Idaho’s new Department of Health and Welfare director is ready to make sweeping changes to the state’s largest agency.

Alex Adams officially took his position June 5, and has already implemented a number of rules and made several leadership changes to help execute his vision — which centers on improving the foster care system.

He took further steps this week by waiving the $100 licensing fee for family daycare homes with six or fewer children.

BACKGROUND

Adams, 39, said his experience as pharmacist and his interest in policy meant that leading the health agency is the perfect intersection of the two.

“What attracted me to it was health care background, experience in state government, hopefully a track record of being able to demonstrate I’ve gotten things done in state government, and it just felt like all those parts of the Venn diagram were overlapping,” Adams said in an interview.

He followed in the footsteps of his father, grandfather and great grandfather by going to pharmacy school. He has a bachelor’s degree and doctor of pharmacy from the University of Toledo and master’s in public health from Johns Hopkins University.

Adams said that, even during school he found himself more interested in looking into why there were differences between what could be done in pharmacies in Ohio and Michigan than he was in practicing in the field.

He took a job in Washington, D.C., for a pharmacy trade group National Association of Chain Drug Stores that lobbied state and federal governments on behalf of large chain pharmacies. Adams and his wife Jennifer, who is an Idaho native, moved to the Treasure Valley, and he was selected to lead the state Board of Pharmacy in 2015.

The regulatory entity operates under the state Division of Occupational Licensing. Adams said his focus as executive director of the board was to reduce as much regulatory red tape as possible and increase access to services. During his tenure, he oversaw a reduction of around 40% of the board’s regulations, the Idaho Press previously reported.

One of his initiatives that he highlighted was allowing trained pharmacy technicians to administer vaccines; Idaho was the first state to do this and much of what the Gem State did was included in the Trump administration’s Public Readiness and Emergency Preparedness (PREP) Act at the beginning of the COVID-19 pandemic, Adams said.

In 2018, he was hired by then Gov.-Elect Brad Little to serve as budget director and oversee the Division of Financial Management. He helped lead the effort to implement Little’s major initiatives such as the grant program Idaho Launch for graduating high school seniors and a bill that made available $1 billion for school facilities.

VISION FOR CHILD WELFAREAdams said that if he’d been asked two years ago what his focus would be for the health agency, he likely would have said Medicaid.

A huge portion of the state budget goes toward the program and many lawmakers have called for reductions to it over the years.

However, in preparing for the job he looked into past reports by the Office of Performance Evaluations that found deficiencies and significant challenges in the state’s foster care system, and he also followed hearings from the Child Protection Legislative Oversight Committee in which foster parents have repeatedly said there’s a need for a cultural shift in the division.

“I don’t think that there’s anything more personal that this department does than child welfare,” Adams said. “And I don’t think you can make a bigger, long-term ROI (return on investment) than improving outcomes in the child welfare system.”

He said he’s been interviewing foster parents since taking the position and hearing many common complaints about poor communication with the department, the feeling that they weren’t trusted and that they weren’t heard.

“Frankly, their stories are gut-wrenching. Hearing what some of them have experienced, hearing their perception of how their cases have gone, I know that we can do better,” Adams said. “And I know that we will do better and that’s why I’ve made that my focus.”

Creating the needed changes is going to require policy changes as well as cultural shifts, he said.

In just the first couple of days on the job he implemented several temporary rule changes — which removed adoption fees, added long-term foster parents to the definition of kin, reduced the time requirement for initiation of work on an application to become a foster parent, and moved Idaho’s rules on foster care to a national model, as previously reported.

Adams also directed the agency to create a “Foster Parent Bill of Rights” and is working to train staff to adhere to it; the document will go live on Aug. 1. It states that foster families have the right to “be treated with dignity, respect, trust, value, and consideration as members of the professional team caring for foster children;” “be supported by the department in their valued role as the primary provider of foster care;” have “timely, accurate, and respectful communication with department staff;” “be actively involved in case planning for children in their care;” and “raise concerns without fear of reprisal and have issues addressed in a sensitive, respectful, timely and confidential manner.”

Adams said cultural changes in the department can be nudged through policies, but really start with leadership.

He highlighted his hire of Monty Prow as his deputy director of child, youth and family services. Prow had been the director of the Idaho Department of Juvenile Corrections. Adams said he was impressed with Prow’s focus on prevention and wanted him to bring that to the Child Welfare division.