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Critical Condition: Idaho Health and Welfare's Annus Horribilis

One state agency's battle against an avalanche of problems

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In September, Ada County prosecutors were readying their case against Melissa Jenkins and Daniel Ehrlick, who were charged with the abuse and murder of Jenkins' 8-year-old son Robert Manwill in July 2009. At the same time, Robert Fellmeth, a law professor who directs the Children's Advocacy Institute at the University of San Diego Law School, said Idaho's Department of Health and Welfare could have done a better job to protect Manwill. Soon thereafter, the department announced it would seek an independent outside review.

"Forget about hindsight," said Fellmeth about Health and Welfare. "I'm sorry. They weren't doing their job."

BW: What prompted you to order an outside review?

Armstrong: There is something called a Keeping Children Safe Panel Process that we use. It's a community review of all of the facts. The panel publishes recommendations but nothing about the case.

So an internal review was done?

Yes. It's not just a review of what the department did but also a review of what law enforcement did. It included anything surrounding the case.

Because this is a criminal trial, there will be other facts coming out, so we're going to wait until then for the outside review. Because there's no other way for us to get access to some of those criminal files.

But do you want to wait that long?

We have no choice. For us to convene a panel prior to the trial could jeopardize the legal proceedings.

Have any of the lessons learned resulted in changes of how the department acts?

We've already implemented them.

Can you tell us about any of them?

No, I can't do that yet. Even with internal reviews we have to be careful not to taint a possible witness.

On Jan. 10, 2011, Otter will deliver his State of the State address. That will launch a 2011 legislative session expected to be more fiscally conservative than 2010. On Jan. 17, 2011, Armstrong is scheduled to once more make the trek to the Capitol and ask lawmakers to fund his already-lean agency.

BW: So how bleak will your message be?

Armstrong: It's going to be extremely difficult. While the State of Idaho has been careful about how we use our rainy day funds and other one-time revenues, this will be the third year of us trying to stretch that money. What we don't know are the revenue forecasts.

Will the list of revenues be shorter for 2012?

Absolutely. What we'll have to do then is prepare for any further reductions that will have to take place. Once cuts are announced, we'll have to put a plan together to achieve those savings. But getting there will be a whole new ball game.

Isn't Medicaid in the red right now?

We're forecasting to be short about $42 million.

Can you put a face to Medicaid?

It's a child: 74 percent of all Medicaid clients are children. It's almost always a child. And quite often, there's a disability. So we have children's mental health benefits available.

At the end of the interview, BW took note of a framed cartoon on Armstrong's desk. In it, two deer stand upright. On the belly of one deer is a big, red bulls-eye.

"Bummer of a birthmark there," says the other deer.

"It kind of depicts the impossible situation that we're in," said Armstrong. "Everything we deal with is highly charged with emotion. I'm having more difficulty with this job than I had years ago. This recession has made it more difficult. On every front we're being challenged to deliver more services and have fewer employees. Our budget is down 19 percent from what it was in 2008. This is a very finite game. There's only so much money. If we're not careful, we'll push people into the Department of Correction. Well, their budget is no better than ours."

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