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Nevada public health leaders ask Legislature for flexible funding, regionalization and workforce support
Summary
State and local public health officials told the Assembly Health & Human Services Committee that Nevada’s decentralized public health system needs sustained, noncategorical funding, workforce expansion and data modernization to respond to outbreaks and serve rural counties.
Nevada public health officials briefed the Assembly Health and Human Services Committee on the structure, recent developments and funding needs of the state's public health system, urging continued noncategorical general-fund support and local regionalization to sustain services in rural and frontier counties.
The briefing explained why public health work is largely conducted outside of statute, how recent regionalization efforts have unfolded and why officials say flexible funding is essential to respond to infectious disease outbreaks, vector threats and other emerging needs.
Julia Peak, deputy administrator for community health services with the Division of Public and Behavioral Health, told the committee that "very little is codified for public health in Nevada law," and described the state's largely decentralized model in which local health districts deliver most services while the state plays a convening and safety-net role in counties without a local district.
Peak and other presenters described multiple priorities: sustaining the noncategorical funds approved last session, continuing data modernization started during the COVID-19 response, expanding regionalization so frontier counties can provide services locally, and addressing a persistent workforce shortage. They said Nevada and Texas are the only two states with the largely decentralized structure described in the presentation.
Officials highlighted Central Nevada Health District as a recent example of regionalization. Central Nevada formed in December 2022 as a partnership among Churchill, Mineral, Pershing, Eureka counties and the city of Fallon. Speakers said the district's experience produced a toolkit to help other counties that wish to regionalize public health services.
Presenters told lawmakers that much public health work is federally funded and often categorical, which restricts how dollars can be used. "We are largely dependent on federal funding," Peak said, noting that some state and local programs would not operate if federal grants ended. Committee members were told larger urban districts are roughly half federally funded; some smaller jurisdictions rely on federal funds for as much as 75 percent of operations.
Officials also described specific program-level work and gaps: Southern Nevada Health District's naloxone distribution and wastewater surveillance, shortages of epidemiologists and environmental health specialists statewide, limited vector-control capacity in mosquito season, and challenges sustaining newly created positions such as tribal liaisons and diversity and equity coordinators once temporary grants expire.
Workforce development efforts spotlighted the UNLV and UNR schools of public health and use of ARPA funds for training and career ladders. Speakers said roughly 20'to—3 percent of the public health workforce are considering leaving their jobs and that the sector needs many more staff to meet national targets.
Committee members asked about multi-state collaboration, lessons learned from COVID-19 and whether the state has returned to pre-pandemic vaccination work. Peak said Nevada participates in interstate communications for confidential case reporting and that COVID-era operational relationships (for specimen transport, use of the National Guard and interagency coordination) improved readiness, though staffing and sustainable funding remain constraints.
The briefing concluded with an invitation to committee members to use the division's public dashboards for district-level immunization and disease data and an offer to provide additional materials on the division's after-action reviews and local needs assessments.
The presentation moved into questions from committee members and was followed on the agenda by a separate bill hearing on Medicaid cancer screening coverage.
Ending: The Division of Public and Behavioral Health said it would provide follow-up materials and data at the committee's request and emphasized that sustaining flexible state funding would allow the system to pivot to emerging public health priorities.
