Committee reviews mental health budget requests, federal grants and transfer exemptions for Idaho Behavioral Health Plan

Alex Williamson, budget and policy analyst with the Legislative Services Office, told the Joint Finance-Appropriations Committee the Division of Mental Health Services budget includes separate children’s and adult programs and that several federal grants and one-time appropriations have driven recent year-to-year changes in appropriations.

The discussion focused on several agency requests: a $6,700,000 supplemental to allow the department to access federal grants tied to the Idaho Behavioral Health Plan (IBHP), an ongoing federal-funded enhancement of $261,400 for operating costs tied to grants from the Substance Abuse and Mental Health Services Administration, and transfer-exemption requests to relax statutory program-transfer limits in Idaho Code 67-35-11 for fiscal 2025 and 2026.

“[The IBHP] was originally slated to go live in 2022. However, due to some delays, it actually went live July of this last year,” Williamson said, explaining that the federal grants were issued at an earlier date and the agency needs appropriation authority now to access the funds. Williamson noted the committee’s earlier actions changed some full-time position totals and that the division now shows 278.23 FTP after prior adjustments.

Director Alex Adams, Department of Health and Welfare, said the IBHP procurement and implementation were large and attracted legal challenges that delayed award and contract start. “This was, I believe, 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 said. He told the committee there was about a year of legal challenges that delayed the process and that once legal matters were resolved the department prioritized careful implementation to avoid service disruptions.

Adams and Williamson also explained the rationale for the transfer-exemption requests. The department asked for an exemption to the 10% program transfer limitations in Idaho Code 67-35-11 to allow broader transfer authority into adult and children’s mental health programs for unforeseen expenditures in fiscal 2025, and the governor recommended not imposing additional transfer limits beyond statutory ones for 2026. Adams said the department’s concern is that statutory restrictions on transferring between personnel costs and other-object classes have forced program suspensions in the past; he cited a temporary suspension of some children’s mental health services earlier in the year when the agency limited spending to remain within existing appropriations.

Senators and representatives asked about cost overruns tied to IBHP and other behavioral health initiatives. Adams told the committee that the IBHP budget estimate was “off by a factor of about 60%,” and that the bigger budget issue for behavioral health is that Medicaid is an entitlement that the state must pay when people qualify; the mental-health budgets discussed in the hearing are intended to “fill gaps” — for example for services Medicaid does not cover or for non‑Medicaid populations.

Committee members asked for more detail on the causes of delays in the IBHP procurement and the department offered to provide additional information from procurement staff. Lawmakers also questioned the department’s authority to move funds internally and whether broader transfer authority would reduce the need for supplemental requests.

The department did not request specific committee votes during the hearing; staff framed the items as requests that will come forward in the committee’s budget decision process.