JFAC reviews Department of Health and Welfare public-health budget; agency seeks restorations, IT modernization

The Joint Finance-Appropriations Committee heard a detailed presentation on the Department of Health and Welfare’s Division of Public Health Services budget, including requests to restore prior ongoing program reductions and fund a slate of one-time data modernization and workforce grants.

The Division of Public Health Services, Director Alex Adams said, is large and complex and ‘‘this was a healthy exercise’’ that trimmed about 6 percent from the program year‑over‑year while restoring some base programs. The division’s FY2025 appropriation was presented as about $164,020,000; the governor’s 2026 request discussed before the committee showed substantial one‑time ARPA/CARES‑era carryovers alongside ongoing restoration requests.

Committee analysts and department staff told members that the division covers five program areas including immunizations, emergency medical services, laboratory services, suicide prevention and awareness, and a health‑care policy initiatives program (which administers the State Healthcare Innovation Plan). Analysts said a large share of the division’s prior appropriations reflected federal CARES Act and ARPA funding and that the department’s current request reflects structural adjustments to return some programs to ongoing status.

Most urgent budget requests and program restorations

Keith Bybee, division manager for budget policy analysis, walked the committee through one‑time and ongoing items. The department identified roughly $8,752,500 in one‑time requests (largely federal funds) that the governor recommended, including items described as: - public health infrastructure and workforce grants focused on hiring and training public‑health staff; - medical education loan repayment funds for clinicians serving in federal health professional shortage areas; - vital‑records data modernization under CDC Data Modernization II to automate birth and fetal death registration and data exchange; - WIC system modernization to improve WIC participant access; and - continued communicable disease prevention grant funding (the packet listed $2,041,800 one time to support 4.4 limited‑service positions for that grant’s fourth year).

On the ongoing side, the division requested roughly $20.8 million to restore programs moved to one‑time in prior years; the governor recommended about $21.5 million in related restorations and a $500,000 initiative for a rural physician incentive program. Specific restoration requests flagged in committee materials included the suicide‑prevention program (established by the legislature in 2016), overdose prevention, refugee health screening, Alzheimer’s and dementia outreach, Fit and Fall Proof (a community exercise program for older adults), HIV/STD/Hepatitis prevention, oral health workforce grants for dental shortage areas, hepatitis surveillance, and WIC nutrition services. A number of these line items showed exact dollar amounts in the department summary: for example, the suicide‑prevention restoration request was listed as $1,807,700 from the general fund and $195,000 in federal funds; the drug overdose prevention restoration was noted at $2,820,200 and four full‑time equivalent positions; refugee screening restoration at $991,000 and 1.5 FTE; and a listed $2,500,000 ongoing request from dedicated funds for the Idaho immunization program (all values as presented to the committee).

Data modernization, ARPA carryovers and IT questions

Senators and representatives pressed department staff for details on data modernization projects that were previously funded with ARPA and other federal grants. Senator Cook requested and Director Adams agreed to circulate a follow‑up 3‑page summary of prior IT modernization work before the committee considered new funding. Adams said the department operates roughly 62 siloed systems and that upgrading vital records and other systems is a high priority to reduce paper processes and improve responsiveness.

Agency structure, program placement and Project ECHO

Several legislators pressed whether some programs should be relocated to other agencies. Representative Price and others asked whether programs such as Alzheimer’s services, Fit and Fall Proof, and the drug overdose prevention program might better fit under the Commission on Aging or the Office of Drug Policy. Director Adams and Division Administrator Elke Shaw‑Tulloch said the department views prevention‑oriented work as central to public‑health responsibilities but said they were open to conversations about optimal placement.

Representative Horman and others questioned a $200,000 line historically used for Project ECHO, which funds continuing medical education hosted by the University of Idaho. Director Adams described the contract as pass‑through funding with the university controlling personnel and program performance and said the department questioned why the item sat in its budget rather than the university’s. Representative Horman asked for intent language removing a direction to continue passing the funding through; several committee members indicated they want further review of pass‑through grants.

Questions about accreditation, DEI language

A number of committee members asked about a newly formed Office of Accreditation and Planning that the department is seeking to restore. Representative Tanner Bierke (who raised the point) expressed concerns after reviewing the office’s accreditation standards documents and flagged repeated references to diversity, equity and inclusion in those materials. Director Adams said accreditation efforts predate his tenure and that the department has added internal review steps to ensure any communications or grants ‘‘comport with Idaho values, specifically family values.’’ He also noted that accreditation is a voluntary process and that removing accreditation status would not automatically affect federal funding.

Federal funding and implementation risk

Committee members asked about exposure to ongoing federal grant conditions. Director Adams noted the department administers more than 100 federal grants and that a brief federal funding freeze earlier in the year had created uncertainty; he said an injunction that affected some draws was later rescinded but cautioned that grant dependencies and carryover funds require ongoing monitoring.

What happens next

No formal committee action or votes were recorded during the hearing. Committee members were invited to follow up individually with analysts for line‑by‑line clarification, and the department agreed to distribute a one‑page summary of prior data‑modernization work funded through federal grants.

Ending

Department leadership told the committee the public‑health portfolio remains large and that the FY2026 request attempts to restore core prevention programs while supporting modernization and rural provider recruitment. Legislators signaled interest in additional detail before making final appropriations decisions.