The Department of Health and Welfare (DHW) has begun the re-evaluation process for Medicaid coverage.  

The department issued around 30,000 notices on Feb. 1 to Idahoans who may no longer be eligible but have remained enrolled in Medicaid because of Medicaid Protection. That allowed people to stay on Medicaid during the pandemic, unless they died, moved out of state, or asked to be disenrolled. Around 150,000 Idahoans are on Medicaid Protection with an unknown status.  

States were allowed by the Centers for Medicare and Medicaid Services to start re-evaluations for people on Medicaid Protection on Feb. 1. States are not allowed to terminate coverage after the re-evaluation until April 1. 

DHW will send around 30,000 new re-evaluation notices each month through July. Participants will have 60 days to respond. They will receive three notices and a text message during that 60-day period.  

Medicaid Re-evaluation Timeline 

Those who are determined to be over-income will be transitioned to Your Health Idaho, the state-based marketplace where they can compare and shop for health insurance.  

It’s important to me to make sure people have health insurance and that they don’t lose appropriate coverage because they failed to respond to one of our notices. It’s also important to me that people who are not eligible for Medicaid understand that there are budget-friendly options at Your Health Idaho. Even if you don’t qualify for Medicaid, you may qualify for a tax credit that will help pay for health insurance coverage.  

But you must respond to the notices.  

If you receive Medicaid, please take action to make sure you receive notices about your benefits and re-evaluations. Report any changes in your household information, including your phone number and address. 

If your contact information has changed, or you want to confirm your current information, call DHW at 877-456-1233 or email MyBenefits@dhw.idaho.gov. You can also report changes by visiting idalink.idaho.gov 

Learn more about Medicaid Protection. 

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.  

When children are not safe in their own homes, they are often placed with a foster family. Some of those children require more care and can’t be placed in a typical foster home. Based on their needs, they require placement with a treatment foster family.  

Idaho doesn’t have nearly enough treatment foster homes for the children who need that critical support. Some youths are being cared for in short-term rentals because a treatment foster family is not available. Youth are also being placed in residential treatment facilities when they are better served in that setting. The number of youths in short-term rentals varies on any given day, but on average there are 10 children waiting for placement, many of whom would qualify for treatment foster care. 

The department works with agencies in local communities to recruit and train treatment foster families. Agencies have been recruiting families for the past year and have not been successful in licensing any treatment foster care families in southern Idaho, specifically. At least 30 families are needed in southern Idaho to meet the needs of these children.  

Children in treatment foster care, generally ages 10-17, have been assessed as having a serious emotional  disturbance, which means they have a diagnosable mental, behavioral, or emotional disorder that limits the child’s ability to function in family, school, or community activities. They may have challenging behaviors and need additional supervision and participation in community services, but they also need a stable and loving family who can support them as they learn positive behaviors.  

These children typically have feelings of neglect or abandonment; have experienced multiple foster care placements, or have bounced from group homes to residential treatment facilities and back to foster homes with parents who lack the knowledge and training and support team to provide care and services to meet their high level of needs.  

Although the work is challenging, treatment foster families can develop a lifelong relationship with the child and their family. Treatment foster families are instrumental in helping youths learn to manage their behaviors and helping parents support their children who have a traumatic history and/or mental health needs.  

If you are an experienced foster parent or have experience with mental healthcare, behavior management, or treatment planning, and have room in your heart and your home for a child that needs a little more, please consider becoming a qualified treatment foster home.  

The department works with two agencies to recruit, train, and support treatment foster families. Please contact them if you are in southern Idaho and can help.  

Pathways of Idaho 

• Email: TFCIdaho@pathways.com
• Website: https://pathwaysofidaho.com/tfc/
• Phone: 208-391-3304 

Rise, Inc. 

• Email: tfcidaho@riseservicesinc.org
• Website: https://riseservicesincid.org/family-services/treatment-foster-care/
• Phone: 208-252-6117 

I hope you have a safe and healthy weekend. As a reminder, our offices will be closed on Monday in honor of President’s Day.    

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

Idaho emergency response and mental health professionals gathered last week for a conference focusing on managing crisis in school settings.

Hosted by DHW’s Division of Behavioral Health Feb. 8 and 9 in Garden City, the Idaho Crisis Con featured keynote presentations about calming aggressive and emotionally disturbed individuals, and preventing school shootings.

“That our conference was held just days before the tragic shootings at Michigan State this week underscores the need to talk about and get ahead of this type of tragedy,” said Statewide Crisis Program Manager Belinda Dalrymple, who works in the Division of Behavioral Health. “Our hearts go out to the people of East Lansing and the 67 other communities where mass shootings have also already taken place this year.”

The Idaho Crisis Con brought together professional counselors, administrators, and public servants with emergency first responders including police, fire, EMS, and corrections. Those in attendance represented the entire spectrum of professionals involved with identifying a potential situation before it escalates, and responding to a situation if it does.

“The 260 people who attended Idaho Crisis Con are professionals who someday may be in a situation where they need to use these techniques to protect students, and themselves,” Dalrymple said.

Crises of varying degrees occur every day in schools across Idaho. Students, parents, teachers, and staff may experience stress and anxiety, and crises can arise. The challenge for counselors, police, and school administrators is figuring out how to help a student in crisis and de-escalate a situation before it gets out of control or becomes violent.

“For administrators, it is essential that they know how to respond to warning signs before there is an attack, so they can intervene and perform an effective threat assessment to hopefully avoid having an attack” said keynote speaker Peter Langman, a sought-after expert on the psychology of school shooters and other perpetrators of mass violence.

Threat assessments can help show a pattern of behavior common among school shooters or would-be school shooters, but only if they are thoroughly investigated and shared with appropriate people. Langman cited situations where administrators, police, parents, and children all withheld information, lied, or underestimated the seriousness of a behavioral pattern.

Langman said there are three types of school shooters: psychopathic (no empathy and/or desire power), psychotic (delusions, hallucinations, and/or want to harm others), and traumatized (chaotic/abusive home life, parental substance abuse, or depression). For each profile, violence may manifest in different ways.

In some cases, a heated situation can be quelled before it escalates.

“De-escalation is a specific strategy which is used to try to help people who are in states of agitation or anger,” said keynote speaker Ellis Amdur, a prominent de-escalation trainer in the Pacific Northwest. “We need to clearly delineate what that strategy is and put it in its proper place for professionals to use. If your kid is in a bad mood and you distract your kid, that is a de-escalation strategy.”

Once a person becomes angry, however, verbal de-escalation becomes challenging.

“You can’t problem-solve with an angry person,” Amdur said. “You cannot de-escalate a violent person.”

Amdur said identifying whether a person is calm, angry, or enraged is necessary to determine how to engage them. If they’re calm, discussion may work. If they’re angry, de-escalation techniques may work. If they’re enraged, first responders should exert control to create space.

De-escalation techniques also may vary. The point is to separate a person from their anger, and that may involve giving compliments, asking questions, or talking about food.

While the Idaho Crisis Con covered a wide range of scenarios and responses, the predominant theme was safety: the safety of students, staff, teachers, and first responders. While crisis situations will no-doubt vary, the ways to prevent or de-escalate include advanced communication among all parties, performing proper threat assessments, and training to use de-escalation techniques that may limit or negate violent acts.

• Learn more about Peter Langman: https://schoolshooters.info/about-dr-langman
• Learn more about Ellis Amdur: https://www.edgework.info/ellis-amdur/

The Idaho Crisis Con is envisioned as an annual event that will bring together first responders and mental health professionals to identify and implement solutions for pressing behavioral health issues.

Dustin Lapray has been with the Division of Behavioral Health for two years. He accepted the role of public involvement officer earlier this month.

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) is doing a number of things to ensure affordable, available healthcare that works. We’re addressing three main areas: healthcare workforce shortages, improving health outcomes and cost-efficient care, and limiting Medicaid spending growth.  

Healthcare workforce shortages 

• The Division of Public Health is working to increase the number of National Health Service Corps (NHSC) clinic sites, which improves access to healthcare for Idahoans. A clinic with the NHSC designation offers a sliding fee scale for patients and loan repayment for providers. Idaho has 299 approved NHSC sites in the state. On July 1, 2022, there were 257 sites in the state.  
• The Division of Behavioral Health is working with the Idaho Behavioral Health Council to implement a comprehensive behavioral health workforce plan. A new plan has been published at: https://behavioralhealthcouncil.idaho.gov/. It contains five goals: promotion, education, credentialing, employment, and retention that all address challenges with the behavioral health workforce in Idaho.  
• The Division of Medicaid is working with stakeholders to address challenges in direct care work force retention and recruitment. Initiatives include a marketing campaign that will increase interest in direct care as a job or career, and a project to improve free training opportunities for direct care workers in Idaho.  

Improved health outcomes and cost-efficient care 

• The Division of Medicaid is gathering data for a preliminary report on the cost-efficiency and quality performance metrics for the statewide, value-based payment program. The report will be complete by Dec. 31, 2023. 
• The division has added the Medicaid Expansion population to the Healthy Connections-Value Care Program. That program is a managed fee-for-service arrangement, using a network of primary care physicians and healthcare providers to serve as the “medical home” for Medicaid participants. The program will help transform Idaho’s healthcare system from one that pays for volume to one that pays for value (healthy patients).  
• The division is also working with stakeholders to establish quality metrics for value-based, managed care, and fee-for-service programs in Medicaid. The metrics will be established by September.  

Limit Medicaid spending growth  

• The division is reviewing recommendations for short-term spending reductions from a recent interim report from the consulting firm Sellers Dorsey. A final report with longer-term recommendations is expected in early April.  

You can read more about all of these initiatives in our Strategic Plan, under Goal 1.  

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.  

Although tooth decay is largely preventable, it remains the most common chronic childhood disease in the United States. The Idaho Oral Health Program strives to support prevention services, including oral health education aimed at reducing children’s decay rates in Idaho.

As soon as teeth appear, decay can occur. One of the risk factors for early childhood cavities (sometimes called baby bottle tooth decay or nursing mouth syndrome) is frequent and prolonged exposure of a baby’s teeth to liquids, such as fruit juice, milk, or formula, which all contain sugar.

Tooth decay can also occur when a baby is put to bed with a bottle. Infants should finish their naptime or bedtime bottle before going to bed. Because decay can destroy the teeth of an infant or young child, you should encourage your children to drink from a cup by their first birthday.

Training cup tips to help prevent tooth decay in children

For sipping success, carefully choose and use a training cup. It is best to choose a training cup that does not have a no-spill valve. The valve requires a child to suck—similar to a bottle—and does not allow the child to learn to sip. As your child’s first birthday approaches, encourage them to drink from a cup. As this changeover from baby bottle to training cup takes place, consider:

• What kind of training cup you choose
• What goes into the cup (serve milk at mealtime and water between meals)
• How frequently your child sips from it

Talk with your dentist for more information, and if your child has not yet had a dental examination, schedule a well-baby checkup for his or her teeth. The American Dental Association recommends a first dental visit before a child’s first birthday.

The link between sugar and tooth decay

Consuming too much sugar can dramatically affect dental health, as well as overall health. Sugar on teeth provides food for bacteria, which produce acid. The acid can eat away tooth enamel.

Almost all foods have some type of sugar that cannot and should not be eliminated from our children’s diets. Many of these foods contain important nutrients and add enjoyment to eating. But there is a risk for tooth decay from a diet high in sugars and starches. Starches can be found in everything from bread to pretzels to salad dressing, so read labels and plan carefully for a balanced, nutritious diet for you and your kids.

Reduce your children’s risk of tooth decay by following some of the following tips:

• Sugary foods and drinks should be consumed with meals. Saliva production increases during meals and helps neutralize acid production and rinse food particles from the mouth.
• Limit between-meal snacks. If kids crave a snack, offer them nutritious foods.
• If your kids chew gum, make it sugarless – Chewing sugarless gum after eating can increase saliva flow and help wash out food and decay-producing acid.
• Monitor beverage consumption – Children should make healthy beverage choices such water and low-fat milk.
• Help your children develop good brushing and flossing habits.
• Schedule regular dental visits.

Brushing and flossing your child’s teeth

It’s important to develop routine dental habits for your child even before teeth come in. Before the first tooth, you can wipe your baby’s gums with a clean washcloth or gauze after feeding.

Once teeth begin to come in, transition to a soft-bristled toothbrush, brushing twice a day, after breakfast and before bed. Using a small amount of fluoridated toothpaste (the size of a grain of rice), will help protect teeth from decay. A pea sized amount of fluoridated toothpaste can be used at age 3, or once the child learns how to spit out the toothpaste.

Begin flossing your child’s teeth once a day when the teeth touch each other. Children usually need assistance with brushing and flossing until age 7 or 8.

Tips for making good oral health habits routine:

• Start habits early, even before the first tooth
• Brush your child’s teeth twice a day
• Use the recommended amount of fluoridated toothpaste
• Model good brushing and flossing habits for your child
• Make brushing fun by using sticker charts or listening to a favorite song while brushing

Where can parents and caregivers go for more information or to locate resources?

• Idaho Oral Health Program: https://healthandwelfare.idaho.gov/health-wellness/healthy-infants-children/oral-health
• American Dental Association: https://www.mouthhealthy.org/
• Centers for Disease Control and Prevention: https://www.cdc.gov/oralhealth/basics/childrens-oral-health/index.html
• American Academy of Pediatric Dentistry: https://www.aapd.org/resources/parent/

Kelli Broyles has worked as the oral health program specialist with the Division of Public Health for three years. She has been a registered dental hygienist for more than 25 years and prior to joining the oral health program, delivered dental care in both public health and private dental settings.

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

Being transparent is very important to all of us here at the Department of Health and Welfare. A good customer experience is also part of our mission to strengthen the health, safety, and independence of Idahoans. Idaho residents have a right to see government records and monitor the actions of state and local government agencies as outlined in the Idaho Public Records Act  (Idaho Code 74-101 through 74-126).

The department is a large and complex organization with eight divisions and nearly 200 programs. The variety and complexity of records, as well as the confidentiality of some records, creates numerous challenges for obtaining the records people are interested in.   

I’m proud to say that our Public Records coordinator works really hard to monitor and keep track of thousands of requests. The department responded to 3,243 public records requests (PRRs) in 2022, with the help of staff in all eight DHW divisions and our legal team.

The majority of PRRs are for personal records, mostly from the divisions of Family and Community Services, Behavioral Health, and Medicaid. We also get hundreds of requests from attorneys, media, trade groups, and others. Some requests are very large and result in thousands of pages of documents being released. These records must be reviewed for confidential information, privileged communications with attorneys, and vendors’ trade secrets, to name a few exemptions.

Our goal is to respond to all the requests we receive in a timely fashion within the time frames permitted under the public records law. But it can be complicated. If we don’t have a clearly defined request or the necessary verification for a requester, fulfilling requests can be challenging.

If you file a PRR with the department, here are some tips that will help your request be filled as quickly as possible:

• Be as specific as you can about the types of documents you are seeking.
• Be sure to include the required verification and identification if required. 
• If appropriate, include a date or a date range in your public records request to help focus the search.
• Key word searches for emails can be costly and wasteful because they may not be specific enough. A higher number of search terms requested will increase the number of records in the request. But more records do not guarantee more information that is relevant to the request. The more specific your request is, the more likely it will be that you will receive the documents and information you are interested in.
• Data requests are not public record requests. Requests for data are handled separately by the programs that keep the data.
• Keep in mind that many records at DHW are paper and may be stored away from state offices and take more time to search. This is especially true for older
  documents.
• If your request will take longer than two hours of staff time and legal review, you will receive an invoice. Payment must be received before records are produced.
• Birth, marriage, and divorce records are not considered public documents. Birth records are legally confidential for 100 years, and marriage and divorce certificates are legally confidential for 50 years.
• If you don’t know what to ask for, we are happy to discuss your request ahead of time. Under the law we cannot ask you why you are seeking records, but if you are willing to discuss it before filing your request, we can provide some guidance to help you focus your request, so you get the documents you want.
   

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. 

Many people who smoke, vape, or chew want to quit. Quitting is possible and it’s one of the best choices a person can make to improve their health and protect their loved ones from cancer-causing chemicals.

It’s still early 2023, and many people are setting goals to live happier, healthier lives. If you or a loved one would like to start living tobacco-free, Project Filter can help.

What is Project Filter?

Project Filter is a state health program that supports people who want to quit smoking, vaping, or chewing. The program’s motto is, “You decide when, and we will show you how.” The program also coordinates with policymakers, community organizations, and schools to help prevent people from using tobacco products. If you never start, after all, you never have to quit.

How does Project Filter support people on their quit journeys?

Quitting is hard. It takes most people multiple tries to stay tobacco free. Many people have an easier time quitting with the supportive help of loved ones and free resources from Project Filter.  

According to former smokers, calling The Idaho QuitLine is one of the best steps you can take to quit successfully. In fact, people who call are seven times more likely to quit using tobacco. The Quitline can be reached 24 hours a day, seven days a week by calling 1-800-QUIT-NOW. You can also watch this short video to hear how Idahoans have quit with the help of Idaho Quitline.

QuitLine coaches are encouraging and well-trained. They know quitting is a personal journey and will help callers tailor their quit plans to their individual needs.  Coaches can also help people find quit medications in the form of patches, gum, and lozenges, which can be shipped directly to people’s homes free of charge.

Finally, the QuitLine serves a wide array of Idahoans and has unique programs tailored for people who are pregnant, living with mental illness, or are Native American. The Idaho Quitline also has coaches who speak Spanish and coaches who work with translators to support people who speak any other language.

Vaping and youth tobacco use

My Life, My Quit is a free and confidential coaching program specifically designed for teens and young adults. The program helps teens and young adults quit vaping or smoking, and the sessions can be done through text messages, chat, or phone calls.

Teens can sign up on www.mylifemyquit.com, which also has resources for parents.

Where can people go for more information?

• For free and compassionate support to quit smoking, vaping, or chewing call 1-800-QUIT-NOW or visit http://www.ProjectFilter.org to learn more.
• For teen-specific resources, look up www.mylifemyquit.com.
• Follow Project Filter on Instagram or Facebook: @projectfilter.

Ashtin Glodt is manager for Project Filter and works in the Division of Public Health. She has six years of education and six years of professional experience in public health. She is especially passionate about promoting equitable community access to health resources.

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

As the Idaho Legislature considers Medicaid Expansion this week, we’ve been called to answer a lot of questions about this complex program.

As a reminder, the Division of Medicaid provides healthcare services for low-income people and families in Idaho. This includes adults and children, pregnant women, people over the age of 65, and people with disabilities who meet eligibility requirements.

If you currently receive Medicaid, please take action to make sure you receive notices about your benefits and re-evaluations. Report any changes in your household information, including your phone number and address.

If your contact information has changed, or you want to confirm your current information, call DHW at 877-456-1233 or email MyBenefits@dhw.idaho.gov. You can also report changes by visiting idalink.idaho.gov

Who is served by Medicaid Expansion?

As of January 2023, around 145,000 Idaho residents are enrolled in Medicaid Expansion. These are individuals who have a monthly income of $1,563 or less, or a family of four with a monthly income of $3,192 or less.

Most of them, over 80%, have reportable income.

Some of them, 24%, have a primary diagnosis of Serious Mental Illness. Medicaid Expansion allowed them access to a wider range of behavioral health services so they could get more comprehensive treatment. The state was paying for some services before expansion. Now for every dollar spent in Medicaid, the state pays 10 cents and the federal government pays 90 cents. The cost of Medicaid Expansion is split with 90% paid for by the federal government and 10% paid for by the state.

By comparison, for every dollar spent for traditional Medicaid, the federal government pays for about 70 cents, while the state pays for around 30 cents.

On average, people with a Serious Mental Illness live about 20 years less than others because they often have untreated physical health issues. Medicaid Expansion allows for more comprehensive treatment of both physical and behavioral health issues, which might help people live longer.

Did Medicaid Expansion reduce costs for healthcare providers?

Yes -- hospitals report spending $42 million less on charity care and had $61 million less bad debt from 2019-2021.

What is Medicaid Protection or continuous Medicaid enrollment?

During the COVID-19 public health emergency, states were not allowed to remove anyone from Medicaid enrollment unless they moved out of the state, asked to be removed, or died. This was called continuous Medicaid enrollment or continuous Medicaid coverage. It was also called Medicaid Protection.

As people’s situations or incomes changed, some of the people enrolled in Medicaid and Medicaid Expansion are no longer qualified to get benefits. Recent federal statute allows the department to remove Idahoans who no longer qualify for Medicaid starting April 1. Notices will be sent to those people starting Feb. 1, and those re-evaluations are expected to be finished by September. If they are found to be ineligible, they will no longer receive Medicaid or Medicaid Expansion benefits.

Does this mean people enrolled in Medicaid Expansion will be removed from the program?

We expect that some Medicaid Expansion participants will no longer be eligible and will be removed from the program. 

Of nearly 450,000 Idahoans enrolled in Medicaid (including Expansion), we know that 300,000 are eligible because DHW staff have completed their re-evaluations.

There are about 150,000 people currently enrolled in Medicaid who we know either don't qualify or have not been in contact with the department during the public health emergency. Of these, 67,000 are enrolled in Medicaid Expansion.

In the re-evaluation process, 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, called Your Health Idaho. 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.

Will the department send out all 150,000 notices on Feb. 1?

The department will send the notices out in batches of about 30,000 each month for the next six months. The federal Centers for Medicare and Medicaid Services requires that we complete the full re-evaluation process for all participants in Medicaid Protection. This means that once we send the notices, customers have up to 60 days to respond. If they don’t respond at all, they can be removed from the program. If they do respond, that starts a process to determine if they are eligible. 

Healthcare costs and Medicaid costs seem to increase each year. Does the department have a plan to keep costs in check?

Containing Medicaid costs is very important to us. Since the pandemic began at the same time Medicaid Expansion was rolling out in Idaho, we don’t yet have a clear picture of the true costs of Expansion. As we move through this next year or two and hopefully away from the pandemic, we expect to get a more accurate idea of what the costs will be.

In the meantime, the Healthy Connection Value Care Program focuses on paying healthcare providers for value, rather than volume. Medicaid participants are connected with a primary care provider who can help them make healthier decisions and get treatment for issues before they become chronic and more expensive.

Here’s how that works. The vast majority of healthcare providers across the state participate in at least one of the 11 value care organizations. These agreements set cost targets for healthcare providers for their Medicaid patients. If the annual cost comes in above the target, the healthcare providers pay Medicaid for a portion of the higher cost. If the annual cost comes in below the target, the healthcare providers share in some of the savings. ​​

To make sure that cost savings are not achieved by reducing access or quality, healthcare providers must also achieve quality targets, which means their patients are achieving better health.​

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. 

Updating Emergency Medical Services (EMS) in Idaho is no small task, but I was grateful yesterday for the opportunity to join my EMS colleagues to discuss the challenges and opportunities that lie ahead for Idaho.

EMS workers from throughout the state — as far away as Boundary County — traveled to Boise on Monday to help make a difference on behalf of the communities they serve. Paramedics, EMTs, air medical  personnel, EMS and Fire department leadership, hospital staff, and many others joined me at the Idaho Statehouse.

While their specific training and missions vary, they attended EMS Day for one purpose: to help educate lawmakers and Idaho residents about the challenges ahead. They explained that EMS services in Idaho are faced with population growth, a fragmented system of volunteers and paid staff, and Idaho’s inherently rural character.

If nothing changes with the current system, a crisis is looming, and I was encouraged that the people we spoke with seemed to understand.

EMS in Idaho is currently provided within a framework of different organizations that vary in patient transport and clinical abilities. Some emergency services use paid career response personnel while others rely on volunteers.

There’s a lot of variation in staffing models, but a consistent thread in Idaho is that rural communities tend to rely on volunteers, who are often the only emergency response available.

The total number of licensed EMS personnel has remained stable over the past 15 years but  hasn’t kept pace with the state’s population growth. Much of the increase in the number of licensed EMS personnel has been in the state’s urban areas, while the number of EMS personnel in rural communities continues to shrink.

If the current trend continues, many rural communities will be at risk of longer EMS response times due to a lack of EMS personnel. Communities that now have a local ambulance service may have to rely on a distant neighboring community for EMS Service.

There have been several efforts over the years to better understand the challenges facing the organizations and personnel who provide EMS in Idaho.

• The Idaho Office of Performance Evaluation published a study in 2010 about the governance of EMS agencies.
• In 2012 and 2018, the Bureau of EMS at the Department of Health and Welfare published reports detailing the concerns and possible solutions specific to volunteer EMS personnel.
• In 2021, the Office of Performance Evaluations published a report about volunteer EMS providers with several actionable recommendations.

After reviewing the latest Office of Performance Evaluations report, the Health Quality Planning Commission asked the Department of Health and Welfare to convene a task force to find policy solutions — including draft legislative language — that will help make sure reliable EMS response is available everywhere in Idaho.

The task force first met in June 2022 and will continue to meet as needed. Four workgroups were formed to explore solutions between monthly meetings.

Another recent development includes hiring six contracted EMS planners who will work with Idaho’s 44 counties to document current EMS response capabilities, best practices, and resource requirements for a sustained EMS response.

The planners are only getting started, but they’ll develop plans for each of Idaho’s 44 counties moving forward.

For more information, visit the EMS Sustainability Task Force webpage.

Wayne Denny is EMS bureau chief in DHW’s Division of Public Health. He’s been with the department for 18 years.

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