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 ACT1 RELATING TO RURAL HEALTH TRANSFORMATION; AMENDING TITLE 56, IDAHO CODE, BY2 THE ADDITION OF A NEW CHAPTER 25, TITLE 56, IDAHO CODE, TO ESTABLISH3 THE IDAHO RURAL HEALTH TRANSFORMATION FUND AND TO ESTABLISH THE RURAL4 HEALTH TRANSFORMATION COMMITTEE; APPROPRIATING ADDITIONAL MONEYS TO5 THE DEPARTMENT OF HEALTH AND WELFARE FOR THE INDIRECT SUPPORT SERVICES6 DIVISION FOR FISCAL YEAR 2026; INCREASING THE NUMBER OF AUTHORIZED7 FULL-TIME EQUIVALENT POSITIONS FOR FISCAL YEAR 2026; APPROPRIATING AD-8 DITIONAL MONEYS TO THE DEPARTMENT OF HEALTH AND WELFARE FOR THE INDIRECT9 SUPPORT SERVICES DIVISION FOR FISCAL YEAR 2027; INCREASING THE NUMBER10 OF AUTHORIZED FULL-TIME EQUIVALENT POSITIONS FOR FISCAL YEAR 2027;11 PROVIDING FOR A REPORT ON SCOPE OF PRACTICE REFORMS FOR PHYSICIAN ASSIS-12 TANTS AND DENTAL HYGIENISTS; AND DECLARING AN EMERGENCY AND PROVIDING13 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 amended16 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 2519 IDAHO RURAL HEALTH TRANSFORMATION PROGRAM20 56-2501. IDAHO RURAL HEALTH TRANSFORMATION FUND.(1) There is hereby21 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 of23 Idaho from the federal rural health transformation program grant. Moneys in24 the fund shall be used solely for federally approved rural health transfor-25 mation program purposes, subject to appropriation by the legislature upon26 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 hereby31 created the rural health transformation committee, hereafter referred to32 as the committee. The committee shall consist of nine (9) members to be33 appointed as follows: four (4) members of the senate shall be appointed by34 the president pro tempore of the senate, one (1) of whom shall be cochair of35 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 shall37 be cochair of the committee; and one (1) nonvoting member shall be selected38 by the governor. The term of a legislative member of the committee shall39 coincide with the term of election to the legislature. A vacancy during the40

2 term of a member of the committee shall be filled by the appointing authority1 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 award7 year and by September 30 for the four (4) remaining award years;8 (c) To establish an expedited award review process with the department9 of health and welfare for funding subawards. The award review process10 shall align with federally approved timelines as outlined in Idaho's11 rural health transformation plan;12 (d) To receive no less than quarterly updates on progress toward funded13 projects, expenditures, and outcomes from the department of health and14 welfare;15 (e) To evaluate the potential and actual success of programs funded16 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 Idaho20 rural health transformation moneys; and21 (h) To make any recommendations to the legislature on the use of funds,22 as long as recommendations are within the parameters of the federally23 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 health27 transformation program awards received or created by the department of28 health and welfare, including but not limited to scoring data, rubrics, and29 reporting information. Such data shall be readily accessible through a se-30 cure portal, website, shared drive, or other method providing instantaneous31 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 and34 Welfare for the Division of Indirect Support Services from the Idaho Rural35 Health Transformation Fund, the following amounts to be expended for the36 designated expense classes, for the period July 1, 2025, through June 30,37 2026:38 FOR:39 Personnel Costs40 $264,300 Operating Expenditures41 3,444,500 Capital Outlay42 28,800 TOTAL43 $3,737,600

SECTION 3. FTP AUTHORIZATION. In addition to any other authorization44 provided by law, the full-time equivalent position authorization provided45 to the Department of Health and Welfare for the Division of Indirect Support46

3 Services is increased by twelve (12.00) for the period July 1, 2025, through1 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 the4 Division of Indirect Support Services from the Idaho Rural Health Transfor-5 mation Fund, the following amounts to be expended for the designated expense6 classes, for the period July 1, 2026, through June 30, 2027:7 FOR:8 Personnel Costs9 $1,328,700 Operating Expenditures10 294,076,500 TOTAL11 $295,405,200

SECTION 5. FTP AUTHORIZATION. In addition to any other authorization12 provided by law, the full-time equivalent position authorization provided13 to the Department of Health and Welfare for the Division of Indirect Support14 Services is increased by twelve (12.00) for the period July 1, 2026, through15 June 30, 2027.16

SECTION 6. RURAL HEALTH TRANSFORMATION PROGRAM -- SCOPE OF PRACTICE17 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 and19 dental hygienists that were identified in the Rural Health Transformation20 Program proposal submitted to the Centers for Medicare and Medicaid Services21 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 of24 efforts to advance those reforms, including legislative or administrative25 actions taken during the prior year and any additional steps necessary to26 fulfill those commitments.27

SECTION 7. An emergency existing therefor, which emergency is hereby28 declared to exist, Sections 1 through 3 of this act shall be in full force and29 effect on and after passage and approval, and Sections 4 through 6 of this act30 shall be in full force and effect on and after July 1, 2026.31