Public health division asks legislature to restore ongoing programs, funds data modernization and workforce incentives

The Division of Public Health Services at the Idaho Department of Health and Welfare asked the Joint Finance Appropriations Committee on Monday to restore a range of ongoing public-health programs, fund one-time data modernization projects paid largely with federal dollars, and continue several workforce incentives aimed at rural areas. Director Alex Adams presented the agency's request and answered legislators' questions alongside Division Administrator Elke Shaw Tullock and fiscal staff.

Why it matters: The division administers core public-health functions — immunizations, vital records, laboratory testing, suicide prevention, emergency medical services and other programs — that affect immunization access for children, disease surveillance, maternal-child services and local public-health districts across Idaho. Committee members pressed officials for detail on how federal ARPA and CARES Act carry-over funds and new ongoing appropriations interact with the base budget.

Adams and division staff described a structural budget shift created when several previously ongoing programs were reclassified as one-time appropriations in recent years. The department reported a fiscal-year 2025 original appropriation of $164,020,000 for the division; roughly half of that goes to trustee and benefit payments, about 18.6% (approximately $27,000,000) to personnel and about $46,000,000 to operating costs. The department said CARES Act and ARPA funding created a gap between appropriated and actually spent amounts in 2021 that is now normalizing.

The agency outlined one-time enhancement requests (totaling $8,752,500 in the legislative book) funded largely from federal grants and recommended by the governor, including targeted projects such as WIC modernization, vital statistics data modernization, public-health data modernization work supported by Epidemiology and Laboratory Capacity (ELC) grants, and a multiyear communicable disease prevention grant supporting limited-service positions. Adams noted a technical supplemental for a cancer data registry that JFAC approved on Jan. 17.

On ongoing restorations, the department requested roughly $20.8 million in ongoing funding to reinstate programs moved to one-time status. Specific restoration requests cited in the hearing included: $1,807,700 general fund (plus $195,000 federal) for the suicide-prevention program; $2,820,200 to restore four full-time positions and program funding for the Drug Overdose Prevention Program; $991,000 and 1.5 FTE for the Idaho Refugee Health Screening Program; $275,200 for Alzheimer’s and related dementias coordination; $140,000 for the Fit and Fall Proof community exercise program; restoration of maternal-child and preventive block-grant funding totaling $190,000 repurposed to support prevention and maternal-child health block grants; roughly $6,944,600 ongoing for Women, Infants and Children (WIC) supplemental nutrition; $957,300 ongoing for HIV-prevention activities; $379,600 for oral-health workforce activities; and $599,200 for integrated hepatitis surveillance and prevention work.

Division Administrator Elke Shaw Tullock described the rural-physician loan repayment (physician incentive) program included in the governor’s initiatives and said those loan-repayment programs have a high retention rate. "We have a very high retention rate. Almost 91% of the providers that receive these loan repayments stay in the state and practice in the state," she said.

Committee members pressed for more detail on a handful of topics. Senator Tanner questioned the Office of Accreditation and Planning and noted his review of accreditation standards that mention diversity, equity and inclusion; Adams replied accreditation is a long-standing, voluntary process and said internal review forms now include questions about how proposals comport with "Idaho values." Senator Cook requested an itemized update on prior data-modernization spending before approving new modernization funding; Adams agreed to circulate a three-page summary to the committee after the hearing.

The department described the immunization assessment fund request and other dedicated-fund items: a request to increase the immunization program's base and a $150,000 ongoing request for Vital Records receipt authority to improve processing of births, deaths and other sensitive records. Officials told the committee home-visiting program funding requests would expand voluntary services to at-risk families by increasing subgrantee capacity.

What was not decided: JFAC members asked questions but did not take a formal vote during this hearing. Adams and staff repeatedly invited legislators to follow up individually with analysts for deeper review of complex items. Adams described the budget exercise as a "healthy" zero-based budgeting review that reduced the division's requested base by roughly 6% year over year.

Looking ahead: Committee leaders said they expect follow-up work, potential trailer-appropriation language and additional conversation about program placement (for example, whether some programs might be moved to other agencies). Adams and division staff said they are open to transfers if another agency could perform a program more efficiently.