Alex Adams tells Idaho senators he will prioritize child welfare, transparency as Health and Welfare director nominee

Alex Adams, the governor's nominee to lead the Idaho Department of Health and Welfare, told the state Senate Health and Welfare Committee on Oct. 23 that his top agency priority is child welfare and that he has undertaken organizational, regulatory and financial changes since taking the post seven months ago.

Adams, who introduced himself as the department's director and described his management approach as "quality over quantity," told senators he has moved to reduce regulatory and statutory clutter, strengthen financial oversight and expand support for foster families and adoptions.

Why it matters: The Department of Health and Welfare is Idaho's largest state agency and administers Medicaid, child-welfare programs, food assistance and other services that directly affect thousands of residents. Adams' stated reforms and budget controls could change how those services are delivered and funded.

Adams told the committee he oversees roughly 3,000 employees across 74 buildings in 37 locations and that, since taking the post last June, he has sought to focus the agency's work by trimming internal regulations and reexamining statutory responsibilities. "We took 2,300 pages of internal regulations and put them in the dustbin of history," Adams said. He told the committee his leadership team will bring a bill that will "barbecue 150 pages of statute" and that the agency plans to cut roughly 200 pages of rules this year.

Adams said he has centered agency leadership on a narrow set of priorities using the 4 Disciplines of Execution framework and a repeated public emphasis: "child welfare, child welfare, child welfare." He told the committee the department seeks to "double the rate of foster homes relative to the number of children" as a metric of success; when he began, that ratio was 0.74 foster families per 100 children entering the system and the agency is now at 0.94.

On specific programs and personnel changes, Adams said he has reorganized finance oversight and placed a chief financial officer reporting directly to him to provide earlier budget warnings and tighter fiscal controls. He described a new internal review function, the Office of Program Integrity, and said the department is executing a corrective action plan on the community partners grant that includes updated conflict-of-interest policies and federal-grants training.

Senators pressed Adams about recent audits and investigations touching the department. Senator Lenny cited a series of incidents, including the community partners-grant problems, an August 2023 duplicate-payment incident of roughly $32 million and an audit finding that $2.5 million intended for welfare programs was recorded to cover payroll. Lenny also referenced an internal investigation from June 2023 about the possible use of state funds for harm-reduction materials. Adams responded that he has prioritized transparency and controls, saying, "Budget is a law, not a suggestion," and outlining the new sign-off process he calls "One Department," which requires division, deputy and director-level approvals for grants, procurements and policy actions.

Adams described several child-welfare actions taken since he assumed leadership: increasing foster-home recruitment, waiving adoption application and home-study fees (he said he has signed for more than 160 adoptions since starting), creating 24/7 call centers to support foster parents after hours and seeking budget authority to lower caseworker caseloads.

Committee members praised the focus on foster-care outcomes but several asked how Adams will balance the emphasis on child welfare with other vulnerable populations'needs, including people with intellectual and developmental disabilities and skilled-nursing oversight. Adams said those services remain part of the agency's mission and that resources directed at child welfare do not mean the agency will abandon other duties; he called the focus a shared goal for the whole agency.

The committee did not take a confirmation vote on Adams at the meeting. As with other gubernatorial appointments, the committee chair said the panel will vote at a later date, likely the following day.

What happened next: The committee moved on to an administrative-rules briefing after the exchange; no formal action was taken on the nomination during the session.

Notes: Quotations are attributed to speakers as identified in the committee record.