Announcer:

The following program is a PBS Wisconsin original production.

Frederica Freyberg:

Wisconsin hospitals start to feel the squeeze caused by the rising COVID infection numbers, numbers that have tripled in the last month. Afghan refugees continue to arrive at Volk Field this week. The base is equipped to provide support to up to 13,000 Afghans. How Wisconsin voted and counted that vote in 2020 is still a hot priority for state Republicans. And it’s mixed news for the Wisconsin wages and jobs outlook heading into this Labor Day weekend.

I’m Frederica Freyberg. Tonight on “Here & Now,” rising COVID cases and what they mean for a small rural hospital in Wisconsin. Wisconsin Public Radio’s Laurel White updates the Republican effort to investigate the 2020 election. New numbers on jobs and wages going into Labor Day. And the Madison Fire Department tries a new way to respond to emergencies and keep the peace. It’s “Here & Now,” for September 3.

Announcer:

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

Frederica Freyberg:

As Delta COVID cases continue to spike, hospitals across the state are bumping up against capacity. Hospitals like the Marshfield Medical Center in Beaver Dam. Its a small rural hospital in Dodge County, a place where cases are on the rise and the percentage of residents fully vaccinated is ten points below the state average. The hospital is nearly full up now and staff there worry for the start of school and the winter months ahead. For more on the situation at Marshfield Medical Center in Beaver Dam, we turn to Angelia Foster, chief administrative officer at the hospital. Thanks very much for joining us.

Angelia Foster:

Thanks for having me this afternoon.

Frederica Freyberg:

So what impact have newly spiking COVID case numbers had on your hospital and its capacity?

Angelia Foster:

So I wish I had better news. We hit 92% our inpatient capacity, and that’s a real uptick from where we’ve been in the last few months. We are seeing a greater need for respiratory care for our patients that are coming in. It is on average — our average daily census is 150% up over what it was just two weeks ago. So we’re feeling the pressure. We’re feeling the strain and we’re just so incredibly sad that we’re back here again this fall.

Frederica Freyberg:

And so I guess it goes without saying that those patients needing respiratory care and the capacity situation is due to patients who come in COVID-positive?

Angelia Foster:

Correct. Yes. Directly tied. We had a point last weekend where we were about 30% of the patients we had in the house were COVID-positive, and 100% of those in ICU on ventilators were COVID-positive.

Frederica Freyberg:

So how concerned are you and your hospital staff about projections of even further surging COVID cases into the fall and winter, especially in a county with lower vaccination rates?

Angelia Foster:

We’re very concerned. You know, Dodge County, new cases are up 53% since last week, school starts back this week. The fair was about two weeks ago, so we’re really anticipating additional surges. And the challenge for us is, last year we weathered the storm, my team here is incredible, the clinicians and providers who take such good care of our community showed up, but we have 20% fewer this year working. They chose to retire or leave healthcare because the post-traumatic stress is so intense. So I’m nervous not only about the surge that’s coming and the fact that we don’t see any let-up in the numbers, and also not having enough staff to be able to meet that need.

Frederica Freyberg:

What are you doing about the shortage of staff? Are you having to go, say, out of state to contract with staff?

Angelia Foster:

So we have some contracted labor but even that pool is small. And so we’ve really turned to a team model. So we’re asking folks who are not traditionally in clinical environments to come in and help. I’m not clinical, but I can stock a PPE cart for them, or I can take a water to a patient, and our staff is showing up and doing incredible things in order to meet the needs of the patients.

Frederica Freyberg:

What about for patients who may be in your hospital for things like heart attacks or stroke, what does this capacity and the needs of these newly incoming patients do to the care for those patients?

Angelia Foster:

Well, of course we always, always, always strive to take care of our patients, and do the very best we can for them. But I can tell you that across the state, we’re all spread thin, so even if I will accept patients, we’ll continue to try to care for the community, but if we need to transfer out even other facilities are not in a position to take folks right now. So it is a strain. And we don’t ever want to get to the point where we have to decide who gets services and who doesn’t, but if we don’t slow down on the trajectory, we could find ourselves there again this fall.

Frederica Freyberg:

And do you find yourselves close to that at this moment?

Angelia Foster:

I think it’s coming in the next few weeks to months, yes, especially if we can’t get folks to get the vaccine or to mask up or to social distance as kids return to school and, you know, I was at the grocery store yesterday, and in this small town here, there were only a handful of us wearing masks. As we all start to transition inside and be more around each other, the Delta variant is much more contagious, and we’re going to have bigger issues this fall.

Frederica Freyberg:

Do you have an indication from the patients who are coming in who are COVID-positive whether or not those were people who had been vaccinated?

Angelia Foster:

So I can tell you that last month at Marshfield Clinic Health System, 94% of those who were hospitalized with COVID had not been vaccinated. And so that’s very concerning for us, not only here in Beaver Dam but across the state. What it shows me is that the vaccine works, right? With only 6% those being hospitalized having had a breakthrough case, what concerns me more is those who have not had that coverage from the vaccine having to be hospitalized and placed on vents and seeking additional respiratory support.

Frederica Freyberg:

What would you want from state or federal officials by way of any help with this?

Angelia Foster:

I think, you know, quite honestly, we need to quit making it a political issue. We need to make it a public health issue and that’s when I need my colleagues and leadership both at state and federal levels to help us with. Most of them have been vaccinated. Most of them are willing to wear masks, and yet when it comes to publicly saying it, they won’t. We need a break. This hospital will have been here a hundred years next year. I am very concerned that it will not look the same. The way we care for our patients will not look the same. Because if we keep going this way, we’ll lose more staff, we’ll be in a worse position and not know what it’s going to look like in the future, so I need my publicly elected officials to step up to the plate with us and help the communities to see, we need to vaccinate, we need to mask up and we need to social distance to get this under control.

Frederica Freyberg:

Because you and your staff are on the front lines of this and seeing it every day.

Angelia Foster:

Yes, yes. And you know, my staff, I had one of my ICU nurses stop me and she said, “I’ve been a nurse for five years, and five years prior to COVID, I had only lost four patients. And in the last year, I’ve lost over 10 that I’m caring for.” She said that is not acceptable when there’s a solution and a vaccine that could very well help my community, because in these rural areas, we really are family, friends and neighbors taking care of our family, friends and neighbors. And it breaks our heart when we see them come in and need the kind of help that they need to recover from COVID if they can recover from COVID.

Frederica Freyberg:

We leave it there, Angelia Foster, we hear it in your voice. Thank you, and thank you for your work.

Angelia Foster:

Thank you, and thank you for helping us to get the message out. Please, get the vaccine.

Frederica Freyberg:

Full seem ahead on the Republican election investigations in Wisconsin. This week, state GOP lawmakers approved authorizing former Supreme Court Justice Michael Gableman to spend at least $680,000 of taxpayer money to investigate the 2020 election. This, of course, is met with derision on the part of Democrats, including the governor. This latest push is one of several investigations into the election in this state. Wisconsin Public Radio Capitol Reporter Laurel White joins us from the Capitol to break this down. Laurel, very nice to see you.

Laurel White:

Thanks for having me.

Frederica Freyberg:

So this investigation, employing former Justice Gableman is backed by Speaker Vos. Does it then take the front seat over the other investigations?

Laurel White:

Well, I think it’s really important to note that it does have the support of the speaker, it was called for by the speaker, and that really does elevate it in terms of kind of attention it’s going to get, how people are going to talk about it. Now is it going to be given more weight in the end than other ongoing investigations like say the Legislative Audit Bureau investigation that’s also ongoing? I think we’re going to have to see as these two things kind of play out, side by side and results come out eventually in the timing of that which comes first, what’s following up, just what it all ends up looking like in the end.

Frederica Freyberg:

So other than the audit bureau and this Gableman investigation, there are others as well, is that right?

Laurel White:

So there are some pending investigations. There’s an effort that state Representative Janel Brandtjen is trying to spearhead. She sent some subpoenas to Milwaukee and Brown Counties, trying to get some election information from those counties to kind of do her own investigation. She’s the chair of the state Assembly Elections Committee. So we have that. We also have an inquiry led by some private citizens. So as you said, several kind of ongoing or pending efforts happening all at the same time.

Frederica Freyberg:

So for his part, what is Robin Vos trying to show former President Trump and his supporters?

Laurel White:

Well, he’s trying to show the president that he’s taking claims of election fraud or wrongdoing seriously. You know, the speaker has really over the past several months taken strong criticism from the former president, from many other people from his party that say he hasn’t done enough to really look into the 2020 election in Wisconsin, and that’s despite required state audits that have taken place, the partial presidential recount that we had in Dane and Milwaukee Counties. Obviously, those several Republican-backed lawsuits that failed to turn up any widespread voter fraud in Wisconsin. So despite all of that, there really is a continued push, especially from the former president, that, you know, we haven’t looked into it enough. Wisconsin hasn’t looked into voter fraud or wrongdoing enough, and Speaker Vos is saying, “I’m going to do that.”

Frederica Freyberg:

Meanwhile, we know former Justice Gableman traveled to Arizona to check in on its Republican investigation and to an event with the My Pillow CEO. What have you learned about where Gableman wants to take the Wisconsin investigation?

Laurel White:

So I haven’t spoken with former Justice Gableman at all about his particular intentions for his investigation. But we did get some new information this week that is pretty interesting. It’s the budget for the investigation, which obviously tells us a lot, and what we found out there is that a very sizable portion of the budget, the entire budget is about — just shy of $700,000, is going to be spent on data analysis, so we know that there’s going to be a firm that’s hired to look at data. We don’t know exactly what that means, but I think it’s kind of safe to say that means, you know, ballots, voting machines, data from voting machines.

Frederica Freyberg:

So with all of the discussion around subpoenas, which you mentioned earlier, being issued to election officials for access to ballots and voting machines, they have to be signed off on by Vos, but what is the status on these subpoenas right now?

Laurel White:

So it’s a very, very good point that you mention that Speaker Vos has to sign these subpoenas that were issued by Representative Brandtjen for them to be valid. That’s according to two different memos from the Legislature’s legal office. The speaker has not signed the subpoenas, so we’re kind of going to see how this plays out in terms of, you know, Milwaukee County and Brown County, whether they reject or accept the calls to release this information. We do expect Milwaukee County to reject the subpoena request and to not release that information.

Frederica Freyberg:

Meanwhile, what are Democrats saying about all of these efforts?

Laurel White:

Well, you know, they really reiterate that we’ve had a lot of investigations into Wisconsin elections so far. They mentioned those things that I mentioned before, the state audits that have already taken place, the partial presidential recount, all of the lawsuits that we saw after the election, none of which have turned up widespread voter fraud. They say that, you know, continuing to investigate, continuing to launch new investigations sends a message that there’s something to find. And in their opinion, there just isn’t anything to find.

Frederica Freyberg:

All right. We leave it there. Thanks for your coverage of it. Laurel White, nice to see you.

Laurel White:

Thank you.

Frederica Freyberg:

Each year around Labor Day, economists at UW-Madison put out a report titled “The State of Working Wisconsin.” This year, as the state recovers from the losses endured during the COVID pandemic, things are a little shaky due to surges caused by the Delta variant. For more on forward progress for the labor economy as well as the backward steps incurred, we turn to associate director of COWS, formerly known as the Center on Wisconsin Strategy at UW-Madison, Laura Dresser. Thank you for being here.

Laura Dresser:

Thanks so much for having me.

Frederica Freyberg:

Well, as you report, COVID obviously really pummeled the workforce. Your report notes that 114,000 jobs were lost with the hardest hit being in the leisure and hospitality sector, with nearly 50,000 jobs lost, and where employment is still down 17.6%. How historic are these losses?

Laura Dresser:

Well, the losses in April of 2020 were historic, massive contraction, and re-instant kind of restructuring. That 114,000 that we’re behind, that’s how many fewer jobs we had in July compared to February 2020. That’s after a lot of months of progress, right, so that the original contraction was intense and deep, and leisure and hospitality actually in April of 2020 was down 50% and has come back each — slowly and unevenly to this level of being almost 20% behind still where it was in February 2020.

Frederica Freyberg:

So it’s still nearly 20% behind. One question often asked is, why didn’t those workers return?

Laura Dresser:

Well, one thing, you can see across the state is that some restaurants didn’t survive the contraction, right? Some jobs in the industry are gone. Some workers didn’t return because last year, their kids were doing school online and it was difficult to find childcare. And especially when you’re getting industry — restaurant industry wages, the childcare situation can be completely impossible and with the online learning, the family demands were high. But I think also some people used the chance to move into different sorts of jobs, jobs with less exposure, right? The idea of being exposed at work through customers or co-workers became more threatening. The idea of not getting health insurance from your job became a bigger negative. And so there are all sorts of ways that workers could reconsider work, but also just this intense contraction that jobs didn’t exist. And so both things are going on and it’s important to remember both.

Frederica Freyberg:

Now you say in your reporting that a weak labor market tips the balance of power toward employers. I would think it would be exactly the opposite, especially as employers report being so desperate for workers?

Laura Dresser:

I know, at this point in the — I mean, in the original part of the interaction, I would say it was clear there was a lot of slack, there were a lot more workers than jobs. I think at this point, there’s just strong evidence that the balance is tipped in the direction of workers for sure. And you can see that in the kind of relatively we’re not back to February 2020 unemployment rates, but we’re back close to that. And you can see that in the recruiting notices that you get in the mail or the signs on the doors, and I think this is an important moment to try and see the unsustainability of the way those jobs were structured before the pandemic to see what it means to have jobs with bad hours, low wages, no paid leave in the context of a pandemic, the people who are serving your food don’t — in most restaurant work sites don’t get paid if they get sick and stay home. So that’s a pretty big incentive to come to work sick. So all these things kind of got revealed, like what’s an essential worker, and then how do we restructure that work to make it — to make life in those jobs sustainable.

Frederica Freyberg:

As you just said, our unemployment rate is down, and this summer in your report, you noted that Wisconsin added more than 13,000 jobs. So that is real progress out of the COVID hole going forward.

Laura Dresser:

Yeah, absolutely. I think we are seeing — we’ve seen real progress, like I said, you know, loss of so — 500,000 jobs, if I remember correctly, in April 2020. So really, we’ve moved a long way forward on that. We’re still behind a little bit, but I think what we’re really seeing now is workers thinking hard about what’s possible for them and their families, what’s safe, can they get childcare, can they afford the things they need in work, and are they safe. And I think the vaccines have really been a game changer, but again, game change, also Delta variant, and that puts people back on their heels a little bit as well.

Frederica Freyberg:

Too many game changes. But today’s national job numbers were lower than projected. What does that foretell in your mind?

Laura Dresser:

Yeah, I think that we’ve had two very strong kind of 700,000-plus jobs reports, and then this month was more like 235. I think that from my preliminary look at those numbers, it looks to me like that’s weaker than expected, but still substantial growth in the right direction, and you see dynamism in sectors in restaurants and in leisure and hospitality that are really needing to recover. So there is recovery there, it’s not as strong as people want — or people expected but it’s still recovery, and so it’s like good news but a reminder that this is a rocky path and there are a lot of dynamics at work. There’s also some evidence of stronger wage pressure in that report, in leisure and hospitality, so seeing that maybe this is a chance that those jobs get restructured a little bit.

Frederica Freyberg:

All right. Well, Laura Dresser, thank you very much. Thanks for your work.

Laura Dresser:

Thanks for having me.

Frederica Freyberg:

Emergency responses to mental health crisis calls are primarily answered by police. Because one quarter of people killed in police shootings have a mental illness. Cities across the nation are looking to change their approach by deploying unarmed first responders instead. Ch Stedman, assistant chief of medical affairs at the city of Madison Fire Department, talked with Marisa Wojcik about a new program in the city. A program that will, depending on the call, dispatch a mental health professional to that 911 call, or send the police.

Marisa Wojcik:

And so how do you decide if a call is answered by this team or by police, especially if time is of the essence?

Ch Stedman:

Yeah, so the 911 dispatchers and the call takers in the 911 center are really integral to this and they’ve done a lot of training around it. And this is something that luckily they’ve already done. They are very aware of the questions that they need to ask the people that are calling 911 and to send that right resource. And they’ve been doing that for decades and decades. Now they just need to make sure that this team follows a particular set of protocol questions such as, you know, with the behavioral health emergency that’s going on, is there any danger involved, are there weapons involved, is there somebody on scene that’s being violent? And if any of the questions are answered to the necessity of having law enforcement there because of some sort of violent situation going on, then law enforcement will still be sent in first to make sure that that scene is safe. If the information from the 911 caller is that, yes, this is a safe situation, but there is somebody having a behavioral health emergency, then they’ll just send this crisis response team or CARES team directly to the scene. So the 911 center is a very important partner in this, and it’s really just them still doing the same job that they’ve always done with just this extra resource that’s available to them.

Marisa Wojcik:

And what exactly are the first responders, this team of two, doing when they respond to a scene?

Ch Stedman:

Yeah, so fortunately, the information from the 911 center and the questions that were asked there all get loaded into a computer-aided dispatch system. And so all of that information shows up on a computer that the responders have available to them so they can kind of see what the information is, kind of know what they’re walking into. And their job really is to initially de-escalate the situation and make sure that they provide an appropriate intervention. And whether that’s a behavioral health intervention on the part of the Journey crisis worker or some sort of medical assessment that needs to be made by the community paramedic, those folks at the scene can make the decision which protocols to follow, which intervention is most appropriate. And really, most importantly, with programs like this around the country, we’re finding that people that are in some sort of mental health or behavioral health crisis, they tend to not want to see folks walking in with guns, right, and so no matter how good a law enforcement is that their job, no matter how good they are at de-escalating a scene, just the presence of somebody in uniform, somebody with a gun on them can exacerbate the situation. So our responders that come into this situation are not in any sort of formal uniform. They’re not responding lights and sirens and a big fire truck. So we hope that initial de-escalation is possible. And then after that, it’s really providing the appropriate intervention for the person at that time, and even then, referring them to the appropriate mental health resources in the community so we can actually work with them on scene, but also drive them to the appropriate facility specific to their needs.

Marisa Wojcik:

And so if it’s needed, will there be a possibility of, in some cases, officers intervening after this team of two of mental health responders get to the scene and maybe things change?

Ch Stedman:

Yes, certainly, if they’re unable to de-escalate the situation or if there is any sense that there is something illegal going on, then of course law enforcement resources would need to be brought in. But the intent of the team is to not have these people that we consider to be patients. Right. That need more help on the medical side and behavioral health side and hopefully keeping them out of the law enforcement world in general, if they’re not needed there. These folks don’t need to be contacted and set down a path towards jail when the path really that’s going to help them is towards a mental health intervention. So at any point, law enforcement officer can call this team and have them come in. This team can call a law enforcement officer, have them come in. And it’s the same on the medical side. If our paramedics are out visiting with somebody that really doesn’t have an acute medical problem, but they have something more low level that is also a behavioral health issue, our paramedics in the field can call the CARES team to come in and make that intervention so that the — so that the person can have a continuum of care that’s better than the paramedics just saying, “Well, you don’t need a transport to the hospital, so we’re leaving. Goodbye. Have a good day.” Right? We’re offering this kind of extra care that takes the person downstream. We can give them a warm handoff to the appropriate mental health provider and then have that referral, take the person to where they need to be.

Frederica Freyberg:

The full interview with Ch Stedman can be seen by going to PBSwisconsin.org and clicking on the news page. That’s our program for tonight. I’m Frederica Freyberg. Have a good weekend.

Announcer:

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