During a Region II Behavioral Health Board meeting on Thursday, Idaho law enforcement officials said they’re worried about how cuts to Assertive Community Treatment, or ACT, will affect their departments.
ACT is a form of intensive treatment program for people with severe mental health disorders, including schizophrenia and bipolar disorder, for whom other therapies have been ineffective.
As NWPB previously reported, a white paper published by the Idaho Association of Community Providers and the Idaho ACT Coalition estimates that cuts to behavioral health services like ACT, which total roughly $20 million, could result in over $150 million in expenses to local governments.
Providers contracted by the state said that as of Dec. 1, grouped services, including ACT, which were previously paid as a “bundle” were ungrouped, with some key elements of those services no longer billable under Medicaid.
Shane Anderson, public information officer for the Latah County Sheriff’s Office, said he expects an increased call load for mental health-related issues because people are losing support services.
Anderson said many of those services went unnoticed in the background, keeping people from being hospitalized or incarcerated. He said before the Latah Recovery Center was established, which partners with the Rural Crisis Center Network, there were even fewer options for people in crisis.
“Honestly, the way we used to deal with it is we only had two options,” Anderson said. “We'd take 'em to the hospital if they're suicidal, or we find some crime they've committed to take 'em to jail so we can at least watch 'em.”
Orofino Police Chief Vince Frazier said eliminating mental health services could lead to more people in jail repeatedly. Fewer services keep deputies busy responding to mental health calls.
“ That means we are not doing other things that we should be doing,” he said.
A letter sent this month by the Idaho Sheriffs’ Association to Gov. Brad Little and several Idaho lawmakers predicted the cuts would result in increased call volumes, involuntary holds of patients, incarceration and court cases.
Several Idaho state lawmakers, including Rep. Lori McCann and Rep. Kyle Harris, attended the health board meeting. Sen. Cindy Carlson and Rep. Charlie Shepherd joined over video calls. U.S. Sens. Jim Risch and Mike Crapo did not attend, but sent staff members on their behalf.
Harris said lawmakers did not make the decision to cut acute behavioral health services. Statewide cuts, including Medicaid, came as a result of an executive order by Gov. Little to reduce general fund spending on Aug. 15. On Aug. 22, the Department of Health and Welfare announced a 4% cut in Medicaid provider pay rates.
“ We didn't have a say in where Health and Welfare was gonna make these cuts, or (McCann and I) both would've been like, ‘you're not cutting behavioral health,’” Harris said.
In a statement, the Department of Health and Welfare said it had been working with Magellan for the past several months to identify provider rate reductions and changes to optional services as allowed under the law.
“The Magellan service and rate cuts are to achieve the required budget holdbacks. The department posted information release MA25-17 on Aug. 22 following the Governor’s Executive Order 2025-05 to address budget stabilization with holdbacks,” said AJ McWhorter, a public information officer for the Department of Health and Welfare, in an email. “Following a period of public comment on these changes and a required access analysis, the department released information release MA25-19 on October 16.”
The notice by the department did not mention the “unbundling” of previously grouped services like ACT, which effectively defunded the programs.
McCann said she called Idaho’s Department of Health and Welfare regarding the cuts and was directed to Magellan Healthcare, the state’s Medicaid administrator.
“ I first got the runaround saying, ‘Well, Magellan cut (those services),”’ McCann said. “I met with Magellan to put it right in their face, and they were like, “OK, let me tell you, we recommended areas that they not cut. That they don't cut the ACT team.”
Harris said he believes if legislators were shown evidence that Medicaid cuts cost more than they saved, the funding could be reinstated in the next session.
“That's what you have to bring, in order to swing some of these people on these committees,” he said. “ The more information we get in committee, you will change votes. I've watched it happen.”
Providers say the cuts may already be doing irreparable harm to those who lost services.
In late November, a lawsuit was filed on behalf of ACT recipients who say they will face an increased risk of hospitalization or incarceration without the program to help them remain stable.
