Preventing Early Expulsion to Promote Child Health

Outcome Report
Awarded in 2018
Updated Aug 18, 2025

At a Glance

Through its grant, Thriving Wisconsin (previously Supporting Families Together Association (SFTA)) and its grant partners focused on improving health outcomes by implementing a tiered model of consultation services delivered by quality coaches and infant mental health (IMH) consultants to address disparities in rates of expulsion among young children in Wisconsin. Beyond direct services, the initiative aimed to demonstrate the effectiveness of this tiered model in both urban (Milwaukee) and rural (Western Wisconsin) settings, with the goal of informing policy and system-level changes.

The Challenge

Wisconsin faces high rates of expulsion in early childhood education, with children of color, children from low-income families and children with special needs being most at risk. These expulsions can have long-term negative effects on a child’s educational and health outcomes. Despite knowing the risks, there is no statewide system to provide support to early educators and families before restoring to expulsion. The current early care infrastructure lacks the integrated services necessary to address challenging behaviors in young children in a trauma-informed, equity-centered way.

Project Goals

This project aimed to improve outcomes for all children by building the capacity of adults to support children’s social and emotional health and prevent expulsion from early care and education setting. The goals were to:

  1. Engage parents, caregivers and early educators in conversations surrounding early care expulsion.
  2. Convene professionals to be trained in components of implementation, including engagement strategies, intake and triaging procedures.
  3. Demonstrate the effectiveness of the proposed model of expulsion prevention in Wisconsin, proving that existing systems can be leveraged to create systemic change that will drive the reduction and elimination of early expulsion.

Results

Throughout the project, over 760 hours were invested in direct support and coordination activities, including more than 90 classroom observations, 70 in-person coaching sessions, 41 virtual coaching sessions, 269 phone calls, 237 emails and 114 meetings with stakeholders. A major finding was the 92 percent data that found that preschool aged boys are four times as likely to be expelled than girls. This data underscores the importance of gender-sensitive interventions in early childhood settings.

The project successfully implemented the Climate for Healthy Interactions for Learning and Development (CHILD) tool across multiple sites, allowing coaches to assess classroom climate, identify relational strengths and challenges and track progress over time. This tool empowered the project’s quality coaches to assess and improve the relational dynamics between children, their peers and childcare programs, focusing on the environmental triggers that influence behavior. By integrating social-emotional development practices and trauma-informed care into their approach, it has fostered an environment where both childcare programs and children feel supported and understood.

Lasting Impact

Due to the COVID-19 pandemic, the project had to take an adaptive approach to ensure continued service delivery. With Milwaukee County sites hesitant to accept in-person support, the project team pivoted to virtual consultation and expanded its service area to include Dane County, increasing access and workforce development capacity. These adaptations not only met emerging needs but also contributed to the long-term sustainability of expulsion prevention efforts across the state.

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COVID-19 Response Grant

Predicting Patient Outcomes in Wisconsin and Nationwide Using the University of Wisconsin’s COVID-19 EHR Cohort Database


Outcome Report
Awarded in 2022
Using the COVID EHR Cohort at the University of Wisconsin (CEC-UW), this project aimed to analyze the disproportionate impact of COVID-19 on racial and ethnic minority groups in Wisconsin, compare disease outcomes between UW Health and other health systems and test associations between risk factors, treatments and vaccine status with disease outcomes. CEC-UW has been collecting electronic health record (EHR) data from all COVID-19 patients across 21 participating health systems and, as of September 2021, has compiled more than 250 EHR elements from 1.1 million COVID-19 patients. This data has the potential to help target high-risk individuals, improve treatment, guide variant management and enhance response to future disease outbreaks. The results revealed that Black and Hispanic communities, along with low-income groups, faced significantly higher infection rates and more severe COVID-19 outcomes. Comparison of outcomes between health systems showed that UW Health patients had better recovery rates and lower mortality due to more effective health strategies, including advanced treatment protocols and higher vaccination rates. Finally, the project found that early treatments and full vaccination greatly improved outcomes, while those with underlying conditions or lack of vaccine access faced worse outcomes.