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The following program is a PBS Wisconsin original production.

Zac Schultz:

Torrential storms leave thousands without power. The EPA recommends tougher standards for forever chemicals in water. And a bipartisan framework could mean new legislation on gun control.

Good evening. I’m Zac Schultz filling in for Frederica Freyberg. Tonight on “Here & Now,” an ER doctor talks about mental health and gun violence, why PFAS contamination and the parts per trillion effects human health, strains to the energy grid could generate emergencies and ongoing formula shortages lead some to the milk bank. It’s “Here & Now” for June 17th.

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Funding for “Here & Now” is provided by the Focus Fund for Journalism and Friends of PBS Wisconsin.

Woman:

No more silence! End gun violence!

Marchers:

No more silence! End gun violence!

Zac Schultz:

Spurred by recent events and calls for action, a bipartisan group of senators earlier this week released details on a gun violence bill that could overcome a Republican filibuster and become law. One centerpiece of the compromise package is a red flag provision that would provide support for states to pass their own bills, creating a process to temporarily remove guns from people who are declared to be a threat to themselves or others. Joining us now to talk about a potential red flag law is Dr. Brad Burmeister, an emergency room doctor at Bellin Memorial Hospital in Green Bay. Thanks for your time today.

Brad Burmeister:

Thank you.

Zac Schultz:

Now, Wisconsin does not have a red flag law. But as an ER doctor, you can and do inquire about guns in the household if you believe someone is having mental health issues. How does that work?

Brad Burmeister:

You know, that’s a great question. So we have a diverse number of patients who present to the emergency department. And we know that there’s some patients who might be struggling with a psychiatric emergency who probably — it is not safe for them to have a gun in their home. Now, in Wisconsin, physicians do not have authority to remove guns from a house, so we’re stuck using it as a risk stratification tool to help understand what patients have a safe setting to return and who might need to be maintained in the emergency department or another psychiatric setting so we can help ensure their safety.

Zac Schultz:

Emergency detention is a process in which the legal system gets involved and can detain someone. A red flaw law is kind of the opposite. It would detain the guns from someone. Does one of those make more sense to you?

Brad Burmeister:

There are likely different applications for both scenarios. Certainly we know that if someone were able to return home who may be lower risk for harming themselves or others, if we can ensure there’s no firearms in their home, we may be able to help preserve the psychiatric services center for patients who might be at higher risk or may need more intensive treatment. You know, certainly having the ability to have a red flag law is something that our medical society — you know, we represent over 10,000 members in Wisconsin with diverse backgrounds, but in general, we have consensus on this matter that physicians think this is something we should have the ability to do in Wisconsin.

Zac Schultz:

For emergency detention, the standard often involves asking the patient if they’re homicidal or suicidal? How much sense does it make to rely on the answers of a person having a mental health crisis to determine that?

Brad Burmeister:

You know, that is a fantastic question. And something that different regions in Wisconsin really struggle with. In Wisconsin, whether or not someone is able to be detained, really is up to law enforcement. It’s not a decision that’s made by a physician in the emergency department or a commonly a psychiatrist, something that law enforcement needs to decide. You know, healthcare providers and law enforcement work hand in hand very often. But you know, it can be challenging and takes some medical expertise to really understand what sort of capacity somebody has to appropriately relay the information of what their thought process is. There’s some patients that may not be truthful when they’re saying they’re suicidal or potentially homicidal. So I think that is what’s the happening part, is how nuanced it is to really make that decision on who is safe to be members in our community both to themselves but also those people around them.

Zac Schultz:

Now, whenever we have a mass shooting like the recent examples in Buffalo or Uvalde, Texas, Democrats at the national level talk about gun control, Republicans usually talk about mental health. In in your profession, how often are you dealing with patients who have mental health problems and should we be conflating those two?

Brad Burmeister:

You know, in the emergency department, we see people who are struggling with either substance use or mental health challenges, you know on a daily basis. It makes up a relatively high volume comparatively of patients who present to the emergency department. You know, I think those two issues, you know, people’s rights to possess a firearm and mental health commonly run side by side with each another. But I think there’s probably opportunities on both ends of that spectrum to improve our regulation in this country by improving access to mental health care and substance use treatments, as well as also improving who exactly we allow to possess a firearm and to what capacity we allow that. You know, a recent study interestingly showed that states that expanded Medicaid actually had improved rates of suicide presumably due to increased access to mental health services.

Zac Schultz:

So are you hopeful that the national debate will actually lead to something substantive that can help you in your job or to prevent mass shootings?

Brad Burmeister:

Yeah. We are very optimistic at this point that for the first time in years or possibly decades, there are good earnest conversations about measures we can take as a nation to improve access to firearms. You know, of course, as physicians, we believe that we do have the constitution and we need to work within the constraints that document has provided to the American citizens. But at the same time, we know that there’s what we think are common sense approaches to limit access for people who it’s very likely it’s just not safe to have access to that weapon.

Zac Schultz:

Thanks for your time today.

Brad Burmeister:

Thank you.

Zac Schultz:

A Dane County judge is referring former Supreme Court justice Michael Gableman to the Office of Lawyer Regulation for “unprofessional behavior and inappropriate comments” he made at a hearing last week. Last Friday we told you Judge Frank Remington was holding Gableman’s Office of Special Counsel in contempt for repeatedly violating the Open Records Law. This week the judge issued his written order, fining the office the maximum $2,000 a day for contempt but also wrote about how Gableman’s actions in court discredited the legal profession. Friday Gableman took the stand and instead of answering questions, proceeded to question Judge Remington’s integrity and make speeches from the witness stand. Then during a break, Gableman kept criticizing the judge.

Michael Gableman:

You know, this is his time to shine, you know. This is his — what passes for success for him.

Zac Schultz:

Gableman went on to criticize the opposing counsel Christa Westerberg. Remington’s order included a professional rebuke of Gableman saying, “In the end, it was readily apparent that Gableman intended to use his appearance to distract from the Office of Special Counsel’s failure to follow the court’s order and perhaps to direct attention away from his office’s illegal records practices. The court will ignore the personal insult. However, the court cannot ignore Gableman’s disruptive conduct and misogynistic comments about a fellow lawyer.”

Earlier this week, a legislative committee allowed new regulations for PFAS contamination to go into effect. A day later, the Environmental Protection Agency released new federal recommendations on PFAS that show Wisconsins new standard is not nearly strong enough to protect human health. Joining us now is Dr. Beth Neary,co-president of the Wisconsin Environmental Health Network. Thanks for your time.

Beth Neary:

Good evening.

Zac Schultz:

Wisconsins new standard on PFAS is 70 parts per trillion for drinking water which matches the old federal recommendation but the EPA’s new standard for one of these so-called forever chemicals is .004 parts per trillion. For those of us that don’t work in parts per trillion, just how big of a difference is that?

Beth Neary:

That’s quite a big difference. So let me but parts her trillion in perspective for you. If I dropped a drop or two of water in an Olympic sized pool, that’s a part per trillion. So what this is saying is this chemical — this toxin is actually a chemical, is very dangerous at very, very low levels.

Zac Schultz:

Manufacturers and chemical companies are opposed to these standards at any level. Saying it will cost too much to comply or it may not even be possible to reach these standards. Are those realistic concerns?

Beth Neary:

Yes, they’re realistic concerns but the reason the EPA came out with this advisory, this has no legal implications to it at this point. It’s an advisory. They’re saying the 70 parts per trillion was an advisory, that’s the old advisory from 2016 that Wisconsin was properly following. So Wisconsin was doing everything it could do. But based on new science, they have come to the conclusion that the 70 was far too high and they need to set lower levels. But yes, the challenge is going to be how do we reach these levels. And that’s yet to be determined.

Zac Schultz:

Now, your specialty is in pediatrics. What does exposure to these contaminants do to children?

Beth Neary:

Okay. Specifically, over time, we’ve learned that the impact of these chemicals are that they can interfere with the body’s natural hormones, which act at very small levels, too. It can increase cholesterol levels. It can increase the risk of certain cancers. And in children, some recent studies show it’s affecting the immune system, to the point where children may not be responding properly to some vaccines and as far as children, it can have effect on developmental disabilities. In pregnancy, women who are exposed can have higher blood pressure and have lower birth weight children.

Zac Schultz:

Now, there are a number of communities across Wisconsin that have found levels of PFAS in their drinking water. Are they doing enough? Can they do enough? What should people who are hearing this information do if they know that there’s PFAS in their faucet?

Beth Neary:

For example, let’s look at Marinette. They have had a problem there and the DNR has stepped up and held the feet of the polluters to provide water for the people in Marinette. In French Island, we also have had a number of people exposed. But what we really need to do is test more. We need to know where the problem is and how to act on it. But the first thing we need to do is test all across the state. The city of Madison has tested all their municipal wells and I would anticipate municipal wells across the country are going to start testing before we can act.

Zac Schultz:

We’ve also heard about a lawsuit filed by Dane County against the Wisconsin DNR because of these new standards and Dane County is typically known as one of the more progressive counties. If they’re suing, saying they can’t have this kind of level enforcement, what does that say for the rest of the state meeting these new standards?

Beth Neary:

You hit on a very difficult situation. We know that many of the companies who have made these chemicals over the years have made quite a bit of money from the use of these chemicals. So I think it shouldn’t be on the onus of the municipalities or the taxpayers. It should be on the onus of the manufacturers to fund the cleanup. If you mess it up, clean it up.

Zac Schultz:

There’s new types of chemicals that are part of this PFAS family and they have their own recommendations that are quite a bit higher than the new federal level, the federal suggestions. What do we know about them and what should we be monitoring there?

Beth Neary:

What we know about some of the substitute chemicals are they do have properties that are very similar to the ones that they are replacing. And that’s showing up in some of the studies, too. But what people listening are going to say, what can I do as an individual? What can you do as an individual is to ask your municipality to test for it and then what can you personally do? You can use water filters. We do know filters work temporarily. But yes, we are looking at a situation that’s going to require many minds to come in and help us figure out how do we clean this up. But that gets at something else. We’re involved in cleanup. That’s two parts. The other part is we need to stop the flow of these chemicals into the environment. So we need to stop what I call nonessential uses of these chemicals. So do we need to have a fry pan that’s nonstick? Not necessarily. So there are some nonessential uses of these chemicals that we could eliminate from society.

Zac Schultz:

Thanks for your time today, doctor.

Beth Neary:

You’re welcome. Thank you for having me.

Zac Schultz:

Extreme weather blew through Wisconsin this week. Heat indexes hit triple digits, creating heat advisories to residents in southeast Wisconsin. And Milwaukee is investigating two heat-related deaths. Severe storms also wreaked havoc, leaving nearly 100,000 without power. Some for days. A spring report from an energy watchdog group warned the Midwest grid is at high risk of energy emergencies and possible blackouts. Marisa Wojcik sat down with electrical engineering emeritus Professor Chris DeMarco to learn more.

Marisa Wojcik:

The grid monitor is warning of these blackouts, growing demand and shrinking supply, so these headlines about potential blackouts, is that creating an alarm?

Chris DeMarco:

Their report in this May of 2022 flagged particularly the north central region of the U.S., the northern Midwest, as being short on sufficient capacity margin. So we always like to build in some margin for unforeseen events: equipment outages, unexpectedly warm weather, some peak in load that wasn’t foreseen. And those margins are slimmer now than these reliability organizations would like them to be. I would say the — NERC is the acronym they go by. NERC raised that alarm I think in part just for action. And the actual operator of the grid throughout much of the middle part of the country is the Midcontinent Independent System Operator. They actually had signs of some of these shortfalls earlier in the spring. And they’ve certainly been trying to take steps. I think NERC’s warning, certainly legitimate, certainly based on real data. But in part, being conservative to spur action to try and avoid significant outages.

Marisa Wojcik:

Is that why experts disagree on the severity, because the report is saying that it’s a sobering situation but other people are saying, we really don’t need to be that concerned?

Chris DeMarco:

You know, there’s certainly a mix of motivations among the different players in the grid. But I think the challenge in much of this is you really are trying to predict things that are inherently random chance. We know that inevitably some equipment will fail. Inevitably we’ll get some conditions we didn’t anticipate. And historically, when severe blackouts have happened, they’re an accumulation of these relatively rare events coming together. So it’s a judgment call in how you weight those different probabilities. I think it is important that the organizations in charge take a conservative approach and you know, grid reliability remains an important need and I think a backdrop to all of this that thankfully thus far has not proven to be as significant a concern as we might have anticipated early in the year, but are there risks of cyber-attacks on the grid simultaneous with these shall we say natural events that might be straining it.

Marisa Wojcik:

Are cyber-attacks a legitimate large concern?

Chris DeMarco:

I think they remain a legitimate concern. The evidence to the extent it’s available publicly, seems to be that there have not been the scale of significant attacks that world events might have caused us to fear earlier in the year. But you know, that’s a situation that evolves day by day.

Marisa Wojcik:

Does Wisconsin have additional capacity? Is that something that can be produced and stored? Or are we importing energy from outside of the state?

Chris DeMarco:

So as a state, we are typically a net importer and indeed, on a broader geographic scale, several of these regions that might so operate switch, by the way don’t coincide exactly with state lines. We’re part of two of the 10 regions that MISO divides up as operational areas for these capacity assessments. They are net importers. The general viewpoint is that’s not a bad thing, provided that’s import capacity that you can absolutely count upon.

Marisa Wojcik:

How much do the somewhat contested high-capacity transmission lines, how do those play into the entire energy landscape in Wisconsin?

Chris DeMarco:

You know, of course, severe weather events can often have an impact over a big geographic footprint. But if you can reach further for your sources of energy, you know, you may move outside of a particular pocket of very hot weather or storm conditions. So it is attractive to be able to move energy effectively over long distances. But it comes at that environmental cost of building transmission lines. You know, like — my personal orientation as an electrical engineer, I probably like transmission lines more than the average person, but I recognize, you know, many folks find them an eyesore and would prefer not to have them close to their property. That represents a societal trade-off we really have to grapple with in policy.

Marisa Wojcik:

Does the increase in battery technology make it easier to store and potentially have energy at hand when emergencies happen?

Chris DeMarco:

Part of the challenge in the power grid, I think even the lay person sort of roughly understands, but the impact may be bigger than many folks recognize. It really is a system in which supply has to match demand moment by moment. And that puts real stresses on the grid. Even a little bit of relief in time, half an hour, certainly several hours, can be very valuable. So I think what you’ll see increasingly, particularly with solar resources, you know — not hard to understand that they produce their maximum output midday. But since we humans tend to feel the accumulated effect of heat, we often tend to pump up our air conditioners most at the end of the afternoon. So you don’t get an exact coincidence in time of when you’re getting the best production from the sun versus when the sun is roughly speaking driving the biggest component of consumption, air-conditioning. And if you can move that a little bit, a few hours in time, you can do a great deal to relieve stress on the grid. And in some cases may lessen the need for longer distance transmission.

Marisa Wojcik:

Professor Chris DeMarco, thank you so much for this conversation.

Chris DeMarco:

Real pleasure to be with you today. Thank you.

Zac Schultz:

The national baby formula shortage has brought a lot of attention to what other options remain when there’s no formula on the shelf. One of the groups benefiting from this new awareness are milk banks. And joining us now is Susan Urbanski, program manager of Mothers’ Milk Bank of the Western Great Lakes, which serves Wisconsin and Illinois. Thanks for your time.

Susan Urbanski:

Thanks for having me.

Zac Schultz:

So does a milk bank work in a similar fashion to a blood bank?

Susan Urbanski:

Yes. We’re a non-profit organization. So as a milk bank, we collect donor milk from moms who have plenty to spare. And we bring it here to our facility in Elk Grove Village. We test it. We pasteurize it and then we distribute it to patients in need. Most of the milk actually goes to hospitals throughout Illinois and Wisconsin for babies in the neo-natal intensive care unit or mother-baby unit. But when we have enough milk and right now, thankfully we do, we’re able also to provide milk for patients at home.

Zac Schultz:

So who are you serving at home? Outside of the hospital in these circumstances, just anyone who’s aware and can come and grab it or do you have a criteria for who gets first dibs at this?

Susan Urbanski:

We do have a prioritization criteria. So we make sure the most medically complex babies have access to the milk first. We have a step-down system from there so that hopefully all babies have access. And right now, thankfully we’re actually able to provide milk for patients at home including healthy babies. So that’s fantastic. But primarily, when we’re working with outpatients, we like to focus on the babies who have those complex medical needs, such as babies who might otherwise need a specialty formula that they can’t currently find.

Zac Schultz:

In the past couple months, there’s been a lot more attention brought to why some women are not able to breast-feed their babies. How important is it for more people to be aware of all the issues and complications surrounding breast feeding?

Susan Urbanski:

There’s plenty of reasons why moms might not be able to provide their own milk. Very often it’s a lack of support. One of the things we do as a non-profit organization is try to support moms to meet their own goals. And that includes connecting them with local lactation resources. But for so many reasons, sometimes that’s just not an option. There’s moms who are taking medications that are contraindicated. There’s families that have no mother that is involved. And then there’s also situations such as adoption and surrogacy or maternal cancer. There’s many, many reasons why human milk may not be available in the immediate family. So we like to come in and help in those situations.

Zac Schultz:

Ive seen you describe there’s both happy and sad reasons for why some women are able or willing to donate milk. Can you walk us through those?

Susan Urbanski:

Yes. So some of the happy reasons that moms are able to donate milk is because they just have plenty. They have lots and lots of milk and they want to pay it forward and share with other families in need. But sitting right hind me, these beautiful stars right here are all hand painted with the names and dates of birth of babies who are honored on our Poppy’s Dream Bereavement Milk Donation Memorial wall. So these are all families who have chosen to donate milk in honor of a baby who has died. So each one of those stars is very special to us and I know a lot of those families personally. And those moms are absolute heroes for being able to offer their milk in a time when they’re hurting. So we’re really grateful for all of our donors, whether it’s happy circumstances or sad circumstances. We’re just grateful for everybody.

Zac Schultz:

You’ve said you’ve seen — you have a surplus right now. Is that due to an increase in both supply and demand? Are you seeing more people come in and be aware of this?

Susan Urbanski:

I wouldn’t necessarily call it a surplus just yet but thankfully, yes. We have seen an increase in demand and supply. So while we have more patients that are currently looking for milk, we have more donor mothers who have answered the call and who are coming forward to be able to provide that milk to families in need.

Zac Schultz:

In terms of what people need to do to donate, what is that process look like?

Susan Urbanski:

That’s great question. We like to try to make the donor application process as simple as possible. Everything is digital. First step is to go to our website. It’s www.milkbankwgl.org and fill out our donor interest form. From there, we’ll give a donor mom a call. She will go through a pre-screening process. We’ll send a written application that can all be completed online. We reach out to each mom’s medical provider for clearance and we also send each mom for a blood draw to make sure that there are no sexually transmitted infections. Once all of that’s done, we have a nurse review the application. And then we can approve that mom as a donor. We also keep in touch with our donors throughout the course of their donation so we know everything is staying safe for as long as they’re donating milk.

Zac Schultz:

How hopeful are you that this attention will increase for the long-term here?

Susan Urbanski:

Im actually really excited because until now, everybody knew what a blood bank was. You mentioned blood banks earlier in the conversation but nobody had ever heard of a milk bank and that was one of our biggest hurdles, was just general awareness. And now people are starting to understand that milk banking is a thing. So I hope that that awareness remains constant and going forward everyone remembers this is an option. Once the shelfs are full again, I don’t want people to forget about the option of milk donation.

Zac Schultz:

Susan Urbanski, thanks for your time today.

Susan Urbanski:

Sure, thanks so much.

Zac Schultz:

For more on this and other issues facing Wisconsin, visit our website and click on the “news” tab.

Finally tonight, a ceremony commemorating the emancipation of enslaved Black people in the U.S. was held at the state Capitol today and the Juneteenth flag was raised.

That is our program for tonight. I’m Zac Schultz. Have a great weekend.

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Funding for “Here & Now” is provided by the Focus Fund for Journalism and Friends of PBS Wisconsin.