It may be impossible to put a price tag on the coronavirus pandemic’s cost to Idaho and Idahoans.

But reporting by the Idaho Capital Sun found that one small piece of the crisis has cost taxpayers more than $27.5 million. That’s how much the state has paid a federal contractor to bring in extra health care workers as the system buckled under the weight of COVID-19 patients.

FEMA will reimburse the state as long as it meets certain requirements.

One piece of COVID-19’s financial toll on taxpayers

Those millions of dollars encompass only what Idaho’s state government has paid ACI Federal, a federal contractor for health care crisis staffing, so far.

It doesn’t include whatever Idaho’s hospitals and long term care facilities spent from their own coffers to keep their beds staffed. It also doesn’t include the cost of another round of health care workers who have just been deployed to Idaho through the contract.

“Right now, 12 facilities currently have (ACI Federal) medical staff in play,” Ben Roeber, preparedness and protection branch chief of the Idaho Office of Emergency Management, said in an interview last Tuesday.

“Things shift by the day,” he said. “We have facilities that indicate, ‘We requested 10 but (now) only need five.’”

There were a total of 485 health care workers sent by ACI Federal to hospitals, nursing homes, assisted living facilities and outpatient clinics as of last week, Roeber told the Sun.

One small part of the pandemic bill

The Federal Emergency Management Agency reimburses Idaho for its payments to ACI Federal — but only if the money goes where it’s supposed to go. Roeber’s job is to ensure the medical staff are needed for COVID-19 patient care.

Even if a hospital is short-staffed because its employees are out sick with COVID-19, they can’t get staffing help unless they have COVID-19 patients.

The Idaho Office of Emergency Management said last week that FEMA had, so far, reimbursed Idaho for $11.8 million of payments to ACI Federal.

Idaho Gov. Brad Little announced last month that he’d requested 503 more health care personnel to aid Idaho, through the FEMA arrangement.

The bulk of those workers are now deploying throughout the state, Idaho OEM officials said.


How does the FEMA staffing work?

When Idaho Gov. Brad Little declared a state of emergency from the coronavirus pandemic in March 2020, it set in motion the process that would allow Idaho to get FEMA’s help with the crisis — and help with hospital staffing, as Idahoans with COVID-19 were hospitalized by the thousands.

To get the taxpayer-funded help, Idaho health care organizations have to go through a multi-step process. They contact their public health district — for example, in Boise, that’s Central District Health — and submit a detailed application.

The Idaho Department of Health and Welfare and the Idaho Hospital Association helps the Idaho OEM “review and then prioritize — knowing we have limited resources — where these resources need to go,” Roeber said.

They look at everything from whether health care staff could be transferred from one hospital to another, to local trends in COVID-19 activity and test positivity rates.

Without FEMA staff, ‘we would be right back in crisis standards’

While it has never been rare for Idaho health care facilities to hire “travelers” to fill vacancies in their workforce, the pandemic created a dangerous mismatch between the number of critically ill patients and the number of people to care for them. That is why Idaho ended up in “crisis standards of care.”

Idaho Health and Welfare Director Dave Jeppesen last week deactivated the care-rationing protocol for the third time — that time, it applied only to Southwest and South Central Idaho — but warned that hospitals and long-term care facilities were still teetering on the edge of crisis.

It doesn’t matter if Idaho is in crisis standards or not, OEM officials explained.

“Certainly, if we took away the 485 staff (deployed as of mid-February), we would be right back in crisis standards of care, so we don’t use that as the deciding factor,” Roeber said.

And while Idaho may have emerged from the official crisis designation, “there’s still shortfalls,” Roeber said. The health care facilities that receive help “could take more,” he said. “I think they’re grateful for anything they can get.”

Matt McCarter, the Idaho Office of Emergency Management’s grants branch chief, noted that Kootenai Health in North Idaho has had “roughly 700 vacancies now, for some time. That’s a lot of hospital staff missing to run your operation.”

The Coeur d’Alene hospital is among those who have “been able to use a good deal of FEMA staffing,” he said.

Medical Staff Support Request
Health care facilities must submit this form and agreement to their region’s public health district. The form helps officials determine whether the request is eligible for staffing through the state contract with ACI Federal, and how best to apportion a limited supply of health care workers. (To page through the full document, click on the bottom of the image.)

By Percy