Health and Welfare nominee Alex Adams tells Senate panel he will prioritize child welfare, pare back agency duties

Alex Adams, the governor's nominee to lead the Idaho Department of Health and Welfare, told the Senate Health and Welfare Committee that his top priority as director is improving outcomes for children in the state's foster-care system and that he has begun a series of organizational and regulatory cuts to allow that focus.

Adams, who said he has served in the role since last June and introduced himself to the committee as "the Director of the Department of Health and Welfare," told senators he has concentrated agency leadership around two themes: "quality over quantity" and "laser focused on child welfare." He said the department employs about 3,000 people, operates 74 buildings in 37 locations, and administers programs ranging from hospitals and Medicaid to vital records and regulation of public swimming pools.

Adams said his leadership has already removed what he described as excessive internal requirements and regulations. "We took 2,300 pages of internal regulations and put them in the dustbin of history," he told the committee. He also said the department will propose statutory consolidation that he expects will eliminate roughly 150 statutory sections and that the agency plans to cut about 200 pages of regulations this year.

Why this matters: Adams told senators he narrowed the agency's priorities so leadership can direct time and resources to the state's highest-need children. He offered concrete targets and operational changes the department is pursuing to reach them.

Adams described the target he and his leadership team set for the agency: to "double the rate of foster homes relative to the number of children." He said the ratio when he started was 0.74 foster families per 100 children entering care and that the ratio had risen to 0.94 during his tenure. "By narrowing our focus, focusing on the big things, focusing on the right things, we've been able to bring some energy, excitement, and leadership to a topic that sorely needed it," Adams said.

Adams listed specific changes he has made or is pursuing: - Organizational changes: an updated senior leadership team of 22 people, 15 of whom are new or in new positions; a chief financial officer who reports directly to the director to raise the priority of budget oversight; and other leadership realignments. - Regulatory and statutory clean-up: removal of large volumes of internal regulations and plans to consolidate and remove outdated statutory provisions and so-called "zombie" grant programs. - Internal controls and integrity: creation of a centralized sign-off process he called "One Department" requiring division administrators, deputy directors and the director to sign off on grants, procurement, sponsorships, regulations and legislative actions; establishment of an Office of Program Integrity (OPI) to perform internal reviews; and a transparency team to improve public records handling. - Child-welfare operational steps: waiver of agency adoption fees (Adams said he has signed off on more than 160 adoptions since he started), efforts to increase foster-family recruitment, and investments in communications and support for foster parents, including 24/7 call-center coverage and a budget request to reduce caseworker caseloads.

Adams said those child-welfare steps were informed by prior legislative oversight and Office of Performance Evaluations (OPE) reports. "We prioritized action plus listening," he said, describing meetings the leadership team and Deputy Monty Pro held with roughly 100 to 120 foster parents to identify recurring problems, particularly around communication and caseloads.

Asked by senators about previous agency problems raised in audits and investigations'including duplicate welfare payments, misallocated funds, and issues with a community-partners grant'Adams said he and his leadership have executed corrective-action work begun by his predecessor. He said that work included updated HR policies on disclosure of conflicts of interest, training on federal grants, a new transparency team for public records, and the internal Office of Program Integrity that is in the hiring stage.

On budget and oversight, Adams told the committee that "the budget is a law, not a suggestion" and said the agency must be accountable to state rules despite a large share of federal funding. He described the department's budget as roughly $6,000,000,000 and said stronger finance oversight provides early warning of programs that might overspend appropriations.

Committee process: The committee did not take a confirmation vote at the hearing. The chair told senators the committee will vote on gubernatorial appointments at a later time, noting the panel would likely vote the following day.

Adams was accompanied in the gallery by his wife and his daughter, whom he introduced during his remarks. Several senators praised Adams' focus on foster care and said they looked forward to working with him if he is confirmed.

Ending: The committee will consider Adams' confirmation at a later meeting; no vote was taken at the hearing.