JFAC reviews Division of Public Health Services budget; members press for program restorations and data modernization details

The Joint Finance-Appropriations Committee convened a hearing on the Idaho Department of Health and Welfare’s Division of Public Health Services budget, where department leaders and legislative analysts outlined program restorations, one‑time enhancements and long‑term structural changes affecting the division’s FY2026 request.

The committee was told the division’s base appropriation for FY2025 was about $164,020,000 and that structural changes after ARPA and CARES Act grants caused a swing in spending and authorization; the department requested restorations and enhancements in FY2026 while the governor recommended a budget that trims roughly 6% year‑over‑year. "It gave us a chance to get about $10,000,000 out of the budget or a 6% reduction year over year," Department Director Alex Adams told the committee.

Why it matters: the Division of Public Health administers core statewide services—immunizations, communicable disease surveillance, vital records, laboratory testing, emergency medical services, suicide prevention, refugee health screening and other prevention programs—that affect public safety, maternal and child health, rural access and disease surveillance.

Division structure and spending profile The division consists of five program areas: physical health services (immunizations, maternal and child health, food safety and other community programs); emergency medical services (licensing, training, statewide EMS communications); laboratory services; suicide prevention and awareness; and health care policy initiatives (which includes the State Healthcare Innovation Plan). The presenters said about 50% of the division’s budget is paid out as trustee and benefit payments (contracts and grants), personnel costs were about 18.6% (roughly $27 million), and operating expenditures near $46 million.

Analysts and department staff described a multi‑year effect from federal pandemic funding (CARES/ARPA) that left appropriation levels higher than ongoing spending in FY2021; the department then converted several previously ongoing programs to one‑time funding, producing a structural question for the FY2026 budget.

Key ongoing restoration requests and one‑time enhancements Committee members and staff walked through the department’s FY2026 requests and the governor’s recommendations. Department materials and testimony identified a set of proposed restorations to regular (ongoing) funding that the division says would return programs to baseline levels after one‑time reductions. Examples discussed with specific dollar figures included:

- Suicide prevention: request to restore $1,807,700 from the general fund and $195,000 federal to continue the program established by the legislature in 2016.\ - Drug Overdose Prevention: request to restore $2,820,200 and four full‑time equivalent positions for the overdose prevention program the division has operated since 2017.\ - Refugee Health Screening: request to restore $991,000 ongoing and 1.5 FTE for mandatory medical screening for refugees resettling in Boise and Twin Falls.\ - Alzheimer’s and dementia program: $275,200 ongoing to support the statewide Alzheimer’s alliance and strategic plan work.\ - Fit and Fall Proof (community fall‑prevention program): $140,000 ongoing.\ - WIC and Women, Infant & Children nutrition: restore $6,944,600 ongoing for supplemental nutrition services and related administration.\ - Oral health workforce, HIV prevention, hepatitis surveillance and diabetes/population health grants: multiple requests (examples discussed included $379,600 for oral health workforce and $957,300 for HIV prevention activities).\

Department staff also outlined one‑time enhancement requests largely tied to federal grants and ARPA carryover: the total one‑time package presented on the ledger was about $8,752,500, and specific items included vital statistics data modernization, WIC system modernization, data modernization for public health management, and a year‑four communicable disease prevention grant request of $2,041,800 to support 4.4 limited‑service positions.

Immunization and vital records The division asked for an ongoing $2,500,000 from dedicated immunization assessment funds to increase vaccine access for Idaho children under 19; the presenters noted the dedicated fund base had last been increased in 2014 from about $17.82 million to roughly $18.97 million. The Bureau of Vital Records requested an ongoing $150,000 in receipt authority; the bureau processes more than 100,000 vital records annually.

Data modernization and IT follow‑up Senators pressed department staff for more detail on how prior ARPA‑funded IT modernization projects have progressed. Director Adams agreed to circulate a three‑page update on Vital Statistics, WIC modernization, and the broader public health data modernization effort; Senator Cook asked for a written status of system upgrades before further year‑over‑year appropriations are approved.

Federal funding dependencies and legal notes Adams told the committee the department still depends on many federal grants and that a recent federal funding pause and subsequent injunction developments created uncertainty; he said there was no current impact but anticipated further discussion on refugee programs. The committee was also told that a technical correction to fund a cancer data registry had been passed by JFAC on Jan. 17 (committee staff noted the correction during the hearing).

Questions from lawmakers Committee members asked whether particular programs might be better housed in other agencies (for example, whether Project ECHO funding should be in the University of Idaho budget or whether some programs belong under the Office of Drug Policy). Adams said the department is open to transfers if another agency could perform the function more efficiently but asked the committee to consider restorations as requested while those conversations continue.

What the committee asked for next Lawmakers asked staff to provide additional documentation: a status report on ARPA and data‑modernization spending and outcomes; clarification of which restorations are statutory obligations; and further detail on performance metrics for restored programs. Director Adams and Division Administrator Elke Shaw‑Tullock said staff would follow up with the requested materials.

Ending note Department leaders framed much of the hearing as an exercise in "0‑based" review of programs that were moved from ongoing to one‑time appropriations during post‑pandemic budget adjustments. The committee did not take votes at the hearing; members requested additional documentation and signaled that some restorations and the data modernization work will receive close scrutiny as JFAC prepares final FY2026 recommendations.