Nevada subcommittee approves budget closings for public health accounts, rejects two new opioid-funded positions

The Legislative Subcommittee on Human Services voted on a series of budget closings and technical adjustments for the Division of Public and Behavioral Health on Friday, including approval of some ARPA-related technical adjustments and transfers contingent on enabling legislation, and rejection of two proposed positions funded from opioid settlement dollars.

The actions affect multiple accounts within the Division of Public and Behavioral Health, including the Office of Health Administration, Environmental Health Services, the Office of State Epidemiology, and the Public Health Improvements program. The subcommittee approved staff recommendations to eliminate certain ARPA-funded positions while retaining others through alternative funding, approved the proposed transfer of Environmental Health Services components to the State Department of Agriculture and Health Care Facilities Regulation contingent on enabling legislation, and declined to approve two new positions proposed to be paid from opioid settlement funds.

Morgan Barlow, program analyst for the Fiscal Analysis Division of the Legislative Council Bureau, presented staff recommendations and the account summaries. Barlow told the committee the governor recommended removal of certain ARPA (American Rescue Plan Act) authority that had supported 13 positions, and staff proposed adjustments to continue eight positions through alternative cost allocation revenue and reserve reductions. On that item, the subcommittee moved to accept staff recommendations and the motion passed following a voice vote.

On the Office of Health Administration (budget account 3223), staff described decision units E499 and E599: E499 would eliminate ARPA authority and 11 positions beginning July 1, 2025 (with technical adjustments to retain limited ARPA support for two positions through March 2027), while E599 would preserve eight positions previously supported by ARPA by replacing ARPA authority with $1,800,000 in cost-allocation revenue and reserve reductions. The subcommittee approved the staff recommendation to accept those adjustments.

On Environmental Health Services (budget account 3194), the governor proposed eliminating the account and transferring program components and personnel to the State Department of Agriculture's Dairy Fund and to the Health Care Facilities Regulation Program. Staff noted a structural deficit in the Environmental Health Services fee structure and said the transferred reserves are intended to temporarily sustain operations while the recipient agencies evaluate fee adjustments or long-term solutions. The subcommittee approved the transfer as recommended by the governor, contingent on passage of enabling legislation (bill draft request 11-21 or similar) and asked that the receiving agency submit a long-term sustainability plan to the Interim Finance Committee by April 2026.

The subcommittee considered a proposal to add one new unclassified medical epidemiologist position funded by $520,468 in opioid settlement transfers from the Fund for a Resilient Nevada to the Office of State Epidemiology (budget account 032019). Senator Titus asked whether the position would be new; agency staff confirmed it would be. Senator Winn moved — and Assemblymember Monroe Moreno seconded — a motion to not approve the $520,468 transfer for the new position; the motion passed on a voice vote.

A separate proposal to establish a new Perinatal Quality Collaborative program — including $688,968 in opioid settlement funds and one new Health Program Specialist (grade 35) — was also rejected by the subcommittee after members raised concerns about overlap with existing nonprofit and advisory entities. The agency described the proposed collaborative as a statewide clinical quality improvement lead that would develop protocols to prevent substance use during pregnancy and expand evidence-based services for substance-exposed infants; still, the subcommittee voted to not approve the requested opioid funding and position.

Staff also informed the committee of an ongoing, evolving federal action: on March 24, 2025, six federal awards to the Division for COVID-19 epidemiology and laboratory capacity were terminated, resulting in reductions in federal funding. Barlow said the terminations correspond to an approximate reduction of $22,700,000 in each year of the 2025–27 biennium for COVID-19 related epidemiology and laboratory activities; fiscal staff recommended technical adjustments to remove those funds in the 2025–27 biennium and said the situation remains under review.

On the Public Health Improvements account (budget account 3234), which was created in 2023 and receives both ARPA funds and a Senate Bill 118 allocation of general funds, the subcommittee approved staff recommendations to include technical ARPA adjustments (adding projected ARPA coronavirus state fiscal recovery authority in FY 2026 and FY 2027) and to continue $7.5 million in general fund appropriations each year of the 2025–27 biennium. The subcommittee also approved a letter of intent requiring the division to submit annual reports to the Interim Finance Committee that mirror prior SB 118 reporting elements.

Multiple other budget accounts were closed as recommended by staff in a single, omnibus motion for staff-closed budgets, including radiation control, WIC, communicable disease, health statistics and planning, immunizations, family planning, chronic disease, emergency medical services and the Marijuana Health Registry. Several administrative transfers and technical adjustments were approved across accounts to align ARPA authority, correct revenue projections, and realign position transfers consistent with proposed reorganization of the Department of Health and Human Services into a Nevada Health Authority; several of those transfers were explicitly contingent on passage of enabling legislation (bill draft request 11-16, assembly bill 544 or similar).

Public comment at the end of the meeting emphasized support for continuing noncategorical public health funding established under Senate Bill 118 (2023). Dr. Chad Kingsley, district health officer for Northern Nevada Public Health at the Washoe County Health District, said, “Nevada cannot currently rely on federal funding... Knowing we have Nevada dollars invested in our local... health authorities helps us plan and prepare.” Amy Hynes Sutherland, Health and Human Services Manager for the Nevada Association of Counties, thanked the committee for continuation of SB 118 funds and noted that the funds “elevated local boards of health decision making in rural and frontier counties.” Emma Rodriguez, communications and legislative affairs administrator at the Southern Nevada Health District, described the recent federal funding clawbacks and urged continued flexibility through noncategorical funding.

Decisions taken at the meeting included both approvals and rejections that will affect staffing, contract authority, and program transfers. Several items approved by the subcommittee are contingent on subsequent enabling legislation and follow-up reports to the Interim Finance Committee.

Members and staff said additional information will be provided to the committee as federal developments and agency projections evolve; the subcommittee adjourned and scheduled follow-up actions where appropriate.