At rules hearing, U.S. EPA hears human toll of unaddressed coal ash pollution

At rules hearing, U.S. EPA hears human toll of unaddressed coal ash pollution

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U.S. Environmental Protection Agency officials were met with photos and tearful stories of deceased loved ones at a national hearing in Chicago on Wednesday regarding the agency’s proposed new rules regulating coal ash. 

The proposed rules, released in May, would subject hundreds more coal ash dumps to federal regulations adopted in 2015. But scores of coal ash dumps would remain unregulated, leading residents and advocates to plead with the EPA to further expand the proposed rules and step up enforcement of existing rules. 

The environmental injustice of coal ash was clear at the hearing, as residents testified from Native American communities in New Mexico and Nevada, Latino communities in Midwestern cities, and Black communities in Alabama and Tennessee, among others. Multiple people told the EPA officials about their friends and family who had died or suffered from cancer or other illnesses they attribute to coal ash. 

The proposed rules would, for the first time, regulate coal ash ponds that were inactive as of 2015. But the rules would still exempt categories of dumps that speakers at the hearing called “arbitrary,” including repositories not in contact with water as of 2015, coal ash dumps at plants closed before 2015 that don’t have a currently regulated pond at the same site, and scattered coal ash used as structural fill. 

“Anecdotally we know such sites include playgrounds, schools, roads and other uses that humans regularly come into contact with,” Earthjustice deputy managing attorney Gavin Kearney said of sites where coal ash fill was used. 

He noted that there is no comprehensive data regarding coal ash ponds supposedly not in contact with liquid, but experts are sure companies will invoke that exception. Earthjustice and its partners, meanwhile, have identified more than 100 dumps on at least 48 sites that would meet the exception for closed ponds at active power plants without another regulated coal ash impoundment.   

“Creating these distinctions undermines confidence in the rule and also gives industry cover, in good faith or bad faith, that they are trying to implement the rule but aren’t sure how it applies to their sites,” Kearney told the EPA representatives. 

Frank Holleman, senior attorney for the Southern Environmental Law Center, likewise warned that it “undercuts the credibility of EPA and our government to have to say, ‘See, that over there is not protected because of some highly technical reason that’s not connected to common sense.’” 

Attorney Faith Bugel testified that regulating all coal ash on a site without exceptions is critical to avoid companies saying that contamination is from an “alternate source,” including coal ash not covered by the regulations, and hence avoiding responsibility for cleaning it up. “So often (alternative source arguments) have been used as an escape valve from the 2015 rules,” Bugel said. 

Drinking water fears

Unregulated coal ash is of particular concern to people who get their water from private wells, as numerous people noted at the hearing. 

Environmental groups’ analysis of company data reported under the 2015 rules shows that groundwater is being contaminated at 91% of those coal plant sites. No testing is required around ash not covered by the regulations. But experts say it is even more likely to be contaminating groundwater, since it was dumped when standards around liners and other protections were even lower. 

Private water wells are only tested if the owner pays for the testing, which is inaccessible for many. Paul Kysel told the EPA about testing his own well water for contaminants associated with farming and getting clean results. He said he didn’t realize that a partially unlined coal ash pond less than a mile from his home in Pines Township, Indiana, could be contaminating his water with chemicals not detected in that test. 

Nearby Town of Pines, Indiana, became a Superfund site due to tons of coal ash from NIPSCO’s Michigan City plant that was used as fill throughout the town. Kysel had moved to the bucolic area from Michigan City, where he was sick of “coal dust, nasty odors, (coal dust) deposits on our vehicles and homes.” 

“We thought we were safe,” after moving to Pines Township, Kysel said. “We weren’t safe.” 

He and other locals are upset that the proposed new rules would still not cover coal ash mixed with dune sand to build up land on the lakefront coal plant’s site. A lawsuit filed by environmental groups in Indiana, Illinois and Tennessee alleges that Lake Michigan is at serious risk of coal ash contamination if erosion and increasing storms cause the land to collapse, as happened near We Energies’ Oak Creek coal plant in Wisconsin in 2011. Lake Michigan provides drinking water for millions of people in Chicago, Northwest Indiana and Southeast Wisconsin, where multiple coal plants line the shores.

The settlement of that lawsuit spurred the EPA to release the proposed new rules, though the rules don’t address ash used as fill at sites like the Michigan City plant. 

“This coal ash is ultimately going to rupture into the lake and cause another catastrophe,” Ashley Williams, executive director of Just Transition Northwest Indiana, said at a rally during the hearing. The owner of a Northwest Indiana microbrewery that relies on Lake Michigan water was among other locals who testified at the hearing. 

Earthjustice senior counsel Lisa Evans noted that the new proposed rules would not have covered the ash in Town of Pines nor the ash that spilled into Lake Michigan at Oak Creek. 

“The EPA should have prevented this damage decades ago,” Evans testified. “It is irrational and illegal to regulate some leaking dumps and not others.” 

Ash was used to build up land and was scattered across plant sites in decades past without record-keeping or regulation. This practice essentially continues in the form of beneficial reuse, where coal ash is legally used as “unencapsulated” structural fill. Advocates have also called for stricter regulation of such reuse, including in Wisconsin, where a vast majority of coal ash is reused and groundwater contamination has been shown as a result. 

Chicago has no coal ash ponds or landfills covered by the existing or new proposed rules. But residents worry that as in Michigan City, coal ash was scattered and dumped across the sites of two coal plants that closed in 2012.

Little Village Environmental Justice Organization Executive Director Kim Wasserman noted that the Chicago neighborhood is densely populated by working-class and Latino residents. She echoed demands that new EPA rules require companies to test for historic coal ash scattered around their sites and clean up any they find. 

There is not “sufficient information about the risk the site still poses to surrounding communities,” Wasserman said. She added that the community does not trust the current site owner given its botched implosion of the coal plant in 2020, sending a toxic dust cloud across the community in an “environmental catastrophe,” as Little Village resident Edith Tovar called it at the hearing.

A moving problem

Enforcement and expansion of the federal rules will ultimately mean many millions of tons of coal ash will be removed and transported to safer locations. Such transport has already caused environmental injustices, even as it mitigates other risks.

Activists from around the country rallied in downtown Chicago on June 28, 2023 after testifying at the EPA’s hearing on proposed new coal ash rules. (Kari Lydersen / Energy News Network) 

Carlos Torrealba, an organizer with the Climate Justice Alliance in Florida, lamented how coal ash from Puerto Rico is being disposed of in Florida, including in a private landfill in a community home to a large and growing Puerto Rican population. The Energy News Network documented how the ash from Puerto Rico poses risks to multiple communities on its route in the Southeast.

“It’s really mind-boggling because that coal ash site was put next to the homes of Puerto Ricans who had been displaced from Puerto Rico by Hurricane Maria,” Torrealba said. “And now they have the double impact of being displaced, seeking refuge and having coal ash dumped next to you.” 

Cerissa A. Brown of the People’s Justice Council in Birmingham, Alabama, decried how coal ash from the infamous 2008 Kingston, Tennessee, spill was delivered to a landfill in the largely Black community of Uniontown, Alabama. The Energy News Network reported last year that Uniontown residents have been unable to get answers from the private landfill company about its coal ash management procedures and whether it still accepts coal ash.

“Exposure to environmental pollution such as coal ash in Uniontown has resulted in residents suffering physical harm and an escalating mental health crisis,” Brown said. “This reveals systemic racism rooted in our communities.”

Handling and moving coal ash can pose serious risks to workers if adequate protections aren’t in place. 

Betty Johnson’s husband, Tommy, was among the first responders cleaning up the 2008 Kingston spill. She broke down into tears testifying about how he and other workers labored without adequate protective gear. She blames his death last month on his exposure to coal ash. Johnson is among workers who have filed lawsuits against the contractor responsible for the cleanup, citing multiple deaths and serious illnesses. Advocates argue that disasters similar to Kingston could happen if regulations do not require the full cleanup of all coal ash dumps.

“My husband and I had plans when I retired to travel; now he’s in the graveyard,” Johnson said. “And I’m here fighting for my husband and all the workers, everyone who has been hurt by you, because you are not doing your job.”

Julie Bledsoe’s husband also worked on the Kingston cleanup, and would come home blowing coal ash out of his nose, coughing up coal ash, and cleaning coal ash out of his ears with Q-tips. 

“Her husband is a hero,” she said of Tommy Johnson. “My husband is a hero. But they were treated like they were trash.”

Enforcement crucial 

While the existing federal rules took effect in 2015, the EPA did very little to enforce them until last year, when it issued a number of findings and decisions. Among these, the EPA denied some companies’ requests for extensions to an April 2021 deadline for unlined ponds covered by the rules to stop accepting waste. 

The evening before the Chicago hearing, Waukegan residents testified on the EPA’s proposal to deny a request to extend that deadline from plant owner Midwest Generation, a subsidiary of NRG.

While residents support the proposed denial of the extension, they are frustrated that the company has already been allowed to dump for more than two years beyond the deadline. The coal plant closed last summer, but a diesel peaker plant still operates on the site, and residents are concerned that waste from that plant is going into the unlined pond. 

NRG spokesperson Dave Schrader said in a statement: “Midwest Generation remains committed to operating its Waukegan facility safely and in compliance with federal and State of Illinois CCR (coal combustion residual) rules and regulations. Midwest Generation disagrees with the U.S. EPA’s recent proposed determination. The mitigation efforts Midwest Generation has implemented at its Waukegan facility were certified compliant by outside experts and are approved methods of monitoring and protecting groundwater. Midwest Generation has ceased burning coal to generate electricity at Waukegan but continues to manage stormwater. Further, Midwest Generation ceased placing CCR in the East Pond when it ceased burning coal. The pond is only used for stormwater and process water unrelated to CCR.”

Waukegan residents testifying at the Chicago hearing noted that they have been demanding a “just transition” including coal ash removal for a decade, with little response from EPA or NRG.

“Publicly available tests conducted independently confirm there is no risk to human health or the environment from the ash ponds or historic ash area,” Schrader said. “Removing the coal ash, however, would pose unnecessary safety and environmental risks to the community, create significant traffic disruptions, and could take far longer than closing in place.”

Advocates say the EPA needs to not only expand the rules to cover all coal ash dumps, but aggressively enforce its rules.

“Rules are awesome, but without enforcement, companies will keep doing what they’ve been doing,” Waukegan resident Eddie Flores, co-chair of Clean Power Lake County, told the Energy News Network. “If the EPA doesn’t act, companies will just ignore what the EPA says.”

Kari Lydersen has written for the Energy News Network since January 2011. She is an author and journalist who worked for the Washington Post’s Midwest bureau from 1997 through 2009. Her work has also appeared in the New York Times, Chicago News Cooperative, Chicago Reader and other publications. Based in Chicago, Kari covers Illinois, Wisconsin and Indiana as well as environmental justice topics.

At rules hearing, U.S. EPA hears human toll of unaddressed coal ash pollution 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.

Cities, towns ‘might finally be able to make ends meet’: Evers celebrates bipartisan shared revenue law

Lodging revenue continued climb in 2022, led by short-term rentals, report shows

Wausau Police lieutenant forced out in 2019 after department investigation found he committed sexual harassment

The Badger Project had to sue the police department to get large parts of the investigation unredacted.

By Hina Suzuki, THE BADGER PROJECT

Grabbing a female officer’s breast during a bullet-proof vest fitting. Voicing public opinions about breastfeeding at work. Asking an officer about her sex life.

These accusations led to the resignation in 2019 of former Wausau Police Lt. Andrew Hartwig after an internal investigation found he violated department policy regarding sexual harassment.

Hartwig, a lieutenant who supervised others, denied groping the officer, and some of the other accusations, but admitted to using language and topics that violated department policy, according to the investigation. He did not respond to a message seeking comment.

The Badger Project obtained the investigation through an open records request with the police department, then had to sue the police department in June of 2022 to get much of the investigation unredacted. A judge ruled in The Badger Project’s favor in March.

Hartwig began working for the Wausau Police Department in 2007. He was promoted to patrol lieutenant in April 2016. The allegations were made after the promotion, Wausau Police Department Chief Benjamin Bliven wrote in an email to The Badger Project on Wednesday.

Due to the accusations, Hartwig was placed on administrative leave, and later “voluntarily” resigned from the police department, according to the resignation agreement. He agreed not to sue the city, and he received a final payout of nearly $12,000, most of which was unused vacation time and administrative paid leave, according to City of Wausau Human Resources Director James Henderson.

After Hartwig’s resignation, Bliven said he “advised all supervisors to train on the harassment policy” and met with employees to discuss the policy and ways an employee can make a complaint if there is harassment in the workplace. “The best way we can make sure employees feel safe at work is to take these types of complaints seriously and investigate them thoroughly,” Bliven said.

Wausau Police Chief Benjamin Bliven

Hartwig repeatedly denied the sexual misconduct allegations during the investigation. “I did not sexually advance, request ‘any sexual favors or other verbal, visual or physical conduct of a sexual nature,’ ” he said. “I consider anybody [at the police department] like brothers and sisters.”

A female officer who is redacted in the investigation document said Hartwig “grabbed her right breast and briefly squeezed it” when assisting her with fastening the Velcro straps on her vest. He “kind of laughed about it” and did not discuss the incident, she said. For fear that Hartwig may lose his career, she said she did not report the incident to the police department.

However, his employment should have been terminated, she said, adding “if it was not me and happened to someone else, then bring the hammer, because it is totally unacceptable.”

Even if the name were unredacted, the Badger Project does not identify the victims of sexual assault.

Hartwig said he could not recall the time he assisted the female officer with her vest. But calling himself “the nicest guy in the world,” he said he would have helped anyone with their vest if asked. He denied the allegation and said he “would have immediately apologized and reported the accident to [his] supervisor” if he thought he had touched her breast.

During the investigation, a different female officer, who is also redacted in the investigation, said Hartwig sexually harassed her by making sexual comments toward her daily. According to the officer, the comments included telling her “how good [her] makeup looked,” discussing with her his frustration with his sex life, and making inappropriate comments about her personal life with her partner. In the investigation, she described those comments as “disgusting” and “creepy.” 

The female officer also shared with the investigation that she felt she was treated “differently” and “more favorably” than male officers. She said the tone of his voice when speaking to her made her “uncomfortable.” One of the witnesses said during the investigation Hartwig spoke “the way an adult male would talk to a young girl, as in a fatherly way” when the female officer called in sick.

The female officer said she did not tell Hartwig to stop his behavior because “he was [her] supervisor.”

Stating that Hartwig and the female officer had “a working relationship,” he denied these accusations. “I take pride in treating everyone fair and equal,” he said.

In addition, other employees at the police department shared during the internal investigation that Hartwig often initiated and was part of sexual conversations. According to the witnesses, those conversations included topics of losing virginity, breastfeeding – in which he allegedly said women should not breastfeed in public because it is “very sexual” and “gets guys thinking” – and females in tight clothes. In regard to these conversations, he said “guys will be guys.” Hartwig acknowledged this behavior, saying, “I would consider [the conversations] unprofessional and in violation of [the Wausau Police Department’s] Standards of Conduct Policy.”

When The Badger Project requested the internal investigation records that described Hartwig’s sexual misconduct allegations, the Wausau Police Department redacted large swaths of the text. After The Badger Project won the open records lawsuit against the department. Marathon County Circuit Court Judge Suzanne O’Neill wrote in the decision, “law enforcement officers, like all public employees, should expect some level of public scrutiny.” 

The redactions were necessary to protect the victims and Wausau’s “right and opportunity to retain competent law enforcement personnel” as well as “to avoid a loss of morale” within the police department, Wausau City Attorney Anne Jacobson said.

The judge agreed that the victim and witness identities could still be kept confidential while allowing more of the investigation’s details to be public.

In 2020, Hartwig went to work for the Cadott Police Department as a law enforcement officer, but left in 2021 to work full-time in construction, according to Cadott Police Chief Louis Eslinger. Hartwig now works as a tattoo artist in Wausau.

The Badger Project is a nonpartisan, citizen-supported journalism nonprofit in Wisconsin.

The post Wausau Police lieutenant forced out in 2019 after department investigation found he committed sexual harassment appeared first on The Badger Project.


Wausau Police lieutenant forced out in 2019 after department investigation found he committed sexual harassment was first posted on June 15, 2023 at 8:39 am.

Wildfire smoke is new hazard in upper Midwest

Wildfire smoke is new hazard in upper Midwest

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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.

Smoke from Canadian wildfires that turned skies along the East Coast a sickly yellow also brought air quality alerts to much of the Midwest this week. State health departments cautioned people with heart and lung conditions to reduce outdoor exposure.

It’s likely more days of bad air will come — not only are fires burning in the west in Alberta and Saskatchewan, and in the east in Quebec, but new blazes have erupted in Ontario, directly north of Minnesota, according to Minnesota Pollution Control Agency air quality meteorologist David Brown. The next plume could arrive Friday.

“We’re kind of surrounded at this point. Any wind direction is likely going to bring some smoke now,” Brown said.

In mid-May, sustained winds blew wildfire smoke in from the West, then a few slow-moving weather systems brought stagnant air that triggered ozone advisories.

“It’s been a very unique spring,” said Craig Czarnecki, outreach coordinator for the Wisconsin Department of Natural Resource’s air management program.

Climate experts say that as the planet continues to warm, this kind of spring will become less and less of an anomaly. In the process, air quality will continue to worsen, as will its impact on human health.

A bird is silhouetted against a hazy sunrise in Bayside, Wisconsin on May 23, 2023, as wildfire smoke drifts in from Canada. (Mike De Sisti / Milwaukee Journal Sentinel)

The largest fires have historically been concentrated in the West, and though there are examples of damaging fires elsewhere, wildfire scientists assumed the eastern part of the continent was immune from the worst effects, said Erica Smithwick, director of the Earth and Environmental Systems Institute at Penn State.

That’s proving untrue.

Higher temperatures, periods of drought and more volatile winds are yielding wildfires that burn faster and stronger than before, Smithwick said. Wildfire season is also getting longer, as rivers in the West dry out sooner and the East sees stronger storms mixed with drought. Some scientists question whether the whole idea of a wildfire season still applies.

“I’ve studied wildfires for decades, and I’m quite alarmed by the changes that we’re seeing to the wildfire systems,” Smithwick said.

The severity of the fires is even affecting how far their smoke can travel. Smithwick said the stronger the blaze, the higher into the atmosphere the smoke can waft, being picked up by winds that travel long distances and ultimately push it into places it wouldn’t normally go.

Air pollution worsens respiratory, heart problems

Fine particulate matter, also known as PM2.5, is one of the main pollutants released from wildfire smoke, which are so tiny they “penetrate pretty deep into our lungs and get into our bloodstream,” according to Katelyn O’Dell, a researcher at George Washington University.

Hotter summers are also making stagnant air days more frequent, according to an analysis from Climate Central, a nonprofit news organization that analyzes and reports on climate science. During those stagnation events, pollutants like ozone get trapped and make breathing more difficult.

Both fine particles from wildfire smoke and ozone can cause respiratory issues like coughing, difficulty breathing and aggravated asthma. People doing physical activity outdoors, particularly those who already suffer from respiratory problems, will usually find it harder to do.

On top of that, PM2.5 can have more dramatic effects because the particles are small enough to get deep into the lungs and even the bloodstream.

“Particulate matter is one of the most well-studied types of air pollution, and it is incredibly dangerous to the body,” said Dr. Neelu Tummala, a clinical assistant professor of surgery and co-director of the Climate and Health Institute at George Washington University.

While short-term exposure typically results in respiratory concerns, chronic exposure brings worsening impacts like increased risk of heart disease, high blood pressure and stroke, Tummala said.

For Black, brown and low-income communities, which already bear a higher burden of air pollution, the recent short-term exposures could further elevate their risk.

Both fine particle and ozone exposure can also result in pregnancy complications like preterm births and babies with low birth weights, Tummala said.

And a 2021 study in the journal Pediatrics found that the particles in that smoke are 10 times more harmful to children’s respiratory health than other types of air pollution. Smithwick, who is also a representative of the Science Moms campaign, said kids are vulnerable because they are more active, play outside more and are still growing.

“We’re definitely going to be seeing this play out in our health systems for many years to come,” she said.

Protect yourself from dirty air

Pay attention to air quality. The Air Quality Index, or AQI, measures risk from dirty air on a scale of 0 to 500. The AQI doesn’t measure the amount of a specific pollutant but generally reflects health impact.

The Environmental Protection Agency’s AirNow site offers real-time readings of AQI and also shows where fires are burning and where smoke is wafting. Purple Air, a company that makes air sensors, also has a network of AQI sensor readings at map.purpleair.com.

People should start paying attention at the orange category of AQI — readings between 101 and 150. That’s when sensitive groups like children, the elderly and those with breathing or heart conditions can encounter problems, said Brown.

He added that relatively healthy people might start to feel headaches or chest tightness at the higher end of orange readings.

In the red category from 151 to 200 AQI, all people, regardless of health, may start to feel effects; the purple category from 201 to 300 is considered very unhealthy; and maroon readings of 301 or higher are hazardous.

Avoid time outdoors when the air is bad. Jesse Berman, assistant professor at the University of Minnesota’s School of Public Health, said it’s safest to stay inside with windows closed and air conditioning on. In a car, run the air conditioner set to re-circulate in the interior of the vehicle, he said.

Put those N95 masks back on. For those who have to be outside for work or commuting, try to relocate tasks or reschedule them, reduce strenuous activity, take breaks in a place free of smoke, and wear a well-fitting mask designed to filter out small particles, like an N95.

The Centers for Disease Control warns, however, that N95 masks are not made to fit children and will not work effectively to protect them from smoke.

Filter your indoor air. In the home, air purifiers with high-quality HEPA filters can help remove pollution that sneaks inside, Berman said.

It may also be worth switching out the filter on a home HVAC system. Airflow filters with a higher MERV rating, an industry measurement of how effective the screen is in capturing small particles, can also help. The Environmental Protection Agency recommends MERV 13 or higher.

Berman warned, though, that tighter filters can clog more quickly and may need to be changed more often. For a cheaper option, O’Dell recommended creating one at home with some filters taped to the four edges of a box fan — a do-it-yourself method known as a Corsi-Rosenthal box.

Wildfire smoke is new hazard in upper Midwest 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.

Rising cost of living in northeast Wisconsin has many working families treading water 

Rising cost of living in northeast Wisconsin has many working families treading water 

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This story was produced as part of the NEW (Northeast Wisconsin) News Lab, a consortium of six news outlets covering northeastern Wisconsin.

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Shannon Pikka loves the work-life balance of her job in construction. She left an office job in insurance and now enjoys being up early and working with her hands as part of a drywall finishing crew. The single mother’s workday ends around 3 p.m. — just in time to greet her two children from school.

“Kids are coming home at that time, and we got the whole evening now together,” Pikka said. “Our job should not dictate our lifestyle.”

Despite changing careers nearly four years ago, she’s still earning apprentice wages due to setbacks during the pandemic when her youngest was in third grade and schools switched to distance learning. 

“I would be a journeywoman right now had I had a babysitting option so I could have still shown up for work and gained all those hours in the year — so that set me back,” the De Pere, Wisconsin resident said. 

The difference is a full $9 an hour. As it is, she’s making just shy of $27 an hour. But with two school-aged kids in her household, paying all of the bills is a stretch. Pikka gets no child support, and she relies on her parents who live nearby to provide child care for the days she needs to be at a remote jobsite for days or even weeks at a time.

“I’m just trying to make ends meet,” she said. 

But government statistics show many in the community earn a lot less than she does. 

The state Department of Workforce Development estimates that two adults working full-time earning $25.54 an hour each is just enough to be self-sufficient in a household with two children when factoring in the cost of housing, transportation, food and child care. 

The average wage in Green Bay, according to the most recent federal Bureau of Labor Statistics report, was $26.29 in 2022. But the median earnings were $21.84 an hour, meaning that half of workers earn less than that.

In other words, many workers supporting families in northeast Wisconsin are just squeaking by, especially at a time when the cost of living is increasing in Wisconsin and across the nation. 

“Self-sufficiency is attainable for the majority of full-time workers if children are not involved,” wrote DWD spokesperson Jennifer Sereno. “However, the situation rapidly changes when just one child is brought into the picture, let alone multiple.”

That’s because the cost of child care can rival tuition at a state university, the Wisconsin Policy Forum wrote in a recent report. A state survey of child-care facilities found the annual median cost for school-aged children starts at around $10,000 but can be as much as $40,000 a year for high-quality infant care in urban areas like Green Bay and Oshkosh. 

Earnings too high to qualify for benefits

Pikka’s household has no second income, yet she is still well above the level to qualify for many public assistance programs.

Her story represents a growing segment of Wisconsin’s working population: those earning too much to qualify for most public assistance programs but too little to afford anything but basic necessities. United Way studies this group of people known as ALICE: Asset Limited, Income Constrained, Employed. Its latest report shows 23% of Wisconsinites fit into this category.

Shannon Pikka is a single mother and a union drywall finisher. Like many in northeast Wisconsin, she dreams of owning a home but does not make enough money to buy. She hopes a promotion to journey status will allow her to become a homeowner. She is seen on a job site on June 2, 2023, in Ashwaubenon, Wis. (Sarah Kloepping / USA TODAY NETWORK-Wisconsin)

Help such as food assistance through the state’s FoodShare program, subsidized child care under the Wisconsin Shares program care and BadgerCare Plus health insurance are not available to many such families, including Pikka’s. 

“These are people who are working,” said Trisha Witt, who works in advocacy for United Way Fox Cities in Appleton. “They’re earning more than the federal poverty level but less than Wisconsin’s basic cost of living.”

When you add in the 11% of people living below the poverty line, the percentage of Wisconsinites struggling financially is 34%, according to the United Way report.

In northeast Wisconsin, the figures are similar, except in urban areas, where the numbers are starker. In Oshkosh, for example 41% of residents are either below poverty or not making enough for basic needs. 

Barriers to prosperity

It’s not due to a lack of employment. Official unemployment is at record lows with federal agencies reporting Wisconsin at a record 2.4% in April. Northeast Wisconsin was hovering at 2% or less. 

But while very few able-bodied adults are outside of the workforce, lack of affordable child care and transportation can keep people from working and meeting their basic needs. 

“No matter what the economic conditions are like,” said Ryan Long, a regional economist for the state Department of Workforce Development in Green Bay, “we know for certain that there are going to be folks who face barriers to work.”

On paper, Pikka has been relatively successful. For 15 years she sold insurance but entered the trades after becoming disillusioned with a desk job. But a string of abusive partners who ended up incarcerated or moving out of state has left her the sole breadwinner for her family.

Her life had been full of hardship from when she was left at a hospital in Colombia where she was born and never picked up. Pikka spent the next three years in an overcrowded South American orphanage where she said she suffered physical abuse.

“I have scars on my body because the nuns could not control the orphanage, so they beat us up,” she said. 

At age 4, a pair of school teachers adopted her and raised her in northeast Wisconsin. If it wasn’t for her parents helping with child care, Pikka said she could never maintain her higher paying career in construction.

“I wouldn’t be able to do it,” she said. “I’d have to go back to my office job.” 

The dearth of affordable child care in Wisconsin is well-documented. The staff shortage in day care centers itself has a ripple effect. On paper, there are roughly 37,500 slots for children in the 19 counties in northeast Wisconsin. But a survey last year of 1,173 child care centers in Wisconsin found nearly half were below capacity. 

“It is important to note that this is licensed capacity and providers may not be using all slots due to staffing shortages, low enrollment, or other factors,” wrote Gina Paige, a spokesperson for the state Department of Children and Families, which licenses day care facilities.

Hot housing market constrained by supply, rising interest rates

Affordable housing is another key to family sustainability. But a shortage of supply has driven up rental prices across the board.

“It doesn’t really matter what the availability of jobs is like if young folks are getting priced out of certain areas because housing is too expensive,” Long said.

Real estate data show that housing prices across the state continue to rise even as sales slump due to constrained supply and rising interest rates that have added to the cost of borrowing.

In April 2023, the median house in northeast Wisconsin cost $260,000. That’s $23,000 less than the statewide median. But the median cost rose 7% across the region in the previous year, similar to the increase statewide. 

Rental housing is out of reach for many residents of northeast Wisconsin, according to U.S. Census figures analyzed by the National Low Income Housing Coalition. This for rent sign is outside a duplex in 2020 in De Pere, Wis. (Sarah Kloepping / USA TODAY NETWORK-Wisconsin)

All this happened while real estate transactions slumped after interest rates spiked from historic lows at below 3% to around 6.6% for a fixed 30-year loan in May. 

The numbers are stark: There were more than 1,500 residential home sales in June 2022, just as the Fed hiked interest rates for a third time in response to inflation fears. Ten months later in April of this year, the region saw half as many closed deals at 777.

Property owners who are locked in with relatively low interest rates are less likely to list their homes now because they’d pay higher rates on their next property, said real estate broker Kevin Jones, co-owner of Adashun Jones in Fond du Lac.

“There are more people pursuing the few properties that are on the market,” he said.

Houses harder to find, more expensive to rent

The region has already faced supply constraints as Baby Boomers live longer and stay put, leaving fewer properties for younger aspiring homeowners.

“We have healthy Baby Boomers — I’m one of them — who are staying in their homes longer, and millennials who are clamoring to find homes and are at a disadvantage because they increasingly have to rely on borrowed money,” Marquette University economics professor David Clark said at a recent economics forum.

He said many millennials of child-bearing age — those born in the 1980s and ‘90s — “kind of got dealt a bad hand” coming out of the Great Recession with a weak labor market and so “logically and rationally stayed out of the market” during the time when working Americans would tend purchase first homes.

Jones, the real estate broker and Fox Valley landlord, said the rental housing market is also hot with rents increasing by 10% to 20% annually. 

“I think it’s because a lot of the rentals have been consolidated into a small group of investors — that’s one side of the story,” he said. “And the other side is there’s just not enough homes and developments that are being created.”

In 2022, the National Low Income Housing Coalition — an advocacy group — listed the fair market price for a two-bedroom unit in northeast Wisconsin at between $757 in rural counties to $889 in the Oshkosh area . The study, citing U.S. Census figures, also found the average rent for a two-bedroom apartment in counties across northeast Wisconsin — for that matter, across the entire state — is higher than the recommended 30% of the average income renters in those counties make. 

Home ownership remains elusive for Pikka. For three years, she has rented a two-bedroom apartment for $875 in De Pere where she enjoys living despite the higher housing prices compared to neighboring Green Bay. Once she works enough hours for journeyman wages, she said she’ll try to buy something.

But Pikka, who is 41, said that’s at least three years away. In the meantime she is pursuing another dream. Pikka would like to visit Colombia with her kids to reconnect with her birth parents.

This story is part of the NEW (Northeast Wisconsin) News Lab’s series, Families Matter, covering issues important to families in the region. The lab is a local news collaboration in northeast Wisconsin made up of six news organizations: the Green Bay Press-Gazette, Appleton Post-Crescent, FoxValley365, The Press Times, Wisconsin Public Radio and Wisconsin Watch. The University of Wisconsin-Green Bay’s Journalism Department is an educational partner. Microsoft is providing financial support to the Greater Green Bay Community Foundation and Community Foundation for the Fox Valley Region to fund the initiative. The mission of the lab is to “collaborate to identify and fill information gaps to help residents explore ways to improve their communities and lives — and strengthen democracy.”

Rising cost of living in northeast Wisconsin has many working families treading water  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.

One in 5 could have dyslexia, but Wisconsin students, parents feel school support falls short

One in 5 could have dyslexia, but Wisconsin students, parents feel school support falls short

Reading Time: 7 minutes

NEW News Lab logo

This story was produced as part of the NEW (Northeast Wisconsin) News Lab, a consortium of six news outlets covering northeastern Wisconsin.

Wisconsin Watch is a member of the networkSubscribe to our newsletter to get our investigative stories and Friday news roundup.

As early as kindergarten, Robin Pierre started to notice that her daughter, Hattie, was falling behind. She wasn’t able to read the books they were sending home, despite being in a charter school known for its focus on literacy. 

Hattie started working with a reading interventionist during kindergarten and throughout first grade. But then her behavior started to escalate. She’d hide under desks and run out of the classroom. She was moved to another charter school for second grade, one focused on play-based learning and field trips in hopes that environment would better suit her.

All this time, Hattie’s trouble reading persisted. Pierre asked to have her evaluated for special education. 

Hattie was assessed; but when Pierre asked questions about dyslexia, she said the school told her they don’t acknowledge dyslexia without a diagnosis, and that could only come from brain imaging. 

“It was a fight at first,” Pierre said.

Dyslexia looks different for each person who has it. It’s a neurobiological learning disability that can make it difficult for people to decode words and read fluently. People with dyslexia may struggle with spelling and reading comprehension as a result of their challenge matching letters to their corresponding sounds. 

The International Dyslexia Association estimates that as many as one in five people could have symptoms of dyslexia, ranging in severity.

Often, people assume that dyslexia is just mixing up letters such as “b” and “d.” It can be that for some people — Pierre said Hattie experienced that — but it’s not the only symptom. For example, people with dyslexia might struggle with slow, choppy reading, memorization or even constantly confuse left and right. It ranges on a spectrum from mild to severe.

For Hattie, reading was “labor-intensive.” She’d often read a sentence three times before she’d actually comprehend what it said. The first few reads were spent trying to identify the sounds for each letter and then trying to put them all together more smoothly, so she could get to the point of comprehension.

Currently, Wisconsin does not require students to be screened specifically for dyslexia, but the state passed legislation three years ago to create an informational guidebook on dyslexia and related conditions to be shared on the state Department of Public Instruction and all school distric websites.

In the years since the guidebook was created, Wisconsin and the rest of the country has turned up the volume on a discussion about literacy after standardized test scores have shown significant declines in language arts during the pandemic

But those conversations usually don’t include students with dyslexia. Families are often left on their own to get their children tested, diagnosed and supported through outside tutoring. And local tutoring agencies are feeling the burden of an increased need to support these students, who are now often even further behind because of the pandemic.  

“It’s something the public school should have done; they should have been able to teach her how to read,” Pierre said.

What Wisconsin school districts do to support students with dyslexia

By state law, schools are required to screen students in 4K through second grade annually for “literacy fundamentals.” This includes letter sound knowledge and something called phonemic awareness — the ability to identify individual sounds within a word — which are generally two areas of difficulty for students with dyslexia. 

Violet Lane answers a question during a sessions with tutor Winnie Mejia at Dyslexia Reading Connections on Wednesday, March 8, 2023 in Appleton, Wis. (Wm. Glasheen / USA TODAY NETWORK-Wisconsin)

DPI told USA TODAY NETWORK-Wisconsin these requirements are “generally agreed upon to be components of screening for dyslexia.” If a screening indicates they needs more testing, there are additional screening options listed in the state’s guidebook that parents and teachers can consider.

In 2021, Republican lawmakers proposed tripling the number of literacy tests for young students to boost low proficiency rates, but Gov. Tony Evers vetoed the bill, saying it lacked evidence and funding. 

The state may mandate early screening, but district by district, the overall approach to literacy can look different. 

The Menasha Joint School District is focused on being “diagnostic” with students, said Renae Braun, a literacy coach.

It does this by screening students in kindergarten through eighth grade three times a year. Those screenings look at students’ comprehension, fluency and knowledge of phonics. Through those, the district identifies a student’s strengths and areas of concern. 

For students behind grade level or who show other challenges on those screenings, the district creates an individual plan — called a Response to Intervention plan — to help them catch up. It focuses on strengthening areas of concern.

There isn’t one method that works for teaching literacy to all students. But Braun said students with dyslexia need explicit teaching and multiple modalities — a combination of visual, auditory and tactile.

“We do dipstick check-ins every two weeks or every week to make sure the plan is accelerating or growing our students,” she said. 

Both Menasha and Kimberly school districts see teacher expertise as vital to teaching students who struggle with literacy, whether it’s diagnosed dyslexia or other challenges.

The Kimberly Area School District added a phonological interventionist to its staff in August 2022. The role was designed to be “an in-house expert on decoding and fluency,” according to Holly Prast, assistant superintendent. 

This interventionist is trained in a specific dyslexia intervention, among other reading interventions, and works with students directly, Prast said. They also collaborate with teachers to provide new strategies to support students who are struggling.

Many districts have hired reading interventionists to support students through pandemic-induced learning loss, but Prast said Kimberly decided to add a phonological interventionist independently of that.

Carrie Willer, director of elementary education for the Appleton Area School District, echoed the need for a variety of teaching methods to support students. The number of students in any given classroom is the number of different learning styles teachers need to work with, she explained. 

“You need a full bag of tricks and a full bag of tools to meet each of those students,” she said. 

Appleton has interventionists, teachers trained in a one-on-one reading recovery program and other methods of support, including small group work and collaboration with parents.

Still, fewer than half of Appleton students are reading at or above grade level. 

A recent audit of the district’s English language arts curriculum showed a need for more emphasis on phonics and letter sound awareness — strategies that would better support students with dyslexia in the classroom. 

Many families with students with dyslexia have to turn to outside tutoring

When Hattie eventually qualified for special education, the district focused only on her ADHD diagnosis. So, not only did Pierre pay out of pocket for neurological exams, but she had to fight to get the district to even recognize the dyslexia diagnosis in her individual education plan.

A pair of tutoring sessions take place at Dyslexia Reading Connections on Wednesday, March 8, 2023 in Appleton, Wis. (Wm. Glasheen / USA TODAY NETWORK-Wisconsin)

It was around then that Pierre found Dyslexia Reading Connection, a nonprofit tutoring organization based in Appleton. That was four years ago, and Hattie has gone twice a week ever since — even through the summers. 

DRC has been around for almost 20 years, but there’s been increased demand since the pandemic, said Kimberly Stevens, executive director. Earlier this year, there were 50 students on the waitlist — five times as many as the organization had pre-COVID. And Stevens said new students are coming in for consultations every week.

Today, Hattie is caught up to grade level and has even become “quite an avid reader,” Pierre said. She credits that success more to the tutoring she paid for from DRC than what the public schools provided.

“I didn’t think this day would come,” she said.

When asked how often Dyslexia Reading Connection is screening students for dyslexia, Stevens said, “constantly.” It tries to keep screenings to about five students a week since the Appleton-based nonprofit is already tutoring more than 110 students online and in person. 

But it’s not just an increase in the number of students. Stevens said students are coming in further and further behind. Before the pandemic, students would come to DRC a year and nine months behind, on average. Now, it’s not uncommon for students to be three or even four years behind where they should be. 

“Parents are desperate to get their kids the right interventions,” Stevens told USA TODAY NETWORK-Wisconsin.

While DRC can’t offer a medical diagnosis, the screening it offers is about an hour long and can usually tell with a high degree of certainty whether the student has dyslexia, Stevens said. After the screening results are explained to the parents, it’s up to them whether they want to move forward with tutoring. It’s first come, first served, since there’s a waitlist, but a family’s scheduling availability may be considered.

On average, students spend four years with DRC working through 10 levels of tutoring that will bring them up to a 10th-grade reading level.

The tutoring starts by breaking language into its smallest parts: individual vowels and consonants. As the levels progress, students move on to syllables, prefixes and suffixes, vowel placement in a word and even influences from foreign languages such as Latin and Greek root words. 

Karrie Brass, a tutor at DRC, said her husband, who has dyslexia, uses a car engine analogy to explain it: The brains of students without dyslexia works like driving an automatic transmission when learning to read, spell and write. They don’t need to work through every step of processing language. Most of it happens under the hood without conscious thought. 

But for students with dyslexia, their brains are more like driving a car with a manual transmission. They need to shift gears, understand the specifics of how letters make sounds and work through each step of the process; otherwise, it won’t be a smooth ride.

Life after high school for students with dyslexia

Hattie is still making her way through middle school, but Pierre said Hattie has dreams of going to college one day.

And she’s not alone.

Take, for example, Meghan Molthen.

A freshman at the University of Wisconsin-Oshkosh, Molthen was diagnosed with dyslexia the summer before sixth grade. She struggled to spell simple words and saw her classmates read at much higher levels than her, but she didn’t understand why until she got her diagnosis. 

Figuring out that she had dyslexia helped give shape to the reason why she was struggling, but it didn’t fix everything. Molthen went to school in Fort Atkinson before moving to Pulaski her sophomore year, so she experienced two districts and their approaches to supporting her dyslexia. 

Although a diagnosis made accessing certain supports simpler, Molthen said there were still challenges because the school systems didn’t understand “how to fully accommodate students with learning disabilities.”

When she toured UW-Oshkosh in summer 2021, she asked the admissions office about accommodations for students with learning disabilities. They told her about a program called Project Success. 

Project Success is a remedial program for students with dyslexia and other language-based learning disabilities at the school. It starts with a six-week summer program focused on phonics and teaching students the relationship between letters and sounds. 

Director Jayme Reichenberger said the program has a reading and writing component, but it also supports students in other ways through the transition from high school to college. By completing the summer program, students can earn up to six credits, which can be a helpful GPA cushion for those early, stressful semesters of college. 

Students also learn about what laws protect their accommodations and what services are available to them. Reichenberger said many students come in not really understanding their diagnosis. They might have attended meetings during their K-12 education, but a lot of them didn’t put a name to their disability. 

It’s not uncommon for Reichenberger to hear students say that their dyslexia was essentially ignored, so she said they try hard to actually say the word “dyslexia.” There are even campus events where students will write messages like “Say dyslexia” on the sidewalk. 

“When a disability is hidden, it’s easy to stereotype and have misconceptions about it,” Reichenberger said.

For Molthen, the program gave her agency over her learning disability. She had a hard time even talking about her dyslexia before, but Project Success taught her how to see it as a benefit. 

“I’m so thankful I have it,” she said of her dyslexia. “It pushes me to be a better person.”

One in 5 could have dyslexia, but Wisconsin students, parents feel school support falls short 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.

ICE aumenta las repatriaciones

El ICE (U.S. Immigration and Customs Enforcement) continuó este viernes 12 de mayo, el envío de múltiples vuelos con varias personas repatriadas a Colombia, El Salvador y Honduras, como parte de las docenas de vuelos enviados cada semana. El pasado 24 de abril, ICE reanudó el proceso de deportación de ciudadanos cubanos que han recibido órdenes finales de deportación

Según el comunicado de ICE, […] las deportaciones hacen parte de la política que hace mucho tiempo atrás se usa para  expulsar a los ciudadanos extranjeros que carecen de una base legal para permanecer en los Estados Unidos. Esta política se aplica a todos los no ciudadanos independientemente de su nacionalidad.

La oficina de ICE Air Operations facilita la transferencia y remocion de no ciudadanos via aerolineas comerciales o vuelos charter para apoyar las operaciones de ICE y DHS. 

Según los reportes de ERO en el  2022, se repatriaron a 72.177 personas a 150 países. 

Por ahora los países se preparan con albergues para recibir a los cientos de ciudadanos que se pronostica llegarán en las próximas semanas. En Colombia el pasado 10 de mayo el aeropuerto de El Dorado recibió 209 migrantes, y la Defensoría del Pueblo de Colombia anunció que dará el acompañamiento necesario para estos repatriados. 

Algunos retornados a Guatemala manifestaron a Univisión 247 que por la situación actual que se vive en USA, no intentarán regresar a USA. Stuard Rodriguez, director de Migración en Guatemala, reportó la entrada de 100 menores de edad, que migraron con falsas ideas sobre el ingreso fácil a USA. 

MIWISCONSIN estará entrevistando a miembros de la comunidad y organizaciones que trabajan de cerca con el tema migratorio. Si usted ve cambio en el color de nuestro logo a azul será una alerta para la comunidad. 

The post ICE aumenta las repatriaciones appeared first on MIWISCONSIN.

No emergency needed: Community paramedics in Wisconsin, elsewhere visit patients at home

No emergency needed: Community paramedics in Wisconsin, elsewhere visit patients at home

Reading Time: 6 minutes

Sandra Lane said she has been to the emergency room about eight times this year. The 62-year-old has had multiple falls, struggled with balance and tremors, and experienced severe swelling in her legs.

A paramedic recently arrived at her doorstep again, but this time it wasn’t for an emergency. Jason Frye was there for a home visit as part of a new community paramedicine program.

Frye showed up in an SUV, not an ambulance. He carried a large black medical bag into Lane’s mobile home, which is on the eastern edge of the city, across from open fields and train tracks that snake between the region’s massive open-pit coal mines. Lane sat in an armchair as Frye took her blood pressure, measured her pulse, and hooked her up to a heart-monitoring machine.

“What matters to you in terms of health, goals?” Frye said.

Lane said she wants to become healthy enough to work, garden, and ride her motorcycle again.

Frye, a 44-year-old Navy veteran and former oil field worker, promised to help Lane sign up for physical therapy and offered to find an anti-slip grab bar for her shower.

Community paramedic Jason Frye takes Sandra Lane’s blood pressure during a visit to her home in Gillette, Wyoming. Frye promised to help Lane sign up for physical therapy and offered to find an anti-slip grab bar for her shower. (Arielle Zionts / KFF Health News)

Community paramedicine allows paramedics to use their skills outside of emergency settings. The goal is to help patients access care, maintain or improve their health, and reduce their dependence on costly ambulance rides and ER visits.

Such programs are expanding across the country, including in rural areas, as health care providers, insurers, and state governments recognize the potential benefits to patients, ambulance services, and hospitals.

Community paramedic programs are operating in six cities in Wisconsin: Madison, West Allis, Racine, Menomonee Falls, Reedsburg and Greenfield, said Jennifer Miller, spokesperson for the state Department of Health Services. Eight others are working toward their community EMS provider licensure.

“Some of these programs have supporting data that shows positive outcomes while others are just getting their programs rolling,” Miller said by email. She said such services across the country “have proven success in a variety of patient care programs ranging from fall prevention to chronic disease management.”

Half of programs in rural areas

Gary Wingrove, a Florida-based leader in community paramedicine, said the concept took off in the early 2000s and now includes hundreds of sites. A 2017 survey of 129 programs found that 55% operated in “rural” or “super rural” areas.

Mindy Dessert speaks about her journey to become a community paramedic at the City of Madison Fire Department administration office in Madison, Wis., Thursday, April 20, 2023. Dessert retired at the end of April. (Samantha Madar / Wisconsin State Journal)

Community medicine can be helpful in rural areas where people have less access to health care, said Wingrove, chair of the International Roundtable on Community Paramedicine. “If we can get a community paramedic to their house,” he said, “then we can keep them connected to primary health care and all of the other services that they need.”

Frye works at Campbell County Health, a health care system based in Gillette, a city of about 33,000 in northeastern Wyoming. Leaders of the community paramedicine program plan to expand it into two adjacent, largely rural counties dotted with ranches and coal mines on the rolling prairie that stretches more than 100 miles from the Black Hills to the Bighorn Mountains.

Gillette serves as a medical hub for the region but has shortages of primary care doctors, specialists, and mental health services, according to a community needs assessment. People who live outside the city face additional barriers.

“A lot of them, especially older people, don’t want to come into town. And basically, those tiny communities don’t usually have health care,” Lane said. “I think it’s just kind of a pain for them to drive all the way into town, and unless they have a serious problem, I think they tend to just figure, ‘Well, it’ll work itself out.’”

Not a ‘cookie-cutter’ operation

Community paramedicine programs are customized to the needs and resources of each community.

“It’s not just a cookie-cutter-type operation. It’s like you can really mold it to wherever you need to mold it to,” Frye said.

Most community paramedicine programs rely on paramedics, but some also use emergency medicine technicians, nurses, social workers, and other professionals, according to the 2017 survey. Programs can offer home visits, phone check-ins, or transportation to nonemergency destinations, such as urgent care clinics and mental health centers.

Many programs support people with chronic illnesses, patients recovering from surgeries or hospital stays, or frequent users of 911 and the ER. Other programs focus on public health, behavioral health, hospice care, or post-overdose response.

Community paramedics can provide in-home vaccinations, wound care, ultrasounds, and blood tests.

They can offer exercise and nutrition tips, teach patients how to monitor their symptoms, and help with housing, economic, and social needs that can affect people’s health. For example, paramedics might inspect homes for safety hazards, provide a list of food banks, or connect lonely patients with a senior center.

Transportation a barrier to health care

Paramedics and patients said some rural residents struggle to access health care because of long distances, cost, lack of transportation, or dangerous weather. Some hesitate to seek help out of pride or because they don’t want to be a burden to others. Some limit trips to town during ranching and farming crunch times, such as calving and harvesting seasons.

Delayed care can let health problems fester until they become an emergency.

Advocates say providing in-home care, resources, and education can help patients reduce such crises and associated costs. Fewer emergencies mean fewer ambulance runs and hospital patients. That could help ambulance services and hospitals reduce costs and the time patients wait for help.

A 2022 scholarly review found that more studies are needed but that data so far suggests these programs reduce costs. It also found links to improved health outcomes and decreased use of ambulances and hospitals.

For example, a pilot program in Fort Worth, Texas, saw a 61% reduction in ambulance rides, according to an academic study of 64 patients. MedStar, the operator, made the effort permanent and says its 904 participants needed 48% fewer ambulance trips, saving an estimated $8.5 million over eight years.

But rural ambulance services, especially volunteer ones, can struggle to staff and fund community paramedicine programs.

Kesa Copps, a co-worker of Frye’s, previously worked as an emergency medical technician in Powder River County, Montana, which has fewer than 2,000 residents. Some people there must drive more than an hour to reach the nearest hospital. The area’s volunteer ambulance service started a community paramedicine program in 2019.

Copps said the program reduced hospital readmissions and extended some elderly patients’ ability to live at home before being admitted to a nursing facility. She visited patients between ambulance runs and had to leave early when a 911 call came in. That’s different from the Campbell County Health model, in which community paramedicine is a full-time position, not split with emergency work.

Adam Johnson, director of the Powder River ambulance service, said the community paramedicine program shut down in 2021 after everyone with the necessary training left the area. Johnson said paramedics are signing up for training to restart the program.

Community paramedic programs spreading

States are increasingly recognizing and regulating community paramedicine, and some require licensed paramedics to obtain extra training to work in the field.

Some ambulance services and health care organizations have piloted community paramedicine programs with the help of state or federal grants. If they find the service saves money, they may decide to continue the program and fund it themselves.

Private insurance companies are increasingly covering community paramedicine, Wingrove said. Wyoming and several other states allow operators to bill Medicaid for the services.

Advocates are now pushing Medicare to expand its limited coverage of community paramedicine, Wingrove said. That would benefit Medicare patients and could spur more private insurers to offer coverage.

The Campbell County Health program’s home visits cost up to $240 per hour and are billed to Medicaid or Medicare, said Frye. That compares with more than $1,300 for an ambulance ride and thousands of dollars for a visit to a hospital ER.

Community paramedicine may soon expand in neighboring South Dakota, another largely rural state.

South Dakota ambulance services have experimented with community paramedicine and lawmakers recently voted to authorize and regulate it.

‘You’re not alone’

Eric Emery, the state representative who introduced the bill, plans to start a program on the sprawling, rural Rosebud Indian Reservation, where he works as a paramedic. He said the operation will focus on diabetes and mental health care.

Community paramedic Jason Frye takes Linda Quitt’s pulse during a home visit in Gillette, Wyoming. Quitt has been navigating diabetes, depression, and a lack of social support after her husband was hospitalized with dementia. Frye said he would see if he could help start a senior walking group that Quitt could join. (Arielle Zionts / KFF Health News)

Emery, a Democrat, said some people struggle to pick up their medication and attend appointments because they lack vehicles or gas money and there’s no public transportation to the hospital. He said some parents and grandparents raising children also struggle to find time to drive to appointments.

“They’re putting the needs of the younger generation or their grandkids before their own,” Emery said.

Back in Gillette, Frye also checked in on Linda Quitt, a 78-year-old facing diabetes, depression, and a lack of social support after her husband was hospitalized with dementia. Quitt said her husband was her walking buddy and helped care for her.

“I had him to wait on me, and now I have nobody,” Quitt said.

Frye said he would see if he could help start a senior walking group that Quitt could join. He told her that socializing can improve health.

“You’re not alone,” Frye told Quitt.

Wisconsin Watch’s Dee J. Hall contributed to this report published by Kaiser Health News.

No emergency needed: Community paramedics in Wisconsin, elsewhere visit patients at home 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.

Louisiana Becomes First State to Issue Drinking Water Report Cards

Louisiana Becomes First State to Issue Drinking Water Report CardsLouisiana Becomes First State to Issue Drinking Water Report Cards

Move aims for transparency and to identify struggling water systems.

The water tower in Sunset, Louisiana. The town’s water system received a D grade in the state’s first report card. Photo courtesy of Patrick under Creative Commons license BY-NC-SA 2.0

By Brett Walton, Circle of Blue – May 11, 2023

In an effort to improve public communication, the Louisiana Department of Health published its inaugural water system report cards last week, becoming the first state in the country to use annual letter grades to highlight the failures and successes of drinking water utilities.

Water systems are already required by federal law to send an annual Consumer Confidence Report to customers with details about drinking water contaminants. The Louisiana Department of Health grading system, which was mandated by a 2021 state law, goes several steps further, combining a range of measurements into a single letter grade for each of the state’s 951 community water systems.

On top of water quality, the grade incorporates data on utility finances, operations, and customer complaints. Utilities must include the grade on annual reports sent to customers.

Forty-one percent of water systems earned an A grade. Six percent received a D, and nine percent failed. Many of the failing systems serve small, rural communities, which often have fewer financial and technical resources.

Amanda Ames, chief engineer at the Department of Health, led the development of the grading system.

“It provides for accountability and for transparency,” Ames said. The public gets an easy-to-understand snapshot of their water provider, she said, while state agencies receive an overview of water utility conditions.

Though many states collect the same data that informs the Louisiana grades, a drinking water report card is a new step. But is it worthwhile to take it?

Manny Teodoro, who studies public policy and consults with water utilities, said that a report card makes intuitive sense. School systems use them. Health departments assign letter grades (or smiley faces) to restaurants based on their cleanliness. The American Society of Civil Engineers publishes an annual report card on the nation’s infrastructure. In the 2021 report card, drinking water systems received a C- and wastewater systems a D+.

All told, report cards have promise, Teodoro said. Still, details matter and he has reservations about how Louisiana designed its grading system.

The Louisiana system works mostly by subtraction, but also some addition. Water utilities start with a score of 100. Points are subtracted in seven categories of infraction that were spelled out in Act 98, the law that mandated the grades. Those categories include exceeding federal and state drinking water standards, failing to have evaluated their water rates, being the subject of customer complaints, and having deficient infrastructure. Utilities can earn up to 10 bonus points for having an asset management plan or participating in training programs.

Letter grades change every 10 points. Scores of 90 and above receive an A while scores below 60 earn an F.

Within the categories the Department of Health determined the point distribution. The highest point-value category is failure to meet federal drinking water standards. The maximum deduction for that category is 30 points, which Teodoro feels is too generous. A utility could have a slew of violations but its penalty is capped.

“This is a recipe for grade inflation,” said Teodoro, a professor at the University of Wisconsin at Madison who is helping to develop a water utility grading system in his state.

Teodoro also thinks that basing a grading system on deductions is more stick than carrot. In other words, even with the bonus points it does not encourage utilities to do more than the minimum requirement.

The Louisiana Department of Health, which developed the grading system itself, said that it looked at various designs, but “ultimately used a point deduction method because it was easy for the public to understand. These annual letter grades are a step in the right direction to increasing transparency and accountability and, ultimately, to increasing water system sustainability.”

Maureen Cunningham, director of water at the Environmental Policy Innovation Center, also called the grades “a step in the right direction” because they generate more information about utility performance. But she was not ready to endorse report cards, in general, as the best approach for improving drinking water outcomes.

“I worry that it’s not always a complete picture of what’s going on,” Cunningham said.

For instance, data on the number of customers who had their water shutoff is not a part of the Louisiana assessment. Nor is data on customer debt.

Cunningham also wondered how the report cards would be received. Could state agencies collect the necessary data and be transparent about the problems that certain communities face without condensing it all into a single letter grade? “I would be interested in seeing what motivates change better: giving someone a failing grade, or just pointing out, ‘Hey, this community needs X, Y, and Z to do a better job.’”

Though perhaps not a perfect system, the grades will be useful, said Leslie Durham, executive director of the Louisiana Infrastructure Technical Assistance Corporation, an agency set up to assist disadvantaged rural governments in applying for federal grants.

“I’m excited about it,” Durham said, referring to the report cards.

For years Durham has worked with rural water systems. In the past, she said it was difficult for some of these systems to acknowledge that they needed help. “They didn’t want to raise any flags or make any waves.” The grading system lays bare some of those struggles in an easy-to-digest format. Accessible information will lead to action, she said.

“Our organization plans on using that grading system to make sure we’re targeting the right folks,” Durham said.

Some are already getting help. Of the utilities earning a D or F, Ames said that more than 30 percent are in line to receive funding to upgrade their water systems.

The post Louisiana Becomes First State to Issue Drinking Water Report Cards appeared first on Circle of Blue.