This story is part of a collaboration between Wisconsin Watch, Milwaukee Neighborhood News Service and The Appeal. 

Four decades ago, a newspaper investigation described Milwaukee’s municipal legal system as “cash register justice.” Thousands of impoverished residents with mental health or substance use issues languished in county jails due to unpaid civil violation fines, costing taxpayers hundreds of thousands of dollars. 

Responding to the outcry from The Milwaukee Journal’s 1985 investigation, the city stopped automatically jailing residents who failed to pay civil fines and expanded its Court Alternatives Program. As a result, Milwaukee sent people like Sue Eckhart to court, where they could help low-income residents and those with mental health problems by offering alternatives to incarceration. 

Eckhart has managed the alternatives program for decades, providing assessments, screenings, and referrals to treatments or community service for those facing civil violations, such as illegal parking or loitering.

Since 2015, the program’s vendor, currently JusticePoint, Inc., has served 705 people with mental health issues, 80% of whom resolved their cases without paying a fine, wrote Eckhart, the organization’s program director, in an email to Wisconsin Watch, Milwaukee Neighborhood News Service and The Appeal. The nonprofit says it’s served 11,000 total clients during the last eight years.

Although the organizations providing those services changed over time, the core staff — Eckhart and her colleagues — stayed put. But in May, Eckhart suffered a “gut punch” when the city terminated her organization’s contract before it expired in 2024.

Officials provided little explanation as to why and did not line up another vendor to take over what many see as vital work to curb mass incarceration. 

“I never saw that coming at all,” Eckhart said in an interview.

In a last-ditch effort to seek answers, JusticePoint sued the city on July 10 — a day before the city’s cancellation took effect. A Milwaukee County Circuit Court judge quickly granted a temporary restraining order, allowing JusticePoint’s services to continue as the dispute unfolds in court. 

But the prospect of eliminating — and not replacing — JusticePoint’s services has stirred confusion and deep concerns among those serving some of Milwaukee’s most vulnerable residents.

At a time when numerous states and cities are taking steps to reduce pretrial detention, advocates in Milwaukee say attempting to halt the city’s court alternatives program is a step in reverse.

“It is shocking that Milwaukee Municipal Court would suddenly cancel the contract for such an invaluable program,” wrote a coalition of 24 local organizations in May after the Milwaukee Journal Sentinel first reported the city’s plans. They added that the court had provided no information on what would happen to the hundreds of people JusticePoint currently serves. 

One of JusticePoint’s clients is Quintin Walls, a 42-year-old father of six, who owed $100 for a civil violation. He has received services from the organization three times now, starting when he received parking tickets while living in his car. Over the years, the organization connected him to community service to pay off his fines and to resources that led him to secure housing.

The coalition urged the mayor and the city’s Common Council to save the program, but officials say neither has control over the contract. The council funds but does not oversee the program, allocating $487,000 for JusticePoint’s services this year.

Two Municipal Court judges, Phil Chavez and Valarie Hill, recommended terminating the contract before a third judge, Molly Gena, was elected in April, city officials said during a June Common Council subcommittee meeting. It would have been illegal and unenforceable if the council had directed the court to rescind the termination notice, Assistant City Attorney Kathryn Block said at the subcommittee meeting. 

Alderman Jonathan Brostoff, who represents the city’s East Side, called the court’s decision “fishy” and “quite troubling.” 

Brostoff and Alderman Michael Murphy, who represents Milwaukee’s West Side, later told Wisconsin Watch they were concerned about the court’s lack of transparency.

Court officials declined to answer questions from Wisconsin Watch, Milwaukee Neighborhood News Service and The Appeal, citing the pending lawsuit.

A spokesperson for Milwaukee Mayor Cavalier Johnson declined to comment for this story, but added that Johnson “was not involved in any decision-making” regarding the contract.

Nick Sayner, JusticePoint’s co-founder and chief executive officer, said he’s troubled by the lack of transparency from officials.

“The court’s silence and the city’s silence tells you that you should be concerned that there’s something else going on here,” Sayner said.

Judges ‘lost faith’ in JusticePoint

Judges Chavez and Hill told Chief Court Administrator Sheldyn Himle they “lost faith” in JusticePoint over the longstanding practice of sharing citations with attorneys at Legal Action of Wisconsin, a nonprofit that provides free legal services to people with low incomes, according to a May 15 email between Sayner and Himle.

The city attorney’s office had advised JusticePoint to share citations during pilot phases of a program to help people with low incomes find legal representation, Sayner wrote to Himle.  

“It is not clear to me how we were to know we should have ceased this activity prior to receiving your feedback,” Sayner wrote. “Once we were notified by your office to end this activity, we stopped providing that information immediately.”

Sayner also told Himle that JusticePoint hadn’t received broader feedback from the court for several years, but was open to it as long as the program’s principles remained consistent. 

Legal Action of Wisconsin attorneys were not aware of any past issues with sharing citations, said Susan Lund, an attorney with the nonprofit. Her firm receives identical copies of citations through police department open records requests and said she did not know why JusticePoint’s information sharing would be a problem. 

(Legal Action of Wisconsin separately sued the Municipal Court in July, alleging the court failed to record hearings on judgments and case reopenings as required by state law.) 

In a May 15 letter, the city’s purchasing department informed Sayner it was terminating JusticePoint’s contract, effective July 11. JusticePoint had not delivered unspecified “possible solutions” following a May 5 meeting, the letter said. 

Eckhart, whose office sits on the second floor of the Municipal Court building, said she was mortified upon learning the news. 

“‘Oh, my God, what are our clients going to do?’” she said she thought. 

The city terminated the contract under a “convenience” clause, rather than for cause, allowing it to be canceled for any reason as long as the city gave JusticePoint 10-days written notice. If it had terminated for cause the city would have had to give JusticePoint 30 days to fix any alleged deficiencies.

“At no point was JusticePoint informed that failure to respond with possible solutions would result in the termination of the contract,” Sayner and fellow co-founder Edward Gordon wrote to the purchasing division.

Plan to replace JusticePoint’s services is unclear 

Speaking at a June subcommittee meeting, Himle said the court planned to continue the Court Alternatives Program without JusticePoint. She did not clearly answer how that would happen without a new contractor. 

“The judges have made some decisions on how to continue as best they can through referrals they may make,” Himle said.

James Gramling, Jr., a retired Municipal Court judge, said in an interview it was unreasonable to expect judges to make such assessments from the bench, particularly in cases unfolding on Zoom.

“The judges seem to think they’re going to be able to identify from the bench people that have addiction, mental health issues and refer them to some agency. Good luck with that — it’s not workable,” Gramling said. 

As a judge, Gramling would assess the needs of defendants and then rely on one of Eckhart’s case workers to perform a full screening outside of the courtroom, Grambling detailed in a letter to the Common Council. Defendants would often be directed to perform community service or receive counseling or treatment. 

“Many thousands of people are processed without individual treatment by the court,” Gramling wrote. “And many of those defendants are disadvantaged members within our community: the poor, those addicted to drugs and alcohol, those suffering from mental health issues.”

Nearly 60% of JusticePoint participants participate in community service. The program’s alcohol and substance abuse program serves more than 90% of participants, as do its mental health services, according to the city budget.  

Gena, the newest of the three Municipal Court judges, said terminating JusticePoint’s contract would make her job “a lot harder.” Speaking at the June meeting, the former Legal Action of Wisconsin managing attorney said she could order people to pay fines but can’t address root causes that will send many people back to court.

“It was indicated that maybe the other judges have a plan — I don’t,” she said. 

JusticePoint’s lawsuit argues termination lacked good cause

In its lawsuit, JusticePoint argues the city violated the Wisconsin Fair Dealership law, which protects “dealers” — typically business owners — whose economic livelihood could be imperiled by “grantors,” who, through a contract, grants dealers the ability to sell or distribute goods or services. The law prohibits a grantor from terminating a relationship with a dealer without good cause, proper notice and the ability to fix any issue at hand. 

“The City seeks to terminate — abruptly, unilaterally, and without good cause — JusticePoint’s relationship with the City,” the lawsuit argues. “Worse yet, the City has not contracted with another vendor to provide these critical services to the people of Milwaukee.”

The Circuit Court granted JusticePoint a temporary restraining order to maintain its contract as the case plays out. A hearing on that order is scheduled for October 5.

‘Thank you for being so kind to me.’ 

Eckhart has collected countless stories of people her colleagues have helped over the decades. She recalled one man who bathed in a pond outside of the Municipal Court building and had racked up many citations while struggling with alcoholism. Eckhart’s team connected him to a treatment service and resolved his tickets.

She said she later saw him with frostbite on his feet during the winter and gave him a pair of heavy socks. He later returned to thank the team. 

“And I’ll never forget that,” Eckhart said.

Then there was Theodora Athans, whose photo appeared in The Milwaukee Journal’s 1985 “Justice Denied” series that revealed how the court created “debtor’s prisons” within the Milwaukee County’s criminal justice system.

Athans lived with schizophrenia and the Milwaukee County Circuit Court found her to be a “danger to herself.”

But Eckhart said her team found Athans housing and the woman later volunteered for the alternatives program.

“Thank you for being so kind to me,” Eckhart recalled Athans later saying when Eckhart visited her while she was sick in the hospital.

“The people we help, I don’t think would get help anywhere else,” Eckhart said, “and that’s the part that bothers me.”

JusticePoint offers incarceration alternatives in Milwaukee. Two judges tried to cancel its contract. 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.

News414 is a service journalism collaboration between Wisconsin Watch and Milwaukee Neighborhood News Service that addresses the specific issues, interests, perspectives and information needs identified by residents of central city Milwaukee neighborhoods. Learn more at our website or sign up for our texting service here.

Public health experts, advocates, nonprofits and politicians don’t always agree with each other. 

But in the case of tackling opioids, they offer this consensus: People should learn how to use Narcan.

Narcan, a brand-name version of naloxone, blocks opioids from binding to receptors in the brain, quickly reversing the effects of an overdose.

Opioid overdoses a growing concern

“Everyone has the potential to find someone that is experiencing an overdose,” said Amy Molinski, peer support specialist at Community Medical Services and one of the peers for the Milwaukee Overdose Response Initiative. The program is a collaboration between the Milwaukee Fire Department, the city of Milwaukee Health Department and other groups. 

In 2022, Milwaukee County confirmed 621 overdose deaths, according to a county overdose dashboard.

In early April 2023, the county linked 17 deaths in just a few days to suspected overdoses. This has prompted warnings about the dangers of fentanyl and other drugs.

Overdose risks extend both to those who take illicit drugs and those who have prescription opioids, said Milwaukee Fire Capt. David Polachowski, who supervises the Milwaukee Overdose Response Initiative.

“If you don’t have Narcan available,” Polachowski said, “there’s just potential for a fatal overdose.” 

In short, Narcan saves lives. Here’s how to use it. 

How to detect the signs of an opioid overdose 

The first step of using Narcan is to know the common signs of an opioid overdose.

They include having pale skin and lips; experiencing slow breathing and “snoring” breaths; vomiting; and having a limp body. In addition, victims can have extremely constricted pupils, or “pinpoint” pupils. 

How to check for responsiveness

The next step is to check for responsiveness.

If someone is experiencing an overdose, they are not able to communicate, said Courtney Geiger, public health strategist with Milwaukee Health Department.

Polachowski said to take the knuckles of your hand and rub it in the center of the person’s chest as hard as you can, while you’re calling their name or just calling out to them.

If the person is unresponsive, check for breathing.

How to check for breathing

See if the person’s chest is rising, or place your hand or head on the person’s chest. 

If the person is breathing but is unresponsive, call 911. A person does not need Narcan if they are breathing, since Narcan’s purpose is to restore breathing.

But, Polachowski said, “You need to call 911 in case it’s not an overdose. You want to have EMS (emergency medical services) on its way, so that they can treat the person for whatever reason that they’re unresponsive … if it’s a diabetic reason or stroke or a heart attack … .”

If the person is not breathing, administer Narcan and still call 911.

“You just put your phone on speakerphone, call 911 and then you start the administration of Narcan,” Polachowski said.

How to administer Narcan

Narcan comes in a nasal spray bottle with enough for two sprays.

Insert the nozzle into a person’s nostril and spray it once. If you can, tilt the person’s body, or at least their head, to the side to prevent choking or aspiration in case of vomiting. 

After the initial spray, wait two to three minutes to see if it works, “which is going to seem like forever,” Polachowski said.

How to prepare for emergency workers to arrive

The goal is to get the person breathing again while waiting for EMS to arrive, Geiger said.

If the first spray does not get the person breathing, then administer the second spray into the other nostril. If the person does not begin breathing after the second spray, begin rescue breathing. 

For rescue breathing, make sure the person is on their back, clear their airway by tilting the head back and chin up, pinch their nose, create a seal with your mouth around the person’s mouth and gently breathe into their mouth for one second.

Keep breathing into their mouth every five to six seconds, until the person can breathe on their own or EMS arrives.

Be ready to relay to EMS as much information as you have about the person’s situation and what steps you have taken.

Where to find Narcan in Wisconsin

Narcan is widely available in Wisconsin and can be purchased without a prescription at hundreds of pharmacies. The Wisconsin Department of Health Services maintains a map showing those locations.

Wisconsin residents can receive free Narcan by mail. Submit a request here. 

Where to find Narcan specifically in Milwaukee

The Milwaukee Health Department distributes and provides training free for Narcan at the Frank P. Zeidler Municipal Building, located at 841 N. Broadway; the Joseph J. Zilber School of Public Health at the University of Wisconsin-Milwaukee, located at 1240 N. 10th St.; and at community events. People can get training, and related resources, by emailing harmreduction@milwaukee.gov or calling 414-309-5295.

Narcan and training also is available at no cost at the Community Prevention Center, a clinic of the Sixteenth Street Community Health Centers. The address is 1243 S. Cesar E. Chavez Drive, and the phone number is 414-897-5645.

Narcan also can be found at no cost in “HOPE Kits,” which are distributed by the Milwaukee Overdose Response Initiative and available at many firehouses throughout the city. The kits also include fentanyl test strips, among other resources.

Jim Malewitz of Wisconsin Watch contributed reporting. A version of this story was first published by Milwaukee Neighborhood News Service, a nonprofit news organization that covers Milwaukee’s diverse neighborhoods.

Here’s where to find Narcan in Wisconsin — and how to reverse an opioid overdose 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.

News414 is a service journalism collaboration between Wisconsin Watch and Milwaukee Neighborhood News Service that addresses the specific issues, interests, perspectives and information needs identified by residents of central city Milwaukee neighborhoods. Learn more at our website or sign up for our texting service here.

Jail safety advocates say Milwaukee County Sheriff Denita Ball refuses to meaningfully engage with them about how to improve conditions at the Milwaukee County Jail, where four people have died since June.

The first of these deaths was Brieon Green, who died in June at the age of 21.

His death spurred the formation of the Justice for Brieon Green Coalition, which has made several demands on Ball throughout the past nine months, including the opportunity to tour the jail, a town hall with Ball, an independent investigation into the deaths and the posting of standard operating procedures for the jail on the sheriff’s website. 

Since Green’s death, 20-year-old Cilivea Thyrion died in December; 49-year-old Octaviano Juarez-Corro died in January; and 37-year-old Terrance Mack died on March 16.

The Milwaukee County Sheriff’s Office said three of the four cases are under official investigation by the Waukesha County Sheriff’s Department. The fourth case is under “internal review” by the Milwaukee County Sheriff’s Office, which declined to comment on specifics of the cases.

Coalition wants action from Sheriff Denita Ball

The coalition ultimately wants the deaths to stop.

It met with Ball in January, shortly after she was sworn in, said Omar Flores, one coalition organizer. During this meeting, Ball agreed to several initial demands, including her participation in a town hall and the opportunity to tour the jail, Flores said.

However, Ball has failed to honor the in-person commitment, according to both Flores and Alan Chavoya, the outreach chair of the Milwaukee Alliance Against Racism & Political Repression, which helps organize the coalition.

The coalition has emailed Ball roughly five times and called her office multiple times and she has not responded, Chavoya said. 

The coalition helped organize a rally on March 21 outside the Milwaukee County Safety Building, part of the complex of buildings that includes the jail.

“We know there’s this myth, right, that everyone who’s locked up in there (the county jail) deserves it,” Chavoya said during the rally. “And I think that’s why the sheriff thinks she can get away with it – because it’s a jail and people are not going to care.” 

“But we care,” he said. “What’s going on inside that county jail?” 

The coalition also includes family members of Green; Students for a Democratic Society-Milwaukee; and the Young Workers Committee.

County supervisors want audit of deaths and suicide protocols

Some county officials agree that Ball’s office lacks urgency in addressing concerns.

In a joint statement on March 21, following Mack’s death, county Supervisors Felesia Martin and Ryan Clancy called for an audit of the deaths of people while in jail, including an examination of the jail’s mental health and suicide protocol. 

“We stand with community demands for both transparency and footage to be released,” said Clancy, who is also chair of the Judiciary, Law Enforcement and General Services Committee. “As with the last three, I expect that neither will be forthcoming.” 

The investigation into Mack’s death is active and “there will be no further comment from the Office of the Sheriff about it at this time, beyond condolences for his family and other loved ones,” James Burnett, director of public affairs and community engagement, said in an email. 

“The deaths of Cilivea Thyrion and Octaviano Juarez-Corro also remain under investigation, as well,” Burnett added. “Both of these investigations as well as that into Mr. Mack’s death are being conducted by the Waukesha County Sheriff’s Department.” 

Although Green’s death was officially ruled a suicide, Burnett said “an internal review of it is still underway.” 

Sheriff Ball: File records request for info

Speaking at a Milwaukee Press Club on Wednesday, Ball vowed to participate in a town hall but did not provide a timeline as to when.

“When I made that promise, I didn’t mean I was going to do it right then and there,” she said.

Ball also said her office plans to put the standard operating procedures for the jail on the sheriff’s website but did not provide a timeline as to when. For those who want access to a standard operating procedure that is not on the site, Ball suggested submitting an open records request.

Mental health and incarcerated people

The conditions in the jail affecting those with mental health problems have emerged as an issue for those advocating for improved safety — problems Ball emphasized during her campaign. 

Ball’s campaign website still lists “supporting mental health” as one of her top priorities.

“Milwaukee County needs to invest more into mental health services, community-based approaches and mental health intervention programs. We need to ensure deputies are trained in recognizing and responding to mental health crises and especially how to de-escalate those situations,” the website says. 

The official investigation ruled Green’s death a suicide, but footage from the jail depicts “gross negligence” and “complete indifference to human life” by officers at the jail, B’Ivory LaMarr, a lawyer for the Green family, alleged during a December news conference after viewing footage.

“Brieon Green literally had a phone cord strangling himself … while a sheriff’s officer goes directly past the cell while he was supposed to be conducting a cell check,” LaMarr said. 

“The purpose of the cell check,” he added, “is to … check on the well-being of the inmate, and that completely was not done.”

Thyrion, who died in December, was on suicide watch when she died by choking on an adult-sized diaper provided to her by officers at the jail, according to LaMarr, who is also the lawyer for Thyrion’s family, during a separate news conference. 

Ronald Schroeder, who is currently in custody at the jail for two felony charges, said, “Certain individuals are just not safe here. And that is why they are committing suicide.” Schroeder spoke to NNS by phone and was contacted at the suggestion of an advocacy group, Incarcerated Workers Organizing Committee-Wisconsin.

Some of the factors that increase risk for those with mental health conditions, Schroeder said he’s observed, include people being forced to stay in their cells for long periods as well as virtually no access to sunlight and fresh air. 

Schroeder also said he is alarmed by the difficulty of accessing needed medications. 

“There are a large number of occupants in the jail that suffer from severe mental illness, including schizophrenia,” Schroeder said. “After talking with many of them, I have learned that many were prescribed and taking psychotropic medications in the community, or the prison system, before they arrived here. But they are not given their psychotropic meds here. When they do have an episode, the reaction is purely putative and not clinical.” 

Ball’s office did not respond to requests for comment about the medication policy for those with mental health conditions. But during the Milwaukee Press Club event, Ball said “it definitely used to be the case” occupants were restricted to their cells for long periods of time, especially at the peak of the staffing crisis around the early months of 2022.

However, Ball said, those in jail have not been locked up for that amount of time “in months” and are currently permitted to be out of their cells from 10 a.m. to 6 p.m.

Ball also said her office is enacting additional changes to better address the mental health needs of those who are incarcerated.

A new mental health counselor will “work in conjunction with our health and mental health providers. This is just an extra layer that we hope will help.”

The Sheriff’s Office also is adding the role of an occupant safety and compliance staff member who will review footage from the jail and serve as “a second set of eyes to make sure we’re doing what we’re supposed to being,” Ball said. The new staff member will be responsible for helping to ensure officers are “doing inspections right.”

Ball’s office also is increasing oversight of the jail, including more unannounced inspections by her, other executive staff members and the Wisconsin Department of Corrections.

Meanwhile, the coalition plans to continue pressuring Ball.

“I think she is seeing that a lot of people are asking questions, and they’re demanding answers,” Chavoya said. “And so, we would love for her to give us those answers.”

This story was originally published by Milwaukee Neighborhood News Service, a nonprofit news organization that covers Milwaukee’s diverse neighborhoods.

Milwaukee County Jail sees four deaths since June. Advocates want answers. 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.

News414 is a service journalism collaboration between Wisconsin Watch and Milwaukee Neighborhood News Service that addresses the specific issues, interests, perspectives and information needs identified by residents of central city Milwaukee neighborhoods. Learn more at our website or sign up for our texting service here.

A nearly 30-year ban on the use of federal grant money by incarcerated students will end this summer.

And Milwaukee Area Technical College, or MATC, has been an important part of this change.

Starting in July, incarcerated students across the country will be able to apply for a Federal Pell Grant, a financial resource for college students.

This money is usually used for expenses such as tuition, housing and books and, unlike student loans, does not typically need to be repaid.

Since 1994, incarcerated students, who would have otherwise qualified, have been unable to apply for this grant.  

In the fall semester of 2016, MATC became the first institution in Wisconsin to admit incarcerated students as part of the U.S. Department of Education’s Second Chance Pell Experimental Sites Initiative.  

The goal of the initiative was to determine “whether expanding access to college financial aid increases incarcerated adults’ participating in postsecondary educational opportunities,” according to a report by the Vera Institute of Justice, a national nonprofit providing technical assistance to both educational institutions and corrections departments participating in the initiative. 

The answer to this question is clear: Yes, it does.

Even in the face of pandemic-related challenges, the number of incarcerated students in the country enrolled in a participating school increased each year from 2016 to 2020, according to a four-year survey conducted by the Vera Institute. 

The number of students in 2016 was 6,116, and in 2020, the number increased by over 75% to 10,897 students. In total, over 22,000 students have participated in the initiative over the course of those four years, and over 7,000 students have earned either a degree, certificate or diploma.  

The number of participating students is expected to vastly expand, , Ben Jones, education director of the Wisconsin Department of Corrections, or DOC, said. 

Closer to home

The initiative also has an impressive track record here in Milwaukee.

Since admitting its first cohort of incarcerated students, the response from both students and professors at MATC has been “phenomenal,” said Sadique Isahaku, MATC’s dean of General Education Academic & Career Pathway. “We’ve been expanding ever since it started.”  

During the first semester in 2016, there were roughly 12 Second Chance students, and there will be 153 students this coming spring, he said.

“Students see it as an opportunity they have never dreamt of,” he said. 

Courses available to students at MATC also have been growing. The initiative began with two programs – welding and computer numerical control, or CNC – and, eventually, it expanded to include associate of arts and associate of science degrees. Soon, associate degrees for business administration and human services also will be available, Isahaku said. 

Lori Geddes, economics instructor and lead faculty for the Second Chance program at MATC, often points to grade point averages, or GPA, and completion rates to prove the success of the program.

Over 75% of these students have a GPA of 3.5 or higher, and their completion rates “far outweigh our traditional students,” she said. “The students are very dedicated to their education because they see education as a means to an end. They realize … they have a lot of hurdles to overcome, and they look at getting a degree as a way to get past some of those hurdles. So, they are very dedicated, and they take their education very seriously.”

In addition to the curricula, MATC provides training for other skills, including those related to getting a job. 

“We prepare them very well,” said Isahaku. “We give them mock interviews. We bring in what I call ‘offender friendly’ employers to interview them days before the graduation.”

Jones of the Wisconsin Department Of Corrections said he believes communities as a whole also are the beneficiaries of increasing educational opportunities for people who are incarcerated.

“One thing that I like to say is that about 93% of the people who are incarcerated today are going to be returning back to their communities,” he said. “And the question that we have to ask collectively is: ‘How do we want their time with us to look like?’”

Ban that prohibits incarcerated students from using Federal Pell Grants ends in July 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.

News414 is a service journalism collaboration between Wisconsin Watch and Milwaukee Neighborhood News Service that addresses the specific issues, interests, perspectives and information needs identified by residents of central city Milwaukee neighborhoods. Learn more at our website or sign up for our texting service here.

Family members and mental health advocates have expressed concern about the safety of patients at Granite Hills Hospital, the psychiatric hospital contracted to serve Milwaukee County residents. 

Among those lodging complaints is Cynthia Berry-Roberson. For decades, she has helped manage the care of a relative with a severe mental illness. Milwaukee Neighborhood News Service is not naming the patient because of privacy concerns voiced by Berry-Roberson.

This relative was hospitalized at Granite Hills twice in 2022, totaling several months as a patient there.

“At first,” Berry-Roberson said, “Granite Hills seemed like such a really nice place, because it’s really new and modern and all that.”  

This sense of optimism was shared by many when Granite Hills opened in January 2022.

The hospital is a central part of the much-touted redesign of the county’s mental health system, a process intended to better serve those in need.

“The redesign focused on improving access to behavioral health services and quality care in our most underserved and vulnerable communities,” Milwaukee County Executive David Crowley said in a news release announcing changes involved in the mental health redesign.

Private hospital systems in the county, such as Advocate Aurora Health and Froedtert and the Medical College of Wisconsin also admit psychiatric patients, but these are usually people with private insurance.

Although Granite Hills is a private hospital, Milwaukee County contracts it to be its primary psychiatric hospital for “those who are indigent,” said Michael Lappen, administrator of the county’s Behavioral Health Division.  

Berry-Roberson’s relative lacks private insurance and was admitted to Granite Hills. The sense of optimism Berry-Roberson said she had about the prospects for treatment there quickly faded.

During one of the two hospitalizations, her relative, who is diabetic, was not being monitored according to protocol, Berry-Roberson said.

“They let her pile a mattress on top of another mattress … and she fell off it when she was asleep, and she hurt her arm,” she said.

Staff did not attend to the injury for three days, and it eventually developed into a Staphylococcus infection, Berry-Roberson said.

“If they had been checking on her — they should have never let her be on two mattresses. And the second thing is — they wouldn’t listen to her, to get medical help right away. Because she asked for it. I know she did because she called and told me,” Berry-Roberson said.

The relative’s arm was operated on, but Berry-Roberson said it will be an injury the relative must deal with “for the rest of her life.” 

Eventually, Berry-Roberson filed a complaint with the state’s Division of Quality Assurance, or DQA, a division within the Wisconsin Department of Health Services that helps monitor various medical facilities. 

The complaint pointed to the lack of adequate monitoring of the relative by Granite Hills staff and the failure to report the injury to her arm.

The DQA conducted an unannounced on-site inspection of Granite Hills in December 2022.

After the inspection, the DQA informed Berry-Roberson that her complaint was substantiated, stating in a letter, “The investigation found that there was sufficient evidence to confirm a violation(s) of state and/or federal requirements related to your concerns.”

The DQA inspection found several other violations: failure to properly restrain or seclude patients; failure to secure medication; failure to secure equipment; failure to administer medication in accordance with the orders of a physician; failure to provide food in accordance with those who require a diabetic diet; failure to follow building safety protocol; and failure to properly monitor those who are at risk for suicide.

While the inspection was conducted at the end of 2022, records requested from the West Allis Police Department reveal other safety-related concerns that took place throughout the year.

From January 2022 to January 2023, there were roughly 20 calls to the West Allis Police Department about battery or assault against patients by other patients. Several of these included sexual assault.

In that same period, there also were roughly 25 calls to the West Allis Police Department concerning battery or assault against staff by patients.

Staffing crisis vs. safety

Benjamin Peerbolt, the director of clinical services at Granite Hills, said in an email, “All issues and complaints are thoroughly investigated and reviewed. Our team strives for excellence each and every day, and we continually look for opportunities to improve our quality of service.” 

Lappen of the county’s Behavioral Health Division attributes the conditions at Granite Hills to several factors, including “failures around policy, procedure and the physical environment” but attributes much of it to the nationwide staffing crisis in health care.

“My sense is that turnover and staffing challenges are the root cause of many of the issues,” he said.

In an email, Robin Weagley, the then-interim chief executive officer also acknowledged the staffing crisis: “Like the entire health care industry, we are facing staffing challenges.”

Brenda Wesley, who just finished a term as the chairperson of Milwaukee County Mental Health Board Community Stakeholder Advisory Council, is more skeptical. 

“Even without a work shortage, the system wasn’t working,” she said.

‘We need to go back to the table’

Despite all the efforts that went into the redesign, many of the goals that were hoped for have not yet been achieved, she added. “We need to go back to the table.” 

The advisory council serves as a liaison and advocates on behalf of those who use the county’s mental health system.

Regardless of all the contributing factors, Lappen said the county and the facilities it works with have an obligation to keep patients safe and provide them with adequate care. 

“I absolutely think there’s work to be done,” he said.  

A more experienced staff would be better able to accomplish these goals, he said. 

Lappen said he worries, though, that reports about conditions at Granite Hills create a sort of self-fulfilling prophecy “because there are these horror stories about how they’re (Granite Hills)) not doing a great job and then it keeps people out of the door.” 

“But,” he added, “they have to figure that out.”

Weagley said Granite Hills has developed strategies “to continue to retain and to attract people to join the health care field doing fulfilling work.”

These strategies include sign-on and retention bonuses, tuition reimbursement, loan forgiveness programs, among others.  This story was originally published by Milwaukee Neighborhood News Service, a nonprofit news organization that covers Milwaukee’s diverse neighborhoods.

Safety concerns mount at Milwaukee County’s Granite Hills psychiatric hospital 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.

News414 is a service journalism collaboration between Wisconsin Watch and Milwaukee Neighborhood News Service that addresses the specific issues, interests, perspectives and information needs identified by residents of central city Milwaukee neighborhoods. Learn more at our website or sign up for our texting service here.

The nationwide public health emergency is scheduled to end on May 11, bringing with it several changes to state and federal resources.

The health emergency provided a key resource specific to fighting COVID-19 known as “medical countermeasures.” This included tests, vaccines and treatments.

When and how changes take place to the accessibility of these depends largely on one’s insurance status, the state they live in and their age.

Here are some things to keep in mind.

Changes to testing accessibility

The changes to testing accessibility will likely have the most resounding public health effect out of any post-emergency change, according to a policy brief published by the Henry J. Kaiser Family Foundation, a nonprofit that conducts health care research and provides health policy analysis.

This will most likely have “broad implications for the people’s ability to get timely COVID diagnoses or prevent transmission,” the brief said.  

It all depends on federal supply

The federal government purchased over-the-counter tests as well as vaccines and treatments, and “as long as the federal supply is available, you cannot be charged for them,” said Jennifer Kates, senior vice president at the family foundation. “When those supplies are up is when challenges will start to arise.” 

Some of these resources made available by the emergency will not end on May 11, but “the clock will start ticking,” Kates added. 

If you have Medicaid

For those who have Medicaid, over-the-counter tests and polymerase chain reaction (PCR) tests, which are ordered by health care professionals, will be free until September 2024, said Kates.

After that point, coverage of over-the-counter tests will vary by state for Medicaid recipients, who also may face some cost-sharing for PCR tests.

Although ultimately decided by individual insurance companies, it is expected those with private insurance coverage, including people with private Medicare plans, will have to cover some portion of the cost associated with over-the-counter tests after the federal supply is depleted, according to the foundation brief. Uninsured people will have to pay the full costs of any over-the-counter tests or PCR tests they purchase.

What happens when federal supply runs out

When the federal supply of vaccines has run out, they will remain free for most with some form of insurance.

They will also remain free for anyone 18 years old or younger who is under- or uninsured, Medicaid-eligible, American Indian or Alaska Native through the Vaccines For Children program. The program allows any child to get a U.S. Centers for Disease Control and Prevention-recommended vaccine for free.

Adults who are uninsured will have to pay out of pocket for vaccines once the federal supply runs out, Kates said.

U.S. Food and Drug Administration doses

The changes to vaccine accessibility do not apply to doses purchased by the U.S. Food and Drug Administration, which are governed by a different emergency declaration.

As with vaccines and over-the-counter tests, treatments for COVID-19, such as nirmatrelvir and ritonavir, will remain free for everyone as long as the supply purchased by the federal government is still available. Once that supply is gone, those with Medicaid will continue to have free access until September 2024, then people may face some cost-sharing, said Kates.

Most with private insurance have already begun paying for COVID-19 treatments and will continue to do so after the end of the public emergency. Those who are uninsured will likely have to pay full price for treatment after the federal supply is gone. 

The Biden administration has stated it will confirm the end of the emergency 60 days before its end date. If that date remains May 11, then that should be mid-March.

What does this all mean for Wisconsin residents?

The Wisconsin Department of Health Services, or DHS, which administers Wisconsin’s Medicaid and BadgerCare Plus programs, is reviewing guidance from the federal Centers for Medicare and Medicaid Services to fully understand the extent of changes caused by the end of the emergency, DHS spokesperson Elizabeth Goodsitt said in an email.

Those seeking the most current information about Wisconsin’s unwinding of benefits can sign up for email updates.

Know the timeline for other resources

The unwinding of many other benefits and resources connected to the pandemic are not tied to the federal emergency. Therefore, these changes, such as those affecting FoodShare benefits and the Medicaid/BadgerCare Plus renewal process, are on different timelines.  

How to get help

People can connect with a Covering Wisconsin navigator by calling 608-261-1455 or 414-400-9489 — or by visiting coveringwi.org or wiscovered.com.  

Or they can call 2-1-1, a service that helps connect people to resources.

What to know about medical costs in Wisconsin as federal public health emergency ends 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.

News414 is a service journalism collaboration between Wisconsin Watch and Milwaukee Neighborhood News Service that addresses the specific issues, interests, perspectives and information needs identified by residents of central city Milwaukee neighborhoods. Learn more at our website or sign up for our texting service here.

After March 31, BadgerCare Plus recipients must return to the pre-pandemic process of reapplying and being re-evaluated for coverage.

Local health care professionals want them to be prepared. BadgerCare Plus serves people who need health care coverage but who may not qualify for Medicaid.

Because of federal legislation that went into effect in March 2020, those who have received BadgerCare Plus benefits have been able to keep those benefits without having to go through the renewal process as was required every 12 months before that time, said Caroline Gómez-Tom, enrollment network and accessibility manager for Covering Wisconsin.

But Gómez-Tom said, “People should not panic.”

Covering Wisconsin is a nonprofit organization based out of the University of Wisconsin-Madison that helps people throughout Wisconsin understand and apply for health insurance.

Here are some crucial details to keep in mind:

How to prepare

First, people should understand that everyone’s date to reapply will be different. 

Renewal dates will fall anywhere from June 2023 to May 2024, said Elizabeth Goodsitt, communications specialist for the Wisconsin Department of Health Services, which manages BadgerCare Plus. 

People should receive a letter in March informing them of their renewal date. They will then receive a renewal packet 45 days before that renewal date, Goodsitt said.

Update your digital accounts

Gómez-Tom said people should update any digital accounts related to Medicaid.

You can create an account on access.wi.gov, which is Wisconsin’s Medicaid website. You can also download the MyACCESS mobile app, “which is probably even easier than the website,” said Gómez-Tom.

These platforms can be used for communicating with the Department of Health Services, or DHS, about renewal dates and other important correspondence.

‘Read everything carefully’

Winona Grieger, a navigator at Gerald L. Ignace Indian Health Center, emphasized the importance of “paying attention” to any correspondence from DHS and “reading everything carefully” to understand what is expected.

Don’t renew prematurely

As far as collecting relevant paperwork to prepare for the renewal, Gómez-Tom counseled that recipients not “jump the gun.” DHS will be, for the most part, assessing people’s employment situation and want the most current pay stubs possible.

Additionally, there is a potential risk in trying to renew prematurely.

“We don’t want people to renew before their time to renew, because that might risk them losing coverage sooner than they would otherwise,” Gómez-Tom said.

Don’t be afraid to ask for help

In addition to household income, household size is the other major factor in whether someone qualifies for Medicaid. UW-Madison outlines these thresholds on a chart. 

Gómez-Tom advises caution in reviewing this information, though, because someone can look at this chart and determine they do not qualify.

“There are other factors that can affect it (eligibility),” she said, including yearly expenses and tax information specific to the applicant. “A navigator can take everything into account and determine that a person actually is eligible.”

“Throughout this whole process and transition, if people have any questions along the way – need help with finding their renewal date, what they will need for their renewals, doing the renewal itself, finding out other options if they find out they are not eligible – navigators are here to help,” said Gómez -Tom. “No question is too small.”

How to get help

People can connect with a Covering Wisconsin navigator by calling 608-261-1455 or 414-400-9489 — or by visiting coveringwi.org or wiscovered.com.  

Or they can call 2-1-1, a service that helps connect people to resources.

What Wisconsin’s BadgerCare Plus recipients should know to keep their benefits 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.

News414 is a service journalism collaboration between Wisconsin Watch and Milwaukee Neighborhood News Service that addresses the specific issues, interests, perspectives and information needs identified by residents of central city Milwaukee neighborhoods. Learn more at our website or sign up for our texting service here.

The looming closure of Ascension’s St. Francis Hospital Birthing Center — the only labor and delivery unit on Milwaukee South Side — is drawing strong pushback from healthcare workers and patients. 

Ascension, a Catholic nonprofit, is one of the largest private health care systems in the United States and has a large footprint in Milwaukee. Critics question the timing and lack of communication over a shutdown that will disproportionately affect the South Side’s heavy Latino population, and they wonder what the move foretells for St. Francis Hospital’s future. 

Wednesday was the last day for admission to the labor and delivery unit, and the last planned discharge is set for Friday, an Ascension Wisconsin spokesperson told Milwaukee Neighborhood News Service, adding: “Labor and Delivery Unit associates will provide additional maternal and fetal expertise in the Ascension St. Francis Emergency Room through January 7.”

The Ascension spokesperson called the closure a “consolidation” of services that gives patients “access to the most comprehensive labor, delivery and postpartum services to all Ascension Wisconsin moms and babies.”

Closure sparks protest

Despite below-freezing temperatures, dozens of people gathered in front of Milwaukee City Hall on Tuesday to protest the closure.

“We are here because we all deserve better than this,” said Tracey Schwerdtfeger, a steward of the Wisconsin Federation of Nurses & Health Professionals (WFNHP) Local 5000, a union representing St. Francis employees. 

“Shame on you, Ascension,” she yelled into the mic.

“Shame,” the crowd yelled back.

The union organized the protest in the days after St. Francis administrators surprised staff with news of the closure.

‘Disorganized and inconsistent’

One St. Francis patient wondered why Ascension didn’t communicate earlier about the shutdown.

Crystal Vallance, a 33-year-old South Side resident, delivered her first child at St. Francis about two years ago and expected to have her second child there too — working with the same doctor.

But while scrolling through social media on Monday, Vallance learned that her care would be disrupted; She noticed a Wisconsin Federation of Nurses and Health Professionals alert about the unit’s closure.

She immediately reached out to her care team to verify the news. 

Vallance is in the second trimester of her pregnancy. During her first prenatal appointment in September, she said, staff told her that St. Francis was closing the labor and delivery unit during weekends. That would force women to go elsewhere if the babies picked a Saturday or Sunday to arrive. But Vallance said her care team expected a full reopening by December as the hospital hired more staff.

“Instead, I find out that they’re permanently closing labor and delivery,” she said. “It was obviously a surprise to my care team as well as to me. I’m sure there’s plenty of women who are closer to giving birth than I am. So merry Christmas, I guess.”

Jamie Lucas, executive director of WFNHP, called the lack of communication a problem.

“This whole thing is disorganized and inconsistent. We were told as recently as last week that the unit was not closing,” he said.

Lucas added that giving birth is such a “deeply personal and intimate experience” and because “so little is in our control about childbirth and our health, we have to get these things right. Where you are going to deliver; having a consistent provider – these are things we can’t afford to screw up.”

Closure adds hassles, barriers

The shakeup adds hassles for Vallance during an already stressful time, she said. Now she must pick a new hospital and a new doctor. The doctor she most trusts lacks admitting privileges to other hospitals, she was told.

Vallance, who lives about a 5-minute drive from St. Francis, must also map out a route to another hospital. Ascension’s St. Mary campus is about 15 minutes away, she said, and its St. Joseph campus is about 20 minutes away. Perhaps she’ll try a different option.

“If I have my druthers, it’s not going to be Ascension,” she said.

Aurora West Allis Medical Center is another option for expecting mothers, said Lucas, but traveling there presents similar barriers.

Vallance has reliable transportation access, and she sympathizes with those who face steeper barriers and are closer to their due dates. In the census tract surrounding St. Francis, at least 40% of residents aged 15 and older are non-drivers, according to a Wisconsin Department of Transportation mapping tool. 

“I think it’s very interesting that a nonprofit — a Christian-affiliated hospital — is continuously trying to pull away from people who need the most,” Vallance said.

A community organization with ties to Milwaukee’s South Side also voiced concerns.

“I think the biggest thing is – our surprise. That there wasn’t an effort to contact … patients themselves to forewarn about this closure, right during the holidays,” said Christine Neumann-Ortiz, executive director of Voces de la Frontera, a nonprofit organization that advocates for the rights of immigrants and low-wage workers.

“The concern, of course, is that this is going to affect many of our members – largely Latina members – and their ability to quickly access a maternity ward,” she said.

In addition to transportation challenges, some residents face barriers around language, affordability, and – sometimes –immigration status, which “make it harder to be able to access health care,” said Neumann-Ortiz.

How did we get here?

Hospital administrators have not provided an explicit reason for the decision, Lucas said, but staff described what they believe has been an incremental dismantling of labor and delivery services at St. Francis. 

As providers left or retired, “Ascension has chosen not to replace or fill” these open positions, said Connie Smith, president of WFNHP.

Recent reporting by The New York Times revealed staffing shortages at other Ascension hospitals in the country, sometimes resulting in what health professionals said were unsafe conditions.

Ascension leaders declined to respond to a request for further comment on specific allegations about staffing, timing and impact.

But a spokesperson said: “Birthing services leaders will work hand-in-hand with obstetricians and parents-to-be to ensure a seamless transition of care.”

Smith made comparisons to other cuts at different Milwaukee-area hospitals within the Ascension system.

“I’ve lived this,” said Smith. “I started at St. Michael’s Hospital within the (Ascension) system. And they closed my labor and delivery unit. Prior to them closing my labor and delivery unit … they reduced services.”

The St. Michael campus closed in 2006, and Smith and her colleagues are “scared this is going to happen at our facility at St. Francis.”

More recently, residents and community members in the North Side expressed concern about the cutting of services at the St. Joseph campus in 2019.

What happens next?

Alderman Scott Spiker, who represents Milwaukee’s 13th District and attended the rally, said that this decision “doesn’t do anybody any good.”

“People should have a right to give birth in their home, in their communities,” he said.

Spiker said Ascension’s nonprofit status gives officials some room to influence the decision. 

“We have partnerships here. We have relationships we can leverage,” he said. “But in the end, we ultimately need folks to do the right thing. And we can lead them to that. But we can’t make them do that.”

“I’m confident we can at least get voices heard that maybe you wouldn’t hear otherwise,” he added. 

How to find new providers

For those who also need to contact potential providers, St. Mary’s unit is located at 2323 N. Lake Drive. The number is 414-585-1000

The unit at the St. Joseph campus is located at 5000 W. Chambers St. The number is 414-447-2000.

The Aurora Women’s Pavilion at Aurora West Allis Medical Center is located at 8905 W Lincoln Ave. The number is 414-328-6000.

The CARE Network of Wisconsin, an organization that provides childbearing education and resources relating to doulas, labor assistants and midwives, can be contacted via its website or Facebook page.

Jim Malewitz of Wisconsin Watch contributed reporting. A version of this story was first published by Milwaukee Neighborhood News Service, a nonprofit news organization that covers Milwaukee’s diverse neighborhoods. 

Ascension to close South Side Milwaukee’s only labor and delivery unit, prompting questions and protest 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.

News414 is a service journalism collaboration between Wisconsin Watch and Milwaukee Neighborhood News Service that addresses the specific issues, interests, perspectives and information needs identified by residents of central city Milwaukee neighborhoods. Learn more at our website or sign up for our texting service here.

The number of young children in Milwaukee County who have received an updated COVID-19 vaccine remains below the average across Wisconsin, even as COVID-19 poses a “medium”-level hazard to the county, according to the U.S. Centers for Disease Control (CDC). 

The CDC announced its approval of the updated, or bivalent, vaccines for 5- to 11-year-olds on Oct. 12.

But as of Dec. 7, only 2.9% of Milwaukee County children ages 5 to 11 have received an updated dose, compared to 3.4% across Wisconsin. The previous week, 131.5 new cases of COVID-19 were reported for every 100,000 people in the county, while 12.7 people were admitted to the hospital for every 100,000 residents. 

Dr. Benjamin Weston, chief health policy adviser for Milwaukee County, wants parents to understand the high degree of safety of vaccines and boosters.

 “This new booster uses the same vaccine mechanism that has been proven safe … . It’s just a change in the recipe,” Weston said during a news conference last month. “Vaccines have been shown to be incredibly safe to all age groups.”

Some side effects have been observed, including fever and fatigue, but they fall within the normal range of side effects associated with other vaccines, he said. Moreover, “the benefits of vaccination far outweigh” the dangers of COVID-19, Weston said.

Although the vaccines are free and available to people throughout the county, demand for the shots remains low.

“There’s so much noise in the conversation around COVID,” said Jennifer Kates, senior vice president at the Henry J. Kaiser Family Foundation, a nonprofit that conducts health care research and provides health policy analysis.

This noise has resulted in fatigue, hesitancy and skepticism among parents.

“People are sort of just no longer able to receive the message because they’ve been hearing about COVID for so long. It’s harder for them to hear those messages or for us to deliver them in ways that folks can hear them,” said Katie Lepak, project officer for the Milwaukee County Public Health Collaborative, an ongoing collaboration among health departments, hospitals, community clinics and pharmacies to carry out a unified public response to the pandemic. 

‘It takes more effort’

In addition to this COVID saturation, “there are structural challenges,” said Kates. “Getting a booster isn’t the same as the beginning days of getting a vaccine.”

“You have to more actively seek it out,” she said. “It takes more effort.”

Kay Smith, a 68-year-old resident of Milwaukee’s North Side, said she “mostly heard about it on the news” but “would have loved” more outreach from the city about the boosters.

She worries about the health of her grandchildren and great-grandchildren, along with family members they live with. 

Phyllis Thompson, 62, lives on Milwaukee’s West Side, and her 8-year-old daughter took it upon herself to learn about vaccines and boosters, out of concern for family as well. 

“Basically, it was her decision,” Thompson said. “She wanted to receive the vaccine, because her grandmother – her grandmother basically is not in good health – and she basically said she wanted to protect her grandmother … .”

“I have a knowledgeable 8-year-old,” she added.

Lepak calls one-on-one conversations between providers and patients the most effective tool to encourage residents to get the vaccines and boosters. 

To this end, the Milwaukee County Public Health Collaborative promotes Healthy MKE, a website that provides up-to-date information and resources regarding providers, testing and vaccines.

“How do we get people to get back in front of their provider to have a conversation with somebody they already have a relationship with?” asked Aziz Abdullah, co-founder of INPOWER, a communications agency located in Harambee that built and manages the Healthy MKE site.

And for those who do not have a trusted provider, Healthy MKE has just published content that incorporates feedback from the community “to call out questions we know people are having,” Abdullah said. 

Of particular relevance to Milwaukee’s North and South Side residents is the collaborative’s work with community clinics, sometimes known as Federally Qualified Health Centers.

These clinics are mandated to serve underinsured and uninsured people.

“In fact,” said Kates, “during the COVID emergency, they were given additional support to do vaccination for communities they serve and get that information out. They are reaching the communities that are the hardest to reach.”

As a whole, however, these clinics, of which there are five in the county, face  workforce issues that limit their ability to reach out formally and administer vaccines.

In an email, Allison Kos, chief medical officer for Progressive Community Health Centers, or PCHC, said, “due to staffing and workforce limitations, PCHC had to suspend our own onsite COVID-19 vaccination efforts.”

“In the early stages of the pandemic, we were able to organize and galvanize people to do community events,” Abdullah said. “And I think those general, open community events are not as open right now maybe due to workforce challenges that we are seeing.”

But Abdullah said other members of the county’s collaborative are helping to bridge the gap.

For example, PCHC and the Wisconsin Department of Health Services collaborated on several vaccination clinics at the end of October through mid-November. 

How to locate vaccine clinics

Healthy MKE’s vaccine finder can be used to locate other clinics and providers administering vaccines and boosters in Milwaukee. People across Wisconsin can also call 2-1-1 or visit vaccines.gov.

A version of this story was originally published by Milwaukee Neighborhood News Service, a nonprofit news organization that covers Milwaukee’s diverse neighborhoods. 

Although free and available, few young children in Milwaukee are getting COVID-19 boosters  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.

Black residents, who make up the largest minority group in Milwaukee County, are committing suicide at a higher rate this year than in any other time during the past 10 years, according to data from the Milwaukee County Medical Examiner’s Office. 

This alarming rate is consistent with a national crisis of suicide in communities of color – a trend that preceded, but was exacerbated by, the pandemic. 

Since 2013, the average number of Black people who committed suicide each year in Milwaukee County, from January through September, was roughly 12 people.

In 2015, there was a low of five people during this time frame, but the number reached 23 people this year. 

Asian/Pacific Islander communities also experienced a sharp increase in the percentage of people who are committing suicide.

In raw numbers, the average number of suicides in a year, from January through September, among Asian/Pacific Islander residents is roughly two people.

In 2022, the number of suicides was six.

The number of suicides for White and Hispanic residents is currently hovering around or below their respective 10-year averages.

Suicides among White residents peaked before the pandemic at 95, from January to September of 2017.

During that time frame this year, the number of suicides was 59, lower than the 10-year average of 67.

For Hispanic residents, the second-largest minority group in the county, the 10-year average for this time frame is roughly six people who have committed suicide during that span this year.

In March, County Executive David Crowley helped launch the Community Health & Healing Series, a series of talks and events addressing mental health for all residents in the county. The talks examined barriers to care and ways in which people can access services.

But the Medical Examiner’s data helps round out this picture.

The data shows that suicide affects every group in Milwaukee County, and it is rising among some minority groups. 

Research indicates in the decade from 2010 to 2020, suicides grew dramatically for Americans of color but most dramatically among Black people.

As the crisis continues in Milwaukee, revealing its own trends and patterns, it is worth reviewing the barriers and resources specific to Milwaukee’s Black communities. 

‘They didn’t understand how to care for Black people‘

Imadé Nibokun, founder and executive director of Depressed While Black, a nonprofit addressing gaps in mental health services for Black people, is upfront about her own experiences with self-harm and the inability of the mental health care system to provide the support she needed. 

“I’ve experienced a lot of times – a lot of different touch points – with the mental health system, and they didn’t recognize I was in distress because they didn’t understand how to care for Black people who are struggling,” Nibokun said.

The experience of reaching out for help but not getting the appropriate kind only deepened her crisis. 

“When I got out of the hospital … I was more suicidal leaving than I was before,” Nibokun said. “I recognized that I asked for help and didn’t feel better – I felt so much more disappointed.”

“Many times, for African-American people, their symptoms are not believed,” said Dr. Lia Knox, co-founder of Black Space, an organization tailoring mental health support and events for communities of color. “Depression hurts, anxiety hurts … but doctors and nurses and clinicians may not believe these symptoms.” 

This common experience breeds ongoing tension between Black communities and mental health systems.

“Historical dehumanization, oppression, and violence against Black and African-American people has evolved into present day racism – structural, institutional, and individual – and cultivates a uniquely mistrustful and less affluent community experience, characterized by a myriad of disparities including inadequate access to and delivery of care in the health system,” to a report from Mental Health America, advocacy group for people with mental illness.

Nibokun once told a therapist she was feeling suicidal. Shortly after, she took a nap, and, because her therapist couldn’t get a hold of her, the therapist called the police to do a wellness check.

“All I could see were their guns,” Nibokun said.

This is a typical example, she said, of the kind of mental health care Black people receive too often, a kind of “punitive care or carceral care – a type of care where the police and punitive measures are employed as the first and only intervention. And it can be terrifying.” 

Knox said, in her experience, stigma around mental health within the Black community is yet another barrier that prevents Black people from getting help. 

Many Black people “see it as a sign of personal weakness or moral failure … so we tend to press on,” she said. 

During a discussion at one of the Community Health & Healing Series events, Crowley cited personal experience with this kind of stigma, referencing the mental health of a relative.  

“When it came down to getting that individual some help, nobody wanted to touch it, because nobody wants to deem a person ‘crazy’ … ,”  he said.

Nibokun qualifies stigma, though, as a survival tool in the face of racism and discrimination.

“I often say that stigma is a response to structural inequality,” said Nibokun. “Historically, Black people were punished for expressing any mental distress.”

“There really hasn’t been a time in history where it’s been safe for Black people to say that they need help,” she added.

This trend, she said, continues to this day in other forms. If a Black person says they need help or are in crisis, “you may lose your kids or lose your job.”

Groups in Milwaukee respond

The pandemic, if it did anything, put an exclamation point on these discrepancies in risk factors for and resources available to Black people with mental health needs. 

There are some important examples within Black communities in Milwaukee that are leading by example, including Black Space and Depressed While Black.

Knox and her colleagues have designed “therapeutic experiences” specifically to address these barriers. 

The first order of business for Knox is to address the stigma head on and “normalize the discussion of mental health and wellness … and dispel the myths about mental illness,” she said.

As a Black clinician, Knox’s presence in the mental health space begins to do the work of normalization, as just over 4% of the psychology workforce in the U.S. is Black. 

“At least 80% of people in our groups say they would love to have a therapist who looks like them,” Knox said.

Nibokun’s work grew directly from her own experiences with hospitalization and getting culturally incompetent care.

Through Depressed While Black, Nibokun works with psychiatric hospitals to give its Black patients hygiene kits with hair care and skin care items specifically tailored to their needs. 

Not only does this allow “patients to live with dignity and care,” Nibokun said, but a patient’s discharge date from the hospital “is often connected to how you look. If you can’t groom yourself, your discharge date is pushed back.” 

Nibokun also works to connect Black people to Black therapists – a connection that was key to getting her the help she needed.

“Despite the trauma I endured in the mental health system, I’ve been able to find Black mental health professionals who saved my life,” Nibokun said.   

Milwaukee County is developing services according to the needs of the community, regularly “looking at data for deaths by suicide,” said Andrea Nauer-Waldschmidt, psychiatric crisis services coordinator for the county’s Department of Health and Human Services. Extending services to people who are incarcerated, as well as after their release, is one example, she added.

Other examples include offering suicide prevention programs aimed at youths and changes to the county’s access clinics, where outpatient crisis services are available, Nauer-Waldschmidt said.

The county relocated one of these clinics to an area that “had lack of availability of mental health resources and purposely found health partners within those communities,” Nauer-Waldschmidt said.  “An individual having access to care closer to where they live is an important part of removing some of those access-to-care barriers.”

Where you can find help 

• BlackLine: a non-police crisis line specifically for people of color: call  1-800-604-5841 
• Milwaukee County Crisis Line: call 414-257-7222 (available in English and Spanish)
• 988 Suicide & Crisis Lifeline, national crisis line: call 9-8-8 (available in English and Spanish)
• Crisis Text Line: Text “HELLO” to 741-741
• Depressed While Black: visit https://www.depressedwhileblack.com/ 
• Black Space: visit https://www.blackspacehq.com/  
• Darkness RISING Project, connecting Black people with Black therapists: visit https://findmeatherapist.org/ 
• A full list of Milwaukee County’s mental and behavioral support: visit https://county.milwaukee.gov/files/county/DHHS/BHD/Crisis-Services/CrisisServicesBrochure.pdf 

A version of this story was originally published by Milwaukee Neighborhood News Service, a nonprofit news organization that covers Milwaukee’s diverse neighborhoods. 

Milwaukee County sees rise in suicides in Black communities is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

News414 is a service journalism collaboration between Wisconsin Watch and Milwaukee Neighborhood News Service that addresses the specific issues, interests, perspectives and information needs identified by residents of central city Milwaukee neighborhoods. Learn more at our website or sign up for our texting service here.

Health insurance can be confusing.

Meet Quentella Perry, who helps people plow through the complexities while working for Covering Wisconsin, a nonprofit organization based at the University of Wisconsin-Madison that educates people about health insurance and helps them choose a plan.  

Just as accountants are busy during tax time, Perry and her colleagues have their hands full helping people navigate the choices offered during the Affordable Care Act open enrollment period.

The open enrollment period is a time during which people can change or sign up for a health insurance plan – either through their employer or the federal health insurance marketplace, where many applicants qualify for subsidies. 

Open enrollment for a 2023 plan runs from Nov. 1 through Jan. 15. Those wanting to start coverage on Jan. 1 must sign up by Dec. 15.

Outside of this time period, people can enroll in plans only under certain circumstances, including getting a new job, getting married or having a child. Those who meet the criteria can enroll in state-run Medicaid programs like Wisconsin’s BadgerCare Plus, throughout the year.

Regardless of the source of health insurance, though, most people face some level of confusion.

This is where Perry and people like her come in.

Perry will resolve that confusion.

She will answer questions.

She will walk applicants through the steps.

Applicants emerge with an insurance plan that meets their needs.

Perry is a licensed health insurance navigator at Covering Wisconsin. The nonprofit operates statewide, including in Milwaukee County, where an estimated 55,000 people lack insurance — 35,000 of whom live in the city of Milwaukee, according to the Milwaukee Health Care Partnership.  

Covering Wisconsin is part of a coalition of organizations and agencies working to increase enrollment among all residents, particularly those who currently lack insurance. 

Becoming a health insurance navigator

Perry, 40, was born and raised in Milwaukee. She has been a navigator for four years but previously spent years as a certified application counselor, or CAC.

CACs work within a medical setting, such as a hospital, to assist patients when they apply for health insurance. They often transition into navigators, who have more experience and can assist CACs when they encounter especially complex or challenging cases.

“This is my passion. I believe education is key. Educating individuals within the community is key. This is something I love doing, and this is why I continue to do this work,” Perry said.

“We don’t receive commissions; all the information we give is impartial. Our services are free to individuals,” she added. “A lot of the agent brokers – they work off commission – and individuals have a hard time trying to figure out if they have their best interest in mind.”

A confusing system

Education must always be the first goal of a navigator, said Cheryl Isabell, Milwaukee community engagement lead at Covering Wisconsin.

“To understand what a premium is … . To explain to them what a copay is. If you’ve never had insurance, or have had to pay for health insurance coverage, you don’t know,” Isabell said.

Even folks who are fluent in the process might struggle to keep track of all that information. 

“It’s very confusing,” said Winona Grieger, navigator at Milwaukee-based Gerald L. Ignace Indian Health Center, which also employs insurance navigators. “Every person that you work with – it’s never the same. Everything is always different.”

After the client understands all these moving parts, “then we discuss different plans,” Isabell said.

Officials urge enrollment

The Wisconsin Department of Health Services has sent out a “call to action” to organizations like Covering Wisconsin.

The mandate is simple: enroll, enroll, enroll.

The call comes as additional financial assistance for health coverage is available. 

If people “have looked before and just chose not to have health insurance coverage, because it wasn’t affordable for them, they should look again,” Isabell said.

Another major change is fixing what insurance professionals call the “family glitch.”

“If you’re employed, your employer may offer health insurance coverage, but it’s only affordable for the employee – the family plan may be unaffordable,” said Isabell. 

Until now, those family members were ineligible for alternative assistance through the marketplace, which left families with bad options: a prohibitively expensive employer plan or a marketplace plan without financial assistance.

“Now that the family glitch has been fixed, the family members have the opportunity to get those tax credits (through the marketplace), so now the whole family can be insured,” Isabell said.

Navigators remain concerned about the potential end of the federal public health emergency, which has allowed people covered by BadgerCare Plus to keep coverage regardless of changes in their income or household size. BadgerCare Plus recipients have also not been required to update their information, which is required every 12 months under normal circumstances.

When the public health emergency finally ends, recipients must update their information and be re-evaluated to determine if they can maintain their coverage.

Although the public health emergency has been extended 11 times since its original declaration in January 2020 and is currently extended until Jan. 11, many health care professionals anticipate its end in 2023.

“A lot of individuals are used to having help through the state program, and with everyone going back to work and everybody becoming employed, some individuals will potentially be at a loss of their coverage, because of them being over the income limit,” Perry said.

Make an appointment with a navigator

To make an appointment with a navigator at one of a number of agencies, you can use this online tool hosted by Covering Wisconsin.

A version of this story was originally published by Milwaukee Neighborhood News Service, a nonprofit news organization that covers Milwaukee’s diverse neighborhoods.

Confused about health insurance during open enrollment? A navigator can 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.

Milwaukee is seeing a spike in deaths among people who lack a regular place to live but don’t meet the standard definition of homelessness.

The Milwaukee County Medical Examiner’s Office recorded 52 deaths of people experiencing homelessness in 2021, more than double the 21 deaths recorded in 2018, according to data provided to Milwaukee Neighborhood News Service. 

Meanwhile, data for January and February show that the county is on pace for as many or more such deaths in 2022. The Medical Examiner’s Office did not respond to a request for more recent data.

But the available data likely underrepresents deaths of people who lack housing, officials said. 

The leading cause of the deaths: Substance abuse, particularly involving opioids like fentanyl.

The deceased include two people who had connected with Street Angels Milwaukee Outreach, which has aided unhoused Milwaukeeans since 2015. Aiming to build a rapport and understand the services residents need, organization staff three times a week hand out items that meet basic needs, including sack lunches, hot meals and hygiene items.  

“We just had a gentleman murdered downtown,” said Dan Grellinger, the group’s homeless outreach specialist. “It shook people up.”

Counting methods are inexact

The lack of standardized methods for determining who lacks housing when they die creates challenges for those serving the population. 

Karen Domagalski, operations manager for the Medical Examiner’s Office, suggested that the data her office keeps likely undercounts deaths among people who are homeless. 

If someone dies at a shelter, for instance, the shelter’s address might be recorded as the place of death, meaning that it would not be readily apparent that the person was experiencing homelessness. 

“We had a homeless person die … in an abandoned building. He may have been an overdose, or it may be hypothermia,” she said. “Family said he was homeless, but an address was provided, so he will most likely not show up on any ‘list’ of homeless deaths.” 

Service providers also struggle to track the unhoused population, and that can affect the resources they offer. Most federal funding goes only to assist people who are either “literally” or “chronically” homeless, as defined by the U.S. Department of Housing and Urban Development, or HUD.

This encompasses people who are living on the street, a “place not meant for habitation” or in a shelter on a short-term basis.

As government entities and nonprofits carry out their funded work, people who lack stable housing but don’t meet the technical definition of homelessness often go unseen and unserved.

HUD-funded assistance programs, for example, include four categories of homelessness:

• People who live in a place not meant for human habitation, in an emergency shelter, in transitional housing or who are leaving an institution where they temporarily lived.
• People who are losing their primary nighttime residence.
• Families with children who face housing instability and are likely to continue in that state.
• People who are trying to leave domestic violence and have no other residence.

“There are pockets of the community who are living in the shadows of the system who are suffering,” said Eric Collins-Dyke, assistant administrator of Supportive Housing and Homeless Services at the Milwaukee County Housing Division. 

“We have to honor this gap in the system and this piece that we are missing. We have to look for more resources. We shouldn’t have to say that we are mandated to do something.” 

Emily Kenney, director of systems change at IMPACT, the parent organization of IMPACT 211, a free helpline and online resource directory that connects residents to services, echoed this need.

“Since 2019, we have been paying more attention to those folks that are unstably housed and try to provide services beyond keeping them from coming into the homelessness systems . . .  beyond what HUD funds us to do.”     

Stable housing helps prevent deaths  

Stable housing – particularly shelter and permanently subsidized housing – remains one of the most effective and recognized ways of preventing deaths of people experiencing homelessness.   

Without this basic need being met, “They freeze to death. They die from heat in the summer. They have multiple health conditions,” said Sherrie Tussler, who serves as the executive director for Hunger Task Force.    

Advocates and homeless services professionals say they are aware of the lack of readily accessible shelter and housing.  

“There’s quite a lot of people who would go into shelter but can’t,” Grellinger said.  

Stephanie Nowak, the community intervention specialist lead for the Milwaukee County Housing Division, pointed out that those with substance abuse or mental illness often feel less accommodated by shelters, further complicating efforts to get them off the street.   

 “We understand why oftentimes people who are street homeless don’t want to use shelter or why that is not a good or right option for them, and we acknowledge that, and we work with them for what would be a better option,” Nowak said.

Grellinger tells people who want help finding long-term housing to expect a wait. 

“We generally tell people – best case scenario – if you get into 211 and get into a housing program and fill out an application and find a landlord, it’s six or nine months out,” he said. “It takes a long time.” 

As the city grapples with its opioid crisis, residents experiencing both homelessness and addiction need housing and accessible treatment to lower their risk of preventable death.  

Shelly Sarasin, the co-executive director of Street Angels, reported consistent bottlenecks in connecting people to certain drug-related resources.

“Fentanyl is really present in our community. Though we have a lot of harm-reduction resources, we don’t have a lot of facilities that are easy to get into.”  

A facility catering specifically to those with opioid addiction would also crucially help those who are seeking treatment, said Gina Allende, the health promotions manager at UMOS, which provides a variety of services to Wisconsin’s migrant and seasonal workers and other diverse populations.

The one detox clinic run by the county serves people seeking services for many different types of addiction but “when people have opioid addiction, it comes right away with withdrawals … and they are concerned they won’t get medication right away and that they are going to suffer,” Allende said.  

Location of treatment facility an obstacle

But people experiencing homelessness run into a range of obstacles that limit treatment access.

Those include location.  

Milwaukee County funds just one facility that provides residential detox and medication-assisted treatment — the use of medications such as buprenorphine or methadone to help suppress withdrawals and limit craving. That’s First Step Community Recovery Center at 2835 N 32nd St. 

The facility is in the North Side Milwaukee neighborhood of Sherman Park, so patients living on the South Side often “don’t feel comfortable” when they find out where the facility is located, Allende said. “It would be a lot easier if people could just walk over there.” 

Patricia Gutierrez, alcohol and drug abuse services director at IMPACT, said she understands this obstacle. 

“When someone calls us, we usually ask them ‘is there someone we can call for you, is there a family member, a friend we can call for you,’” she said. “If it’s serious and life-threatening, we’re going to call an ambulance or police to see if they can take you down there. We just want to make sure the client gets there, and we use whatever avenue we can to get them there.”  

UMOS and Street Angels regularly collaborate with the Milwaukee Fire Department via its Milwaukee Overdose Response Initiative, or MORI, to help bridge this transportation gap. When UMOS or Street Angels staff encounter someone who wants treatment, they will call MORI to help arrange a ride. 

Opioid settlement could help

Still, advocates and homeless services professionals cited two reasons to be hopeful for progress. 

The first is the $400 million in opioid settlement money Wisconsin will receive over the next 18 years. This money has been earmarked for prevention programs, residential treatment and medication-assisted treatment, among other programs.   

The settlement money will also fund harm reduction and overdose prevention resources, including naloxone and fentanyl test strips. The growing availability of such resources offers people working in the field another source of hope.  

Harm reduction refers to practices that aim to limit the dangers involved in behaviors that pose risks to one’s health, such as drug use or sex work — a contrast to zero-tolerance policies. 

UMOS, Street Angels and MORI distribute fentanyl test strips and naloxone, which service providers call life-saving resources. 

Milwaukee Fire Department Capt. David Polachowski, who oversees MORI, helped develop its “hope kits,” which include naloxone, CPR face shields, fentanyl testing strips, a card for Narcotics Anonymous and contact information for MORI and UMOS.  

“Our success is — are these people still alive? Because then there’s the potential for us, or anybody, to assist. That’s a win,” Polachowski said. 

A version of this story was originally published by Milwaukee Neighborhood News Service, a nonprofit news organization that covers Milwaukee’s diverse neighborhoods. The nonprofit Wisconsin Center for Investigative Journalism (wisconsinwatch.org) collaborates with Milwaukee Neighborhood News Service, Wisconsin Public Radio, PBS Wisconsin, other news media and the UW-Madison School of Journalism and Mass Communication. All works created, published, posted or disseminated by the Center do not necessarily reflect the views or opinions of UW-Madison or any of its affiliates.

Unhoused and underserved: Milwaukee sees increase in homeless resident deaths 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.