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ADSD budget hearing highlights caseload growth, state general fund jump and opioid-funded epidemiologist posts
Summary
Administrators told the Nevada joint subcommittee the Aging and Disability Services Division faces rising caseloads and a $234 million increase in state general fund requests; the division requested medical epidemiologist positions funded with opioid-settlement money to study substance exposure in seniors and infants.
Dina Schmidt, administrator for Nevada’s Aging and Disability Services Division (ADSD), told the Joint Subcommittee on Human Services that the division’s proposed biennial budget reflects substantial caseload growth and a large increase in the requested state general fund. Schmidt said the department’s state general fund request increases by about $234 million — roughly a 45% jump — driven by last-session rate increases for developmental services, a reduction in the Federal Medicaid Assistance Percentage (FMAP) and notable caseload growth.
Schmidt provided demographic context: she said an estimated 269,000 Nevadans age 5 and older have some form of disability, roughly 2.3% of the state population have difficulty performing activities of daily living, and the population age 60 is projected to reach 17% of Nevada’s population by year’s end. Between 2012 and 2022 Schmidt said Nevada’s population age 60 rose by about 42%, which she said is increasing demand across social services, transportation and medical caseloads.
As part of the administrative decision units, ADSD proposed two medical epidemiologist positions (decision units E259 and E266). Schmidt said one epidemiologist would focus on substance use and opioid impacts in older adults and adults with physical disabilities; she referenced a SAMHSA statistic (2019) noting opioid use disorder among older adults. The other epidemiologist is described as helping to identify prenatal and infant substance-exposure impacts and tools to mitigate developmental harm in children ages 0–3.
When asked whether the epidemiologist positions would be paid from federal grants, Schmidt confirmed those positions are intended to be funded with opioid-settlement monies rather than Title XX social services block grant funds. Deputy Administrator Ricky Robb confirmed the epidemiologist for early intervention (0–3) also is proposed to be paid from opioid funds and described the role as developing interventions to address prenatal exposure and support affected infants and toddlers.
Schmidt and Robb also discussed the division’s continued use of ARPA funds to support IT modernization and a transfer of some management positions between budget accounts for cost allocation; they noted Medicaid funding in division charts is classified under “Other” while the state general fund increase offsets reduced federal FMAP and caseload-driven costs.
The presentations did not include formal votes. Legislators pressed for additional detail about how the epidemiologist roles would gather Nevada-specific data and how that data would be used to shape interventions. Schmidt said Nevada lacks detailed, state-specific data about older adult opioid use and that the epidemiologist would help produce that evidence base to design interventions and protective approaches.
