Mental health providers in Idaho say they’re having difficulty stabilizing severely mentally ill patients after the state cut Medicaid funding for certain behavioral health programs.
One of those programs was Assertive Community Treatment, or ACT. It was used for decades to treat people with mental illnesses including major depression when other treatments had failed.
But many of the services that made ACT what it was were cut in December as part of a statewide reduction in Medicaid reimbursement.
ACT funding had paid for providers to meet clients where they were, in their homes and communities. That is no longer being paid for.
Sara Bennett, a Lewiston-based clinician who had been contracted to run the regional ACT program, said many of those patients are now struggling.
One key part of ACT had included funding for a nurse who could go into the community to provide medical treatment alongside behavioral health care workers.
Bennett said because that position is no longer reimbursed, at least two patients she knows are weeks behind on anti-psychotic medications.
“We spent a year and a half stabilizing them, and now they’re both very much unstable and their symptoms are very significant,” she said.
Another former ACT patient, she said, ended up hospitalized after funding was cut. Prior to the funding cuts, some people booked in county jails or going through mental health were referred to her team for treatment, but now they aren’t.
About a third of the former ACT patients her team saw have been unable to maintain any services, she said.
“Another third, it’s really inconsistent, not nearly as regular as it had been,” Bennett said.
Idaho made cuts to a number of behavioral health programs, which NWPB first reported in December.
Estimates by the Idaho Association of Community Providers predict cuts to those programs could cost the state more than $150 million in local taxpayer dollars.
A new report builds on the previously published white paper, and predicts an especially heavy financial burden on homeowners in Boise and other service-area hubs including the greater Lewiston area, Idaho Falls and Pocatello.
Ric Boyce is the co-director of Idaho Association of Community Providers and a clinician who administered his region’s ACT team in Pocatello.
“For local taxpayers footing the bill for increased emergency care, we are looking (at) between $200 and $800 per person, per year,” he said.
According to a news release sent by Rehabilitative Health Services in Idaho Falls, which provides staffing for the Behavioral Health Crisis Center of Southeast Idaho, those cuts coincided with an increase in patients at behavioral health crisis centers.
In Idaho’s Regions 6 and 7, Behavioral Crisis Centers in Pocatello and Idaho Falls reported a significant combined increase in patients, according to the release. The centers saw a 34% increase in client visits in December from the previous year, and a 43% increase in January 2026 compared to January of 2025.
Boyce said behavioral health problems are also increasing other health risks for clients. One former ACT patient died after a post-procedural infection from routine medical care. That might have been avoided, he said, with early intervention as a part of ACT.
“Normally, we would’ve had multiple team members with eyes on that person. We would’ve identified that they needed medical care. We would’ve sent out our nurses as part of ACT. If they were refusing to go, we would’ve sent down our counselors who had training in how to motivate people to follow through with medical care,” Boyce said.
Bennett and Boyce said they’ve been talking with legislators in hopes of restoring funding for ACT and other behavioral health services in the near future.
