NV lawmakers mull maternal health protections for ’27 session, punt on child welfare funding fix

The committee can recommend 15 bill draft requests, with five specifically focusing on child welfare, for the 2027 Legislative Session, which starts Feb. 1. 

The proposals lawmakers approved Tuesday, though just at the beginning the drafting phase, are influenced by nearly eight months of feedback and presentations from state and local agencies and nonprofits 

Neglected for years, child services funding formulas are badly outdated, lawmakers told

Among the information state lawmakers received during the interim hearings was about how the state funding model for child welfare services is outdated and hasn’t kept up with inflation. 

The legislative recommendation approved Tuesday would further study and review how child welfare agencies are funded during the next interim session, kicking any likely solution to the 2029 Legislative Session. 

“While the proposal before you today is not entirely what we had hoped for, I would say that we are heartened that this committee is willing to consider analyzing and evaluating the funding of child welfare in our state,” said Cadence Matijevich, government affairs liaison for Washoe County. “I appreciate that just because we can’t have everything that we want doesn’t mean that we get nothing.”

Clark and Washoe officials told state lawmakers in June that counties rely on an annual state block grant as a main source of funding for the services, but the amount has been capped since 2012.

If the state adjusted the block grant funding for inflation it would take Clark County’s block funding base from roughly $42 million – the rate it’s been for more than a decade – to $63.1 million. 

Washoe County received  $14.3 million in block grant funding under the state cap since 2011. If the block grant was adjusted for inflation the county’s child welfare services would instead receive roughly $22 million. 

The committee Tuesday also approved a proposal that would seek legislation to reform or end a variety of ongoing state reports. 

One currently required report that would get the axe analyzes services received by Medicaid recipients who have been diagnosed with an autism spectrum disorder. 

Other reports on the block include one on the Aging and Disability Services Division program providing free hearing aids to certain children, and a biannual report on the finances and operations of the Silver State Health Insurance Exchange.

Autism nonprofits and advocacy groups urged lawmakers to reconsider the elimination of the report on access to services.

“This data helps us to understand wait times between diagnosis and the treatment for children with autism on Medicaid,” said Jan Crandy, former chair Nevada Commission on Autism. “The data helps us to understand if we have an adequate workforce who are enrolled as Medicaid providers, especially the registered behavior technicians, to deliver appropriate and prescribed treatment hours.”

While the majority of proposals were approved unanimously, the Republican state Sen. Robin Titus voted against a slate of policies seeking to address maternal health.

Democratic Assemblymember Tracy Brown-May, who chairs the committee, likened the broad-ranging proposal to a state “momnibus” bill.  

Among numerous maternal health provisions, the proposal includes: 

• seeking federal authority to provide reimbursement for the performance of social determinants of health screenings; 
• requiring health insurers to provide coverage for at-home blood pressure monitors through 12 months postpartum; 
• Authorizing a special enrollment period that includes a pregnant individual upon the confirmation of their pregnancy;
• prohibiting mental health and substance use disorder treatment providers from refusing to treat a patient solely because the individual is pregnant or postpartum; 
• requiring commercial health insurers operating in Nevada to include licensed and accredited freestanding birth centers in their provider networks for covered maternity and newborn service.

Titus, who is a physician, said she is “concerned that a provider such as myself may not feel comfortable treating somebody and having legislation that mandates I treat somebody regardless of the condition, when I don’t feel perhaps that I’m qualified to do that,” adding that it was a “slippery slope I cannot support.”

She also questioned the effectiveness of at-home blood pressure monitoring for up to 12 months after birth, but not during pregnancy when mothers are at risk of preeclampsia, a serious condition that causes high blood pressure and contributes to maternal mortality rates.   

“I think that there are just pieces of this legislation that we would flesh out in further detail that are not written in this work session document,” Brown-May said. 

State lawmakers also proposed creating an office within the Division of Insurance that is specifically tasked with the identification, investigation, and referral of suspected health insurance fraud.

“This office shall coordinate with the Office of the Medicaid Inspector General, NVHA , along with the Insurance Fraud Unit and Medicaid Fraud Control Unit of the Office of the Attorney General, to coordinate and streamline investigations,” the work session document reads. 

Other ideas being mulled for the session include appropriating roughly $7 million from the state general fund to local health agencies for disease surveillance and codifying the Olmstead decision – a 1999 U.S. Supreme Court ruling that found people with disabilities have a qualified right to receive state-funded support and services in their communities rather than institutions – into the Nevada Constitution.