Health and Welfare seeks $6.7M supplemental, transfer exemptions to fund Idaho Behavioral Health Plan

The Department of Health and Welfare asked the Joint Finance-Appropriations Committee on Wednesday for $6.7 million in one-time federal authority to cover the first year of the Idaho Behavioral Health Plan and for $261,400 in ongoing federal funds to support grants administered under the Substance Abuse and Mental Health Services Administration.

The request also included a transfer-exemption request to loosen limits in Idaho Code 67-35-11 that limit program transfers. Department staff and the director said the exemption would allow the agency to move resources into adult and children’s mental-health programs during unforeseen fiscal-year 2025 expenditures.

Why it matters: agency leaders said the IBHP funding fills gaps that Medicaid does not cover — such as respite care and services for non‑Medicaid patients — and supports crisis and community behavioral health services launched after the plan went live in July 2024. Committee members pressed the director for details about contract delays and the department’s request for broader transfer authority.

Alex Williamson, a budget and policy analyst with the Legislative Services Office, told the committee the department is seeking federal authority now because grants tied to the plan were issued around the planned 2022 go‑live date and the agency cannot access those funds without a current appropriation. Williamson said the supplemental would permit the department to draw down federal dollars that remain available.

Alex Adams, director of the Department of Health and Welfare, said the IBHP procurement and rollout “precede me” and described the contract as unusually large. “I believe it is the largest contract in the history of the state, so I do think it is wise and prudent for the department to do it right versus to do it quickly,” Adams told the committee. He also said roughly a year of legal challenges delayed the process.

Adams and other witnesses explained the practical effect of the transfer-exemption request. Adams said the department must distinguish between entitlements (services required by statute, such as Medicaid) and gap‑filling programs funded by these appropriations. Because the department lacks authority to reclassify certain appropriations between personnel and other expense categories without legislative approval, it has faced situations in which it temporarily limited services to stay within existing appropriations. “We had to temporarily suspend children’s mental‑health services,” Adams said, describing that as one of two options the agency faced when program demand exceeded available spending authority.

Committee members asked for more detail on why the IBHP contracting process was delayed and whether the department could have moved faster. Adams cited legal challenges and argued that rushing a large, complex contract can lead to service disruptions and payment problems. Senator Cook suggested inviting procurement staff to explain the timeline; other members sought follow‑up materials on contract oversight and the department’s plans for using the requested federal funds.

The department also referenced other behavioral health appropriations in recent years, including ongoing funding for community behavioral health clinics and one‑time appropriations to support the 988 crisis line and other community services. Williamson noted prior committee decisions that shifted some authorizations and that the slides presented to the committee reflected actions taken earlier in the week.

The committee did not take a final vote on the supplemental or on the transfer-exemption request during the hearing. Department staff said they would provide additional written detail about the award timeline and the federal grants tied to the behavioral health plan.