Health and Welfare committee approves series of Department rule dockets, including newborn screening and Medicaid changes

The Idaho House Health and Welfare Committee approved a package of rule dockets from the Department of Health and Welfare, voting to adopt or approve all items on the day's agenda after discussion on several. Major actions included extending temporary hospital licensing rules, adopting updates to the newborn screening chapter, increasing certain drinking-water laboratory fees, and approving the department's proposed changes that reflect the transfer of direct behavioral-health service delivery to the state's new managed-care contractor.

The approvals came during a full committee meeting in which department staff said some chapters were narrowed because they duplicate federal requirements or are being incorporated into statute. Jared Larson, legislative and regulatory affairs chief for the Department of Health and Welfare, told members that the newborn screening changes “do not change any of the process of how the screening is conducted.” He also explained that several rule chapters were being pared back because they “repeat CMS regulations, state Medicaid rules, and or state waiver authority.”

Why it matters: the package affects licensing and oversight language for hospitals, newborn screening procedures, how the department shares child-protection information with foster families, fee structures for state-certified drinking-water labs, and multiple behavioral-health chapters now tied to the state's contract with a managed-care administrator. Several changes are interim or procedural — the department said it will run legislation to move some of the remaining language into statute later this session.

Committee discussion focused most heavily on three topics: newborn screening language changes and incorporation by reference; how the shift of behavioral-health direct services to the Idaho Behavioral Health Plan contractor affects rules and legislative oversight; and the Medicaid rule cleanup that clarifies the department will follow legislative scope-of-practice decisions. Director Alex Adams told the panel the changes reflect the department shifting from direct service provision to oversight of contract performance.

Votes at a glance

- Docket 16-0314-2301 (Hospitals, temporary rule): Approved. - Docket 16-01003-2401 (Emergency medical services, pending rule): Approved. - Docket 16-0212-2401 (Newborn screening): Approved after substantive questions and department explanations. - Docket 16-0213-2401 (Drinking water lab certification fees): Approved; department said change will increase annual receipts by about $8,300. - Docket 16-0501-2401 (Use and disclosure of department records): Approved; rule revised language to promote "maximum transparency" within legal limits. - Docket 16-0605-2401 (Medical neglect and disabled infants): Approved. - Docket 16-0418-2401 (Children's agencies and residential licensing): Approved. - Docket 16-0407-2401 (State Hospital North & South, repeal of duplicative fee chapter): Approved. - Docket 16-0717-2401 (Substance use disorder services): Approved; committee heard supportive testimony from a behavioral-health trade group. - Docket 16-0733-2401 (Adult mental health services): Approved (substitute motion carried; two nays were recorded on the substitute motion). - Docket 16-0737-2401 (Children's mental health services): Approved. - Docket 16-0313-2401 (Consumer-directed services): Approved. - Docket 16-0309-2401 (Medicaid basic plan benefits, rule consolidation): Approved.

Committee members and department staff said the package generally removes duplicative or obsolete language, incorporates up-to-date references to federal materials where appropriate, and prepares some remaining text to be moved into statute in forthcoming legislation. Director Adams described the effort as returning policy decisions to the legislature: "When you make scope-of-practice decisions, this is obviously something that...we are going to honor," he said.

Several members asked for follow-up materials: what changes were introduced in the incorporated references (for example, a drinking-water manual update), which struck rule language is now reflected in the Magellan contract for behavioral health, and where the public can obtain copies of the IBHP contract. Deputy Director Juliet Sharon said the full Magellan contract is a public record and may be obtained via a records request, and that service descriptions are also published on Magellan's and the department's websites.

The committee adjourned after approving the day's docket list and was told more rule dockets would return to the committee next week.