Walworth County Health and Human Services presented a proposal on June 18 to contract out therapy services for the county’s Birth-to-3 early intervention program, a change the department says would reduce levy dependence but that therapists warned could disrupt services for families.

The proposal, presented to the Human Resources Committee by the department representative Carlo Nevakosi, would shift therapy work currently done by county-employed therapists to a private vendor. “If we move forward with this proposal in a 2026 budget, 4 county staff would be displaced,” Nevakosi told the committee, while noting that “one provider agency… has interest in bringing all of them on” though no contract exists.

Program staff and several therapists urged the committee to keep the Birth-to-3 therapists as county employees. Heather Abels, who said she has worked in the county’s Birth-to-3 program for 25 years, said, “Changing the current makeup of the Birth-to-3 program could negatively impact the services we are able to provide to the kids in the county.” Paige Lancaster Bozell, an early childhood special educator on the team, said being county employees gives the team “direct access to all information needed” and warned outsourcing could “have long term unintended costs.” Occupational therapist Jeanne Luedke asked the committee “to consider voting against the proposal to eliminate my position within the county and outsource services to a private agency.”

Carlo Nevakosi told the committee the arrangement of contracting therapy services is used by most other counties and could provide operational efficiencies and a deeper bench of available therapists. He described the county’s current financials for Birth-to-3: the program’s maintenance-of-effort accounting match is $458,000 (which allows the county to receive a $194,000 state grant), program revenue is about $240,000, and the county contributed roughly $990,000 in tax levy for the program in 2025. Nevakosi said those numbers, combined with billing difficulties and high administrative cost, motivated the proposal.

Therapists raised service and continuity concerns if the program were outsourced: they said contract staff would likely lose access to county vehicles, county-issued phones, existing workspaces, and county benefits (including Wisconsin Retirement System participation). Abels said losing those tools and workspace would harm “the team’s communication and collaboration.” Committee members also asked whether a vendor would honor current hourly rates and what benefits differences would mean for employee retention; Nevakosi said one vendor had indicated interest and suggested it would match hourly rates but that no guarantee existed without a contract.

Committee members asked for more information before any budget decision. Nevakosi said he would return in July with follow-up data requested by the committee, including how other counties structure hybrid arrangements, outcomes reported by those counties, program evaluation metrics, and an average annual per-child cost based on caseloads. The committee also agreed to coordinate a joint session with the Health & Human Services committee so both bodies could hear the discussion once rather than in separate meetings.

No formal action to change the program or approve contracting was taken at the June 18 meeting; committee members asked for additional information and scheduled the topic to return in July.