In foster care, Idaho Department Health and Welfare budget proposal focuses on prevention

BOISE (Idaho Capital Sun) — As the Idaho Department of Health and Welfare seeks to address issues in foster care, the agency is looking to funnel more resources toward preventing kids from being placed in foster care in the first place.

In its budget request to be considered during the 2025 legislative session, the state health agency is asking to raise the child welfare budget by almost $15 million to $65.2 million, and add 68 new full-time staff for a total of nearly 503 staff in fiscal year 2026, which starts June 2026.

If approved by the Idaho Legislature, some new funding and staff requested would go toward funding prevention work, reducing agency caseworker workloads, enhancing support to foster parents and improving kids placements in child welfare.

More than eight in every 10 children in the Department of Health and Welfare’s custody are placed in a care setting, like foster care or congregate care; the remaining kids stay in their homes, with agency prevention services geared toward helping families ensure kids’ safety.

A major goal Health and Welfare outlined is to reverse that trend: to have the vast majority of kids remain in their homes and receive prevention services, with the rest of kids in placement settings.

That prevention focus involves putting “as many resources at the beginning of that journey,” Idaho Department of Health and Welfare Director Alex Adams told the Idaho Capital Sun and CBS2 in a joint interview.

State Sen. Melissa Wintrow, a Boise Democrat who has for years worked on child welfare issues, welcomed the focus on prevention and the requests to boost staffing.

“This Legislature has said over and over that we value our children. And I believe that,” she told the Sun and CBS2. “But in order to value our children, we have to fully invest in the resources to support them. And that could be prevention services, which I highly support,” along with decreasing caseloads and providing resources for children with complex needs, who often are placed in congregate care.

What Health and Welfare’s budget request asks for

The budget request calls for funds and new staffing across four key child welfare areas, geared toward improving the safety of kids in their homes; improving placements; enhancing support for foster parents; and reducing agency caseload workloads to improve children’s outcomes.

Here’s how those requests breaks down:

1. Improving kids’ safety in their homes: $3 million in total funds, including $1.46 million in federal funds and nearly $1.6 million in state general funds. No new jobs are requested.
2. Improving placement fit and stability for children in foster care: $1.2 million in total funds, including over a half million dollars in federal funds and $674,000 in state general funds. Twelve new full-time jobs are requested.
3. Enhancing support for foster parents: $3.1 million in total funds, including $1.4 million in federal funds and nearly $1.7 million in state general funds. Fifteen new full-time jobs are requested.
4. Improving children’s outcomes by reducing agency worker caseloads: $1.3 million in total funds, including $631,500 in federal funds and $690,000 in state general funds. Fourteen new full-time jobs are requested.

The agency also seeks to raise foster care and assistance payments to $74.5 million next fiscal year, up from the $62.8 it was budgeted this year, but down from what it estimated its actual expenses will be this year, which was projected at nearly $77 million.

The Department of Health and Welfare, like other state government agencies, submitted its budget request Sept. 1. But official decisions on the budgeting process are still months away.

In January, Idaho Gov. Brad Little is expected to issue his own budget request to the Idaho Legislature.

That’s also when the Idaho Legislature is set to convene for the 2025 legislative session, which often stretches into the first few months of the year. That’s when state lawmakers would craft individual budget bills authorizing state agencies to spend money — including state and federal funds.

What is prevention in child welfare?

Each year, the Idaho Department of Health and Welfare receives around 24,000 calls alleging abuse or neglect to its hotline, Adams told the Sun. Health and Welfare sends out staff to assess child safety in around 15,800 cases annually, Adams said.

In most cases, kids are determined safe and remain in their home, Adams said. But in 11% of cases, kids are deemed unsafe and end up in the custody of Health and Welfare, he said.

About 85% of children that end up in the Department of Health and Welfare custody end up in placements — meaning they are placed in foster care; the care of other family members, called kinship care; group homes, known as congregate care; or another setting, like a hospital or juvenile corrections.

The rest of the kids in Health and Welfare’s custody, about 15% of cases, are treated as “prevention” cases. That’s where the child remains in their home and families receive services focused on safety, such as parent anger management classes, substance use disorder treatment, connections to welfare programs like food stamps or WIC, or other resources.

In prevention cases, the department sends staff out regularly to oversee that children are safe, Adams said.

Now, the Idaho Department of Health and Welfare hopes to reverse that 85-15 split, of mostly placing kids in service placement settings, rather than keeping them home with prevention services — to have 85% of kids in the agency’s custody in prevention services, rather than placement settings.

“A placement should be the tool of last resort,” like in cases of physical or sexual abuse, Adams told the Sun.

Formerly the governor’s budget chief, Adams took over as Idaho Department of Health and Welfare director in June, soon announcing foster care as a top priority.

Why is Health and Welfare focused on prevention?

Monty Prow, deputy director for Idaho Department of Health and Welfare’s Child, Youth & Family Services, likened the focus on prevention to investing in fences or ambulances, referencing an old poem.

Picture a cliff, Prow told the Sun. If you build a fence — tall, wide, and without gaps and holes — then people who approach won’t fall off, he explained.

“And along the way, create trauma for themselves and their families and victims. And end up at the bottom of the cliff needing an ambulance,” Prow said.

“Would you rather invest in fences or ambulances?” he said. “It’s very clear. Research is clear that investing in avoiding the fall from the cliff is far better for everybody. Not just the youth, not just the family, but the community.”

Adams said the agency thinks it can serve kids more effectively and safely in prevention — by keeping kids in their homes, and delivering the right services at the right time.

But the agency’s plans also include efforts to make placements work better, focused on the “right kid, right place, right time” concept, seeking to avoid congregate care, Adams said, including a rate increase for foster families.

Wintrow said the success of Director Adams’ plans relies on legislative support, and she criticized the Legislature’s yearslong trend of tax rebates that refund tax revenue.

Even if he “has all these grand ideas, if the Legislature doesn’t provide the funding and the support, then they’re just ideas,” she said. “And I have seen that happen before, unfortunately.”

But Wintrow criticized the Department of Health and Welfare for suspending enrollments in a child care aid program in August amid a projected budget shortfall, which she says creates a “safety hazard” for children.

“I’d also like to see (Adams) advocate for the full picture of child safety and protection. And to put those child care grants back in effect, use the $50 million of foregone money to pay what is needed and help these families get into child care to reduce their stress and trauma so they can go to work and pay the bills,” she told the Sun. “Because if you don’t have child care, you are directly risking putting more kids in the foster care system.”

Health and Welfare spokesperson AJ McWhorter says the agency is still enrolling into the program some high-risk populations, including foster children and kids with disabilities, which officials exempted from the pause. And he said the agency continues to work on budget issues with lawmakers.

In its budget request, Health and Welfare asked for a “sustainable increase” for the program, called the Idaho Child Care Program, McWhorter said. And he said the agency noted in a letter to lawmakers on the state’s budget committee “a desire to work together on a sustainable roadmap for leveraging the accumulated one-time balance” of program funds.

Prevention part of broader child welfare trends

Idaho’s focus on prevention in child welfare is part of a broader national trend, spurred by a 2018 federal law called the Family First Prevention Act, Adams told the Sun.

“Tremendous reports” by Idaho’s Office of Performance Evaluations (OPE), an independent state agency that conducts critical state government watchdog work, gave Health and Welfare a roadmap, Adams said, including to focus on prevention even before the national push toward it.

OPE Principal Evaluator Amanda Bartlett, who has worked on child welfare reports, said she was optimistic to see what happens next. After 2017 and 2018 OPE reports, she said she didn’t see large changes in the department that she’s seeing now.

But she stressed that child protection is complex, and works best when solutions are tailored to individual children, along with having broader strategies.

Keeping kids safe with their biological family is great, she said.

“But reunification at all costs can’t be the goal, because it’s not appropriate for every child,” Bartlett said. “And so I think what we really want is a system that is very good at balancing all of the interests at play, and has enough resources to make sure that the child’s best interest — the individual child’s best interest — can remain at the center of every decision.”

Adams says he likes OPE’s structure so much that the Department of Health and Welfare is planning to create its own Office of Program Integrity for internal third-party analysis of agency programs.