Joe Lombardo
Governor
Richard Whitley
Director
FY 2024-25 Budget Presentation
Division of Public and Behavioral Health
Lisa Sherych, Administrator
February 15, 2023
Department of Health and Human Services
Helping people. It’s who we are and what we do.
Division of Public and Behavioral Health
Organizational Chart
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Charts and tables created by the Department of Health and Human Services, Division of Public and Behavioral Health
Summary of Agency Sections
• Community Health Services: provides core public health prevention programs and services by establishing and maintaining relationships with
community partners, identifying and maximizing resources, and collaborating to improve public health outcomes for all communities within
Nevada.
• Office of State Epidemiology: provides a comprehensive epidemiology structure that focuses on infectious disease,
environmental, occupational, chronic disease, health equity, and facility-based epidemiology. This section is responsible for statewide standards
and systematic data collection across the state. This section also supports preparation, prevention of outbreaks and poor health outcomes, and
surveillance efforts which can help inform upstream policies and decisions across DHHS.
• Regulatory and Planning Services: provides licensing and certification of healthcare facilities, childcare facilities, medical laboratories and
personnel, dietitians, music therapists and food establishments. This section is also responsible for vital records (birth/death and
marriage/divorce records), medical marijuana regulation, emergency medical systems, public health preparedness and radiation control.
• Clinical Services: provides direct services for those suffering from mental illness by operating inpatient hospitals at both ends of the state. The
civil hospitals include Rawson-Neal, in Las Vegas, and Dini-Townsend, in Sparks. The forensic hospitals include Lakes Crossing Center and Stein
Muri Forensic Hospital. Additionally, outpatient services are provided statewide, including the rural and frontier communities for public and
mental health needs.
• Behavioral Health Policy: provides oversight and quality assurance to behavioral health providers statewide; designs, plans, funds, and
implements systems of care, including behavioral health prevention, early intervention, treatment and recovery support services; establishes
funding priorities for behavioral health services and supports through close collaboration with communities and stakeholders; evaluates
outcomes of behavioral health interventions; and guides policy and financing options across DHHS.
• Administrative Services: provides leadership, support for fiscal services, human resources and information and technology.
• Public Health Infrastructure and Improvement: provides oversight of statewide improvement in public health infrastructure and improvement.
This includes workforce initiatives, public health accreditation, data modernization, and public information.
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Community
Health Services
Office of State
Epidemiology
Regulatory and
Planning
Services
Clinical
Services
Behavioral
Health Policy
Administrative
Services
Public Health
Infrastructure
and
Improvement
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Division of Public and Behavioral Health
Budgeted Funding Sources
2022-23 and 2024-25 Biennium
$1,015,540,352 $1,143,581,919
Charts and tables created by the Department of Health and Human Services, Division of Public and Behavioral Health
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Summary by Budget Account
Charts and tables created by the Department of Health and Human Services, Division of Public and Behavioral Health
BA 3149 Child Care Services
Overview
• The Child Care Licensing (CCL) program is responsible for licensing and
monitoring childcare facilities.
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BA 3149 Child Care Services
Budget Information/Changes
• Budget funded through Child Care Licensing fees and a federal block grant
transfer from DWSS.
• Enhancements/Transfers
• E225 – Requests 4 new Child Care Facility Surveyor FTEs and 1 new Child Care Facility
Survey Supervisor FTE.
• SFY24 Total Cost – $ 354,375 State General Fund – $0
• SFY25 Total Cost – $ 454,900 State General Fund – $0
• E900 – Transfers Child Care Licensing Program to Division of Welfare and Supportive
Services.
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BA 3153 Cancer Registry
Legislation Regulations Revenue Projections Position Timeline
AB 471 (81
st
Legislative
Session) established
approval new fee revenue
to sustain the Nevada
Central Cancer Registry
LCB File No. R010-22 filed with
the Secretary of State 12/29/22
BA 3216:
SFY23: $15,000 (1/1/23 – 6/30/23)
SFY24: $125,000 - $155,000
SFY25: $125,000 - $155,000
BA 3101:
SFY23: $1,190 (2/1/23 – 6/30/23)
SFY24: $106,883
SFY25: $106,883
One of the two Health Program
Specialist I FTEs is anticipated to
be hired before June 2023.
There is projected to be
adequate fee revenue to hire
the second position in October
2023.
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Charts and tables created by the Department of Health and Human Services, Division of Public and Behavioral Health
BA 3190 Health Statistics and Planning
Overview
• The Office of Vital Records (OVR) issues certified birth and death certificates,
maintains and protects all vital records, and processes all legal corrections
and amendments to these vital records. OVR participates in the National Vital
Statistics System and responds to the data and statistical needs of federal
agencies, state agencies, local agencies and researchers.
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BA 3190 Health Statistics and Planning
Budget Information/Changes
• Budget funded through fees and federal funds.
• Enhancements
• E225 – Requests 1 new Accounting Assistant I FTE to assist with fiscal duties.
• SFY24 Total Cost – $48,510 State General Fund – $0
• SFY25 Total Cost – $60,557 State General Fund – $0
• E226 – Requests 1 new Administrative Assistant II FTE to process birth certificates.
• SFY24 Total Cost – $51,302 State General Fund – $0
• SFY25 Total Cost – $64,396 State General Fund – $0
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BA 3190 Health Statistics and Planning
• Enhancements (continued)
• E227 – Requests 1 new Management Analyst I FTE to support NDOC birth certificate requests
and SSA errors.
• SFY24 Total Cost – $72,523 State General Fund – $0
• SFY25 Total Cost – $93,425 State General Fund – $0
• E228 – Requests 1 new Management Analyst I FTE to support workload associated with death
records.
• SFY24 Total Cost – $72,523 State General Fund – $0
• SFY25 Total Cost – $93,112 State General Fund – $0
• E229 – Requests 1 new Management Analyst I FTE to support workload associated with birth
records.
• SFY24 Total Cost – $72,523 State General Fund – $0
• SFY25 Total Cost – $93,112 State General Fund – $0
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Overview
• EHS enforces sanitation regulation for food protection, temporary food
establishments, mass gatherings, bottled water manufacturing, drug and
cosmetic manufacturing, public accommodations, recreational vehicle parks,
institutions, pools and spas, sewage, and invasive body decoration (tattoos).
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BA 3194 Environmental Health Services
Budget Information/Changes
• Budget funded through fees, federal and county reimbursement funds.
• Enhancements
• E226 – Requests to eliminate 2 Environmental Health Specialist III FTEs due to the
creation of the Central Nevada Health District.
• SFY24 Total Cost – ($187,132) State General Fund – $0
• SFY25 Total Cost – ($192,153) State General Fund – $0
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BA 3194 Environmental Health Services
BA 3213 Immunization Program
Caseload
• New caseload for the non-federal match required for purchasing vaccines for Nevada Check-Up
• In 2020, there was a 90% ACA Enhanced FMAP rate; the match since then has declined, resulting in the need for more
State General Fund to meet the need of CHIP participants
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Charts and tables created by the Department of Health and Human Services, Division of Public and Behavioral Health
State Fiscal
Year
CHIP Caseload -
IZ
General Fund
Projection
Enhanced (CHIP)
FMAP
ACA Enhanced
(CHIP) FMAP
Nevada
Contribution (GF)
Actuals/
Projections
by Year
NV CHECK UP
Projections
(DHCFP
portion)
Total Estimated
Vaccine Cost
(GF plus DHCFP
portion)
Nevada Immunization Program Caseload Overview
BA 3216 Health Care Quality
and Compliance
Overview
• The mission of the health care facilities section, is to protect the safety and
welfare of the public through regulation, licensing, and education. This is
accomplished through assessing regulatory compliance of health care
facilities and medical laboratories, during periodic inspections and complaint
investigations.
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BA 3216 Health Care Quality
and Compliance
Budget Information/Changes
• Budget funded through fees, federal funds and State General Fund specific to
CBLAs.
• Enhancements
• E225 – Request to eliminate duplicative regulation and barriers to the employment of
medical professionals (Nursing Pools) in Nevada (NRS 449.0153; BDR 23A4063069).
• SFY24 Total Cost – ($171,524) State General Fund – $0
• SFY25 Total Cost – ($171,524) State General Fund – $0
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BA 3218 Public Health Preparedness
Overview
• This program is responsible for the preparation and management/mitigation
of public health emergencies caused by natural disasters or terrorism;
primary care health planning, and provider recruitment and retention; and
emergency medical systems response.
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BA 3218 Public Health Preparedness
Budget Information/Changes
• Budget funded through fees (Certificate of Need and J-1 Visa for Primary
Care) and federal grant funds.
• Enhancements/Transfers
• E225 – Request to fund 90% of the Poison Control Services Contract.
• SFY24 Total Cost – $218,608 State General Fund – $218,608
• SFY25 Total Cost – $218,608 State General Fund – $218,608
• E226 –Request to support the Nevada Trauma Registry Contract and existing
supporting FTE.
• SFY24 Total Cost – $0 State General Fund – $0
• SFY25 Total Cost – $167,335 State General Fund – $94,749
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Overview
• The Biostatistics and Epidemiology budget account serves the Office of Public
Health Investigations and Epidemiology (OPHIE) and the Office of State
Epidemiology (OSE). OPHIE records and analyzes reportable disease information,
conducts interviews with infected individuals and their contacts, refers individuals
for medical treatment, analyzes data from disease investigations, identifies risk
factors, provides education and recommendations on disease prevention, and
works in conjunction with appropriate agencies to enforce communicable disease
laws.
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BA 3219 Biostatistics and Epidemiology
BA 3219 Biostatistics and Epidemiology
Budget Information/Changes
• Budget funded through federal grants and State General Fund.
• Enhancements
• E225 – Request transitions 1 contract Business Process Analyst I to an FTE to coordinate
the statewide system for disease management.
• SFY24 Total Cost – $67,514 State General Fund – $0
• SFY25 Total Cost – $92,722 State General Fund – $0
• E226/E490 – Request aligns funding for 1 existing Grants and Projects Analyst II FTE
with the CDC ELC grant.
• SFY24 Total Cost – $93,901 State General Fund – $0
• SFY25 Total Cost – $98,735 State General Fund – $0
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BA 3220 Chronic Disease
Overview
• State of Nevada Chronic Disease Prevention and Health Promotion (CDPHP) Section
informs, promotes and coordinates efforts at the local, regional and state level to
support healthy lifestyles to prevent and manage chronic disease.
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BA 3220 Chronic Disease
Budget Information/Changes
• Budget funded through federal grants and State General Fund.
• Enhancements
• E225 – Request transitions 1 contract Business Process Analyst I to an FTE to support
the WISEWOMAN Program
• SFY24 Total Cost – $65,942 State General Fund – $0
• SFY25 Total Cost – $90,343 State General Fund – $0
• E226 – Request funds the WISEWOMAN Women’s Health Connection database
maintenance costs.
• SFY24 Total Cost – $102,150 State General Fund – $0
• SFY25 Total Cost – $102,150 State General Fund – $0
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BA 3223 Health Administration
Overview
• The Office of Health Administration oversees the enforcement of all laws and
regulations pertaining to public and behavioral health along with ensuring
adequate services are provided for persons with mental illness, substance use
disorders, co-occurring disorders, and other related conditions.
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BA 3223 Health Administration
Budget Information/Changes
• Budget funded through indirect and cost allocation along with State General
Fund for specific targeted programs (Mammovan and Poison Control).
• Enhancements
• E226 – Requests ARPA funding for the continuation of 10 intermittent fiscal FTEs.
• SFY24 Total Cost – $844,771 State General Fund – $0
• SFY25 Total Cost – $885,754 State General Fund – $0
• E230 – Requests 1 new Information Technology Professional III FTE to support cyber
security activities.
• SFY24 Total Cost – $92,685 State General Fund – $0
• SFY25 Total Cost – $120,952 State General Fund – $0
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BA 3223 Health Administration
• Enhancements (continued)
• E231 – Requests funding to support ongoing maintenance for the Electronic Contract
Management System.
• SFY24 Total Cost – $80,000 State General Fund – $0
• SFY25 Total Cost – $80,000 State General Fund – $0
• E241 – Requests 2 new Information Technology Professional III FTEs to support the
large number of division applications.
• SFY24 Total Cost – $184,875 State General Fund – $0
• SFY25 Total Cost – $241,405 State General Fund – $0
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BA 3223 Health Administration
• Enhancements (continued)
• E242 –Requests 1 new Personnel Analyst II FTE to address quality assurance
investigations.
• SFY24 Total Cost – $69,216 State General Fund – $0
• SFY25 Total Cost – $88,929 State General Fund – $0
• E244 – Requests funding to purchase multi-factor authentication software.
• SFY24 Total Cost – $97,000 State General Fund – $97,000
• SFY25 Total Cost – $97,000 State General Fund – $97,000
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BA 3223 Health Administration
• Enhancements (continued)
• E245 – Requests funding support CarbonBlack software.
• SFY24 Total Cost – $109,908 State General Fund – $109,908
• SFY25 Total Cost – $107,162 State General Fund – $107,162
• E247 – Requests funding to support encryption software.
• SFY24 Total Cost – $13,782 State General Fund – $13,782
• SFY25 Total Cost – $12,840 State General Fund – $12,840
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BA 3224 Community Health Nursing
Overview
• Community Health Services (CHS) provides nursing services for health
promotion; risk identification and reduction; diagnosis and treatment of
sexually transmitted diseases; family planning; and public health
preparedness coverage in Nevada's rural and frontier counties.
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BA 3224 Community Health Nursing
Budget Information/Changes
• Budget funded through fees, federal grants, and county reimbursement
funds.
• Enhancements
• E225 – Request funds 5% of 9 FTEs with State General Fund due to the loss of the
Family Planning Grant.
• SFY24 Total Cost – $55,831 State General Fund – $55,831
• SFY25 Total Cost – $56,693 State General Fund – $56,693
• E490 – Request eliminates the Family Planning grant (Title X), which expires in March
2023.
• SFY24 Total Cost – ($84,349) State General Fund – $0
• SFY25 Total Cost – ($84,862) State General Fund – $0
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BA 3234 Public Health Infrastructure
Overview
• The Public Health Improvements account would be overseen within the DPBH
Administration Unit. It will be dedicated to public health improvement efforts,
agency wide projects, workforce and staffing projects, and other such
overarching services.
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BA 3234 Public Health Infrastructure
Budget Information/Changes
• Budget funded through federal grant funds.
• Enhancements/Transfers
• Request new BA to support Public Health Improvements, intended to focus on public
health infrastructure and strategic improvements in services. This budget account will
include ARPA investments in the local health departments, as well as data
modernization to the out-date public health systems. This includes a focus on quality
improvement and transparency through public health accreditation and investment in
public health workforce projects.
• E900 – Request to transfer the ARPA funds previously approved for the Public Health
System in BA 3223 to the new Public Health Infrastructure Account.
• SFY24 Total Cost – $6,240,000 State General Fund – $0
• SFY25 Total Cost – $2,080,000 State General Fund – $0
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BA 3235 Emergency Medical Services
Overview
• The purpose of the Emergency Medical Services (EMS) program is to promote and
support a system that provides prompt, efficient, and appropriate emergency
medical care, ambulance transportation, and trauma care to the people of
Nevada.
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BA 3235 Emergency Medical Services
Budget Information/Changes
• Budget funded through fees, federal funds and State General Fund.
• Enhancements/Transfers
• E225 – Request to balance forward all fees.
• SFY24 Total Cost – $7,480 State General Fund – ($7,480)
• SFY25 Total Cost – $7,480 State General Fund – ($7,480)
• E230 – Request additional State General Fund to support the software program used to
track and record training and certifications for EMTs in the state.
• SFY24 Total Cost – $287,945 State General Fund – $287,945
• SFY25 Total Cost – $298,450 State General Fund – $298,450
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Appropriations Act - Back Language
• Request funds appropriated to:
• Maternal, Child and Adolescent Health Services;
• Immunization Program
• To be available for both Fiscal Year 2023-2024 and Fiscal Year 2024-2025 and may be
transferred from one fiscal year to the other with the approval of the Interim Finance
Committee upon the recommendation of the Governor.
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Questions?
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Contact Information
Lisa Sherych
Administrator
l.shery[email protected]v.gov
Debi Reynolds
Deputy Administrator
dreyn[email protected]v.gov
Julia Peek
Deputy Administrator
[email protected]v.gov
Cody Phinney
Deputy Administrator
c.phinne[email protected]v.gov
Jo Malay
Deputy Administrator
jmalay@health.nv.gov
http://dpbh.nv.gov/
Acronyms
• AB- Assembly Bill
• ACA- Affordable Care Act
• ARPA- American Rescue Plan Act
• BA- Budget Account
• BDR – Bill Draft Request
• CBLAs – Community Based Living Arrangement
• CC- Carson City
• CCL- Child Care Licensing
• CDC- Centers for Disease Control
• CDPHP- Chronic Disease Prevention and Health Promotion
• CHIP- Children’s Health Insurance Plan
• CHS- Community Health Services
• DHHS- Department of Health and Human Services
• DO- Director’s Office
• DPBH- Division of Public and Behavioral Health
• DWSS- Division of Welfare and Supportive Services
• ELC- Epidemiology and Laboratory Capacity
• EMS- Emergency Medical Services
• EMT- Emergency Medical Technician
• FMAP- Federal Medical Assistance Program
• FTE- Full Time Equivalency
• HCQC- Healthcare Quality and Compliance
• HPS- Health Program Specialist
• LCC- Lakes Crossing Center
• LV- Las Vegas
• MCAH- Maternal, Child, and Adolescent Health
• NCCR- Nevada Central Cancer Registry
• NDOC- Nevada Department of Corrections
• NNAMHS- Northern Nevada Adult Mental Health Services
• NRS- Nevada Revised Statutes
• OPHIE- Office of Public Health Investigations and Epidemiology
• OVR- Office of Vital Records
• PCN- Position Control Number
• PRAMS- Pregnancy Risk Assessment Monitoring System
• RNO- Reno
• SFY- State Fiscal Year
• SNAMHS- Southern Nevada Adult Mental Health Services
• SSA- Social Security Administration
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