Human services subcommittee approves multiple aging and disability budget closings, holds caseload funding steady for community programs

CARSON CITY, Nev. (April 30, 2025)

The Joint Senate Committee on Finance and the Assembly Committee on Ways and Means, Subcommittee on Human Services closed budget items for the Department of Health and Human ServicesAging and Disability Services Division (ADSD) on April 30, approving several targeted staffing and funding adjustments while declining broader caseload-based increases for community-based long-term care services. The panel voted on 12 budget accounts and related technical adjustments during a hybrid hearing in Carson City and Las Vegas.

Kimber Ellsworth, fiscal analyst with the Legislative Counsel Bureau—s fiscal analysis division, told the subcommittee the panel would close 12 ADSD budgets, including action on an unclassified medical epidemiologist position funded with opioid settlement dollars. "The new position would assist in developing recommendations and targeted interventions to mitigate the impact of opioids on the aging population," Ellsworth said.

Why it matters: the subcommittee—s decisions affect staffing levels, provider rates and service capacity for older adults and people with disabilities across Nevada. Several actions touch wait lists, vacancy rates in state programs and uses of restricted funds such as the Fund for Resilient Nevada and the Fund for a Healthy Nevada.

Major decisions and context

- Opioid epidemiologist: The panel approved adding one unclassified medical epidemiologist to focus on opioid use and related health outcomes among older adults. Fiscal staff said the position will be funded by a transfer from the Fund for Resilient Nevada using opioid settlement funds. The recommendation was presented by Ellsworth and approved following a motion by Assembly Member Mosca, seconded by Senator Scheibel.

- Case management system one-time costs: The subcommittee approved a budget amendment adding $441,202 in general fund appropriations for one-time costs tied to the agency—s existing case management data system. The motion was made and carried unanimously.

- Consumer Health Assistance: The governor—s original recommendation would have added five positions. After March 2025 caseload updates and a finance office amendment delaying one start date, fiscal staff recommended approving $465,448 in total funding (including $209,452 in general fund) over the 2025—27 biennium to establish caseloads and add associated staffing (three positions under the updated projections). The subcommittee approved the staff recommendation.

- Autism Treatment Assistance Program (ATAP): Fiscal staff presented updated March 2025 caseload information that would raise costs above the governor—s submission. A member moved an alternative motion to align staffing and service costs with the governor—s originally projected caseloads rather than the March update. Assembly Member Mosca moved to recommend approval of $1.5 million in general fund appropriations (motion language reflected the motion offered on the record); the motion passed unanimously.

- Home- and community-based services (community-based care): The subcommittee debated significant differences between the governor—s recommended caseload staffing and the agency—s March 2025 caseload projections. Ellsworth said the March projections were notably higher and that projected wait lists could comprise more than one-third of total projected demand by the end of the biennium. She told members that if the subcommittee funded only the projected funded caseload and excluded wait lists, staffing and service costs would decline below current legislative levels and could eliminate several positions in FY 2026.

Senator Scheibel asked whether following the staff recommendation would avoid layoffs; Ellsworth replied, "Correct. It would maintain existing funding." After discussion, Assembly Member Mosca moved not to approve the governor—s proposed caseload adjustments and instead to maintain the FY 2025 legislatively approved base caseload and associated staffing levels. The subcommittee also approved issuing a letter of intent directing the Aging and Disability Services Division and the Office of Data Analytics to evaluate caseload methodology, staffing needs, service costs and wait-list management and report to the Interim Finance Committee during the 2025—26 interim. The motion carried unanimously.

- Provider rates for community options and personal assistance services: Fiscal staff described two sets of cost estimates: figures used in the governor—s submission (average monthly cost per individual of $11.53 for the Community Options Program for the Elderly and $19.47 for Personal Assistance Services) and the agency—s updated billing data (average monthly cost per individual of $13.30 for Community Options and $2,435 for Personal Assistance Services). Fiscal staff calculated additional general fund appropriations of $802,375 would be needed in each year of the biennium to fund the programs at the agency—s updated per-person cost estimates. The subcommittee approved the staff recommendation as presented.

- Adult Protective Services and Long-Term Care Ombudsman: Ellsworth reported the governor—s recommendation would add 55 positions; updated caseloads would require 67. The account currently carries a roughly 20% overall vacancy rate (about 30% for adult protective services adult-rights specialist positions and about 7% for long-term care ombudsman positions). Citing vacancy rates and the state—s budget environment, Assembly Member Mosca moved not to approve the proposed adjustments. The subcommittee approved the motion to deny the governor—s requested caseload staffing increases.

- Other accounts and technical adjustments: The subcommittee approved multiple other closing items recommended by the governor, including budgets for the Nevada Commission for Persons Who Are Deaf, Hard of Hearing or Speech Impaired; the Tobacco Settlement Program; Senior RX and Disability RX; Communication Access Services; the Facility Outreach and Money Follows the Person program; planning, advocacy and community grants (including ARPA-related technical adjustments); and the Nevada Statewide Independent Living Council. Fiscal staff were granted authority to make technical adjustments as needed to align transfers and reserves, including actions tied to the Fund for a Healthy Nevada and the Taxi Cab Authority.

Public comment and adjournment

During public comment, Stephen V. Cohen spoke in support of the Autism Treatment Assistance Program, urging continued collaboration between staff and the community. The subcommittee then closed public comment and adjourned.

What the subcommittee directed staff to do

- Maintain FY 2025 base caseloads and staffing for community-based care instead of approving the governor—s caseload increases. - Issue a letter of intent directing the Aging and Disability Services Division and the Office of Data Analytics to evaluate caseload methodology, staffing needs, service costs and wait lists and to report to the Interim Finance Committee during the 2025—26 interim. - Permit fiscal staff to make technical adjustments across multiple budget accounts and transfer actions tied to the Fund for Resilient Nevada, the Fund for a Healthy Nevada and the Taxi Cab Authority.

Ending: The subcommittee closed the ADSD budget-closing hearing after unanimous votes on the listed motions and then opened and closed a short public-comment period.