Health and Human Services Week started in the Joint Finance-Appropriations Committee on Monday with an overview of the Department of Health & Welfare by Director Richard Armstrong. Armstrong started by stating that the budget appeared to be a maintenance budget, however there are several significant opportunities to improve the health and safety of the citizens of Idaho. Armstrong provided budget recommendations totaling an overall increase of 3.3% and explained that Idaho will have the opportunity to "think bigger" with health policy initiatives.

One of the department's visions is to transition all Medicaid participants to care management solutions. Last month Idaho was awarded a 4-year federal grant for 40 million dollars that will help the department improve the health of all Idahoans. The State Healthcare Innovation Plan (SHIP) is based on the foundation of the patient centered medical home (PCMH). Idaho conducted a pilot program in 2014 to determine the health home impacts on Medicaid hospital care. The program reduced average monthly member costs by over 20% and the preliminary estimate of return on investment is 10/1. The department is asking for spending authority to use $8.9 million of the federal grant to be administered by the Healthcare Policy Initiative program. With the money, primary care practices will be transitioned to the PCMH model. Grant money will be used to connect electronic health records to the Idaho Health Data Exchange and develop regional collaborative with health districts to support local, coordinated care. 

The governor is recommending a 3% salary increase. Director Armstrong explained that low pay is driving workforce turnover in the department. In 2014 there was a voluntary turnover rate of 13.6% and pay was identified as the main or contributing factor in 54% for the cases. Workers are leaving for the private sector where the average pay increase is 38%. Armstrong acknowledges that they cannot compete with the private sector on pay alone but they need to stay competitive. He stated, "We don't want to become the training ground for the private sector." The department's workload remains high and Armstrong urged JFAC to support the governor's 3% recommended increase to retain productive workers.

Director Armstrong thanked the committee for the appropriation of funds last year for Idaho's first Behavioral Health Crisis Center in Idaho Falls and is seeking funding for a second. The crisis centers will provide safer, more effective and more efficient alternatives to jails and ERS.

Idaho has one of the most effectively operated exchanges in the country. Director Armstrong reports that in Idaho "we figured it out". The shared eligibility system allowed for quickly and effective implementation of the exchange. The shared services has allowed for the collection of data previously unattainable by the department. People that earned less than 100% of poverty and were not eligible for Medicaid or tax credit were identified. This population of people is now referred to as "The Gap". Director Armstrong told the committee no matter what your position is on Medicaid redesign, the conversation revolves around the people that fall in the gap. He closed with, "No matter what direction you decide to go, I think we can do a better job than what we have now." 

Both national and state economies are recovering. Unemployment has dropped, but the amount on public assistance hasn't. People are working, but they are not earning a livable wage. In 2014 the number of Idahoans receiving public assistance increased by 20%. Director Armstrong stated that low wages in Idaho impact self- sufficiency and that the long-term answer is livable wages for Idaho workers. 

Director Armstrong's full presentation can be found here

Other topics presented during Health & Welfare week in JFAC can be found at:

http://legislature.idaho.gov/budget/JFAC/presentations/index.htm

On Wednesday, January 21 the House Health & Welfare committee heard presentations from Roger Hales, Administrative Attorney on behalf of the Board of Optometry, the Licensing Board of Professional Counselors and Marriage and Family Therapists, the Speech and Hearing Services Licensure Board, the Board of Midwifery, the Idaho Board of Massage Therapy, and the Board of Occupational Therapy. Brian White, Licensed Physical Therapist from the Board of Physical Therapy also presented.

The House Health & Welfare Committee agenda and subject text can be found at:

http://www.legislature.idaho.gov/sessioninfo/2015/standingcommittees/hhel.pdf

On Thursday the Senate Health & Welfare committee heard presentations regarding criminal history and background checks and the investigation and enforcement of fraud, abuse, and misconduct. Topics also included child and family services, adult mental health services, and rules of the Idaho Board of Nursing.

The Senate Health & Welfare Committee agenda and subject text can be found at:

http://www.legislature.idaho.gov/sessioninfo/2015/standingcommittees/shel.pdf

During his speech on Wednesday at Boise State, President Obama highlighted that in the past year alone, around 10 million uninsured Americans received health insurance, including right here in Idaho and that health care inflation is at the lowest rate in 50 years. He stated, "We can't suddenly put the security of families back at risk by taking away their health insurance." The policies that have been put in place are working and will work as long as politics do not get in the way. 

Bills/Rules of Note

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