House Health and Welfare approves rule changes for several licensing boards, holds two dockets for follow-up

BOISE — The Idaho House Health and Welfare Committee on Jan. 15 reviewed multiple rule dockets from the Division of Occupational and Professional Licenses and approved final or temporary rule changes for several professional licensing boards while pausing action on two dockets for further information.

Cecily Metcalfe, Board Services Program Manager for the Division of Occupational and Professional Licenses and executive officer for multiple licensing boards, presented a series of omnibus, "0-based" rewrites for board chapters and described changes intended to remove duplicative language, align continuing education cycles with biennial renewals and update licensure pathways. Katie Stewart, bureau chief in the division's administration bureau, presented temporary fee reductions the division said were adopted under 2024 appropriation intent language.

Why it matters: The rules and temporary fee changes adjust renewal cycles, continuing-education requirements, examination references and fee schedules for several health-related professions. Several boards are operating with low or negative cash balances, prompting committee members to press for consolidation, fee adjustments and written plans to bring boards into the statutorily required cash-balance range.

What the committee approved and what it deferred

Nursing-home administrators (Docket 24-0901-2401): The committee approved the Board of Examiners of Nursing Home Administrators' rewritten chapter as final. Metcalfe said the rewrite deletes duplicated statutory language, reorganizes sections (legal authority, scope, licensure, fees), clarifies trainee and preceptor requirements and aligns continuing education with a biennial renewal cycle. Metcalfe asked the committee to approve the pending rule as final; the committee approved it by voice vote.

Residential care facility administrators (Docket 24-1901-2401): Metcalfe presented a similar chapter rewrite and said the board reduced continuing-education requirements from 12 hours every 12 months to 12 hours every 24 months, removed the jurisprudence exam and increased several fees to comply with a legislative cash-balance requirement. Committee members pressed the division for details: Metcalfe reported this board's cash balance was negative $109,271.24 as of Sept. 30 and said fee changes in the pending rule would move the board to about 31% of the five-year rolling average of expenditures by fiscal year 2028. Committee members asked for a written plan explaining the deficit and timelines for recovery. The committee held the docket and set a time certain to revisit it on Feb. 12.

Genetic counselors (Docket 24-2401-2401): Metcalfe told the committee the Genetic Counselors Licensing Board's rewrite removes duplicative provisions (including an inactive-license status the division said lacked statutory authority) and removes a board-level continuing-education requirement because certification through the American Board of Genetic Counseling or the American Board of Medical Genetics already requires continuing certification ("6/14" cited in the presentation). The committee voted to hold the docket for one week (to Jan. 29) for a limited follow-up on incorporation-by-reference language and related questions.

Midwifery (Temporary Docket 24-2601-2501): Katie Stewart said the midwifery board had been consolidated into the Idaho Board of Nursing during the 2024 session, allowing the division to lower midwifery fees substantially. The board voted to decrease its fees an average of about 90%, moving from a prior $200 initial application and $850 renewal to $35 for initial licensing and $35 for renewals; the committee approved the temporary rule docket.

Dentistry (Temporary Docket 24-3101-2501): Stewart said the Board of Dentistry voted to decrease fees by 25% (part of an effort aligned to 2024 intent language). The committee approved the temporary rule docket; Stewart said the dentistry board's cash balance represented roughly 294% of its five-year rolling average of expenditures (about $1.2 million).

Nursing (Temporary Docket 24-3401-2501): Stewart said the Board of Nursing approved an average 20% fee decrease for certain licensure items (for example, a renewal fee example cited decreased from $90 to $70). The committee approved the temporary rule docket.

Committee concern about deficits and consolidation

Several representatives pressed Metcalfe for financial detail and for a plan to address negative balances. Metcalfe said the division is pursuing efficiencies, including a bill to consolidate the nursing-home-administrator and residential-care-administrator boards, implementing a new licensing system and cross-training staff. "We do expect expense reductions by combining them," Metcalfe said of the pending consolidation. She also noted the division plans to consider negotiated rulemaking next year to address fee levels.

Representative VanderWag and others repeatedly asked for a clear recovery plan and historical financial detail before approving the residential care docket. Representative McCann asked the division to provide historical cash-balance information and a written plan for returning boards to the statutorily required cash-balance range.

Votes at a glance

- Docket 24-0901-2401 (Idaho Board of Examiners of Nursing Home Administrators): Motion to approve presented and adopted by voice vote (motion carried).

- Docket 24-1901-2401 (Idaho Board of Examiners of Residential Care Facility Administrators): Motion to approve was made; substitute motions led to holding the docket. Committee voted to hold until Feb. 12 for additional financial information and a written plan.

- Docket 24-2401-2401 (Genetic Counselors Licensing Board): Committee voted to hold for one week (to Jan. 29) for follow-up on incorporation-by-reference and related issues.

- Docket 24-2601-2501 (Board of Midwifery, temporary rules): Committee approved; fees decreased (division stated an average 90% reduction tied to consolidation into Board of Nursing).

- Docket 24-3101-2501 (Board of Dentistry, temporary rules): Committee approved; board voted to reduce fees by 25% (division reported the board held a large positive cash balance).

- Docket 24-3401-2501 (Board of Nursing, temporary rules): Committee approved; board voted to reduce certain fees by an average of 20%.

What the rules change, in brief

- Continuing education: Several chapters were rewritten to align continuing education cycles with biennial renewals; the residential care administrators' requirement was changed from 12 hours per 12 months to 12 hours per 24 months. For genetic counselors, a board-level continuing-education requirement was removed because national board certification requires ongoing maintenance.

- Examinations and licensure pathways: Some chapters removed specific examination details as those are determined by third-party providers; residential care administrators' jurisprudence exam was removed in accordance with cited statutory authority; some rules now add a licensure pathway for holders of a health-services-executive credential.

- Preceptors and trainees: Nursing home administrator rules were reorganized to consolidate trainee application requirements and clarify eligible preceptors (licensed administrators in good standing with at least two consecutive years of experience).

- Fees and cash balances: Several boards adjusted fees to comply with legislative intent language and statutory limits. Metcalfe reported the nursing-home-administrator board had a negative cash balance of $7,128.78 as of Sept. 30. The residential-care board's negative balance was reported at $109,271.24 as of Sept. 30; Metcalfe said the pending rule's fee changes would put that board at roughly 31% by the end of fiscal year 2028. The genetic counselors board reported a positive balance of $143,548.51 as of Sept. 30; the dentistry board was reported at roughly $1.2 million (294% of its five-year rolling average).

What comes next

The committee will revisit the held residential care docket on Feb. 12 and the genetic counselors docket on Jan. 29. Committee members noted temporary fee decreases must ultimately be approved by both legislative bodies to take effect. Metcalfe and Stewart said the division will provide additional financial detail and a written plan, and they signaled intent to pursue board consolidations and negotiated rulemaking where appropriate.

The committee adjourned after completing its docket review and said it would meet again to consider additional rules and RS introductions later in the week.