Idaho sheriffs worry Medicaid mental health cuts pose ‘significant public-safety concern’

By Kyle Pfannenstiel
Idaho Capital Sun

Idaho sheriffs are warning elected officials that new state Medicaid cuts to critical mental health services for people with severe mental illness could pose a public safety risk. 

A letter by the Idaho Sheriffs’ Association is the latest in a string of concerns over cuts by a state Medicaid contractor that stem from the state’s attempts to avoid a projected budget shortfall.

Effective on Dec. 1, the contractor that runs Idaho Medicaid mental health benefits, Magellan of Idaho, planned to cut specialized mobile teams that treat patients with severe mental illness who have struggled in routine settings. It isn’t immediately clear whether the cuts are already in effect. 

In a letter dated Dec. 1 to Gov. Brad Little and Republican leaders in the Idaho Legislature, Idaho Sheriffs’ Association President Samuel Hulse urged elected officials to recognize and address the situation. He called the state’s budget situation “self-inflicted.”

“We acknowledge the state’s budget challenges which are self-inflicted by an overly aggressive tax reduction stance of the Legislative Branch and a complicit Executive Branch continuing to reduce tax revenue creating a budget shortage,” wrote Hulse, who also serves as Bonneville County sheriff. 

“These reductions to mental health services represent a significant public-safety concern,” he continued. “As sheriffs, our foremost duty is to protect the people of Idaho. We urge state leadership to recognize the real-world public-safety consequences of these decisions and to work with counties to ensure Idahoans in crisis — and the agencies who respond to them — are not left without support.”

The state’s projected budget deficit is coming after the Legislature and Little approved $450 million in tax cuts during the 2025 legislative session, following years of income tax cuts that have reduced the state’s revenue by $4 billion, the Idaho Capital Sun previously reported. 

Magellan and the Idaho Department of Health and Welfare could not be immediately reached for comment.

Sheriffs say cuts could worsen mental health crises, shifting costs to jails, EMS and more

Since Magellan announced the cuts, patients and mental health clinics have sued the Idaho Department of Health and Welfare and top state health officials.

The Idaho Sheriffs’ Association echoed concerns by some mental health providers, warning that the cuts could worsen mental health crises, shifting costs onto jails, emergency medical services and local taxpayers “who will bear the operational and financial burden of managing the consequences.” 

On Dec. 1, Magellan also announced more cuts to Idaho Medicaid mental health services that will start Jan. 1, 2026. The cuts include:

• Blocking providers from billing for skills training and development groups for adults starting Jan. 1 in some cases, except for people age 17 and younger and adults who are receiving the early and periodic screening, diagnostic, and treatment benefit. 

• Requiring more frequent prior authorization for two services: adult intensive outpatient services, and adult skills-building/community-based rehabilitative services. All adults receiving the adults skill-building/community-based rehabilitative services will need prior authorization. 

Jason Coombs, founder of Brick House Recovery, a substance abuse treatment center in Boise and Idaho Falls, told the Idaho Capital Sun in a statement the cuts could limit care access in Idaho.

“These reductions across multiple levels of care raise serious concerns about our ability to adequately serve one of Idaho’s most vulnerable populations,” he said. “While I initially understood the need for greater accountability and some level of tightening within the system, the cumulative impact of these changes may unintentionally limit access to essential mental-health and substance-use treatment.”

This story was produced by Boise-based nonprofit news outlet the Idaho Capital Sun, which is part of the States Newsroom nationwide reporting project. For more information, visit idahocapitalsun.com.

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Sheriff Wheeler: ‘I 100% agree’ that cuts to mental health care will endanger public safety

By Zach Hagadone
Reader Staff

As top county law enforcement officers throughout Idaho cautioned Gov. Brad Little and legislators in a Dec. 1 letter that budget cuts will imperil mental health care services affecting public safety, Bonner County Sheriff Daryl Wheeler told the Reader, “I 100% agree with the substance of the letter.”

“Cutting these services guarantees that local law enforcement, EMS and hospitals will see an increase of calls for service and patient contacts,” he said. “As noted in our letter, any cost saving the state realizes by eliminating these services will be shifted to the counties to pick up.”

According to the letter from the Idaho Sheriffs’ Association, six programs are on the chopping block as the state works to cut costs amid a looming budget shortfall (see “Idaho sheriffs worry Medicaid mental health cuts pose ‘significant public-safety concern’” on this page). In the letter, ISA called the shortfall “self-inflicted” by deep tax revenue cuts in the 2025 legislative session.

According to ISA, programs eliminated effective Dec. 1 include:

• Assertive Community Treatment teams, which work with individuals diagnosed with severe and persistent mental illness;

• Partial Hospitalization Programs, which help people safely transition to the community after they’ve left inpatient treatment or jail;

• Homes with Adult Residential Treatment, which without funding will lose clinical stabilization and result in clients reentering the crisis care system;

• Early Serious Mental Illness, an early psychosis program whose removal “dumps all eligible people” into the crisis care system, as well as on ERs, EMS, police, sheriffs deputies and jails;

• Intensive Outpatient, which allows individuals to receive treatment in their own surroundings, rather than undergoing full hospitalization;  

• Peer Support, which helps people navigate care systems, stay engaged with treatment and maintain quality of life. In addition, ISA stated, those services allow individuals who have successfully reclaimed their lives to give back to the community. “Loss of these jobs is not only wrong, it will result in unfortunate outcomes for many,” the association wrote.

According to ISA’s letter, beyond the increased costs and labor that will fall on law enforcement and other public safety and health care agencies, “We also know that once these functioning systems are disrupted, it will take substantially more time to build them back.”

Wheeler told the Reader that, “Of the list of six services listed in our letter, Bonner County will feel the effects of the loss of Peer Support services,” adding that the other services are not offered in Bonner or Boundary Counties. 

“I would suspect that the majority of persons who are suffering a mental health crisis and requiring a law enforcement response, are utilizing the Peer Support services provided by Health and Welfare,” Wheeler said. 

“I will predict that the stability that support provides, now that it is eliminated, will cause instability and require an intervention by the Sheriff’s Office and local law enforcement,” he added. “Once again, we will be forced to pick up the pieces of this broken system and further stretch our limited resources.”