Idaho health officials ask committee for transfer exemptions, federal authority to access delayed behavioral health grants

At a Joint Finance-Appropriations Committee budget hearing, Legislative Services analyst Alex Williamson and Department of Health and Welfare (DHW) Director Alex Adams described federal and state funding needs tied to the Idaho Behavioral Health Plan (IBHP), the 988 crisis line rollout and community mental health programs and asked the committee for transfer-exemption authority to move funds across program categories.

The Idaho Behavioral Health Plan, which went live in July 2024 after implementation delays, carries federal grants that the department says it needs legislative appropriation authority to access. Alex Williamson, budget and policy analyst with the Legislative Services Office, told the committee the agency is requesting a $6,700,000 one-time federal supplemental to support the first year of IBHP operations and an ongoing federal operating increase of $261,400 to support grant administration.

Why it matters: Director Alex Adams and the analyst said the IBHP funds cover services that fill gaps not paid by Medicaid — for example, services for non‑Medicaid-eligible children and crisis services for people who do not qualify for Medicaid. Adams told the committee the IBHP contract was large and subject to legal challenges that delayed implementation but that “it is wise and prudent for the department to do it right versus to do it quickly.” He also said the Medicaid budget hearing in March will include a fuller IBHP discussion.

Committee requests and transfer exemptions: The department asked for two transfer-exemption items. First, a fiscal 2025 exemption to Idaho Code 67-35-11’s 10% program transfer limitation to allow department-wide transfers into adult and children’s mental health programs to address unforeseen fiscal year needs. Second, the department requested that the governor’s recommendation to remove additional restrictions be adopted so the division could move funds between personnel (PC), operating (OE) and trustee and benefit payments as needed. Williamson said the department’s existing restrictions require legislative approval to reclassify personnel dollars to other object classes, which the department argues has forced program reductions in the past.

Staffing, timing and federal grants: Adams and Williamson said some IBHP grant authority was budgeted for earlier fiscal years and, because of the later go‑live date and implementation delays, the department needs current-year appropriation authority to draw down the awards. Williamson reported that the Division of Mental Health Services’ authorized full‑time positions (FTP) were revised from an earlier 305 FTP to 278.23 FTP after committee actions taken the previous week.

Contracting and vendor questions: Committee members pressed whether Magellan — the state’s contract manager — or other vendors (Janus was mentioned by a legislator as a contractor with DEI statements on its site) could provide services. Adams said the department is agnostic about vendors that meet contract standards and that Magellan contracts with appropriate subcontractors to deliver services.

Next steps and context: The department emphasized that some behavioral health spending covers non‑entitlement services (gap‑filling for non‑Medicaid services and services Medicaid does not cover) while Medicaid remains an entitlement the state must fund as caseloads change. The department asked the committee to consider the transfer-exemption language to reduce the need for recurring supplemental requests. The full IBHP contract and Medicaid implications are scheduled to be discussed in the upcoming Medicaid budget hearing.

Sources and immediate follow-up: Committee members asked DHW for additional budget detail and for written updates about IBHP billing and implementation; Director Adams said he would provide more information to the committee.