Introduction: the Facts about Whom We Serve

The Noncoastal West is a term IFEHC's Medical Director believes he devised in 2014. It describes the lower U.S. States situated between the Mississippi River and excluding the three West Coast states and two Gulf Coast States. Some trivia:

1. Consists of 17 states.
2. Forms nearly 1/2 (technically 42%)  the entire U.S. land mass. This includes territories and noncontinental U.S. states.
3. Forms slightly over half (50%) the entire U.S. continental/contiguous land mass.
4. Contributes just under 1/6 (16%) the U.S. total population.
5. Contributes a total of 99 electors (18%) to Electoral College.
6. Falls into three different time zones.
7. Pejoratively referred to by the national elite as "flyover states".

Those states are (in descending order of uninsured): Oklahoma, Wyoming, Nevada, Arizona, Idaho, South Dakota, Missouri, New Mexico, Utah, Kansas, Arkansas, Colorado, Montana, Nebraska, North Dakota, Iowa, and Minnesota.

According to the Department of Health & Human Services (DHHS), the poverty lines for 2021 are $12,880 for a household of one and $26,500 for a household of four. To qualify for Medicaid, households need to fall under 138% the poverty lines. This means that a household of one must earn less than $17,774.40 and that a household of four must earn less than  $36,570. According to the U.S. Census Bureau, the median income in 2019 was $41,537. At IFEHC, we accordingly suspect that the bulk of the 9.4% uninsured fall in the income range between $18 K and $41 K. For our purposes, we define lower middle wage earners as those earning annual wages in that range.

There are many issues related to the pandemic that are hotly debated. Please note IFEHC is using various sources; including JAMA, the CDC, and even the local health board.

1. The Delta variant
2. Recent CDC full approval of Pfizer's BNT162b2 vaccination. Partial authorization for individuals under the age of 16.
3. Ethics of mandating vaccinations
4. Novel mechanisms of the Pfizer and Moderna vaccinations
5. Lack of medical supplies
6. Lack of access
7. Resurgence of other diseases such as RSV and even STD's
8. Mental health issues secondary to the isolation
9. Various proposed treatments; including hydroxychloroquine, monoclonal antibodies, and antibiotics.

Idaho Department of Health & Human Welfare oversees the 7 public health districts in Idaho.

1. Idaho Public Health District 1, or Panhandle District Health (PDH). Serves Coeur d'Alene and Post Falls.
2. Idaho Public Health District 2, or Northern Central District Health (NCDH). Serves Moscow.
3. Idaho Public Health District 3, or Southwest District Health (SWDH). Serves Meridian.
4. Idaho Public Health District 4, or Central District Health (CDH). Serves Boise, Nampa, and Mountain Home.
5. Idaho Public Health District 5, or South Central Health District (SCHD). Serves Twin Falls.
6. Idaho Public Health District 6, or Southeastern Idaho Public Health (SEIPH). Serves Pocatello, American Falls, Downey, Malad, Preston.
7. Idaho Public Health District 7, or Eastern Idaho Public Health (EIPH). Serves Idaho Falls, Blackfoot, Rexburg.

Eastern Idaho Public Health is one of eight health districts in Idaho. "EIPH is not a state agency or department, but rather a governmental entity created by the State (Idaho Code Title 39, Chapter 4)" (August 23, 2021 communication). EIPH has a three-part mission:

1. To prevent disease, disability, and premature death
2. To promote healthful lifestyles
3. To protect and promote the health and quality of our environment

It serves seven counties: Bonneville, Clark, Custer, Fremont, Jefferson, Lemhi, Madison, and Teton.

Click the link below to direct to their website.

For those who are underinsured or do NOT have insurance, please be advised that there are many programs available. This includes both insurance programs and government subsidies (the Advanced Premium Tax Credit).

Programs include the Healthcare Exchange for individual health insurance, Medicare Advantage, various Medicare programs, Medicaid, and travel insurance.

All these programs have different rules. What they tend to have in common are open enrollment periods (for the Healthcare Exchange, that's November 1 - December 15) and exceptions due to special qualifying events. Special qualifying events include losing coverage, changing income, and marriage/divorce.

Idaho uses its own healthcare exchange portal, YourHealthIdaho. This is where you find a list of insurance brokers and sign up for a healthcare plan or apply for Advanced Premium Tax Credit (APTC).

Idaho is one of approximately eight states that do NOT use the Federal portal. Thus, the National Healthcare Exchange and Idaho may have separate rules such as deadlines. If you live in Idaho, the state deadlines are what apply. Click below to access Your Health Idaho.

We strongly recommend finding a broker. In likelihood, IFEHC will direct you to find one. Below, we print a list of the ten closest agents to our location (Zip Code 83404). Agents are important to advise you of the programs that are available. They are paid commission by the insurance companies, which means consumers do NOT pay them. To the consumers, their service is free. In our experience, agents help cut down paperwork by knowing what to ask and being willing to wait on the phone for long periods on behalf of the consumers they represent. For a full list, set up an account on the Idaho HealthCare Exchange website.

General:

1. Idaho Department of Labor (IDOL). They help coordinate various needs of individuals who have lost their jobs and their families. They fundamentally work within our scope of serving lower middle-wage earners.
2. Idaho Department of Health & Human Welfare (IDHHW). Oversee the local health departments (see the Health Departments section).
3. Resource Group (sponsored by DHHW). Not a clinic but a coordination agency.
4. Idaho Falls Community Outreach Center. http://www.ifoutreach.org/freemed.aspx

In Idaho SEIPH/District #6:

1. SEIPH/District #6's various free health clinics and training programs.
2. Pocatello Free Clinic. https://pocatellofreeclinic.com
3. FreeMed - serves SE Idaho. 208-528-6337

In Idaho EIPH/District #7:

1. EIPH/District #7's various free health clinics and training programs
2. Rexburg Free Clinic. https://www.rexburgfreeclinic.org
3. IFEHC - of note, we claim to serve the entire region through our three (3) organizational goals.
4. FreeMed - serves SE Idaho. 208-528-6337

The Medical Director of IFEHC's Employment Health Clinic noted that many new drivers had concerns about the process of obtaining a DOT-CDL medical card. This resource is intended to help familiarize applicants with the process of the DOT-CDL physical examination. Please note that this study guide is NOT intended to prepare anyone for an examination. Indeed, IFEHC is not in a position to guarantee results on any exam on the basis of this study guide or any other materials presented.  

List of DOT-certified substance abuse professionals. Accessed from NAADAC's directory on September 7, 2021. According to NAADAC: "[T]he following directory lists people who have successfully obtained the U.S. Department of Transportation's Substance Abuse Professionals (SAP) Qualification through NAADAC's Substance Abuse Professional's U.S. DOT Alcohol and Drug Testing Regulation Qualification Independent Study Course."

Disclaimer that IFEHC does NOT endorse the contents of this directory. Because IFEHC cannot routinely update the list, we recommend you check NAADAC directly to verify the provider is still listed and confirm with the provider when scheduling an appointment. Are you a new DOT-certified SAP serving the non-Coastal West who wants to be listed? Contact IFEHC (info@IFEHC.com)!