Committee urges broader medication access, more training and continuity-of-care in Nevada opioid needs assessment

A state subcommittee meeting to review Nevada's opioid needs assessment emphasized widening access to medications for opioid use disorder (MOUD), boosting workforce training and peer-support roles, and fixing gaps in care when people leave incarceration.

Chair Danita Smith called the meeting to order and led a line-by-line review of the draft treatment goals. Smith said committee reviewers found limited funding directed to opioid treatment programs (OTPs): "we have 13 opioid treatment programs, the state was awarded 94,900,000, but only 1 program got $110,000 and that was in Reno," and urged the group to ensure OTPs and medications beyond buprenorphine are represented in recommendations.

Taylor Tomlinson, an addiction physician and committee member, urged stronger workforce development: "There should be teaching and education in the state medical schools and the PA schools" and more inpatient consult services, addiction fellowships and Project ECHO support to expand clinician proficiency in treating opioid use disorder.

Jane B. Hatfield, a committee member who spoke from lived experience, described how weak discharge navigation and low Medicaid reimbursement make it difficult to retain people in care after release from jail or hospital. "If you give me a piece of paper, I was not showing up," she said, arguing for funded warm handoffs and peer-support roles that bridge hospitals, jails and community treatment.

On treatment objectives, members agreed objective wording should explicitly include methadone and naltrexone alongside buprenorphine so the plan does not inadvertently limit medications. Staff noted that a federal change removing the X-waiver for buprenorphine prescribing means the plan should not suggest providers still need a special waiver to prescribe buprenorphine.

The group discussed program models and access strategies that could be emphasized in the biennial report: expanding mobile medication units to reach rural and hard-to-reach populations, funding peer-support/community health workers as billable services, encouraging data reporting and outcome measures for treatment programs, and supporting MOUD availability in jails and specialty courts.

During the public comment period, Heather Kerwin, an expert working on the state needs assessment, said several mobile MAT programs are expanding in Northern Nevada and offered to connect the subcommittee with providers. "There are actually 3 new mobile MAT treatments...serving the Northern Quad Counties," she said. Jess Angel, a member of the public, urged attention to the federal 1115 Reentry Demonstration Waiver and reported the State had applied; Terry Kearns noted Nevada Medicaid is conducting statutorily required rate-review surveys.

Votes at a glance: The committee approved the prior meeting's minutes by voice vote after a motion from Taylor Tomlinson and a second from Jane B. Hatfield. The motion passed with members present (quorum 3 of 4).

Next steps and context: Staff proposed, and members agreed, to consolidate today's points into two or three high-level recommendation bullets for the biennial report (workforce/education; transitional care and funding mechanisms; evidence-based standards and MOUD inclusion) and to follow up with provider briefings about mobile units and the status of the Medicaid reentry waiver. The group scheduled follow-up meetings to refine the recommendations ahead of the report deadline.