Idaho’s Department of Health & Welfare, the state’s largest agency, has faced record caseloads, reduced workforce and cuts in benefits in recent years, Director Dick Armstrong told JFAC this morning as he gave an overview of H&W division budget hearings to come. Two-thirds of department’s funding comes from the federal government, and about a quarter from the state, he said. For next year, Health & Welfare is requesting $617 million in state general funds, a $7.3 million, or 1.2 percent, increase from last year. In total funds, it’s a 6.8 percent increase.

Armstrong noted that while most attention with regard to the national health care reform law has focused on state decisions on a health insurance exchange and expansion of Medicaid, aside from those issues, the law also makes a series of mandatory changes affecting all states that in Idaho will have the effect of increasing the state’s number of people eligible for Medicaid by approximately 70,000. “We are now gearing up, we are all hands on deck, to prepare for this huge increase of medically eligible participants,” Armstrong said. It'll mean a 30 percent caseload increase.

Idaho could lose huge amounts of its funding for its current Medicaid program if it didn’t comply with the changed rules, he noted. “We have to comply with the mandatory requirements that the ACA makes to Medicaid. The stakes are huge if we don’t.”

Another big change coming is that the ACA requires mental health parity for health insurance coverage in 2014, Armstrong said. That means almost everyone will have coverage for mental health treatment. But a gap remains at the community level, he said, because while treatment works, recovery depends on community support. “Our vision is to help communities develop the infrastructure and programs necessary to support the wellness of their residents who have mental illness,” he said.

Said Armstrong: "With almost everyone theoretically having mental health coverage in 2014, we have an unprecedented opportunity for improving the overall mental health system. We have been working on mental health transformation for over a decade, and this provides the best opportunity to make significant improvements if we approach it right."