May 11 is the end of the federal Public Health Emergency declared to help combat COVID-19. This provides a great opportunity to reflect on the enormity and impacts of the pandemic as well as celebrate the rapid roll-out of public health protections, vaccines, therapeutics, testing and so much more. It is also important to pause and honor the memory of over 1.2 million Americans and almost 5,500 Idahoans who have lost their lives related to COVID-19.

Idaho public health responded to the COVID-19 pandemic in early 2020. Due to the nature of the response and the need to be nimble, we rapidly scaled up operations. We expanded testing operations, pursued virus sequencing, expanded disease investigation infrastructure, and swiftly and equitably distributed vaccines and therapeutics. We did this while maintaining baseline public health services and contending with waves of new SARS-CoV-2 variants, evolving scientific findings, and pandemic fatigue.

Emergency authorities provided through the state and national emergency declarations, as well as the federal public health emergency, allowed for flexibilities and support for all sectors to address the pandemic.

During the pandemic, we invested in and leveraged previously developed tools, technologies, and strategies, and also developed new ones such as interactive dashboards, communications pathways, and geospatial mapping to assist individuals, communities, health systems, and policy makers to make data-informed decisions to promote health. Safe and effective vaccines were developed, testing platforms became broadly obtainable, and effective therapeutic treatments for COVID-19 were widely available.

Broad adoption of telehealth technologies for a wide array of healthcare services was instrumental to continue to provide care to patients and limit the spread of the virus. This also led to increased access to healthcare services, especially for those in remote or rural areas of Idaho, as well as for those who have difficulty traveling to appointments due to mobility issues or transportation barriers.

Telehealth proved to be an effective way to manage chronic conditions and mental health issues and has been embraced by patients and healthcare providers alike. While the pandemic brought many challenges, the growth of telehealth services is one positive outcome that will continue to benefit Idahoans in the years to come.

Now, as we look to the future through a lens of optimism, we must take the lessons we’ve learned and the challenges we’ve faced into the next chapter in our story. We've seen firsthand the devastating toll that a global pandemic can bring, but we've also seen the incredible resilience and strength of the human spirit, as evidenced by all of you. We've pulled through one of the most difficult times in recent history and have emerged from this crisis even stronger than before. We have proven that as Idahoans we can come together to overcome even the most challenging of situations.

As we move beyond the federal Public Health Emergency, it’s important to remember that our fight against COVID-19 is not yet over. The virus will continue to circulate in our communities, and we need to continue to provide resources and support to help all Idahoans make informed decisions about their health. Together, we will continue to promote the health and well-being of all Idahoans.

For additional details about the impacts of the ending of the federally declared COVID-19 Public Health Emergency on May 11, 2023, please see the DHW website: https://publicdocuments.dhw.idaho.gov/WebLink/DocView.aspx?id=25746&dbid=0&repo=PUBLIC-DOCUMENTS

Elke Shaw-Tulloch is the administrator of the Division of Public Health, and the state’s public health officer. She has worked for the department since 1996 and was promoted to division administrator in 2012. Since February 2020, she has focused most of her time on responding to the coronavirus pandemic. 

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

May is National Foster Care Month and an opportunity to build further awareness about issues affecting foster care in Idaho. There are around 1,500  foster children at any given time in Idaho, and we’re always in need of more families willing to help, whether as kinship caregivers or as foster parents.

When children can’t safely remain with their parents, the first place we look is to relatives or close family friends where children can maintain close family relationships and cultural traditions.

Close family and friends who care for children in need of temporary homes are called kinship caregivers, and Idaho has tens of thousands who take on the role when a child’s parents aren’t able to. Kinship living arrangements may be made formally through the courts or through Health and Welfare’s Child Protection Program.

Often, however, family members or close family friends voluntarily take relative children into their homes during family crisis. This can be challenging legally, financially, and emotionally. If you are a kinship care provider in Idaho, you aren’t alone, and help is available.

Idaho’s Kinship Program offers resources for kinship caregivers to help with financial costs, legal resources, support groups, respite resources, and more.

If children don’t have a relative or close family friend who can take them during a crisis, foster families are also an option, and Idaho is always in need of more foster families.

To consider becoming a foster parent, call 2-1-1 or 800-926-2588 or visit: https://healthandwelfare.idaho.gov/services-programs/children-families/….

Cameron Gilliland is the administrator of the Division of Family and Community Services. He has worked for the department since 1996 in various capacities and was promoted to administrator in August 2021. He has been trained as a clinical social worker and has overseen policy for the Child Welfare Program and managed several developmental disability programs in the department.

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 Idaho Department of Health and Welfare continues to re-evaluate eligibility for people enrolled in Medicaid who have been protected from being disenrolled from the program during the pandemic.

As of April 24, we have processed 43,419 re-evaluations out of the total of 153,857 people in Medicaid Protection. Of those, 15,837 have been determined eligible and 27,582 have been determined to be ineligible.  Customers determined ineligible for Medicaid because their income was over the limit to qualify for Medicaid have been referred to the state’s health insurance marketplace, called Your Health Idaho, to determine their options.

Those who no longer qualify for Medicaid may be eligible for the Advance Premium Tax Credit (APTC). That credit can be used to buy health insurance on the state-based health insurance market. The department has worked closely with Your Health Idaho to create transitions for those who may need to switch from one kind of coverage to the other.

Medicaid Protection was put in place at the beginning of the COVID-19 pandemic. It provided continued Medicaid coverage for people who may have become ineligible. States were not allowed to remove anyone from Medicaid rolls unless they died, moved out of state, or requested to be removed. The U.S. Congress ended that protection earlier this year.

DHW started sending notices in February and will continue to do so each month through July for those in Medicaid Protection.

We are publishing the numbers by 5 p.m. each Monday at https://healthandwelfare.idaho.gov/medicaidprotection.

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. 

Students across the Northwest were encouraged to get creative and help raise awareness about the dangers of radon gas by participating in the 2023 Northwest Radon Poster Contest.

Radon is a naturally occurring radioactive gas that can build up in our homes. Both old and new housing can have radon gas.

Testing is the only way to know if your home has radon because the gas is colorless, odorless, and tasteless. Long-term radon exposure is the number one cause of lung cancer in nonsmokers and the second-leading cause of lung cancer in smokers. 

Youth between the ages of 9 and 14 living in Idaho, Oregon, and Washington were eligible to participate in the poster contest, which ran through the winter months, and winners were recently announced. To view contest winners, visit https://healthandwelfare.idaho.gov/northwest-radon-poster-contest-winners.

Regional winner (Idaho, Oregon, and Washington)

Overall winner: $300 - Finnegan Grose, 5^th grade from Wallace and Pricilla Stevenson Intermediate School, Washington

Idaho winners

1st place: $100 - Cora LaMunyon, 5^th grade, Mary McPherson Elementary

2nd place: $75 - Layla Williams, 6^th grade, Kamiah Middle School

3rd place: $50 - Leander Glock, 4^th grade, Discovery Elementary School

The overall regional winner will be entered into the National Radon Poster Contest in the fall, sponsored by The Conference of Radiation Control Program Directors (CRCPD).

The Northwest Radon Poster Contest was sponsored by the Idaho Department of Health and Welfare, Nez Perce Tribe, Oregon Radon Awareness Program, Spokane Tribe of Indians, and Washington Department of Health - Radon Program in collaboration with the Northwest Radon Coalition and U.S. Environmental Protection Agency Region 10.

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 is committed to optimizing health and preventing crises. We believe that all Idahoans should be as healthy and self-sufficient as possible. We believe it so much that it’s the third goal in our Strategic Plan.

There are several ways to support being as healthy and self-sufficient as possible, but we’ve settled on four objectives.

Reduce Idaho’s suicide rate.

• The Suicide Prevention Program is working in local communities to support healthcare providers who are using Zero Suicide Institute trainings and programs. The goal is to have four pilot sites in Idaho by June 2024.
• The Suicide Prevention Program is also working to improve state, tribal, and local capacity to use data to identify and address equity and risk disparities in high-suicide-risk populations.
• The department also is supporting and increasing the use of 988 Suicide and Crisis Lifeline and behavioral health crisis centers in Idaho through partnerships and collaboration between separate programs in the department, the Idaho Suicide Prevention Action Collective, and the Idaho Crisis & Suicide Prevention Hotline.

Address health disparities in Idaho communities with strategies that focus on conditions where people live, work, and play.

• The department has invested in two high-risk communities so far -- Elmore County - Western Idaho Community Health Collaborative (WICHC) and Bannock County - Southeastern Idaho United Way. Both communities provided an update on their activities recently. The Bannock County United Way of Southeastern Idaho’s team shared details about the new Ride United transportation service, which provided 500 miles of rides to Pocatello Free clinic and recovery center clients in February. The Elmore County team reported the Elmore County Commission approved a new Community Health EMS (CHEMS) position, and they will soon be ready to hire and implement the program. Extensive groundwork to build capacity and develop a CHEMS program suited for Elmore County has been ongoing for the past year and a half.
• The department is collaborating across divisions to determine how Medicaid data and possibly other division’s data may be geo-coded to look at the impact of social determinants of health on the clients we serve. Ideally, these results would help drive prevention and intervention work in a more effective way. The group also discussed potential school-based data or other data our partners have that would be useful.
• The Idaho Legislature approved a rule change to in the 2023 session to increase the Federal Poverty Limit to 175 percent, which will allow more working families to have childcare and maintain their employment.
• Data analysts in the Division of Public Health have developed the GHI Index to provide an in-depth analysis of factors impacting community health. Indicators include measures of social vulnerability and social determinants of health at the census tract level. The GHI Index will be publicly available in May.

Prevent or reduce the impact of Adverse Childhood Experiences (ACEs) across the lifespan of Idahoans by creating a coordinated DHW program delivery framework.

• The department has established a cross-division ACEs team and is in the process of identifying cross-divisional and collaborative efforts with internal and external partners.
• The department has created a staff training program called How Adverse Childhood Experiences (ACEs) Impact Adult Health and Functioning. This program focuses on social-emotional learning to build awareness of how ACEs affect the health and daily lives of adults.
• The department is in the initial stages of identifying opportunities to increase the number of trauma-informed providers in the state.

Reduce the department’s employee voluntary turnover rate.

• The department is in the process of reviewing and updating its process for exit interviews for use in the development of a stay interview program. Staff have started using a new format for exit interviews for employees who have accepted new jobs outside the department.
• The department is working with Idaho Division of Human Resources to start a leadership program for DHW’s current and future leaders.

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

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 top three leading causes of death in Idaho in 2021 were diseases of the heart, cancer, and COVID-19. Almost 9,000 Idahoans died of those causes out of 18,334 total deaths. The next three categories--accidents, respiratory diseases, and Alzheimer's disease--resulted in fewer than 3,000 deaths.

At the same time, there were 14,030 marriages, 6,392 divorces, and 22,427 babies born to Idahoans in 2021. More than 6,000 babies were born to unmarried parents.

The total population in the state in 2021 was 1,900,923 people.

We know all of this and more because the Bureau of Vital Records and Health Statistics at the Department of Health and Welfare registers and documents records of vital events that happen to all Idahoans, including births, deaths, marriages, and divorce.

The bureau also issues copies of vital records, such as birth certificates, to those who are legally allowed to have them.

The bureau also provides public health data and analysis of health trends that can be used to develop and shape future health interventions and programs.

The bureau has recently published two items:

• The annual update to the violent death reporting dashboard.
• The 2021 Vital Statistics Summary for Idaho fact sheet.

The violent death reporting dashboard collects information about deaths of Idaho residents that are a result of force or power against self or others. It includes homicides, suicides, deaths from legal intervention, deaths of undetermined intent, and deaths from the accidental discharge of a firearm.

The fact sheet is a summary of Idaho’s population, births, deaths, marriages, and divorces for residents for 2021, the year for which we have the most current and complete data.

See more fact sheets and annual reports at: https://publicdocuments.dhw.idaho.gov/WebLink/browse.aspx?id=11588&dbid=0&repo=PUBLIC-DOCUMENTS

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

One child abused is one child too many.

All children deserve to feel safe in their homes, with their families.

Too often, that is not the case. The Department of Health and Welfare receives nearly 23,000 reports of child abuse, neglect, and abandonment each year in Idaho.

This month, as we recognize National Child Abuse Prevention Month, I urge you to learn what to do if you think a child may be in an abusive situation.

To report suspected child abuse, neglect, or abandonment call:

• Statewide: 855-552-KIDS (5437)
• Treasure Valley: 208-334-KIDS (5437)
• 2-1-1 or local law enforcement

Everyone in Idaho is required to report child abuse, neglect, or abandonment when they know about it. This includes doctors, hospital residents, therapists, interns, nurses, coroners, teachers, daycare providers, social workers, relatives, and friends. 

If you aren’t sure if a child is unsafe, it’s important to make the call anyway. It might feel scary and difficult to make the call, but a child’s life could depend on it. When a report is made, a social worker will determine if the report meets the criteria to do a safety assessment. All reports are documented in the department’s database and will be reviewed if more calls are received about the same family. 

Callers can choose to provide their name and phone number so they can be contacted to confirm the report or provide more information, or they can remain anonymous. Department staff do not disclose caller information to the family. If the family requests their records, information about the caller is redacted.

Children do best when they can remain safely with their families, and the department works hard to make that happen if possible. Our Child Welfare staff are dedicated to protecting Idaho children, keeping Idaho families together, and putting others first. The work they do is difficult and sometimes unappreciated. I am so grateful for their service.

But they can’t protect children without your help.

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 about 80 million dogs living in U.S. households, there are unfortunately about 4.5 million dog bites each year, with many dog bite victims being children.

In Idaho, dog bites are increasing, and visits to Idaho emergency departments by children for dog bite injuries are trending up.

Hospitalizations for dog bite injuries are increasing as well, particularly for boys 5 to 17 years old. Most years, there are about 20 people hospitalized for dog bite injuries in Idaho. In 2020, that number more than doubled to 46. In 2021, the most current data available, there were 34 dog bite-related hospitalizations, which was a decrease from 2020 but still increased compared to the years prior.

Dog bite injuries can be severe and may cause mental, emotional, and physical trauma. From 2018 through 2021, dog bites caused more than 165 fractures, 40 partial or complete amputations, and 10 detached ear lobes or lips in Idaho.

Dog bites also carry a risk of bacterial infection, which can be reduced with prompt medical care. A dog infected with rabies can transmit the virus before showing signs of rabies, which is fatal without prompt medical care after a bite.

Although dog bites can come from any dog at any time, most bites requiring hospitalization occur in summer months in Idaho.

Steps you can take to protect yourself and your family:

• Remember that any dog can bite. At least one in five dog bites treated in Idaho are from a family dog. Any dog can bite, especially if it’s scared, injured, or sick. Read a dog's body language and give it space if it seems stressed. Leave a dog alone when it’s eating or sleeping. Make sure your dog is vaccinated against rabies.
• Supervise babies and toddlers around dogs – even if it is the family dog. In Idaho, three out of 10 dog bite-related hospitalizations were for children 4 years and younger. Some of these bites occurred when the child and dog were alone together, even for just a minute. A bite can happen quickly, so supervise young children around all dogs, all the time. 
• Prevent dog fights to prevent dog bites. Breaking up dog fights leads to more than 100 emergency department visits a year in Idaho. Dog trainers say there is no safe way to break up a dog fight. Prevent dog fights by reading the dogs' body language and, if possible, separate dogs before they start fighting.
• Approach unfamiliar dogs with caution. Every year in Idaho, more than 90 emergency department visits are to treat patients with bites from stray or unfamiliar dogs. Approach any unfamiliar dogs with caution and contact Animal Control for assistance if needed. If you are bitten by a dog, you can also contact Animal Control for help getting the dog's vaccination history.
• Seek medical care early and take care of wounds. Delayed medical care leads to about 65 infections each year in Idaho. Puncture wounds from a bite may be deeper than they appear, and prompt and thorough wound care is needed to avoid infection. Dogs vaccinated against rabies can still carry other germs. Your healthcare provider may prescribe antibiotics, rabies post-exposure treatment, and a tetanus vaccine. The recommended treatment will depend on the injury and the vaccination history of you and the dog.

Learn more:

• Tips for children to prevent dog bites from World Health Organization: https://apps.who.int/rabies/resources/educational_material_children/en/index.html
• How to read dog body language from American Veterinary Medical Association: https://www.avma.org/resources/pet-owners/how-read-dog-body-language
• Rabies information from Idaho Department of Health and Welfare: https://healthandwelfare.idaho.gov/health-wellness/diseases-conditions/rabies

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

Can you imagine a place that offers services to stabilize people in a behavioral health crisis as well as treatment for those with serious and complex mental illnesses and substance use disorders? A place that serves everyone -- regardless of age, where they live, or their ability to pay?

I can. And I’m grateful that Idaho Gov. Brad Little and the members of the Idaho Legislature also could. Gov. Little recommended and the Idaho Legislature has appropriated $12 million over two years for Certified Community Behavioral Health Clinics (CCBHCs) to improve access and the quality of behavioral health services in Idaho. We’re grateful for the state’s support.

CCBHCs create access to an array of services, stabilize people in crisis, and provide necessary treatment for those with complex mental illnesses and substance use disorders. They also ensure an approach to healthcare that emphasizes recovery, wellness, trauma-informed care, and the integration of physical and behavioral health. 

The goals of the CCBHCs are to increase access to community-based mental health and substance use disorder services (especially in communities and areas that need more access), support the integration of behavioral health with physical health care, and increase use of evidence-based practices.

In a nutshell, they are health clinics that provide whole-person care under one roof. If some of the needed services are not directly provided by the health clinic, they have formal relationships in place that easily link a patient to the needed service.

Idaho has four clinics that became Substance Abuse and Mental Health Services Administration (SAMSHA) /federal grant recipients in the fall of 2022. They are Heritage Health (based in the Coeur d’Alene area), Community Health Association of Spokane (expanding into the Lewiston area), Terry Reilly Health Services (clinic will be located in Caldwell), and Family Health Services (based in Twin Falls).

The grants are for four years and up to $1 million each year for each recipient. Based on the recommendation of the Idaho Behavioral Health Council, Idaho will initially use state funding to provide additional support for these four new clinics, with plans to add more clinics next year.

CCBHCs must provide nine core services, either directly or through formal partnerships.

These nine services must be provided by the clinic, or through formal relationships the clinics build with providers of those other services, so clients can access those services and doesn’t fall through the cracks.

Clinics have to develop plans on how those nine services will be provided.

The CCBHC model was developed by SAMHSA and the Centers for Medicare and Medicaid Services (CMS). It was tested during a federal demonstration project that started in 2017. It began in eight states with 66 clinics. CCBHCs are currently in 42 states and territories, with 430 clinics total. The U.S. Congress has invested $1.97 billion to date on CCBHCs. 

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. 

A total of 153,837 Idaho residents are in Medicaid Protection, which means they couldn’t be removed from Medicaid during the pandemic unless they died, moved out of state, or asked to be removed based on federal law. Since Congress removed that protection, DHW has been working to determine which participants are still eligible.

DHW started sending notices in February for the first group and in March for the second group, for a total of 54,418 people (35% of the total people in protection) and are preparing to send out the third group in the first week of April.

So far, the program has processed more than 32,898 individuals in Medicaid Protection since the beginning of February. This count, current as of March 27, includes those in groups one and two, as well as people who have contacted the department to complete their renewal because they had a change in circumstances or who had another benefit (such as food stamps) that prompted the program to also complete their Medicaid renewal.

Of the total 32,898 people processed, 13,647 have been found to still be eligible (5,240 of those are in Medicaid Expansion) and 19,251 have been found to no longer be eligible (8,585 of those are in Medicaid expansion). Those who are no longer eligible will lose coverage starting April 1. Those determined to have too much income to qualify for Medicaid are being referred to the state-based health insurance marketplace, Your Health Idaho, where they can discuss their options and potentially buy health insurance.

The department will continue to send renewals each month through July for those in Medicaid Protection.

Starting April 10, the department will track the number of renewal notices sent, the number of people who remain eligible, and the number who are no longer eligible on our website at https://healthandwelfare.idaho.gov/medicaidprotection. The numbers will be updated weekly.

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.