The Walworth County Health & Human Services Board convened on June 18, 2025, to discuss the ongoing challenges and financial implications of the Birth to 3 program, a critical service for children with developmental delays. The program, which is mandated by the state, requires a significant annual investment from the county, amounting to approximately $990,000, far exceeding the required maintenance of effort of $458,000. This funding is essential for maintaining eligibility for a $194,000 state grant, but the program's financial sustainability is under scrutiny due to billing difficulties and reimbursement issues.

During the meeting, officials highlighted that the Birth to 3 program operates as an entitlement service, meaning eligible children must receive services regardless of their insurance status. This has led to complications in billing, particularly with Medicaid, where reimbursement is contingent on referrals from Medicaid-affiliated pediatricians. The county's relatively small billing department struggles to compete with larger agencies that have more robust billing infrastructures, resulting in limited revenue generation from the program, which typically brings in around $240,000 annually.

To address these challenges, the board is considering a proposal to retain four program staff members while contracting with an external vendor to provide additional therapy staff. This vendor has expressed interest in hiring the current therapists at their existing hourly rates, although differences in benefits and operational practices may arise. The board is optimistic that this partnership could enhance service delivery and compliance with state requirements, as the vendor has successfully met these standards in other counties.

While the discussion did not result in immediate action, it underscored the pressing need for sustainable funding solutions for the Birth to 3 program. The board acknowledged that the financial strain is not unique to Walworth County, as many counties face similar challenges with state funding remaining stagnant despite rising operational costs. As the board prepares the 2026 budget, they are seeking input and direction from members to navigate these complexities and ensure continued support for families in need of these vital services.