S 1453

                    LEGISLATURE OF THE STATE OF IDAHO
 Sixty-eighth Legislature  Second Regular Session - 2026
                                 IN THE SENATE
                             SENATE BILL NO. 1453
                             BY FINANCE COMMITTEE
1AN ACT
2  RELATING TO RURAL HEALTH TRANSFORMATION; AMENDING TITLE 56, IDAHO CODE, BY
3      THE ADDITION OF A NEW CHAPTER 25, TITLE 56, IDAHO CODE, TO ESTABLISH
4      THE IDAHO RURAL HEALTH TRANSFORMATION FUND AND TO ESTABLISH THE RURAL
5      HEALTH TRANSFORMATION COMMITTEE; APPROPRIATING ADDITIONAL MONEYS TO
6      THE DEPARTMENT OF HEALTH AND WELFARE FOR THE INDIRECT SUPPORT SERVICES
7      DIVISION FOR FISCAL YEAR 2026; INCREASING THE NUMBER OF AUTHORIZED
8      FULL-TIME EQUIVALENT POSITIONS FOR FISCAL YEAR 2026; APPROPRIATING AD-
9      DITIONAL MONEYS TO THE DEPARTMENT OF HEALTH AND WELFARE FOR THE INDIRECT
10     SUPPORT SERVICES DIVISION FOR FISCAL YEAR 2027; INCREASING THE NUMBER
11     OF AUTHORIZED FULL-TIME EQUIVALENT POSITIONS FOR FISCAL YEAR 2027;
12     PROVIDING FOR A REPORT ON SCOPE OF PRACTICE REFORMS FOR PHYSICIAN ASSIS-
13     TANTS AND DENTAL HYGIENISTS; AND DECLARING AN EMERGENCY AND PROVIDING
14     EFFECTIVE DATES.
15 Be It Enacted by the Legislature of the State of Idaho:
16      SECTION 1. That Title 56, Idaho Code, be, and the same is hereby amended
17 by the addition thereto of a NEW CHAPTER, to be known and designated as Chap-
18 ter 25, Title 56, Idaho Code, and to read as follows:
19CHAPTER 25
20IDAHO RURAL HEALTH TRANSFORMATION PROGRAM
21      56-2501. IDAHO RURAL HEALTH TRANSFORMATION FUND.(1) There is hereby
22 created and established in the state treasury the Idaho rural health trans-
23 formation fund. The fund shall consist of moneys received by the state of
24 Idaho from the federal rural health transformation program grant. Moneys in
25 the fund shall be used solely for federally approved rural health transfor-
26 mation program purposes, subject to appropriation by the legislature upon
27 recommendation from the rural health transformation committee as estab-
28 lished in section 56-2502, Idaho Code.
29      (2) The Idaho rural health transformation fund shall be subject to an-
30 nual public reporting of all receipts and expenditures.
31      56-2502. RURAL HEALTH TRANSFORMATION COMMITTEE.(1) There is hereby
32 created the rural health transformation committee, hereafter referred to
33 as the committee. The committee shall consist of nine (9) members to be
34 appointed as follows: four (4) members of the senate shall be appointed by
35 the president pro tempore of the senate, one (1) of whom shall be cochair of
36 the committee; four (4) members of the house of representatives shall be ap-
37 pointed by the speaker of the house of representatives, one (1) of whom shall
38 be cochair of the committee; and one (1) nonvoting member shall be selected
39 by the governor. The term of a legislative member of the committee shall
40 coincide with the term of election to the legislature. A vacancy during the
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1  term of a member of the committee shall be filled by the appointing authority
2  of that member, and members may be reappointed to a subsequent term.
3(2) The committee shall have the following powers and duties:
4(a) To establish rules for governance and operation of committee pro-
5ceedings;
6(b) To establish any additional requirements for funding subawards,
7which shall include application scoring rubrics, for the first award
8year and by September 30 for the four (4) remaining award years;
9(c) To establish an expedited award review process with the department
10      of health and welfare for funding subawards. The award review process
11      shall align with federally approved timelines as outlined in Idaho's
12      rural health transformation plan;
13      (d) To receive no less than quarterly updates on progress toward funded
14      projects, expenditures, and outcomes from the department of health and
15      welfare;
16      (e) To evaluate the potential and actual success of programs funded
17      with moneys from the Idaho rural health transformation fund;
18      (f) To retain oversight of moneys in the Idaho rural health transforma-
19      tion fund;
20      (g) To require a sustainability plan for any initiative funded by Idaho
21      rural health transformation moneys; and
22      (h) To make any recommendations to the legislature on the use of funds,
23      as long as recommendations are within the parameters of the federally
24      approved Idaho plan.
25      (3) The committee shall remain active until all moneys in the Idaho ru-
26 ral transformation fund have been appropriated and expended.
27      (4) The committee shall have access to all data regarding rural health
28 transformation program awards received or created by the department of
29 health and welfare, including but not limited to scoring data, rubrics, and
30 reporting information. Such data shall be readily accessible through a se-
31 cure portal, website, shared drive, or other method providing instantaneous
32 or real-time access.
33     SECTION 2. In addition to the appropriation in Section 1, Chapter 209,
34 Laws of 2025, there is hereby appropriated to the Department of Health and
35 Welfare for the Division of Indirect Support Services from the Idaho Rural
36 Health Transformation Fund, the following amounts to be expended for the
37 designated expense classes, for the period July 1, 2025, through June 30,
38 2026:
39 FOR:
40 Personnel Costs  $264,300
41 Operating Expenditures  3,444,500
42 Capital Outlay  28,800
43  TOTAL  $3,737,600
44      SECTION 3. FTP AUTHORIZATION. In addition to any other authorization
45 provided by law, the full-time equivalent position authorization provided
46 to the Department of Health and Welfare for the Division of Indirect Support
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1  Services is increased by twelve (12.00) for the period July 1, 2025, through
2  June 30, 2026.
3      SECTION 4. In addition to any other appropriation provided by law,
4  there is hereby appropriated to the Department of Health and Welfare for the
5  Division of Indirect Support Services from the Idaho Rural Health Transfor-
6  mation Fund, the following amounts to be expended for the designated expense
7  classes, for the period July 1, 2026, through June 30, 2027:
8  FOR:
9  Personnel Costs  $1,328,700
10 Operating Expenditures  294,076,500
11  TOTAL  $295,405,200
12      SECTION 5. FTP AUTHORIZATION. In addition to any other authorization
13 provided by law, the full-time equivalent position authorization provided
14 to the Department of Health and Welfare for the Division of Indirect Support
15 Services is increased by twelve (12.00) for the period July 1, 2026, through
16 June 30, 2027.
17      SECTION 6. RURAL HEALTH TRANSFORMATION PROGRAM -- SCOPE OF PRACTICE
18 COMMITMENTS. It is the intent of the Legislature that the State of Idaho con-
19 tinue to pursue the scope of practice reforms for physician assistants and
20 dental hygienists that were identified in the Rural Health Transformation
21 Program proposal submitted to the Centers for Medicare and Medicaid Services
22 and that contributed to the state's program scoring and award determination.
23 The Department of Health and Welfare shall report to the Joint Finance-Ap-
24 propriations Committee and the germane policy committees on the status of
25 efforts to advance those reforms, including legislative or administrative
26 actions taken during the prior year and any additional steps necessary to
27 fulfill those commitments.
28     SECTION 7. An emergency existing therefor, which emergency is hereby
29 declared to exist, Sections 1 through 3 of this act shall be in full force and
30 effect on and after passage and approval, and Sections 4 through 6 of this act
31 shall be in full force and effect on and after July 1, 2026.