Idahoans gathered in Nampa on Wednesday, June 14, to celebrate a multi-phase, multi-tiered project that is improving the system of care at the Southwest Idaho Treatment Center, a state-run facility for people with developmental disabilities.

Called SWITC, the state-run facility offers crisis care for individuals with complex behavioral needs. Its mission is to “support individuals in crisis to become stable, develop skills, and successfully transition to the community.”

SWITC staff and project managers hosted the Wednesday open house to feature the Developmental Disabilities Crisis System Improvement Project, which includes enhancing community-based services, on-campus services for SWITC residents, razing outdated infrastructure, and building needed new facilities.

When complete, the Crisis System Improvement Project will improve the crisis system of care for individuals with intellectual and developmental disabilities, particularly those who also have co-occurring medical conditions or co-occurring mental health conditions.

SWITC residents, department staff, legislators, and advocacy groups attended to learn about project milestones and phases. Many took advantage of the opportunity to tour the campus and see active demolition of old, unused campus buildings.

The four-phase demolition project is projected to be complete in December of this year. Project managers expect ensuing construction to be complete in 2025 or 2026. The Crisis System Improvement Project is focused on building the capacity of community-based providers, creating specialized clinical teams with expertise in complex cases, and implementing a new care model at SWITC.

Specific accomplishments highlighted at the Wednesday open house include:

• Securing a contract with the National Center for START Services. The contract will help Idaho become certified in a national best-practice crisis prevention and response model.  Learn more about START services here:  https://centerforstartservices.org/START-Model.
• Full implementation of P.E.R.M.A. at SWITC campus. PERMA is a person-centered, wholistic, positive psychology approach to treatment and well-being. The approach emphasizes positive emotions, engagement, relationships, meaning, and accomplishments—the concepts from which the acronym is derived.
• Medicaid State Plan Amendments. Idaho Medicaid submitted two state plan amendments to the Centers for Medicare and Medicaid Services (CMS).  If approved, the amendments will enable Medicaid to fund services that would support future crisis prevention and response services, both in the community and at SWITC.
• Demolition of Unused Buildings on SWITC Campus. The most outwardly visible change at SWITC involves demolition of eight buildings on SWITC campus. Buildings slated for demolition are old, unused structures that are damaged beyond repair. An architectural feasibility study determined it would not be cost effective to remodel the buildings. The new care model will feature construction of a new assessment and observation unit and a small number of step-down apartments to assist residents to transition back to community-based living.

The Developmental Disabilities Crisis System Improvement Project is expected to conclude in 2025 or 2026.  Please direct questions about the project to DDCSIP@dhw.idaho.gov.

Chad Cardwell is deputy division administrator for Family and Community Services. He’s worked with DHW for 33 years and has been helping to oversee the Crisis System Improvement Project.

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

Wildfire smoke contains a mixture of air pollutants that are unhealthy for anyone to breathe but are especially dangerous for people in sensitive groups such as children, older adults, pregnant women, and people with heart or respiratory conditions. It is important for every Idahoan to understand the risk of poor air quality from smoke before a wildfire and what to do if air becomes smoky. 

Know your risk

The risk of fine particle-related health effects varies throughout a lifetime. Risk is generally higher during childhood, lower in young adulthood, and the risk grows as we age. People with respiratory and cardiovascular conditions should be particularly diligent about limiting exposure to wildfire smoke.

For more information about people who are sensitive to air quality and most at risk for negative health impacts from wildfire smoke, visit the links below.

• People with asthma and other respiratory diseases
• People with cardiovascular disease
• Children (< 18 years of age)
• Pregnant women
• Older adults
• People of low socio-economic status
• Outdoor workers

Common effects of smoke exposure include irritated eyes, nose, and throat. You should call your healthcare provider immediately if you have shortness of breath, chest pain or tightness, headaches, fatigue, or a combination of these symptoms that worsen.

Limit smoke exposure

When air quality conditions are poor, reduce the amount of time spent outdoors and limit outdoor activities as much as possible. Pay attention to local air quality reports and health warnings. Real-time air monitoring information is available at https://airquality.deq.idaho.gov/home/map.  

The most effective way to reduce exposure is to stay indoors with windows and doors closed. . If temperatures are high and you don't have air conditioning, go someplace that does, like the mall or library.  If you must drive in an area with smoky air, keep all windows closed and turn the vehicle airflow to recirculate to reduce the amount of smoke in the vehicle.

While indoors:

• Keep your windows and doors closed.
• Avoid activities that increase indoor pollution (e.g., burn candles, use propane or wood-burning stoves, aerosol sprays, smoke tobacco products, vacuum) .
• Use portable air cleaners to reduce indoor air pollution.
• Use damp cloths or mops to trap dust and particles that settle on surfaces.
• Adjust your central air conditioning system to prevent indoor air pollution.
• Use an air filter rated MERV 13 or higher and turn the system fan on.
• If the system brings fresh air into the home, ensure it is operating in recirculation mode, including closing the fresh-air intake to prevent outdoor spoke from getting inside.
• Change system filters more frequently, as they may become clogged or dirty.

People who must be outside in the smoky air can use "particulate respirators" or N95 respirators to reduce smoke exposure. Respirator masks worn correctly can provide some protection by filtering out fine particles in the smoke.

A good respirator mask seal suctions the mask to your face during inhalation. It should also be easy to breathe while wearing the mask. The mask should create a breathing space by resting far away from the face to help reduce tightness or difficulty breathing that snug-fitting masks can produce.

The fit is particularly important for masks used during outdoor exercise or when used during long periods, such as in jobs that require being outside.

Be informed

The resources below have up-to-date information on smoke conditions and how to stay healthy during wildfire smoke events:

• Idaho Health and Welfare Wildfire Smoke
• Air Quality Index
• AirNow
• Guide for Staying Healthy During Wildfire Smoke
• Idaho Department of Environmental Quality Smoke Information and Map
• Washington State Department of Health Wildfire Smoke and Face Masks
• Reduce Your Smoke Exposure
• Protecting Your Lungs from Wildfire Smoke and Ash

Carolee Cooper is an Environmental Health Program Specialist for the Department of Health and Welfare.

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

Idaho’s Infant Toddler Program is not well known, but the work it does for children ages birth to 3 years who have developmental delays or disabilities is life-changing.

Children who take part in early childhood education programs such as the Infant Toddler Program grow up to be more likely to graduate from high school and have higher incomes, less dependence on public programs, and fewer encounters with the criminal justice system because they often have their issues resolved.

The Infant Toddler Program offers an array of therapeutic, educational, and supportive services that may include developmental therapy, speech therapy, occupational therapy, physical therapy, service coordination, family training, and coaching.

The program uses evidence-based principles to help families support their child's learning at home, during daily routines. A lead therapist works with the parent or primary caregiver by sharing expertise, developing in-home strategies, and using coaching principals to meet the child’s developmental needs. This empowers the parent or caregiver to independently meet their child’s needs every day in their home or in the community between visits from the Infant Toddler Program. This is when learning naturally occurs.

The program, which served more than 4,200 Idaho children last year, is free for Idaho families who are referred to the program. It is paid for through private insurance for families who have it, Medicaid, and federal and state funds.

The program is growing -- enrollment increased 14.3% in the last five years. That means some families are currently on wait lists. This is concerning for us because timely access to quality early intervention services improves delayed skills for many children. As a child grows, delayed skills become more difficult to change. To help reduce the wait list, we’re exploring additional options and recruitment efforts for some positions that are difficult to fill, and using tele-therapy when it’s appropriate.

Learn more about the program, including how to make a referral at https://healthandwelfare.idaho.gov/services-programs/children-families/about-infant-toddler-program

I hope you have a safe and healthy 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. 

With all the news around Medicaid Protection, I wanted to take a few minutes to offer some information about who Idaho Medicaid serves across the state. Idaho Medicaid staff is working hard to provide about 425,000 vulnerable Idahoans, many of whom are children, with affordable healthcare when they don’t have other options. Medicaid serves about 40% of all the children in Idaho.

Medicaid is the main way in Idaho and nationally that home and community based services and behavioral health services are paid for. It plays an important role in keeping Idahoans safe, healthy, productive, and thriving in their communities.

To be eligible, a person must be a resident of Idaho and either a U.S. citizen or a qualified legal non-citizen.

Once those requirements are met, there are two ways someone can be eligible: based on income or based on age and disability. Eligibility requirements are typically reviewed annually.

1. For income-based eligibility, adults must have income below 138 percent of the Federal Poverty Limit. For a family of four, this is $3,450 a month. Children must be below 190 percent of the Federal Poverty Limit.
2. Medicaid also is available to people who are 65 years old or are blind or disabled. They must meet income and resource limits based on disability and other factors.

Medicaid administers three plans for adults and children.

The basic plan

The basic plan is for people who are in good health and don’t generally have disabilities or special health needs. This plan provides health, prevention, and wellness benefits. It  includes the expansion population.

• Number of adults in this plan: 34,351
• Number of adults in this plan under Medicaid expansion: 134,538
• Number of children in this plan: 179,464

The enhanced plan

The enhanced plan is for people with more complex health needs and medical conditions, disabilities, or special health needs, and for those over the age of 65. The plan provides all the basic plan benefits, plus developmental disability services, children’s service coordination, and long-term care supports. This plan includes home and community based services through waivers for aged and disabled people and those with a developmental disability.

• Number of adults in this plan: 18,689
• Number of children in this plan: 26,877

The Medicare-Medicaid Coordinated Plan

The Medicare-Medicaid Coordinated plan (MMCP) is for people who are eligible and enrolled in both Medicare and Medicaid. This plan provides enhanced plan benefits, plus enrollment in a managed care plan to help coordinate Medicare and Medicaid benefits. These people also have access to a care coordinator.

• Number of adults in this plan: 31,598
• Number of children in this plan: None

I hope you have a safe and healthy 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. 

The Department of Health and Welfare (DHW) works hard to strengthen your trust and confidence in us and in the work we do. We’ve chosen four ways in our Strategic Plan to accomplish this.

Reduce the regulatory burden on the public imposed by our administrative rules.

• DHW met all established administrative rulemaking deadlines for the 12 chapters scheduled for review and rewrite this year. That included conducting at least one negotiated rulemaking session and two public hearings for each of those chapters.
• DHW also developed a redline version of each of the revised chapters that clearly shows the changes.

Proactively communicate with the public about how our work improves the lives of Idahoans in need.

• Communications staff developed training and other materials to help improve internal and external communications and branding consistency.
• We frequently promote cross-divisional work among our employees to staff and the public in blog posts like this one.
• We’ve implemented the use of plain language to improve the customer experience and make sure our communications are easy to understand.
• We’ve added the ability to subscribe to press releases and blog posts so you can stay on top of the most current news and information from DHW.
• We’re also implementing new ways to track our engagement with local media.

Manage our money, people, physical space, and technology resources to best serve the people of Idaho.

• The department developed a plan to consistently buy and upgrade technological needs to make sure business continuity is supported.
• Many of the other tasks associated with this objective are on hold, pending the transition to a new system that handles finance, personnel, accounting, and reporting for state agencies.

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

• We are on track to implement a federally endorsed criminal history and background check system that enhances user experience and reduces the need for manual processing by October.
• We’re also on track to complete the background checks faster and more efficiently.

You can learn more about each of these objectives in our Strategic Plan.

I hope you have a safe and healthy Memorial Day weekend. Our offices will be closed on Monday in honor of the holiday.

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

Pools, waterparks, hot tubs, splash pads, and spray parks are great places to have fun in the summer, but you can get sick if germs contaminate the water. People who get into the water can carry and spread germs.

Follow these four easy steps to help keep germs out of the water and stay healthy.

1. Stay out of the water if you have diarrhea.
2. Shower before you get in the water.
3. Don’t pee or poop in the water.
4. Don’t swallow water.

Why is this important?

If you get into the water when you have diarrhea, you could make others sick. Most outbreaks linked to the water we swim, relax, and play in are outbreaks of diarrhea. These outbreaks are caused by germs like Cryptosporidium (or “Crypto” for short), norovirus, and E. Coli.

These germs—sometimes millions at a time—can spread when someone who is sick has diarrhea in the water. Other people can get sick if they swallow the germy water—even just a mouthful.

Even when it’s treated properly with chemicals, the water can still have germs.

Pool chemicals like chlorine and bromine are added to the water to kill germs. But they don’t work right away. If used properly, they can kill most germs within a few minutes. However, some germs like Crypto, can live in properly treated pool water for several days.

Let the chemicals use their power on germs—not on your pee, poop, sweat, and dirt.

The job of pool chemicals is to kill germs. But when pee, poop, sweat, and dirt rinse off our bodies and into the pool water, the chemicals break down these other things instead of killing germs. This uses up the chemicals’ power, which means there’s less to kill germs. That’s why it’s important to follow the four steps above.

For more tips about healthy and safe swimming, visit the CDC's website: https://www.cdc.gov/healthywater/swimming/swimmers/steps-healthy-swimmi…

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

Backyard birds such as chickens, ducks, geese, and turkeys are increasing in urban and suburban areas. Raising these birds is a popular way to have homegrown eggs and poultry, and a fun way for children to learn about caring for animals. While keeping poultry flocks can be fun and educational, they can carry harmful germs that can make you sick.  Follow these tips to keep yourself and your family healthy while enjoying your backyard flocks.  

Wash your hands. Wash your hands and your children’s hands with soap and running water after touching backyard poultry, handling fresh eggs, or anything in the area where your birds live or roam. Wash hands after touching eggs, handling poultry equipment, and being in poultry areas. Use hand sanitizer if soap and water are not readily available.

Keep birds outside and don’t eat or drink near them. Never bring baby chicks into the home, where they could contaminate indoor surfaces. Avoid eating and drinking around them.

Monitor young children. Children younger than 5 years old should not handle or touch chicks, ducklings, or other live poultry. Younger children are more likely to become ill. Older children should only handle baby chickens, ducklings, or other backyard poultry under adult supervision. If you are supervising young children, teach them to avoid putting their hands or baby poultry near or in their mouths and make sure they wash their hands thoroughly after handling the birds. Do not give small children chicks or ducklings as gifts.

Avoid spreading germs. Don’t kiss or snuggle your birds and don’t touch your face or mouth after handling them. Change your shoes after walking in the coop and before you go inside, so you do not track any germs into the house. Clean poultry supplies like food and water containers outside. Cook your eggs thoroughly.

Diseases backyard flocks can spread include salmonellosis, avian influenza, campylobacteriosis, and E. coli. Specific tips for each germ are listed below.

• Salmonellosis is caused by bacteria called Salmonella

In birds, Salmonella can live in the intestines and can be shed in their droppings, without them appearing ill. In people, Salmonella can cause diarrhea, fever, and stomach cramps anywhere from 12 to 72 hours after infection. People with salmonellosis are usually sick for four to seven days and can spread it to others. If you think you or a loved one has a Salmonella infection, you should seek medical attention immediately.

Children under 5 years of age (particularly those younger than 12 months) and people with underlying health conditions, older than 65, or with a weakened immune system, can get very sick from Salmonella bacteria, even requiring hospitalization. Children are likely to get infected because their immune systems are still developing, and they are much more likely to snuggle or kiss chicks and put their fingers in their mouths after touching birds.

• Avian influenza is caused by an influenza virus

Avian influenza, or “bird flu,” is a contagious respiratory illness circulating in birds that is caused by influenza viruses. Although related, these are not the same viruses that people might get during the regular influenza season. Human infections from bird flu are rare, but influenza viruses could spread from birds to people and then spread from person to person, potentially leading to a new pandemic. The few human infections that have been identified have caused mild illness in some people, but severe illness in others.

Because there is a risk for infection when handling sick or dead birds, bird owners should be careful and contact their veterinarian and the Idaho State Department of Agriculture (see link below) right away for guidance on how to report and manage any sick birds. For birds that test positive, public health officials will work with bird owners to monitor for symptoms and recommend testing if they become ill.

• Campylobacteriosis is caused by the bacteria Campylobacter

Campylobacter is common in the intestines of birds and is shed in droppings. Like Salmonella, the bacteria can infect and cause illness in people even if the birds look healthy.  Symptoms in people include diarrhea, fever, and stomach cramps within two to five days of becoming infected. Ill people are sick for about one week and are contagious to others. Careful handwashing can prevent spread in the household. Children under 5 years of age and people with underlying health conditions, those who are older than 65, or with a weakened immune system can get very sick.

• E. coli is caused by the bacteria Escherichia coli

Birds naturally have E. coli in their gut, and rarely look sick. The bacteria can be shed in bird droppings. Although most kinds of E. coli are harmless, others can make people sick. Most symptomatic people will have stomach cramps, diarrhea, and vomiting that starts three to four days after being infected and will be sick for up to a week. Some people develop a type of kidney failure (hemolytic uremic syndrome, or HUS) and must be hospitalized. Severe illness is more likely in children under 5 years of age and people with underlying health conditions, those who are older than 65, or with a weakened immune system.

Resources:

• Safely Keeping Backyard Poultry, from CDC:  https://www.cdc.gov/healthypets/pets/farm-animals/backyard-poultry.html
• Salmonella, from CDC: http://www.cdc.gov/salmonella/
• Avian influenza, from CDC: https://www.cdc.gov/flu/avianflu/index.htm
• Avian influenza, from USDA: https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/animal-disease-information/avian
• Avoiding zoonotic disease from CDC: https://www.cdc.gov/zoonotic/gi/index.html
• Idaho State Department of Agriculture avian influenza site, including sick bird screening survey: https://agri.idaho.gov/main/animals/avian-species/avian-disease/avian-influenza/#:~:text=If%20you%20see%20any%20avian,information%20on%20testing%20the%20animal

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

The Department of Health and Welfare (DHW) continues to process re-evaluations for Medicaid participants who had continuous Medicaid coverage during the pandemic even if they had become ineligible.

Federal law would not allow anyone to be removed from any state’s Medicaid rolls unless they died, moved out of state, or asked to be removed. Since Congress changed that earlier this year, DHW has been processing re-evaluations.

As of Monday, 50,944 re-evaluations have been processed out of a total of 153,857 people on Medicaid Protection. Of those, 20,171 have been determined eligible, and 30,773 have been determined to be ineligible. Those who are no longer eligible because they have too much income have been referred to the state’s health insurance marketplace, Your Health Idaho.

DHW began this process in February. It will continue in phases every month through this fall.

Data is updated by 5 p.m. each Monday at https://healthandwelfare.idaho.gov/medicaidprotection

For Medicaid participants

To make sure you receive notices regarding your Medicaid eligibility and re-evaluations, be sure to report any changes to your contact information, including mailing address and phone number. If your contact information has changed, or you want to confirm your current information, visit idalink.idaho.gov. You also may report changes by calling 877-456-1233 or emailing MyBenefits@dhw.idaho.gov

I hope you have a safe and healthy 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. 

As Mental Health Awareness Month, May offers 31 days to raise awareness of and reduce the stigma surrounding behavioral health issues. The awareness campaign highlights ways mental illness and substance use disorders may affect all of us – patients, providers, families, and communities.

Here are some ways you can help raise awareness and reduce stigma for yourself, your family, your neighbors, and your friends here in Idaho.

When it comes to mental health, small actions can equal big impact.

If you’re worried about your mental health, or about the mental health of someone you know, there are resources and people willing to help, no matter the situation. The simple act of talking about mental health can promote acceptance and encourage people to seek help.

Whether you share resources, encourage others to seek help, or are simply there for someone when they need you, all Idahoans can instill hope and help others to reach out when they’re most in need.

Self-care is important for your mental health

Despite life’s stressors, there are simple steps you can take to promote self-care, like prioritizing sleep, practicing gratitude, ensuring you’re eating a balanced diet, and drinking plenty of water.

When you take care of yourself, your physical and emotional health improves. You become more resilient and can find ways to manage stress in a healthy and positive way.

Mental health is essential to your overall health and quality of life and taking care of yourself is an essential part of your mental health.

All of us play a role in one another’s mental wellness

Language matters. When we use open and compassionate language around mental health issues, we empower ourselves and encourage others to find the help they need.

No matter the situation, there’s always help and hope

Be aware of the signs and symptoms of mental health issues so that we can all work together to support one another.

If you’re worried about your mental health or about someone you know, there are resources and people willing to help, no matter your situation.

Whether by sharing resources, encouraging others to seek help, or simply being there for someone in need, we instill hope and can help others to reach out when they need it most.

Resources:

• 988 is Idaho’s behavioral health crisis line. Call or text 988 to get the help and support you need. It’s free, confidential, and always connects you with a trained crisis counselor.
• If you or someone you know needs help, call the Idaho CareLine by dialing 2-1-1 or texting 898211 to connect with a 2-1-1 community resource specialist. If you or a loved one struggles with alcohol or substance use, please call 2-1-1.
• Visit DHW’s list of behavioral health crisis resources online: https://healthandwelfare.idaho.gov/services-programs/behavioral-health/behavioral-health-crisis-resources

Dustin Lapray is a public involvement officer with the Division of Behavioral health at DHW.

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

I’d like to share a report I read recently about exciting work being done in the Division of Behavioral Health to help Idaho youth overcome serious challenges and become stronger emotionally and mentally.

The work involved a learning collaborative approach, which I was thrilled to see is being used, and had amazing insights and results. The approach was analyzed to see if helping youths build strengths also reduces their needs.

The analysis was the first step in a larger statewide learning process called the Idaho Learning Collaborative, which engages practitioners as partners in learning and adjusting treatment plans to improve outcomes for youth and families. The overall goal of the collaborative is to help Idaho youth develop strengths and reduce their needs, so they are more resilient.

The exciting news is that this approach worked. It helped to gather evidence that’s helping youths build strengths such as coping skills, interpersonal skills, resilience, and family, and helps them live healthier lives overall. This is especially true if their increased strengths help reduce their needs, which include anger control, anxiety, emotional and/or physical regulation, and others.

A success story in the report is reprinted below, with permission from the report’s authors.

Emily (name changed) loves animals of all kinds, especially dogs. She struggled to complete homework and household chores and engaged in oppositional behaviors. Emily also has some social deficits, i.e. difficulty understanding social cues and boundaries. This vulnerability was manipulated by peers, resulting in instances of bullying and victimization.

Focused efforts were made by the Child and Family Team to leverage this interest toward building strengths in areas of Education, Family, and Coping/Savoring. To earn playtime with a neighbor’s puppies, Emily was willing to work toward compliance with expectations of daily living (personal hygiene, chores, etc.) and completion of school assignments to teacher’s expectations.

This resulted in improved grades and decreased stress in the family, which in turn encouraged caregivers to consider allowing Emily to adopt a pet of her own. Adoption of a puppy aided the child in accepting/fulfilling further responsibilities at home (caring for the dog), and she improved her Coping and Savoring skills by turning to it for comfort when needed for her anxiety and other distressing emotions. Additionally, her emotional regulation began to improve when she experienced the dog avoiding her when she raged but would approach her when it sensed she was struggling with anxiety. Finally, engaging in dog-training activities began to result in Emily’s increased understanding of what boundaries are, how they work, and why they are necessary/helpful.

I really appreciated reading Emily’s story. Given the incredible impact of this single example, the possibilities of future work like this is very exciting. 

I hope you have a safe and healthy 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.