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Lawmakers press Health & Welfare on mental‑health cuts, ACT team changes after reported deaths
Summary
At a JFAC hearing, legislators pressed the Health & Welfare director on how cuts and program changes — including unbundling ACT teams — affect crisis services and hospital capacity; the department said component services remain, Magellan is coordinating care, and staff will provide utilization data and follow‑up.
Lawmakers pressed the Idaho Department of Health and Welfare on Wednesday over reductions to behavioral‑health services, the unbundling of assertive community treatment (ACT) teams and two reported deaths that members linked to service changes.
Senator Wintrow and Representative Cook asked whether rate reductions and service eliminations — including an across‑the‑board 4% reduction for Magellan and mirrored cuts on the non‑Medicaid side — are threatening the state’s psychiatric hospitals and crisis services. Director Juliette Sharon said the department is monitoring access, has worked to preserve crisis and hospital contracts and will provide follow‑up data on utilization and capacity.
"We are monitoring access to services, very closely," Sharon told the committee, adding the department is seeking to preserve hospital and crisis services while balancing difficult budget decisions.
Ross Edmonds, administrator of the Division of Behavioral Health, acknowledged two deaths reported in areas served by ACT teams and said component services that made up ACT (counseling, case management, psychiatric services) remain available, although the bundled ACT team model is no longer provided through Medicaid. "ACT as a service is no longer available as a bundle... those individual services are still available," Edmonds said, and he described at least one client who transitioned from service user to recovery‑coach as a success story.
Several members said anecdotal reports and early local data suggest increased strain on emergency departments and psychiatric units since ACT changes. Representative Manwaring asked what the department is tracking; Sharon replied the department and Magellan are monitoring hospitalizations, emergency‑department psychiatric utilization and what services clients who were on ACT are still engaging with, and said Magellan's care coordinators outreached clients before ACT removal.
Committee members asked the department to provide concrete utilization and outcome metrics, performance deliverables from Magellan and any recoveries or corrective actions identified through program‑integrity reviews. The director said Magellan submits monthly, quarterly and annual deliverables, and the department has used corrective action plans when performance was insufficient.
The committee did not take formal votes. Members requested follow‑up on specific data points — hospital and ED utilization, psychiatric‑unit occupancy, lists of providers and services affected by reductions, and detailed costing for proposed position restorations tied to the Jeff D. settlement — before reconvening Monday morning.
