Department outlines public health budget restorations, seeks one‑time and ongoing funding for workforce, data and prevention programs

The Joint Finance-Appropriations Committee heard a presentation on the Department of Health and Welfare's Division of Public Health Services budget that asked the committee to restore several programs to ongoing funding and approve one‑time enhancements for data modernization and workforce supports.

Keith Bybee, division manager of budget policy analysis for the Legislature's staff, told the committee that Public Health Services 'is comprised of five programs'and briefed members on how CARES Act and ARPA carryover and structural changes have driven recent swings in expenditures. "What you're seeing is the downstream effect of all of the CARES Act and ARPA funds that were going through this program at the time," Bybee said, explaining why spending in some years was much higher than realized appropriations.

The discussion centered on two categories of requests: one‑time enhancements largely tied to prior ARPA and federal grants, and restoration of programs the department said were moved from ongoing to one‑time appropriations in prior budget actions. Bybee said the total requested one‑time enhancements shown in the agency's book sum to about $8,752,500 and that the agency requested roughly $20.8 million in ongoing enhancements in its agency request; the governor recommended about $21.5 million ongoing.

Why it matters: the division oversees immunizations, communicable disease surveillance, laboratory services, vital records, home visiting, suicide prevention and other statewide programs that are delivered largely through contracts with local public health districts and providers. Restoration or continued reduction of these programs would affect public‑health services delivered across Idaho.

Most significant items

- Program restorations: The department asked to restore ongoing funding for a set of programs the legislature previously moved to one‑time funding. Examples cited by Bybee and department staff included the Office of Accreditation and Planning (newly formed to support national public health accreditation), suicide prevention, the Drug Overdose Prevention Program, refugee health screening, Alzheimer's and dementia coordination, the Fit and Fall Proof program for older adults, maternal and child health block grant repurposing, diabetes prevention efforts, HIV prevention, oral health workforce activities, hepatitis surveillance and the Women, Infants, and Children (WIC) supplemental nutrition program. Bybee provided amounts for several restorations in the presentation: suicide prevention ($1,807,700 general fund and $195,000 federal), drug overdose prevention (restore 4.0 FTE and $2,820,200), refugee health screening (1.5 FTE and $991,000), Alzheimer's coordination ($275,200), Fit and Fall Proof ($140,000), and other listed items.

- One‑time data and system modernization: The division asked for multiple one‑time investments for data modernization, including vital statistics automation, public health data system modernization, WIC system improvements and general public health data exchanges that the presenters tied to federal epidemiology and laboratory capacity grants. Bybee and Director Alex Adams said Idaho operates dozens of siloed systems and that upgrades would increase efficiency and transparency.

- Immunization assessment fund and vital records: The presentation referenced an immunization assessment fund request and a request for ongoing dedicated funds for the Bureau of Vital Records and Health Statistics. The transcript includes two figures in proximity: a referenced figure that was transcribed as a $22,500,000 request and a separate line that the division "requests $2,500,000 ongoing from dedicated funds" for the Idaho immunization program; that section of the transcript contains inconsistent phrasing and the committee requested follow up documentation. The Vital Records bureau requested $150,000 ongoing from dedicated funds to support timely processing of birth, death and related certificates.

- Workforce and rural incentives: Among the governor's initiatives highlighted was $500,000 from the general fund for a rural physician incentive (medical education loan repayment) program to encourage physicians to practice in federally designated health professional shortage areas. Division administrator Elke Shaw Tullock told the committee the loan repayment programs have a high retention rate: "Almost 91% of the providers that receive these loan repayments stay in the state and practice in the state."

Committee questions and department responses

Committee members asked about the scope and placement of programs, whether initiatives such as Project ECHO belong in the department budget, and the department's decision to seek accreditation‑related staffing. Director Alex Adams said the move to reexamine the base budget had been a '''healthy exercise'' of zero‑based budgeting and that the department removed about $10 million from the FY2026 request compared with FY2025 levels he described as inflated by pandemic federal funding. Adams also discussed the department's intent to focus its work and partner with other agencies where appropriate, for example on substance use prevention versus overdose response training.

Follow‑up and next steps

Multiple legislators asked for additional documentation before voting, particularly about the status and outcomes of earlier ARPA/modernization projects and about details for IT and system upgrades. Director Adams offered to provide a follow‑up memo and materials to the committee. Bybee noted one technical supplemental (a cancer data registry correction) had already been passed by JFAC on Jan. 17.

Ending

Committee chairs asked members to raise detailed questions individually with analysts and staff before any trailer‑bill negotiations. The department left materials available for follow up; members requested additional written detail on the data‑modernization efforts and the precise structure and funding for the immunization assessment and vital records requests.