Monday will start the first regular session of the sixty-seventh Idaho Legislature. Lawmakers and state agency personnel have been gearing-up for a full session. I have enjoyed meeting with the chairs of the Health and Welfare committees in the House and Senate to get to know them a little better before session begins. I am looking forward to working with leadership in these committees on initiatives that will strengthen the health, safety, and independence of Idahoans. 

DHW personnel also have been busy responding to legislators’ inquiries and preparing information to help inform decision-making once the session begins and bills are introduced. 

Ultimately, legislators, not agencies, are responsible for setting policy and direction. State agencies have a role on the front and back ends of the process. On the front end, the role of state agencies is to provide accurate, timely information to legislators to help inform their decisions. Then, after the votes are taken and decisions are finalized, the role of state agencies on the back end is to implement those decisions.

One of the most important things the Idaho Legislature does is set the budgets for all the state agencies. It’s a big job – the 20 members of the Joint Finance-Appropriations Committee (JFAC) have a steep learning curve as they prepare for, listen to, and consider presentations about all the programs and services the Department of Health and Welfare (DHW) and other state agencies provide for Idahoans so they can make budget recommendations to the House and Senate.

To effectively provide services for Idahoans with complex social, economic, and health issues, DHW is organized into eight divisions, with 11 budgets, that support the work we do every day to help strengthen the health, safety, and independence of all Idahoans. 

On Jan. 17 and 18, I will present an overview and the department’s budgets to JFAC. Here’s the department’s JFAC schedule. You can watch and listen online at Idaho in Session.      

Tuesday. Jan. 17:

• 8 a.m. to 8:45 a.m. -- Department of Health & Welfare (Director’s overview)
• 8:45 a.m. to 9:10 a.m. Child Welfare
• 9:10 a.m. to 9:30 a.m. Services for Developmentally Disabled
• 9:30 a.m. to 9:45 a.m. Break
• 9:45 a.m. to 10:05 a.m. Service Integration
• 10:05 a.m. to 10:30 a.m. Division of Welfare
• 10:30 a.m. to 11:00 a.m. Division of Medicaid

Wednesday, Jan. 18:

• 8 a.m. to 8:20 a.m. Public Health Services
• 8:20 a.m. to 8:40 a.m. Domestic Violence Council
• 8:40 a.m. to 9 a.m. Developmental Disabilities Council
• 9 a.m. to 9:20 a.m. Indirect Support Services
• 9:20 a.m. to 9:40 a.m. Break
• 9:40 a.m. to 10 a.m. Licensing & Certification
• 10 a.m. to 10:20 a.m. Substance Abuse Services
• 10:20 a.m. to 10:40 a.m. Mental Health Services
• 10:40 a.m. to 11 a.m. Psychiatric Hospitalizations

The House Health and Welfare Committee meets daily at 9 a.m., and the Senate Health and Welfare Committee meets Mondays through Thursdays at 3 p.m. Topics that directly relate to Health and Welfare are commonly introduced in these committees. Those meetings also can be watched at Idaho in Session.           

I am looking forward to a successful session and to working with the legislators. Together, we share a passion and commitment to the people of Idaho.

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 last two weeks of the year are a good time to slow down, reflect on the past year, and look forward to the year that’s about to unfold.

Our mission remains the same as we move into the new year: We’re dedicated to strengthening the health, safety, and independence of Idahoans. We continue to work toward healthcare that is affordable and available; to protect children and vulnerable adults; to help Idahoans be as healthy and self-sufficient as possible; and to earn and keep your trust.

I am thankful for DHW employees whose steadfast commitment makes a difference for Idahoans. They work for the department because they want Idaho to be a great place to live and raise a family. They prioritize public service and helping others. It can feel stressful and daunting sometimes, but the personal rewards are significant. The difference they make for Idahoans often leads to lasting change.

I’m also thankful for the many community partners and stakeholders who work hand-in-hand with DHW to help Idahoans live their best possible lives. These relationships are critical in meeting the needs of Idahoans. I appreciate their expertise and contributions to our great state.

I want to take a moment to wish you joy and happiness during this holiday season, no matter how you celebrate. I hope you also find joy in your successes from the past year, and I hope you look forward to more successes in the coming year.

Happy, healthy holidays!

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 holidays can be a difficult time for many – financial pressures, stress, and emotional issues can feel overwhelming.

If you’re struggling this holiday season, we can  help. The Department of Health and Welfare offers an array of services ranging from food assistance to help with a substance use disorder or mental health crisis — and a whole spectrum of services in between.

988 Suicide and Crisis Lifeline

The 988 Suicide and Crisis Lifeline provides support to Idahoans who are experiencing a behavioral health crisis. Dialing 988 in Idaho leads callers to the Idaho Crisis and Suicide Hotline. Anyone experiencing thoughts of suicide, mental health issues, substance use crisis, or any other kind of emotional distress can call or text 988 all day every day. People can also dial 988 if they’re worried about a loved one who may need crisis intervention. For more information: https://call988idaho.com/

211 Idaho CareLine

The Idaho CareLine is a free, statewide community information and referral service. Simply dial 211 on your phone between 8 a.m. and 6 p.m. Mountain Time to get in touch with a community resource specialist who can help with a wide range of programs and services, including all of the programs and services listed below. For more information about the 211 Idaho CareLine visit https://healthandwelfare.idaho.gov/services-programs/211

Food assistance

The Supplemental Nutrition Assistance Program (SNAP), formerly known as the Idaho Food Stamps Program, helps low-income families buy the food they need to stay healthy. Learn more by visiting https://healthandwelfare.idaho.gov/services-programs/food-assistance/about-snap

Women, Infant, & Children (WIC) is a federally-funded supplemental nutrition program for Women, infants, and children up to the age of 5. The program’s goal is to help families by promoting healthy lifestyle choices. More about WIC: https://healthandwelfare.idaho.gov/services-programs/food-assistance/about-wic

Additional community food resources include the school lunch program, summer meal program, statewide food program, and emergency food assistance programs. For more information about, or to apply for, community food resource programs: https://healthandwelfare.idaho.gov/services-programs/food-assistance/school-lunch-program

Financial assistance

Aid to the Aged, Blind, and Disabled (AABD) program may be able to provide cash assistance for people who are 65 or older, blind, or disabled. Those who are eligible will receive a small payment each month to help with living expenses. More information: https://healthandwelfare.idaho.gov/services-programs/financial-assistance/about-aabd-cash-assistance

Temporary Assistance for Families in Idaho (TAFI) provides temporary cash benefits for eligible low-income families to help pay for food, clothing, shelter, and other essentials. More information: https://healthandwelfare.idaho.gov/services-programs/financial-assistance/about-tafi

Home and utility assistance is also available and includes a range of programs:

• Weatherize your home: https://healthandwelfare.idaho.gov/services-programs/financial-assistance/home-heating-and-utility-assistance/about-weatherization
• Heating assistance: https://healthandwelfare.idaho.gov/services-programs/financial-assistance
• Telephone assistance: https://healthandwelfare.idaho.gov/services-programs/financial-assistance
• The Low Income Household Water Assistance Program helps low-income families pay their water and wastewater bills. More info: https://healthandwelfare.idaho.gov/services-programs/home-heating-and-utility-assistance/about-water-assistance

Healthcare assistance

Medicaid offers healthcare coverage for people in a variety of life situations and an array of health needs, including coverage for low-income adults, children, pregnant women, the elderly, and people with disabilities. More info: https://healthandwelfare.idaho.gov/services-programs/medicaid-health

Most people with developmental disabilities live in their communities. However, when they also have complex needs that results in a crisis, there is currently limited access to effective treatment.

To address these gaps, the department is creating three new crisis system components to add to the existing system: residential, teaming, and capacity building. This new model will allow adults to access a full range of crisis care that supports them and allows them to remain in their communities whenever possible.

Residential: When treatment must be done outside of the person’s community, two new care settings are being implemented.

The first is an assessment, observation, and stabilization unit. This is for people with developmental disabilities who are in crisis and need intensive or urgent behavioral, mental health, and/or medical care.

The second setting, called step-down housing, is for those who are no longer in crisis but are not yet ready to move back into their homes in their local communities. Step-down housing will model community living. Residents will live in apartment-like units with one or two people in each unit.

Significant psychiatric, behavioral, and nursing services would also be available in this setting, but the primary focus would be to help residents grow the skills they need to successfully return home and receive services in their communities. 

This means that the state will transition away from using Southwest Idaho Treatment Center (SWITC) as a long-term residential care setting for people with developmental disabilities and instead the new care settings will focus on short-term crisis and stabilization.

Teaming: This project is creating new specialized clinical teams to support people in the community and in the new care settings when their needs cannot be met using traditional community or crisis services.

These teams will provide cross-systems planning, coordination, and emergency supports with the goal of keeping people in their communities whenever possible. These specialized clinical teams will be nationally certified in best practices and provide expert services to people in all types of care settings.

Capacity building: Increased community capacity to meet the needs of people with developmental disabilities will reduce the need for residential services. Strategies to increase capacity include:

• Creating support levels for people with exceptional needs
• Increased access to existing services
• Higher qualifications and/or training for providers
• Improved transition processes

What comes next

The department will seek approval from the Centers for Medicare & Medicaid Services (CMS) to allow for Medicaid to pay for the services to support the new model.

The department also will bring a funding request to the Joint Finance-Appropriations Committee (JFAC) for a contract with Center for START Services. The request will fund a national certification to ensure adherence to best practices for the proposed teaming services. 

Then, to implement services needed for the new model, the department will engage in rule promulgation, including stakeholder feedback, and seek legislative approval.

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. 

An Ohio measles outbreak currently underway should serve as a clear reminder that it’s time to get our children caught up on vaccinations—particularly for those who may have slipped behind schedule during the COVID-19 pandemic.

Measles is a highly contagious respiratory disease that can result in severe, sometimes permanent, complications including pneumonia, seizures, brain damage, and even death. It’s caused by a virus that lives in the nose and throat mucus of an infected person and spreads easily through breathing, coughing, and sneezing.

While it’s one of the most contagious human viruses, it’s also almost entirely preventable through vaccination.

As of Tuesday, Dec. 13, the Ohio outbreak in and around Columbus had infected 74 people, most of them children who are unvaccinated (having zero doses of vaccine) or under-vaccinated (having had only one dose of a two-dose recommended vaccine). Of those cases more than half are among kids between 1 and 2 years of age, and more than a quarter of the patients required hospitalization. There have been no reported deaths.

In the United States as a whole, as of Dec. 8, 88 measles cases in five jurisdictions have been reported this year. The number is up sharply from the 49 cases reported in 2021 and 13 cases reported in 2020—and down considerably so far from the 1,274 reported in 2019 when several large outbreaks occurred in the United States.

There are currently no measles cases reported in Idaho, but it’s safe to say that public health officials are concerned. Measles anywhere is a threat everywhere, as the virus can quickly spread by infected people to multiple communities and across international borders.

Because measles is so contagious, communities should have a vaccination rate of at least 95 percent to keep the illness from spreading. Among children born during 2018 in Idaho, 93 percent had received their first dose of the measles, mumps, and rubella (MMR) vaccine by 24 months of age, and about 95 percent had received their first dose by 35 months of age.

However, a lower proportion of Idaho children receive their second MMR dose before entering Kindergarten and are not considered fully protected, making our vaccination rate lower than 95 percent among Idaho school-aged children.   

The U.S. Centers for Disease Control and Prevention (CDC) recently warned about a drop in measles vaccination coverage in children during the COVID-19 pandemic, estimating that 40 million kids missed a measles-containing vaccine in 2021, including 25 million who missed their first dose and 14.7 million who missed their second dose.

In 2021, 22 countries experienced large outbreaks that have persisted into 2022. When combined with vaccination gaps, the outbreaks pose a threat everywhere. In 2021 there were an estimated 9 million cases and 128,000 deaths from measles worldwide.

The Ohio outbreak is believed to be tied to one of four separate cases over the summer among individuals who became infected after traveling to a measles-endemic country.

The message going into the holiday season of family travel and gatherings is clear. If you have a child who is 12 months of age or older, and not up to date with their measles, mumps, and rubella vaccine, please make every effort to get them vaccinated as soon as possible.

Sarah Leeds is the manager of the Idaho Immunization Program  in the Division of Public Health. She has served in this position since June 2019, focusing on increasing coverage among Idahoans of both routine and COVID-19 vaccines.

Follow the Department of Health and Welfare on Twitter, Facebook, and Instagram for updates and information you can trust.

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’m pleased to announce that the Department of Health and Welfare’s (DHW) publication 2022-2023 Facts, Figures, and Trends is now available online.

This reference provides a robust look at DHW – who we serve, the services we provide, and how those services are paid for. It also provides information about the department’s budget – how much it gets, how much is spent, and who and what it is spent on.

For each of the department’s eight divisions, the book covers funds approved by the Legislature for the current state fiscal year as well as highlights and work done in the previous state fiscal year.

I use it often to remind myself about a specific program or to check some data. It’s a valuable tool for anyone who wants to have a better understanding of the work we do. The book is created each year by the Office of Communications, in close teamwork with all the divisions and councils.

Here are some of the highlights outlined in the book from state fiscal year 2022:

• SFY 2022 was the first full year of operation for State Hospital West, a 16-bed psychiatric facility for youth ages 12 through 17 in Nampa. State Hospital West opened in May 2021, replacing the adolescent unit at State Hospital South in Blackfoot. The new hospital allows the majority of patients to get help closer to home in the Treasure Valley. In SFY 2022, State Hospital West had 58 admissions, with an average length of stay between 50 and 60 days.
• During SFY 2022, Child and Family Services struggled to hire and keep social workers, who are critical to do the child welfare work. Bonuses, pay increases, and adjustments to working requirements were put in place to address the lack of social
  workers. Finally, more non-social worker employees were recruited to do many child welfare tasks.
• The Division of Licensing & Certification licensed 221 new facilities, homes, and agencies.
• The Division of Medicaid worked with hospitals and primary care providers to develop the Healthy Connections Value Care Program to move from traditional volume-based payments to value-based payments. Value-care organizations are responsible for controlling costs and improving health outcomes of their patients. This program went live on January 1, 2022.
• The Division of Public Health led a cross-department team to establish an Adverse Childhood Experiences Data Framework. The framework contains recommendations for sharing and using data regarding adverse childhood experiences, commonly called ACES, in a coordinated way across the department. The Division of Public Health also published two data reports showing how adverse childhood experiences impact Idahoans.
• Self-Reliance provided additional support through the American Rescue Plan Act (ARPA) to Idaho child care providers. Having safe, affordable, and high-quality child care for families throughout Idaho allows parents to go to work while children are being cared for. The Idaho Child Care Program issued more than $34 million to the Idaho Community Program Grant. This grant helped groups provide activities that support student learning, learning loss, and behavioral health supports for children ages 5-13.

I encourage to take a look at the book.

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. 

Idahoans who haven't gotten a Star Card ID yet may want to start planning so they're ready for the deadline, which was recently extended to May 2025.

At that time Idahoans will need a Star Card, U.S. Passport, military ID, or some other form of REAL-ID compliant identification to enter federal buildings or board commercial airplanes.

To get a Star Card, Idahoans must provide a birth certificate or passport, social security card, and two proofs of Idaho residency such as a mortgage statement or current utility bill to the Department of Motor Vehicles.

For those who do not have passports, the Department of Health and Welfare's Bureau of Vital Statistics can provide copies of Idaho birth certificates for $16.

Birth certificate order processing times vary depending on the volume of requests. As requests increase, processing times may also increase. Those who wait until the last minute may encounter delays.

The Bureau of Vital Records and Health Statistics does not have a public counter, and all requests for certified copies of birth certificates must be submitted online or by mail. Go to www.healthandwelfare.idaho.gov/vitalrecords for information about how to submit a request and estimated processing times.

If you were not born in Idaho, visit https://www.cdc.gov/nchs/w2w/index.htm to access a list of U.S. vital records offices

The bureau can also help if there's a mistake on your birth certificate. As with requesting a copy of your birth certificate, act sooner than later to help ensure that mistakes are corrected in time for the new deadline.

Additional information is available at the following links:

• Department of Homeland Security: https://www.dhs.gov/real-id
• Idaho Transportation Department: https://itd.idaho.gov/starcard/
• DHW's Bureau of Vital Records and Health Statistics: www.healthandwelfare.idaho.gov/vitalrecords

Kathy Anderson has worked in the Bureau of Vital Records and Health Statistics for 14 years.

James Aydelotte has been bureau chief of the Bureau of Vital Records and Health Statistics for 16 years.

Follow the Department of Health and Welfare on Twitter, Facebook, and Instagram for updates and information you can trust.

I know the employees at the Department of Health and Welfare (DHW) work really hard to serve Idahoans. But I love it when that hard work is recognized on a national level.

Idaho’s Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, helps low-income families buy the food they need to stay healthy. More than 122,400 Idahoans received benefits in October. The federal program is run in Idaho by the Division of Welfare / Self Reliance, which is part of DHW.

I’m very pleased to announce that our program continues to be a leader in the nation for timeliness and accuracy. The U.S. Department of Agriculture recently published a report that identifies and measures potential risks states may face as they transition to post-pandemic operations. The states were compared to each other and to national targets.

By all the measures, Idaho comes out in the top.

The report considered several different categories during the years of 2019, 2020, and 2021. The categories were customer service level, payment error rate level, SNAP participation trend level, waiver usage level (some states received COVID-19 SNAP waivers to help their programs during pandemic), and combined support level, which signals how unprepared a state might be for the end of the public health emergency.

Idaho was among the 14 states and territories out of 53 that would require no additional support to provide a high level of service for Idaho families when the public health emergency ends. For comparison, 25 out of 53 will require moderate support, and 14 out of 53 will require significant support when it ends.

This is wonderful recognition of the consistently excellent work employees in the Division of Welfare / Self Reliance do to process SNAP applications quickly and efficiently for Idaho families.

We don’t yet know when the federal public health emergency will end, but this means that struggling Idahoans will continue to get their benefits in a timely fashion. The national benchmark for processing SNAP applications is 30 days. In Idaho, hungry families typically receive their benefits within four days of applying.

If you are in need of food assistance, please visit https://healthandwelfare.idaho.gov/services-programs/food-assistance/apply-snap or call 877-456-1233.

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. 

Public health officials around the country are reminding people that it's OK and appropriate to mask up. This is especially true entering the season of holiday parties and family gatherings.

COVID-19 continues to spread, and it's joined this fall and winter by higher levels of flu and RSV. All three are respiratory illnesses spread by saliva and droplets produced when people talk, cough, sneeze, and even breathe.

One sure-fire way to slow the spread of all three is to wear a quality, well-fitting mask when you are in crowded, indoor environments. N95 or KN95 masks are recommended for the highest protection, but the best mask is the one you’ll use, so get the most protective mask you can that fits well and is comfortable for you.

If you're sick, or you've been around someone who's sick, and you can't stay home, please consider wearing a mask in public. It protects those around you.

Likewise, don't judge those who choose to wear masks. Masks help protect vulnerable people who may be avoiding illness while fighting a severe disease like cancer or heart disease. Or they may be taking as many precautions as possible to protect a vulnerable loved one.

It’s clear that more people are getting sick. RSV has spiked in Idaho the last four weeks. Flu also swept across the U.S. this month, and we estimate high or very high activity in all but one of Idaho's seven public health districts. The percent positivity of COVID-19 tests done in the state and reported to public health also crept upward last week from 6.6 to 7.6 percent.

It's impossible to know how sick you might get from RSV, flu, or COVID-19, but we do know there are steps you can take to try to avoid getting them in the first place. There are vaccines that will help fight flu and COVID-19, and all three can be slowed or stopped when people wear masks.

Holiday parties include family and friends, some of whom may be vulnerable to these viruses that are already circulating. So please think about masking up, especially around very young or older people, and be compassionate and respectful of others who mask up, too.

Resources:

• CDC mask guidance: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/masks.html
• COVID-19 in Idaho: https://coronavirus.idaho.gov/
• Flu in Idaho: https://www.gethealthy.dhw.idaho.gov/infectious-disease-idaho
• RSV in Idaho: https://www.gethealthy.dhw.idaho.gov/resp-synct

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. 

Follow the Department of Health and Welfare on Twitter, Facebook, and Instagram for updates and information you can trust.

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

Healthcare systems in rural areas like Idaho face unique challenges. More than 88 percent of Idaho is classified as rural. DHW’s Bureau of Rural health and Primary Care is working to confront those challenges in several ways.

More than 98 percent of Idaho faces a shortage of primary care professionals, and more than 95 percent of the state doesn’t have enough dental health professionals to serve their communities. One-hundred percent of Idaho has too few mental health professionals.

To work toward improving these numbers, the Bureau of Rural Health and Primary Care offers programs and resources to improve access to healthcare in rural and underserved areas.

These efforts include clinician recruitment and retention programs such as loan repayment programs when they decide to practice in Idaho for a certain amount of time and in health professional shortage area designations. Efforts also include education and resources for critical access hospitals, rural health clinics, and free medical clinics, as well as support for the transition to value-based healthcare from fee-for-service care. 

To help draw attention to these statewide challenges, Idaho Gov. Brad Little signed a proclamation on Thursday, Nov. 17, to honor National Rural Health Day. The proclamation draws attention to the “distinct and critical role” the Bureau of Rural Health and Primary Care and Idaho Rural Health Association play by leading efforts to meet rural Idahoans’ unique healthcare needs.  

Idahoans who live in rural communities  tend to be older, more likely to be uninsured or underinsured, have a greater number of chronic illnesses, and are more likely to have poorer health behaviors because they have limited access to healthy foods and physical activity.

Rural residents are more likely than those who live in urban areas to die early from all five leading causes of death: heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke.

Health services, meanwhile, do more than help rural Idahoans stay healthy. They are important economic engines. Health services contribute significantly to disease prevention and management and play a vital role in supporting state and local economies.

In Idaho, the average doctor supports an estimated 12 jobs and generates about $1.9 million in economic benefits for their communities. Improving healthcare for Idahoans also means strengthening Idaho’s rural economies.

For more information about how the Bureau of Rural Health and Primary Care is working to improve healthcare in rural parts of the state visit ruralhealth.dhw.idaho.gov.

Gina Pannell is bureau chief of the Bureau of Rural health and Primary Care in DHW’s Division of Public Health.

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