Coalition pushes more state funding for program that helps children with developmental delays

Shenell Harden’s son Jackson was born premature at 27 weeks. 

Harden, a Milwaukee native, was diagnosed with cancer during the pregnancy and was receiving chemotherapy while Jackson was still in her womb. 

“It wasn’t really known what the duration of his life would look like,” Harden said. 

Jackson stayed in the neonatal intensive care unit after he was born. He was slow to hit the milestones typical for growing babies. He was on oxygen, had trouble holding up his head and didn’t begin to develop language or respond to Harden as expected. 

“I was worried that he would be set back, especially in his physical abilities,” she said. 

Harden’s son received physical therapy and speech therapy shortly after he was was released from the hospital through Wisconsin’s Birth to 3 Program. Jackson celebrated his third birthday on Easter Sunday and is now speaking fluently.

“It (Birth to 3) changed my hope and my thinking and direction of what his future would look like,” Harden said.  

Around 13,200 Wisconsin children receive help through the state’s Birth to 3 Program every year. The program is for families with children under the age of 3 who have developmental delays or disabilities. It provides the family with a team of speech therapists, occupational therapists, physical therapists and special education teachers. 

Ben Weston, the chief health policy advisor for Milwaukee County, said it’s critical those children receive services at a young age.

“If you can’t get the proper services — if you can’t get physical therapy, if you can’t get speech therapy, you can’t get addressing a learning delay — then you’re going to set that child back. Not just for a few years, but you could set them back for their entire life,” Weston said. 

In Wisconsin, the federally-mandated program is funded by the federal government, state government, counties as well as through Medicaid and insurance. 

“That’s how it’s supposed to work. But at every level, it’s been underfunded,” said Polina Makievsky, the president and CEO of Penfield Children’s Center in Milwaukee.

Penfield Children’s Center is one of the three providers for the Birth to 3 Program in Milwaukee County. The center, along with other providers and counties in Wisconsin, is calling for a $10 million increase in state funding for the program starting next year.

The request comes as state funding for Birth to 3 has remained flat over several years according to the group. Meanwhile, statewide enrollment in the program has increased by 19 percent since 2020, according to the statewide Nurturing Every Start Coalition.

A spokesperson for the Wisconsin Department of Health Services said funding for the program in Gov. Tony Evers’ 2025-27 budget proposal remains at its current funding level of $6.9 million a year. 

The coalition found that around 47 percent of the funding for the program each year comes from the county tax levy and from county community aids. 

“So with state funding being flat, the counties have increasingly had to draw upon county levies and using their community aids to fill that gap, and they’re not filling the gap,” Makievsky said.

An issue brief from the coalition said that funding structure “places a disproportionate financial burden on local governments.”

“And that’s just not … sustainable for us as a community,” Milwaukee County Executive David Crowley said at a Tuesday press conference. 

Medicaid reimbursements to providers for the program declined by 7 percent while private insurance reimbursements declined by 42 percent from 2015 to 2023, according to a January report prepared by the Birth to 3 Sustainability Workgroup.

There used to be nine providers for the Birth to 3 Program in Milwaukee County, but now there are only three.

“If providers aren’t getting reimbursed, it’s hard to convince them to continue to engage with the Birth to 3 Program,” Weston said.

The coalition is calling for more state funding for the program in order to “keep up with growing caseloads and give rate increases to service providers,” according to the coalition’s website.

St. Francis Children’s Center serves around 330 children each year through the program. Laura Felix, the executive director of the center, said its Birth to 3 Program is the only program the center offers that has a budget deficit each year.

“This is not just a Milwaukee County issue, this is across the state,” Felix said.

Felix said Medicaid does reimburse the center for a flat rate of service.

“But that money, that contract does not cover the cost of all of these therapies,” Felix said.

Around 1,200 children were served through the Birth to 3 Program at Penfield Children’s Center last year, according to Makievsky. 

“We are proud and honored to do this work, but I will tell you, it has brought increasingly mounting challenges for us,” Makievsky said. 

Penfield Children’s Center  was forced to close a $1 million budget gap last year.

“We have been dipping into our reserves to cover the gap,” Makievsky said.

A spokesperson for Gov. Evers didn’t respond to a request for comment for this story.