BOISE, ID – Idaho sheriffs are warning elected officials that new state Medicaid cuts to critical mental health services for people with severe mental illness could pose a public safety risk.

A letter by the Idaho Sheriffs’ Association is the latest in a string of concerns over cuts by a state Medicaid contractor that stem from the state’s attempts to avoid a projected budget shortfall.

The contractor that runs Idaho Medicaid mental health benefits, Magellan of Idaho, plans to cut specialized mobile teams that treat patients with severe mental illness who have struggled in routine settings starting Monday. It isn’t immediately clear whether the cuts are already in effect.

In a Monday letter to Gov. Brad Little and Republican leaders in the Idaho Legislature, Idaho Sheriffs’ Association President Samuel Hulse urged elected officials to recognize and address the situation. He called the state’s budget situation “self-inflicted.”

“We acknowledge the State’s budget challenges which are self-inflicted by an overly aggressive tax reduction stance of the Legislative Branch and a complicit Executive Branch continuing to reduce tax revenue creating a budget shortage,” Hulse, who also serves as Bonneville County sheriff, wrote.

“These reductions to mental health services represent a significant public-safety concern,” he continued. “As sheriffs, our foremost duty is to protect the people of Idaho. We urge State leadership to recognize the real-world public-safety consequences of these decisions and to work with counties to ensure Idahoans in crisis — and the agencies who respond to them — are not left without support.”

The state’s projected budget deficit is coming after the Legislature and Little approved $450 million in tax cuts during the 2025 legislative session, following years of income tax cuts that have reduced the state’s revenue by $4 billion, the Idaho Capital Sun previously reported.

Magellan and the Idaho Department of Health and Welfare could not be immediately reached for comment.

Sheriffs group says cuts could worsen mental health crises, shifting costs to jails, EMS and more

Since Magellan announced the cuts, patients and mental health clinics have sued the Idaho Department of Health and Welfare and top state health officials.

The Idaho Sheriffs’ Association echoed concerns by some mental health providers, warning that the cuts could worsen mental health crises, shifting costs onto jails, emergency medical services and local taxpayers “who will bear the operational and financial burden of managing the consequences.”

On Monday, Magellan also announced more cuts to Idaho Medicaid mental health services that will start Jan. 1. The cuts include:

• Blocking providers from billing for skills training and development groups for adults starting Jan. 1 in some cases, except for people age 17 and younger and adults who are receiving the early and periodic screening, diagnostic, and treatment benefit.
• Requiring more frequent prior authorization for two services: adult intensive outpatient services, and adult skills-building/community-based rehabilitative services. All adults receiving the adults skill-building/community-based rehabilitative services will need prior authorization.

Jason Coombs, founder of Brick House Recovery, a substance abuse treatment center in Boise and Idaho Falls, told the Idaho Capital Sun in a statement the cuts could limit care access in Idaho.

“These reductions across multiple levels of care raise serious concerns about our ability to adequately serve one of Idaho’s most vulnerable populations,” he said. “While I initially understood the need for greater accountability and some level of tightening within the system, the cumulative impact of these changes may unintentionally limit access to essential mental-health and substance-use treatment.”

This story first appeared on Idaho Capital Sun.