Assembly panel hears bill to expand Medicaid reimbursement for nonemergency behavioral-health transport

Assembly Member Gregory Hafen II, sponsor of Assembly Bill 31, told the Assembly Committee on Health and Human Services that the bill would create Medicaid reimbursement for certain nonemergency secure behavioral-health transport services to expand trauma-informed transport options and reduce reliance on law enforcement and emergency medical services.

The bill’s chief presenter, Dr. Kevin Austin Garner, chair of the Southern Regional Behavioral Health Policy Board, said AB 31 would raise Medicaid reimbursement rates "by 15% for rural counties, and 10% statewide" and would allow mileage for empty trips to be reimbursed so private providers are compensated for the full trip. "This legislation is critical to addressing one of the most pressing challenges in Nevada's behavioral health system: safe, timely, and appropriate transportation for individuals in crisis without unnecessarily burdening our first responders," Dr. Garner said.

Supporters told the committee that current practice often places ambulances and patrol cars out of service for hours when they transport people in crisis long distances to appropriate facilities. Assembly Member Hafen described Tonopah as an example: "They have one ambulance in the entire community," and lengthy transports can take that vehicle out of service for a day, he said. Mark Funkhouser, identified as the Southern Regional Behavioral Health Coordinator, testified as a presenter on behalf of the regional board.

The presenters described models used in other states in which nonambulance vans equipped for secure transport and staffed by trained behavioral-health workers carry people in crisis, allowing emergency ambulances and police to stay in their jurisdictions. Dr. Garner said those models include a trained mental-health worker in the vehicle who can begin trauma-informed care at pickup; if a person’s condition exceeds the transport team’s capacity, the team would call 911 for an ambulance. Gregory Hafen added that some rural or volunteer responders lose income when pulled from their jobs for long transports.

A fiscal summary provided during the hearing estimated AB 31 would increase Medicaid expenditures by about $1,260,000 in fiscal years 2026–27. Dr. Garner and other presenters argued that the fiscal note does not capture potential savings from reduced law-enforcement and EMS overtime and decreased emergency-room utilization; presenters cited national research indicating law enforcement agencies spend a meaningful portion of time on behavioral-health transports.

Public safety and hospital representatives offered support. Ryan Beaman of the Professional Firefighters of Nevada and Blaine Osborne of Nevada Rural Hospital Partners testified in favor, saying the bill would benefit rural departments and critical-access hospitals by keeping first responders available and reducing stigma associated with transport in patrol cars. Valerie Haskin, Rural Regional Behavioral Health Coordinator, gave remote testimony noting private companies previously failed to enter Nevada markets because low Medicaid rates and Nevada’s higher costs made operations unviable; she said the proposed reimbursement increases would help attract providers.

Committee counsel read the statutory definition referenced in the bill, stating that "nonemergency secure behavioral health transport services" is defined in Nevada Revised Statutes as use of a motor vehicle other than an ambulance or other emergency response vehicle that is "specifically designed, equipped, and staffed" to allow observation and to prevent escape or access to the driver or controls.

The committee held the hearing and received testimony in support and in the neutral position; no committee vote on AB 31 was recorded during this hearing. Presenters and supporters recommended that implementation include a process for HHS to determine distribution and encouraged consideration of federal waiver authority to obtain higher reimbursement; they also discussed workforce training and certification for transport staff as a follow-up implementation item.

The hearing record shows questions from multiple Assembly members about whether the transport vehicles would be ambulances or vans, who would staff them, and how the services would be positioned statewide; presenters said models use equipped vans with trained mental-health staff and recommended local decisions in coordination with DHHS for roll-out and pilot projects.

The committee closed the hearing on AB 31 without taking a vote.

Ending: The committee moved next to a separate bill hearing (AB 60). The Assembly did not adopt or reject AB 31 at this hearing; the record reflects a public hearing with invited testimony, questions from members, and no formal final action recorded.