is part of the problem — or has the potential to be part of the problem in pollution,” said Olson, who farms crops and used to be a dairy farmer. “If we’re going to look at pollution, let’s look at the bigger picture.”

Clothing-optional campground owners Jen and Scott Matthiesen initially signed onto the lawsuit before attorneys requested they withdraw out of concern their business — “we’re not a nudist camp,” Jen said — would distract from the case. The couple worried that singling out farming could pave the way for special regulation of other businesses.

New Laketown Sup. Ron Peterson ran on the promise of overturning the ordinance. He believes it unlawfully superseded state laws. Those laws ban local authorities from regulating livestock more strictly than the state — unless they can prove a need to protect health or safety.

“The Wisconsin Legislature has been very clear in the statute that it’s their intent that they want uniformity in the regulation of animal agriculture,” said Peterson, a former attorney.

Gaps in DNR regulations 

But supporters of Laketown’s ordinance say it merely corked regulatory leaks.

The DNR acknowledges it lacks legal authority to manage how livestock farming affects odor, noise, traffic and other issues unrelated to water quality. The agency also has struggled to keep pace with the proliferation of CAFOs, defined as farms holding at least 1,000 animal units.

The vast majority of Wisconsin’s 337 operations form the backbone of the state’s dairy industry. Just a dozen house swine.

As the DNR sees more proposals for large farms in recent years, staff shortages and turnover have fueled a backlog in permitting, delays in CAFO inspections and inconsistencies in violations enforcement, according to legislative reports.

As of June, the DNR’s permitting backlog totaled 20%, slightly less than this spring when administrators said they would need an additional 2.25 full-time-equivalent staff to handle the growing workload.

Sidestepping ‘right-to-farm’ protections

Wisconsin’s “right-to-farm” and livestock facility siting laws protect farmers from nuisance claims and generally rebuff local control over CAFOs.

Regulating livestock operations, but not banning them or restricting their locations, could enable communities to sidestep the laws — with major implications for the state’s $104.8 billion agricultural industry.

The strategy, successfully deployed in 2016 in Bayfield County, appears to be spreading. Facing the prospective expansion of a dairy CAFO in Pierce County, about 60 miles south of Laketown, residents are urging county supervisors to enact a CAFO moratorium until they can develop an ordinance.

“The problem is, we’re a disease for them,” said Trade Lake resident Rick Painter, a retired attorney who opposes Cumberland’s construction. “We’re a cancer, and they can’t afford for the cancer to metastasize.”

When confronted with legal threats, Laketown was among the few Wisconsin local governments to stand its ground, perhaps due to the deep expertise of its full- and part-time residents.

Trade Lake property owner and trial lawyer Andy Marshall and his brother David agreed to represent the town at no cost. If the other towns requested assistance, Andy Marshall said he would offer his services. Without money for a good legal defense, he said, small towns can get “steamrolled” by wealthy interest groups.

“It shouldn’t be the community that suffers because these companies can’t safely operate,” Marshall said.

Farmers want expansion options 

Farmer Sara Byl views the anti-CAFO chorus with increasing skepticism. 

Her family owns Northernview Farm, growing about 600 acres of corn and alfalfa to feed their herd of Holsteins in Laketown. Before Sara and her parents sued over Laketown’s ordinance, she served on the town’s livestock facility licensing committee, which studied whether it needed CAFO regulations.

Byl felt the effort evolved into a push against all large-scale farming rather than one hog CAFO.

“It was all about the hog farm — hog farm this, hog farm that,” she said. “Then they left off the word ‘hog’ and they just kept saying ‘farm.’ ”

The Byl family, three generations of farmers, doesn’t operate a CAFO, but Sara says the farm might grow if her son, nieces or nephews pursue agriculture careers. 

Farmers expand for multiple reasons, said Michael Langemeier, a professor in the agricultural economics department at Purdue University.

Farm expansion and consolidation help lower production costs, increase efficiency and satisfy demands for safe, low-cost and uniform agricultural products. Larger farms also can financially support multiple owners and obtain favorable prices on supplies. 

But CAFO opponents argue the consumer gains are offset by the federal policies that support large livestock farms, including taxpayer funded subsidies, and other costs resulting from their health and environmental impacts.

Bracing for next lawsuit

Although newly elected Laketown officials rescinded the rules in April, the CAFO regulations of four other towns remain intact.

That same month, the Dairy Alliance submitted public records requests to all towns in the advisory group for communications from current or former town supervisors about the group’s work. The Farm Bureau also requested records from all advisory group members related to its work, as well as its expenses.

Asked for comment, Cindy Leitner, the Dairy Alliance’s president, ceased correspondence with Wisconsin Watch after being provided with questions. H. Dale Peterson, general counsel to the Farm Bureau, did not respond to interview requests.

“I see it as a great opportunity to show the Farm Bureau all the great work we’ve done,” quipped Lisa Doerr, the advisory group’s chairperson.

Doerr, who grows forage on her 80-acre Laketown farm, contends the group was not a governmental body and lacked decision-making powers, so its members aren’t subject to Wisconsin’s public records law. She denied Peterson’s request.

“If they want to push me, then bring it on,” Doerr said.

Bone Lake town Chairman Andy Brown already fulfilled the records requests.

“I don’t have anything to hide,” he said. “If they want to see my emails back and forth about how to make this happen, then fine.”

With a defense team at the ready, Brown says he isn’t worried. “This is an important test case, and somebody’s gonna have to be in front of that firing squad some time or another,” he said.  “And so if it’s us, it’s us.”

Wisconsin towns brace for next fight on local control over large farms is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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

Wisconsin Gov. Tony Evers’ partial veto that attempts to lock in a school funding increase for 400 years drew outrage and surprise from his political opponents, but it’s just the latest creative cut in a state that’s home to the most powerful partial gubernatorial veto in the country.

“Everybody will shout and scream,” said former Democratic Gov. Jim Doyle, “but he’s got ’em.”

Wisconsin governors have the most expansive partial veto power in the country because, unlike in other states, they can strike nearly any part of a budget bill. That includes wiping out numbers, punctuation and words in spending bills to sometimes create new law that wasn’t the intention of the Legislature.

That’s exactly what the Democratic Evers did on Wednesday with a two-year state budget passed by the Republican-controlled Legislature.

The Legislature had language in the budget increasing the per pupil spending authority for K-12 public schools by $325 in the 2023-24 and 2024-25 school years. Evers, a former state education secretary and public school teacher and administrator before that, vetoed the “20” and the hyphen to make the end date 2425.

The change means that until a future Legislature and governor undo it, the amount schools can spend through a combination of property taxes and state aid will increase by $325 annually until 2425. That’s farther in the future — 402 years — than the United States has been a country — 247 years.

“It’s creative for sure,” said Bill McCoshen, a lobbyist who previously worked under former Gov. Tommy Thompson.

Creative, but not unprecedented.

Reshaping state budgets through the partial veto is a longstanding act of gamesmanship in Wisconsin between the governor and Legislature, as lawmakers try to craft bills in a way that are largely immune from creative vetoes. Vetoes, even the most outlandish, are almost never overridden because it takes a two-thirds majority of the Legislature to do it.

Republican Assembly Speaker Robin Vos, during a Thursday interview on WISN-AM, vowed to try, though he admitted it would be difficult.

Vos called Evers’ 400-year veto “an unprecedented brand-new way to screw the taxpayer … that was never imagined by a previous governor and certainly wouldn’t by anybody who thinks there is a fair process in Wisconsin.”

Former Republican Gov. Scott Walker in 2017 used his veto power to extend the deadline of a state program program from 2018 to 3018. That came to be known as the “thousand-year veto.” He also delayed the start date of another program by 60 years.

The Republican Thompson was known for his use of the “Vanna White” veto, named for the co-host of Wheel of Fortune who flips letters to reveal word phrases. Thompson holds the record for the most partial vetoes by any governor in a single year — 457 in 1991. Evers this year made 51.

Wisconsin’s partial veto is uniquely powerful because it allows the governor to change the intent of the Legislature, just as Evers did, said Kristoffer Shields, director of the Center on the American Governor at Rutgers University. Shields said he plans to cite the latest Evers veto when teaching about executive power.

“Many people in Wisconsin, I suspect, are surprised that the governor can do this,” Shields said. “And now that we know he can do this, that can lead to changes.”

Wisconsin’s partial veto power was created by a 1930 constitutional amendment, but it’s been weakened over the years, including in reaction to vetoes made by Thompson and Doyle.

Voters adopted a constitutional amendments in 1990 and 2008 that took away the ability to strike individual letters to make new words — the “Vanna White” veto — and eliminated the power to eliminate words and numbers in two or more sentences to create a new sentence — the “Frankenstein” veto. Numerous court decisions have also narrowed the veto power.

Rick Esenberg, director of the conservative Wisconsin Institute for Law and Liberty, said he expected there to be a legal challenge to Evers’ 400-year veto.

“This is just a ridiculous way to make law,” Esenberg said.

The Wisconsin Supreme Court sided with Esenberg’s group and undid three of Evers’ partial vetoes in 2020, but a majority of justices did not issue clear guidance on what was allowed. Two justices did say that partial vetoes can’t be used to create new policies. In August, the court flips from conservative to liberal control. That further clouds how it may rule on veto power, an issue that over the decades has drawn bipartisan support and criticism.

Even as questions about the legality of the veto swirl, conservatives are trying to benefit politically by arguing that the ever-increasing spending authority Evers enacted will open the door to higher property taxes.

“The veto would allow property taxes to skyrocket over the next 400 years,” Republican Assembly Majority Leader Tyler August said in a statement. “Taxpayers need to remember this when getting their tax bills this December.”

But Doyle, the former Democratic governor who issued nearly 400 partial vetoes over eight years, praised Evers for effectively restoring an automatic increase in school spending authority that had been in place starting in the 1990s. Doyle’s successor, Walker, and the GOP-controlled Legislature removed it.

“What Governor Evers did was masterful and really important and something that everybody should have expected him to do,” Doyle said. “I’m sure they’re kicking themselves over why they didn’t they see this little number thing.”

Wisconsin governor’s 400-year veto angers opponents in state with long history of creative cuts is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.