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Idaho health officials seek authority to shift funds as behavioral health plan costs surface
Summary
Department of Health and Welfare officials told the Joint Finance-Appropriations Committee they need temporary and ongoing authority to transfer funds across programs to cover higher-than-expected costs tied to the Idaho Behavioral Health Plan and to stand up 988 crisis services.
Alex Williamson, a budget and policy analyst with the Legislative Services Office, told the Joint Finance-Appropriations Committee the Division of Mental Health Services is requesting a mix of federal supplementals and transfer-authority changes to support the Idaho Behavioral Health Plan and related services such as 988 crisis-line operations.
The Idaho Behavioral Health Plan (IBHP) went live in July 2024 after delays; the department now seeks a $6.7 million one-time federal supplemental for the plan and a $261,400 ongoing federal operating increase to cover grant administration costs, Williamson said. She also described a department request for exemptions to statutory program-transfer limits under Idaho Code 67-35-11 so the department can move funds across programs during fiscal 2025 and beyond.
"The appropriation was for 2022 and is no longer usable by the agency," Williamson said of federal grants tied to the original IBHP timeline, explaining the supplemental is needed to access federal funds that remain available. The governor recommends the requested federal receipt authority and the transfer-exemption language, she said.
Department of Health and Welfare Director Alex Adams told the committee the IBHP contracting process was protracted in part because the contract was large and drew legal challenges. "I believe this was 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, adding there were about a year of legal challenges that delayed implementation.
Adams and Williamson drew a distinction between Medicaid-covered behavioral health services and the division’s gap-filling budgets. Adams said the division's budgets pay for services Medicaid does not cover (for example, respite care) and services for non‑Medicaid patients (such as children above 300% of the federal poverty level). He told members that, because some of these services are not statutory entitlements, the department has to manage within its appropriation and has, at times, temporarily suspended services when funding was insufficient.
Senators pressed department officials on whether bidding and contract delays contributed to the department’s need for supplemental authority. Adams reiterated legal challenges and the size of the procurement slowed the process; he maintained the department prioritized getting the system operational without breaking provider payment flows.
Why it matters: committee members flagged the budget risk of grant timing and of rules that limit transfers between personnel, operating and trustee/benefit categories. Department leaders said transfer exemptions would let them move underused program dollars to cover shortfalls and avoid recurring supplemental requests. Legislators asked for follow-up details on the IBHP budget and on contractor arrangements for 988 operations.
The committee did not take a formal vote on the department’s requests during the hearing; Adams and Williamson said they would provide additional detail to the committee on the grants, contractor relationships and the requested transfer authority.
