Idaho budget hearing: Health and Welfare seeks staff, prevention funding to reduce costly congregate care

The Department of Health and Welfare told the Joint Finance and Appropriations Committee on Feb. 20 that it is seeking staff and one-time funding to expand prevention work and recruit foster families as a strategy to reduce expensive congregate-care placements.

The department, represented by Director Alex Adams and analyst Alex Williamson, asked the committee to authorize 36 prevention specialist full‑time positions, additional clinicians and licensing staff, and a $14.1 million supplemental tied to foster‑care population forecast adjustments. The agency says rising mental‑health and substance‑use needs among youth and a shortage of specialized community placements are driving an increase in congregate‑care use and costs.

The request matters because congregate care is far more expensive than other placements and is associated with poorer outcomes, Director Adams told committee members. "If a child is removed from their home and placed in foster care, it's $16 a day. If I don't have a foster bed available to them, congregate care is $380 a day," Adams said, adding the department is working to have "the right kid, right place, right time." The department reported foster and assistance payments represented about 60% of the child‑welfare budget in fiscal 2024.

Agency context and proposed changes Alex Williamson, budget and policy analyst with Legislative Services, said the division (retitled youth safety and permanency following a recent reorganization) is authorized 434.8 FTP, with 45.8 vacancies as of Feb. 10;…