Gregory Dickerson, administrator of Human Supports of Idaho and chairman of a regional mental health council, told the House and Senate Health & Welfare committees that HB 221, as written, would push more patients into more-expensive institutional care. He urged the lawmakers to hold the bill in committee and work with stakeholders to find a better solution. "There are several checks and balances in place," he said, calling requirements in the bill "expensive and unrealistic."

Evangeline Beechler said more than half her staff at Access Behavioral Health Services would be laid off if the bill were passed, and half of her adult mentally disabled clients would no longer receive any services. She described one client who suffers from impulse control problems has struggled with violent tendencies, but is among the non-waivered developmentally disabled population that would lose services under the bill. "I honestly believe she will end up dead or in jail or in an institution," Beechler told lawmakers, "and this is the reality of some of the situations."

Steve Millard, president of the Idaho Hospital Association, testified in favor of the bill, and said hospitals are agreeing to put up millions in assessments to avoid deeper cuts. "I want to compliment the drafters of the legislation who put in the managed care piece," Millard said. "I believe it has the opportunity in future years to save dollars for the state." Proposed patient co-payments in the bill in many cases will be picked up by the providers, he said, because the patients can't pay; however, he said  he doesn't consider that a big problem.