Idaho Senate Health & Welfare committee approves a package of administrative rule changes, addresses newborn screening, drinking‑water lab fees and behavioral‑​

The Idaho Senate Health and Welfare Committee approved a package of administrative rule dockets Wednesday that the Department of Health and Welfare said streamline existing rules, remove duplicative language, and align rules with contracts and federal requirements.

The committee approved more than a dozen rule dockets by voice vote after presentations from Jared Larson, Legislative and Regulatory Affairs Chief for the Department of Health and Welfare, and department staff. Motions on each docket were carried on voice votes; the committee recorded no roll‑call tallies in the transcript.

The adopted changes include: repeal or consolidation of obsolete emergency medical services chapters; a non‑substantive reorganization of the newborn screening rules; an update to drinking‑water laboratory certification and modest increases to laboratory certification fees; a policy change to emphasize sharing department records with foster caregivers where permitted by law; repeal of a chapter tied to child‑welfare temporary rules; repeal of state hospital fee rules that duplicate federal Medicaid/CMS requirements; removal of Department service‑provider language for substance‑use disorder (SUD) and mental‑health services now delivered under contract with Magellan; and a broad, ZBR (zero‑based review) rewrite of the Medicaid basic plan to remove duplicative federal requirements from state rule text.

"The requirements for newborn testing and newborn screening has been in Idaho code since 1921," Jared Larson told the committee when presenting the newborn‑screening docket, noting the department removed outdated or duplicative text and changed some internal requirements from "must" to "should" to reflect internal laboratory practices rather than substantive program changes.

Why it matters: the package affects multiple groups — new parents, foster families, clinical laboratories, Medicaid participants and behavioral‑health providers — by clarifying what the department will administer directly, what is delivered under contract, and which technical standards the state will reference rather than repeat in rule.

Key items and discussion

Newborn screening: The committee adopted a rewrite and reorganization of the newborn screening chapter. Larson told senators the underlying screening requirement traces to Idaho law from 1921 and that the rewrite is a ZBR effort to remove duplicative language. In response to a question from Sen. Shippy about parental consent, Larson said he was not certain whether explicit informed‑consent language appears in code but noted Idaho law includes a religious exemption. The transcript records no change to consent policy; the rule package restructures internal laboratory and processing language.

Drinking‑water laboratory certification and fees: The Department proposed incorporating by reference EPA Supplement 2 to the Manual for the Certification of Laboratories Analyzing Drinking Water (Fifth Edition) and increasing several certification fees. Dr. Christopher Ball, chief of the Bureau of Laboratories, told the committee the supplement (published in 2012) adds certification language for testing two parasites, Giardia and Cryptosporidium, and that no Idaho laboratories are currently certified to perform that testing. The department proposed increasing the annual base chemistry discipline fee from $50 to $100, moving microbiology testing to a flat annual fee of $150, and raising the out‑of‑state chemistry base fee from $50 to $200. The department estimated net additional receipts of about $8,300 annually and said it received no negative public comment during the extended fee rule comment period.

Foster care records and disclosure: The committee adopted a rule that changes the department's default posture on release of information, particularly in the child‑welfare context, to "share as much information as we can" with foster parents and others who need it to support placements, subject to law. Larson said the revised language aims to ensure foster families and private children's agencies have the information necessary for safe placements; Deputy Director Juliette Sharon discussed implementation and safeguards during questions.

Behavioral health rules and contract administration (SUDs, adult and children’s services): Several dockets remove or modify rule language that treated the Department as a direct service provider for substance‑use disorder (SUD) treatment, adult mental‑health services and children's mental‑health services. Larson and department staff said those services are now provided under a contract with Magellan that took effect July 1, 2024, and the rule changes align state rules with that contract and with statute. The department also proposed allowing additional, substantially similar credentialing bodies for SUD provider certification to ease workforce shortages; Peyton Darst of the Idaho Behavioral Health Association testified in favor, saying reciprocity would help expand the workforce. Britney Shipley testified with concerns about new language adding "medical necessity" for children's mental‑health services, asking for clarity on who determines medical necessity and how it interacts with judicial orders for treatment. Deputy Director Juliette Sharon told the committee medical‑necessity determinations are made by clinicians and reiterated the department's intent is to clarify existing practice, not remove access to services.

Medicaid basic plan rewrite: Larson described a wide ZBR rewrite of the Medicaid basic plan chapter intended to strip duplicative federal requirements from state rule text and leave state policy levers clear for the legislature. The department said the rewrite reduces the chapter from about 150 pages to about 80 pages and clarifies provider definitions so the department does not act as a secondary scope‑of‑practice policymaker when the Legislature or licensing boards set scope.

Public comment and negotiated rulemaking: For several dockets, department staff said the changes were produced through negotiated rulemaking and that either no written public comments were received (fee rule) or concerns raised during rulemaking addressed implementation clarifications. For the children's mental‑health docket, department staff acknowledged comments and arranged for department staff to answer stakeholder questions on medical‑necessity language.

Votes at a glance (motions carried by voice vote unless noted)

- Docket "sixteen‑one‑three‑two‑401" (chapter repeal/consolidation of EMS chapters) — motion by Sen. Harris; second Sen. Ziderfeld; outcome: approved (voice vote). - Docket "sixteen‑two‑twelve‑two‑401" (newborn screening ZBR/rewrite) — motion by Sen. Blalock; second Sen. Van Orden; outcome: approved (voice vote). - Docket "Sixteen‑twoThirteen‑two‑401" (drinking‑water lab certification/fee changes) — motion by Sen. Harris; second Sen. Wintrow; outcome: approved (voice vote; one recorded opposition noted in transcript). - Docket "sixteen‑five‑one‑two‑401" (use/disclosure of department records — foster care context) — motion by Sen. Wintrow; second Sen. Blaylock; outcome: approved (voice vote). - Docket "Sixteen‑six‑five‑two‑401" (full chapter repeal tied to child welfare) — motion by Sen. Harris; second Sen. Wintrow; outcome: approved (voice vote). - Docket "Sixteen‑fourEighteen‑two‑401" (children's agencies/foster care licensing alignment) — motion by Sen. Harris; second Sen. Wintrow; outcome: approved (voice vote). - Docket "Sixteen‑four‑seven‑two‑401" (state hospital fees chapter repeal) — motion by Sen. Blaylock; second Sen. Van Orden; outcome: approved (voice vote). - Docket "16O7172401" (substance use disorder services — remove Dept. as direct provider; allow additional certifiers) — motion by Sen. Wintrow; second Sen. Ziderfeld; outcome: approved (voice vote). - Docket "23,332,401" (adult mental‑health services — align with Magellan contract) — motion by Sen. Harris; second Sen. Ziderfeld; outcome: approved (voice vote). - Docket "1607300324000001" (children's mental‑health services — align with Magellan contract; add medical‑necessity language) — motion by Sen. Harris; second Sen. Ziderfeld; outcome: approved (voice vote). - Docket "16 0 3 1 3 2 4 0 1" / "Sixteen‑threeThirteen‑two‑401" (consumer directed services ZBR rewrite) — motion reported by Senator Shippey; outcome: approved (voice vote). - Docket "sixteen‑three‑zero‑nine‑24‑01" (Medicaid basic plan ZBR rewrite) — motion by Sen. Harris; second Sen. Wintrow; outcome: approved (voice vote).

Discussion vs. direction vs. decision

- Discussion: Committee deliberations and stakeholder testimony clarified language and implementation (for example, questions about parental consent for newborn screening and who determines medical necessity for children's mental‑health services). - Direction/assignment: Department staff committed to follow up with stakeholders on implementation details, and Deputy Director Juliette Sharon offered to follow up on eligibility/ID‑card questions raised about emergency Medicaid. - Formal action: The committee moved and approved each docket listed above by voice vote; no item in the transcript was tabled or failed.

Clarifying details pulled from the hearing

- Newborn screening: department said the screening requirement has existed in Idaho law since 1921 and that Idaho law provides a religious exemption; the rule rewrite mainly removes duplicative language and reorganizes sections. - Drinking‑water labs: fee changes proposed — chemistry discipline base $50→$100; microbiology flat fee $150; out‑of‑state chemistry $50→$200; estimated net additional receipts ≈ $8,300 annually; EPA Supplement 2 (2012) incorporated by reference; no Idaho labs currently certified for Giardia/Cryptosporidium testing, per Dr. Ball. - Behavioral‑health contracting: Magellan contract effective 07/01/2024; SUDS/adult and children's behavioral‑health services now administered under contract with department oversight; department proposed accepting an additional credentialing body for SUD certification to address workforce shortages. - Medical necessity: Public commenter Britney Shipley urged clear definition of who determines medical necessity and cautioned that the rule should not allow medically necessary determinations to override court orders; Deputy Director Juliette Sharon replied that medical necessity determinations are made by clinicians and that the rule clarifies existing practice, not restrict access.

Who testified

- Peyton Darst — represented the Idaho Behavioral Health Association; supported adding credentialing reciprocity to expand workforce. - Britney Shipley — testified (self‑identified) raising concerns about medical‑necessity language in children's mental‑health rules and its interaction with judicial orders.

What’s next

Committee members were reminded of an adoption‑related informational event the department scheduled for the Lincoln Auditorium; the committee adjourned and will reconvene at its next regular meeting.

Ending

Committee deliberations Wednesday produced a broad set of rule updates the Department described as mainly procedural or editorial, and several changes meant to align rules with a July 2024 contract that moved many direct services to a contracted vendor. Senators pressed department staff on implementation details, and department officials pledged follow‑up on stakeholder questions raised during testimony.