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Medicaid expansion bringing savings for Idaho's courts

Previously, about 15.5% of those in treatment courts were eligible for Medicaid; with the expansion, 58% are now eligible.
Credit: KTVB
File photo of the Idaho Statehouse.

BOISE, Idaho — Idaho’s courts are anticipating saving more than $1.5 million in the coming year due to Medicaid expansion, as people going through drug courts and other special treatment courts become eligible for Medicaid coverage.

The Idaho Press reports in anticipation of those savings, the state Legislature last year covered $913,000 of the treatment funds for the court programs this year with one-time funding only. Sara Thomas, administrative director of Idaho’s courts, told the Legislature’s Joint Finance-Appropriations Committee on Monday that the courts have done an intensive study to determine the Medicaid eligibility of those receiving services through the courts, and came up with an additional $600,000 in anticipated savings to the state general fund, for a total of more than $1.5 million.

Previously, about 15.5% of those in treatment courts were eligible for Medicaid; with the expansion, which voters approved in November of 2018 and which went into effect Jan. 1, 58% are now eligible.

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Medicaid will cover 50% of the costs of needed treatment services for those participating in the court programs, Thomas told lawmakers.

“Medicaid covers medically necessary treatments,” she said, “but the treatment courts in Idaho necessarily cover some things that are not medically necessary,” such as drug testing. “That is not medically necessary, but it is necessary for accountability and it is necessary success in that program.”

She did caution that all of this is based on projections, and there are still some unknowns. “Should they not be accurate or should something change with Medicaid expansion, we will have to come back and ask for additional funding to maintain current services in the treatment courts,” Thomas told the joint budget committee.

Sen. Jeff Agenbroad, R-Nampa, who serves on the joint committee, said, “I think we are still learning things about who the Medicaid expansion population is. We undershot a little last year in a conservative manner.”

Rep. Melissa Wintrow, D-Boise, another panel member, said, “It seems like that’s moving in the right direction. I was actually pleasantly surprised.”

She said she was particularly pleased to hear that the Judicial Branch interviewed every treatment court participant, some of them more than once, to make an accurate determination.

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Overall, the proposed budget for Idaho’s judiciary next year reflects just a 1.5% increase in state general funds to $51.1 million; in total funds, including $22 million in dedicated revenues from court fees and $1.9 million in federal funds, it’s a half-percent increase to $74.3 million.

“Every day, throughout the state, Idaho’s judges are doing some of the most important work that can be done,” Thomas told the lawmakers.


Caseloads are growing, she said. In fiscal year 2019, just in cases newly filed, there were, on average, 359 per district judge and 1,698 per magistrate judge.

“As you can imagine, Idaho’s courts are very busy and are feeling the impact of growth in our state,” Thomas said.

Last year, the Legislature approved adding one district judge and two magistrate judges in Ada County this year. For next year, the courts are requesting a new district judge and two magistrates in District 1 in North Idaho, which hasn’t gotten a new judge since 2006. During that time, Bonner County’s population grew 11% and Kootenai County’s grew 25%, Thomas said, pushing case filings per judge in the North Idaho region well above the state average.

“This level of work is simply not sustainable,” she said, with judges holding dozens of court hearings in a single day.

And despite the new judges in Ada County this year, Thomas said, “The 4th District is still struggling, and it’s notified the Supreme Court of its need to add more judges.”

The courts will continue to assign seniors judges to help fill in there, she said. “We’ll continue to assess, and may be requesting additional resources in the near future.”

The courts also are requesting $34,000 in ongoing funding next year for Americans with Disabilities Act consulting regarding access issues at county courthouses; that previously had been handled with one-time funds for the past two years, but Thomas said it’s become clear there are “needs we see continuously arising throughout the state.”

The courts also are requesting $405,200 for staff statewide in the Guardian Ad Litem/Court Appointed Special Advocate program, which is required by law to provide an advocate for each child involved in Child Protection Act proceedings regarding abused, neglected or abandoned children.

The joint budget committee is scheduled to complete its hearings and begin setting state agency budgets Feb. 14.

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