JFAC reviews Public Health Services budget as agency seeks restoration of programs and one‑time ARPA projects

The Joint Finance‑Appropriations Committee (JFAC) on Monday reviewed the Department of Health and Welfare’s Division of Public Health Services budget, as agency leaders asked the panel to restore a number of previously reduced programs and fund one‑time projects financed with federal ARPA and CARES Act carryovers.

The Division of Public Health Services requested restorations and ongoing enhancements totaling roughly $20.8 million in its agency request and sought about $8.75 million in one‑time federal enhancements tied to ARPA and other public health grants; the governor’s recommendation shown to the committee totaled about $21.46 million in ongoing funding. Director Alex Adams described the 2025 base as $164,020,000 and said the agency’s 2026 request reflects a structural true‑up after CARES and ARPA funds flowed through the division in prior years.

Why it matters: The division administers programs that counties, clinics and hospitals rely on for immunizations, communicable disease surveillance, vital records, suicide prevention, EMS, and other core public‑health services. Restorations would reestablish staff and grant support that officials said were moved from ongoing budgets into one‑time appropriations after the pandemic funding surge.

Adams and budget analyst Keith Bybee framed the request as partly a “0‑based” reassessment after pandemic grants. Bybee, introduced as “division manager of budget policy analysis,” told members the division currently has 256.52 full‑time‑equivalent positions established and reported four vacancies as of Aug. 31, 2024. He said about half of the division’s expenditures go to trustee and benefit payments, with personnel costs around 18.6 percent and operating expenditures near $46 million.

Committee discussion focused on several program lines the department asked to restore, including suicide prevention (established by the Legislature in 2016), the Drug Overdose Prevention Program, refugee health screening, Alzheimer’s and dementia coordination, Fit and Fall Proof (a community exercise program for older adults), HIV prevention, oral health workforce activities, hepatitis surveillance, and the Women, Infants and Children (WIC) nutrition program. Bybee and Adams also described multiple one‑time data‑modernization efforts: vital records modernization, WIC system upgrades, and grants described as epidemiology and laboratory capacity (ELC)‑related data modernization initiatives intended to automate birth/death registration and improve public‑health data exchange with the CDC’s National Center for Health Statistics.

Members asked for more detail on ARPA and systems upgrades before approving additional funds. Senator Cook asked the department for a follow‑up memo describing what prior ARPA‑funded systems work has delivered and what additional funding would do. Adams agreed to circulate a short packet after the hearing and said the division manages “about 62 different, siloed systems” that underpin multiple programs.

Several legislators raised questions about the Office of Accreditation and Planning, a recently formed office inside the division. Senator Tanner (Bierke) expressed concern about repeated references to diversity, equity and inclusion language in accreditation standards he had reviewed. Adams replied accreditation is a voluntary process the department began pursuing in 2012 and said the department added internal review steps to ensure proposed grants, communications and sponsorships “comport with Idaho values, specifically family values.” He characterized the department’s 0‑based review of programs as “healthy but challenging.”

Other items discussed included: a request described on the budget slides as a dedicated immunization assessment fund entry (the presentation referenced both $22,500,000 and a request for $2,500,000 ongoing from dedicated funds for the Idaho immunization program), a request for $150,000 ongoing for the Bureau of Vital Records receipt authority, and $725,900 ongoing in federal funds to expand home‑visiting services to additional counties identified by needs assessment. The governor also proposed $500,000 from the general fund to continue medical education loan repayment under the rural physician incentive program.

The department and members agreed to follow up outside the hearing with additional documentation on data modernization, grant timelines, and the detailed amounts and sources for each restoration. No formal votes or motions were taken during the presentation.

(Quotes and attributions in this story come from the hearing transcript; see speaker list below.)

The committee moved on to residency programs after roughly 90 minutes of questioning; no formal actions on the public‑health budget were recorded at the hearing.