Budget chief picked for Idaho Health and Welfare job

The Idaho governor’s budget chief will take the helm of the state’s largest agency, according to an announcement that included other major staff and cabinet changes.

Gov. Brad Little announced on Tuesday that Alex Adams will be the new director of the Idaho Department of Health and Welfare. Adams had served as the administrator of the Division of Financial Management since 2019.

Lori Wolff, who has been Little’s director of operations since 2023, was named the new administrator of DFM. Little also promoted Sara Stover, his director of cabinet affairs, to deputy chief of staff.

“All three of these intelligent people are valued members of my team,” Little said in a news release. “I am grateful they continue to dedicate their talents to public service, and I am excited to see what they will accomplish for the people of Idaho in their new roles.”

Adams, Wolff and Stover will officially be in their new roles June 5.

The health agency had been headed by interim director Dean Cameron since the beginning of 2024. The previous director, Dave Jeppesen, had announced his retirement in November 2023.

Adams had also served as interim director of the Idaho Public Charter School Commission and the executive director of the Idaho Board of Pharmacy.

Prior to his work with the state of Idaho, he was vice president of pharmacy programs at the National Association of Chain Drug Stores, a national trade association.

Adams has a doctor of pharmacy degree from the University of Toledo in Ohio and a master of public health degree from Johns Hopkins University Bloomberg School of Public Health.

As administrator of DFM, Adams has played a major role in helping craft the governor’s proposed budgets and was deeply involved in working with lawmakers to write legislation that included some of Little’s top priorities.

A recent example was this year’s centerpiece school facilities funding bill, HB 521.

Wolff, who now steps into the budget chief role, had also been the administrator of the Division of Human Resources and interim director of the Governor’s Office of Energy and Mineral Resources and the Department of Administration.

She had worked for the health department for 18 years, including as the deputy director and division administrator. She was born in Salmon, Idaho, and has a master’s degree in public administration from Idaho State University.

Stover took the role of director of cabinet affairs in 2022, in which she worked with agency directors to “align agency operations with the Governor’s priorities,” according to the news release. She has also served as Little’s senior policy advisor for health care.

Stover has been working in the executive branch since 2001. She worked for the Division of Financial Management under previous Govs. Butch Otter, Jim Risch, and Dirk Kempthorne, and was also a policy aide for Risch and Kempthorne.

HEALTH DEPARTMENT AND LEGISLATURE

Cameron, the interim Health and Welfare director, will continue working as director of the Department of Insurance, which is a role he’s been holding concurrently with his position as interim head of the health department.

Cameron took over the department amid some tension between the agency and the Legislature — especially the state budget writers. Before his predecessor stepped down, there was an ongoing disagreement over how the agency handled a large federal grant program meant to serve school-aged kids aged 5-13 during the pandemic.

The Joint Finance and Appropriation Committee (JFAC) in February 2023 directed staff to perform an audit of the Community Partner Grant Program after questions were raised that it served kids younger than 5.

An audit of the program, released last summer, yielded eight significant findings, including that it may have gone to ineligible programs, which staff deemed serious enough to recommend an investigation from the attorney general.

The agency disagreed with all the findings and initially said there would be no corrective action plan submitted.

At the beginning of the 2024 session, JFAC co-chairpersons said the committee would hold one of the agency’s budgets hostage as a “negotiation piece” until there was a corrective action plan submitted.

The budget-writing committee released the hostage budget in March, and co-chairpersons Rep. Wendy Horman, R-Idaho Falls, and Sen. Scott Grow, R-Eagle, said they were pleased with Cameron’s response.

“(Cameron) has done an excellent job, being a new interim director there, he obviously had to get on top of all that,” Grow said at the time. “But the work that he’s done with his people to respond to those requests and to satisfy the concerns of the audit, that has been very impressive. So we feel good about moving ahead with funding the budget.”

Little praised Cameron in the statement announcing the staff changes.

“I appreciate Dean for stepping in as interim director at Health and Welfare during a critical legislative session,” Little said. “He brought strong leadership to the agency with his wealth of experience and knowledge both in the legislative branch and the executive branch as well as the private sector.”

The health agency is also home to one of the state’s largest, and most debated budgets — Medicaid.

The cost, when including federal and state general funds combined, has increased significantly in recent years, with a total price tag of around $4.7 billion this year. In 2020, the budget total budget was $2.8 billion.

Most of the funding comes from the federal government and is required to be paid to cover reimbursable costs. State general fund money makes up 18% of the Medicaid budget.

Ways to reduce the costs have been a topic of debate and the goal of an interim committee last year, which met several times to come up with recommendations. The committee didn’t agree on many recommendations, but it was decided to create a Legislative Review Panel to review Medicaid contracts.

Guido covers Idaho politics for the Lewiston Tribune, Moscow-Pullman Daily News and Idaho Press of Nampa. She may be contacted at lguido@idahopress.com and can be found on X @EyeOnBoiseGuido.