APPROPRIATIONS – HEALTH AND WELFARE – RURAL HEALTH – Relates to the appropriation to the Department of Health and Welfare for rural health care for fiscal year 2027.

LEGISLATURE
OF
THE
STATE
OF
IDAHO
Sixty-eighth
Legislature
Second
Regular
Session
-
2026
IN
THE
SENATE
SENATE
BILL
NO.
1453
BY
FINANCE
COMMITTEE
AN
ACT
1
RELATING
TO
RURAL
HEALTH
TRANSFORMATION;
AMENDING
TITLE
56,
IDAHO
CODE,
BY
2
THE
ADDITION
OF
A
NEW
CHAPTER
25,
TITLE
56,
IDAHO
CODE,
TO
ESTABLISH
3
THE
IDAHO
RURAL
HEALTH
TRANSFORMATION
FUND
AND
TO
ESTABLISH
THE
RURAL
4
HEALTH
TRANSFORMATION
COMMITTEE;
APPROPRIATING
ADDITIONAL
MONEYS
TO
5
THE
DEPARTMENT
OF
HEALTH
AND
WELFARE
FOR
THE
INDIRECT
SUPPORT
SERVICES
6
DIVISION
FOR
FISCAL
YEAR
2026;
INCREASING
THE
NUMBER
OF
AUTHORIZED
7
FULL
-
TIME
EQUIVALENT
POSITIONS
FOR
FISCAL
YEAR
2026;
APPROPRIATING
AD
-
8
DITIONAL
MONEYS
TO
THE
DEPARTMENT
OF
HEALTH
AND
WELFARE
FOR
THE
INDIRECT
9
SUPPORT
SERVICES
DIVISION
FOR
FISCAL
YEAR
2027;
INCREASING
THE
NUMBER
10
OF
AUTHORIZED
FULL
-
TIME
EQUIVALENT
POSITIONS
FOR
FISCAL
YEAR
2027;
1
1
PROVIDING
FOR
A
REPORT
ON
SCOPE
OF
PRACTICE
REFORMS
FOR
PHYSICIAN
ASSIS
-
12
TANTS
AND
DENTAL
HYGIENISTS;
AND
DECLARING
AN
EMERGENCY
AND
PROVIDING
13
EFFECTIVE
DATES.
14
Be
It
Enacted
by
the
Legislature
of
the
State
of
Idaho:
15
SECTION
1.
That
Title
56,
Idaho
Code,
be,
and
the
same
is
hereby
amended
16
by
the
addition
thereto
of
a
NEW
CHAPTER
,
to
be
known
and
designated
as
Chap
-
17
ter
25,
Title
56,
Idaho
Code,
and
to
read
as
follows:
18
CHAPTER
25
19
IDAHO
RURAL
HEALTH
TRANSFORMATION
PROGRAM
20
56
-
2501.
IDAHO
RURAL
HEALTH
TRANSFORMATION
FUND.(1)
There
is
hereby
21
created
and
established
in
the
state
treasury
the
Idaho
rural
health
trans
-
22
formation
fund.
The
fund
shall
consist
of
moneys
received
by
the
state
of
23
Idaho
from
the
federal
rural
health
transformation
program
grant.
Moneys
in
24
the
fund
shall
be
used
solely
for
federally
approved
rural
health
transfor
-
25
mation
program
purposes,
subject
to
appropriation
by
the
legislature
upon
26
recommendation
from
the
rural
health
transformation
committee
as
estab
-
27
lished
in
section
56
-
2502,
Idaho
Code.
28
(2)
The
Idaho
rural
health
transformation
fund
shall
be
subject
to
an
-
29
nual
public
reporting
of
all
receipts
and
expenditures.
30
56
-
2502.
RURAL
HEALTH
TRANSFORMATION
COMMITTEE.(1)
There
is
hereby
31
created
the
rural
health
transformation
committee,
hereafter
referred
to
32
as
the
committee.
The
committee
shall
consist
of
nine
(9)
members
to
be
33
appointed
as
follows:
four
(4)
members
of
the
senate
shall
be
appointed
by
34
the
president
pro
tempore
of
the
senate,
one
(1)
of
whom
shall
be
cochair
of
35
the
committee;
four
(4)
members
of
the
house
of
representatives
shall
be
ap
-
36
pointed
by
the
speaker
of
the
house
of
representatives,
one
(1)
of
whom
shall
37
be
cochair
of
the
committee;
and
one
(1)
nonvoting
member
shall
be
selected
38
by
the
governor.
The
term
of
a
legislative
member
of
the
committee
shall
39
coincide
with
the
term
of
election
to
the
legislature.
A
vacancy
during
the
40

2
term
of
a
member
of
the
committee
shall
be
filled
by
the
appointing
authority
1
of
that
member,
and
members
may
be
reappointed
to
a
subsequent
term.
2
(2)
The
committee
shall
have
the
following
powers
and
duties:
3
(a)
To
establish
rules
for
governance
and
operation
of
committee
pro
-
4
ceedings;
5
(b)
To
establish
any
additional
requirements
for
funding
subawards,
6
which
shall
include
application
scoring
rubrics,
for
the
first
award
7
year
and
by
September
30
for
the
four
(4)
remaining
award
years;
8
(c)
To
establish
an
expedited
award
review
process
with
the
department
9
of
health
and
welfare
for
funding
subawards.
The
award
review
process
10
shall
align
with
federally
approved
timelines
as
outlined
in
Idaho's
1
1
rural
health
transformation
plan;
12
(d)
To
receive
no
less
than
quarterly
updates
on
progress
toward
funded
13
projects,
expenditures,
and
outcomes
from
the
department
of
health
and
14
welfare;
15
(e)
To
evaluate
the
potential
and
actual
success
of
programs
funded
16
with
moneys
from
the
Idaho
rural
health
transformation
fund;
17
(f)
To
retain
oversight
of
moneys
in
the
Idaho
rural
health
transforma
-
18
tion
fund;
19
(g)
To
require
a
sustainability
plan
for
any
initiative
funded
by
Idaho
20
rural
health
transformation
moneys;
and
21
(h)
To
make
any
recommendations
to
the
legislature
on
the
use
of
funds,
22
as
long
as
recommendations
are
within
the
parameters
of
the
federally
23
approved
Idaho
plan.
24
(3)
The
committee
shall
remain
active
until
all
moneys
in
the
Idaho
ru
-
25
ral
transformation
fund
have
been
appropriated
and
expended.
26
(4)
The
committee
shall
have
access
to
all
data
regarding
rural
health
27
transformation
program
awards
received
or
created
by
the
department
of
28
health
and
welfare,
including
but
not
limited
to
scoring
data,
rubrics,
and
29
reporting
information.
Such
data
shall
be
readily
accessible
through
a
se
-
30
cure
portal,
website,
shared
drive,
or
other
method
providing
instantaneous
31
or
real
-
time
access.
32
SECTION
2.
In
addition
to
the
appropriation
in
Section
1,
Chapter
209,
33
Laws
of
2025,
there
is
hereby
appropriated
to
the
Department
of
Health
and
34
Welfare
for
the
Division
of
Indirect
Support
Services
from
the
Idaho
Rural
35
Health
Transformation
Fund,
the
following
amounts
to
be
expended
for
the
36
designated
expense
classes,
for
the
period
July
1,
2025,
through
June
30,
37
2026:
38
FOR:
39
Personnel
Costs
40
$264,300
Operating
Expenditures
41
3,444,500
Capital
Outlay
42
28,800
TOTAL
43
$3,737,600
SECTION
3.
FTP
AUTHORIZATION.
In
addition
to
any
other
authorization
44
provided
by
law,
the
full
-
time
equivalent
position
authorization
provided
45
to
the
Department
of
Health
and
Welfare
for
the
Division
of
Indirect
Support
46

3
Services
is
increased
by
twelve
(12.00)
for
the
period
July
1,
2025,
through
1
June
30,
2026.
2
SECTION
4.
In
addition
to
any
other
appropriation
provided
by
law,
3
there
is
hereby
appropriated
to
the
Department
of
Health
and
Welfare
for
the
4
Division
of
Indirect
Support
Services
from
the
Idaho
Rural
Health
Transfor
-
5
mation
Fund,
the
following
amounts
to
be
expended
for
the
designated
expense
6
classes,
for
the
period
July
1,
2026,
through
June
30,
2027:
7
FOR:
8
Personnel
Costs
9
$1,328,700
Operating
Expenditures
10
294,076,500
TOTAL
1
1
$295,405,200
SECTION
5.
FTP
AUTHORIZATION.
In
addition
to
any
other
authorization
12
provided
by
law,
the
full
-
time
equivalent
position
authorization
provided
13
to
the
Department
of
Health
and
Welfare
for
the
Division
of
Indirect
Support
14
Services
is
increased
by
twelve
(12.00)
for
the
period
July
1,
2026,
through
15
June
30,
2027.
16
SECTION
6.
RURAL
HEALTH
TRANSFORMATION
PROGRAM
-
-
SCOPE
OF
PRACTICE
17
COMMITMENTS.
It
is
the
intent
of
the
Legislature
that
the
State
of
Idaho
con
-
18
tinue
to
pursue
the
scope
of
practice
reforms
for
physician
assistants
and
19
dental
hygienists
that
were
identified
in
the
Rural
Health
Transformation
20
Program
proposal
submitted
to
the
Centers
for
Medicare
and
Medicaid
Services
21
and
that
contributed
to
the
state's
program
scoring
and
award
determination.
22
The
Department
of
Health
and
Welfare
shall
report
to
the
Joint
Finance
-
Ap
-
23
propriations
Committee
and
the
germane
policy
committees
on
the
status
of
24
efforts
to
advance
those
reforms,
including
legislative
or
administrative
25
actions
taken
during
the
prior
year
and
any
additional
steps
necessary
to
26
fulfill
those
commitments.
27
SECTION
7.
An
emergency
existing
therefor,
which
emergency
is
hereby
28
declared
to
exist,
Sections
1
through
3
of
this
act
shall
be
in
full
force
and
29
effect
on
and
after
passage
and
approval,
and
Sections
4
through
6
of
this
act
30
shall
be
in
full
force
and
effect
on
and
after
July
1,
2026.
31