The department’s 2023–2027 Strategic Plan is now in full motion as we head into the fall. I would like to provide a brief overview of each of the objectives in the plan, which you can find on the DHW website.

Strategic Goal 1: Ensure affordable, available healthcare that works

Objective: Help reduce healthcare workforce shortages

Some Idahoans may not have access to needed healthcare services due to workforce shortages and limited access. The divisions of Public Health, Behavioral Health, and Medicaid are working to:

• Increase the number of sites offering sliding fee scales for patients.
• Help recruit and retain nurses in rural communities.
• Improve direct-care workforce retention and recruitment with hospitals, care facilities, and behavioral healthcare providers.

Objective: Ensure that 50 percent of Medicaid payments are tied to measurable outcomes of better health and cost-efficient care

Under a fee-for-service healthcare system, providers are paid more when they provide more services, not for delivering a higher quality of care. The Division of Medicaid is working to:

• Reimburse for value over volume.
• Restructure Medicaid payments to hold providers accountable for costs and quality.
• Add the Medicaid Expansion population to this work.

Objective: Limit Medicaid spending growth

If Medicaid funding needs exceed overall growth in state revenues, the state will be in the difficult position of either pulling funding from other state programs or increasing taxes to fund Medicaid. The Division of Medicaid is working to:

• Achieve a growth rate that does not exceed a pre-set benchmark.
• Monitor and manage high-cost services.
• Limit the use of low-value, medically unnecessary services.

Strategic Goal 2: Protect children, youth, and vulnerable adults

Objective: Provide in-home preventative services for children who have experienced abuse or neglect and can be served safely in their homes

Idaho lacks a comprehensive, statewide, evidenced-based service continuum for children and families who experience abuse or neglect. The Division of Family and Community Services is working to:

• Implement an intensive standardized in-home case management structure.
• Provide at least three evidence-based services for in-home and foster care cases.
• Improve time to permanency for children in foster care by 10 percent.

Objective: Develop and implement a behavioral healthcare system in Idaho that provides the services that people need, when they need them

Idaho’s current behavioral healthcare services are not structured to maximize the effectiveness of services to for people with behavioral health conditions. The Division of Behavioral Health is working to:

• Collaborate with the Idaho Behavioral Health Council to implement initiatives such as increasing the Idaho behavioral health workforce, establishing Idaho Psychiatric Residential Treatment Facilities for youth, and piloting Certified Community Behavioral Health Centers.
• Improve the children’s mental health system of care, as measured by an improvement of the Child and Adolescent Needs and Strengths Assessment (CANS).
• Launch the 988 crisis line and implement the Idaho behavioral health crisis system.

Objective: Enable adults with developmental disabilities to access a full continuum of crisis care that supports them to remain in communities whenever possible

Most people with developmental disabilities are successfully supported in the community. However, community provider capacity does not allow for effective treatment of people with complex needs that result in unsafe behaviors.

The Division of Family and Community Services is working to:

• Make sure that individuals who have a developmental disability and complex behavioral, mental health, or medical needs receive services that are person-centered, trauma-informed, and delivered in the least restrictive environment possible.
• Make sure that people who have a developmental disability receive appropriate treatment, whether they are living on a state-owned campus, in the community, or are transitioning back to the community from a campus setting.
• Provide services while maintaining safety for clients and the community.

Strategic Goal 3: Help Idahoans become as healthy and self-sufficient as possible

Objective: Reduce Idaho’s suicide rate

As the seventh leading cause of death, suicide is a critical public health issue in Idaho. It brings tragic loss to individuals and entire communities each year. In 2020, Idaho’s suicide rate ranked fifth highest in the United States and was 1.6 times the national average. The Division of Public Health is working to:

• Reduce Idaho’s suicide rate from 23.8 to fewer than 19.0 per 100,000 by June 30, 2025.
• Improve capacity to use data to identify and address equity and risk disparities in high suicide risk populations.
• Increase the use of the Idaho Crisis & Suicide Hotline (988) and Behavioral Health crisis centers.

Objective: Improve conditions in socially disadvantaged communities to prevent disease, injury, and violence

Conditions where people live, learn, work, and play (also called the social determinants of health) contribute to preventable differences in disease, injury, violence, and the ability to be healthy. To address these conditions in Idaho’s socially disadvantaged populations, the divisions of Public Health, Medicaid, and Welfare are working to:

• Invest in one high-risk community each year.
• Explore a cross-division, braided funding strategy to support communities that are addressing the social determinants of health.
• Deliver childcare services to 20 percent more Idaho families whose income is higher than the federal poverty limit but who still can’t afford some necessities.

Objective: Prevent or reduce the impact of Adverse Childhood Experiences (ACEs) across the lifespan of Idahoans

Trauma experienced during childhood severely increases the likelihood of poor physical and mental health throughout life. To address the impact of ACEs, the divisions of Public Health, Medicaid, Family and Community Services (FACS), Behavioral Health, and Welfare are working to:

• Identify opportunities to increase the number of trauma-informed providers and increase awareness of these providers.
• Implement three initiatives identified by the Suicide, Overdose, and Adverse Childhood Experiences Prevention Capacity Assessment Tool.
• Develop an ACEs continuing education training program for providers.

Objective: Reduce the department’s employee voluntary turnover rate

Economic pressure is making it difficult to hire and retain employees, which can negatively impact services to our customers. The department is looking into what more can be done to recruit, retain, and develop staff. Human Resources initiatives include:

• Implementing a “stay” interview program to assess employee job satisfaction.
• Implementing a leadership development program.
• Conducting a compensation study in each division at least every other fiscal year.

Strategic Goal 4: Strengthen the public’s trust and confidence in the Department of Health and Welfare

Objective: Reduce the regulatory burden on the public imposed by our administrative rules

Rules, regulations, and oversight activities are necessary to ensure the health and safety of Idahoans but are less effective when outdated, overly restrictive, or when oversight activities are inefficient or not completed on time. The Division of Licensing and Certification is working to:

• Review and rewrite 12 administrative rule chapters by Dec. 31, 2022.
• Decrease the overall number of words, including restrictive words, in administrative rule chapters.
• Conduct at least one negotiated rulemaking session and two public hearings for each rule chapter scheduled for review and rewrite.

Objective: Build the trust and confidence of the media, employees, those we serve, and other stakeholders through communication strategies that support our mission and vision

Idahoans would be more able to make informed decisions about their health, safety, and independence if they had improved exposure to timely, clear, consistent communications from DHW. The Office of Communications is working to:

• Improve understanding of the department’s work by sharing narratives that demonstrate our compassion and trustworthiness.
• Improve our customers’ experience through use of plain language and other strategies.
• Engage more effectively with community organizations and healthcare providers.

Objective: Navigate global economic, social, and technological changes through matured strategies for resource management

Established strategies for resource planning across divisions over many fiscal years are not flexible enough to respond to emerging economic, social, and technological changes in the global environment. The divisions of Management Services and Information and Technology are developing and implementing proactive, long-term strategies for:

• Procurement of goods and services.
• Maintenance and upgrades for technological needs.
• Acquisition, maintenance, and operation of buildings and facilities.

Objective: Enhance public health and safety by improving the effectiveness and visibility of regulatory activities

Rules, regulations, and oversight activities are necessary to ensure the health and safety of Idahoans but are less effective when outdated, overly restrictive, or when they are inefficient or not completed in a timely manner. The divisions of Management Services and Licensing and Certification are working to ensure that Idahoans are safe, and feel safe, by:

• Completing at least 25 percent of overdue onsite inspections of skilled nursing facilities and assisted living facilities.
• Offering a better user experience and more efficiency in the federally endorsed Criminal History Background Check system.
• Improving the average resolution time for criminal history background checks from 30 days to 6 days.

Stay safe and healthy on this Labor Day weekend! 

The Idaho Department of Health and Welfare is dedicated to strengthening the health, safety, and independence of Idahoans. Learn more at healthandwelfare.idaho.gov.