Posts Tagged ‘Mike Willden’

State Officials Crunching Numbers For Gov. Sandoval To Make Decision On Medicaid Expansion

By Sean Whaley | 3:22 pm July 12th, 2012

CARSON CITY – Nevada officials are busy preparing cost and enrollment estimates so Gov. Brian Sandoval will have reliable information before deciding whether to expand Medicaid following the U.S. Supreme Court ruling last month upholding much of the Affordable Care Act.

But even if Sandoval does not expand Medicaid to 138 percent of the federal poverty level as provided for in the law, the program is expected to grow significantly as Nevadans who are now eligible but not enrolled decide to sign up when the health insurance mandate takes effect on Jan 1, 2014.

The effective date is in the middle of the first year of the upcoming two-year budget now being prepared by the Sandoval administration. The Legislature will take up the budget, and the Medicaid issue, when the 2013 session starts in February.

State officials are readying data for Sandoval to make a Medicaid decision

Mike Willden, director of the Department of Health and Human Services, and state Budget Director Jeff Mohlenkamp, are gathering the data to show the anticipated effects on the state budget of these two distinct Medicaid groups.

“Our goal is to have the numbers over to the governor by the end of next week,” Willden said. “We’re just not ready to give out numbers yet and I don’t want to give out bad numbers. There are 10 moving parts.”

Mohlenkamp said the court threw everybody “a bit of a curve,” when it decided states do not have to opt into an expanded Medicaid program.

State Budget Director Jeff Mohlenkamp. / Nevada News Bureau file photo.

“So we’re now in the process of analyzing what that looks like, the pros and cons of that, the financial impact on the state of the options, and, is it absolutely straightforward; you either opt in or opt out,” he said. “Or are there other options within the Supreme Court ruling that we can consider.”

Sandoval’s initial response was to reject an expansion

When the Supreme Court said the federal government could not penalize states if they do not choose to opt into the Medicaid expansion, Sandoval’s initial comment was that the state could not afford to do so. But he is awaiting the information before deciding how to proceed.

“This is going to be a governor’s office decision,” Mohlenkamp said. “The governor will make the decision as to the policy of the state going forward. He has not yet made that decision. He’s looking for a very critical analysis of what the options are and the pros and cons for the state.”

The bigger cost to the state general fund will likely come from those eligible but not enrolled in Medicaid, because the state share of adding those individuals is projected to be 38 percent in 2014, compared to a 62 percent share from the federal government.

This cost to the strapped state budget will occur whether or not an expansion is approved by the Nevada Legislature.

All of the analysis is dependent on the implementation of the federal health care law. Republican members of Congress and GOP presumptive presidential nominee Mitt Romney want to repeal the law.

Federal funding will cover most, but not all, of a Medicaid expansion

Federal funding will pay for 100 percent of any Medicaid expansion for the first three calendar years beginning in 2014, with the state required to pick up a percentage of the cost beginning in 2017. The first year state cost is 5 percent, in 2018 the state cost is 6 percent, in 2019 the state cost is 7 percent, and in 2020, the state cost is 10 percent.

But Willden said there are also administrative costs to the state that are not fully covered by the expansion but instead are shared between the federal government and the state at a 50-50 match. They include information technology costs and the cost to hire new eligibility workers, for example, he said.

State Health and Human Services Director Mike Willden / Nevada News Bureau file photo.

“And so we’re trying to again cost out for the governor, clear through 2020, because there are state costs involved in those out years even though everybody says it’s 100 percent federal the first three,” Willden said. “There are state costs in the out years, there are also state costs associated with the administrative costs for the new eligibles.”

There will be some savings because mentally ill people now being treated by the state at full cost to the state general fund will be Medicaid eligible, and there will be some savings to the counties because they now use county general fund money to pay for medical care for individuals who would become Medicaid eligible, he said.

The counties are analyzing that potential impact, Willden said.

Another question that is being researched with federal officials is whether the opt-in option would require a full commitment to the 138 percent of poverty level, of if some lesser level could be pursued, he said.

“The goal is to try to get all of this to come together in the next couple of weeks,” Willden said. “That way the governor would have enough information to at least review on the opt in, opt out opportunity.”

Medicaid expansion would cover new groups, including childless adults

If Medicaid is expanded in Nevada, new participants will be childless adults, who are not covered by the state program now, Willden said. The other expansion will come from parent caretakers of children who are covered at 75 percent of poverty now.

Medicaid now covers primarily low-income children, the disabled, pregnant women and seniors. These groups are now covered at different poverty rates ranging from 100 percent to 138 percent.

State lawmaker concerned about long-term financial implications of an expansion

State Sen. Ben Kieckhefer, R-Reno, who will be involved in the Medicaid issues in 2013 as a member of the Senate Finance Committee, said Sandoval is taking a prudent course because there are so many unanswered questions given the Supreme Court’s surprise decision allowing states to opt out of the expansion.

A critical question is what happens with the generous federal funding after 2020 and as Congress and the President grapple with unsustainable spending on federal programs, he said.

“It is a very good deal in the first couple of years,” Kieckhefer said. “I mean the feds pay 100 percent of the medical costs for the first three years. That’s a great deal. It then goes down to 90 percent after the fifth year. And there is nothing that mandates that that goes on forever.

“So I think the stronger concern is, how does the federal government continue to justify paying 90 percent of those costs as it’s trying to deal with the massive federal deficit and reducing that deficit,” he said. “And I think that there is a strong likelihood that eventually the feds start shifting that cost burden back to the states and that’s a risk that the state needs to weigh.”

Assembly Ways and Means Chairwoman Debbie Smith, D-Sparks, said her plan is to have an overview of the court ruling from staff at the Legislature’s Interim Finance Committee on Aug. 23.

“I want to just make sure that we have a really good understanding of what all the possibilities and ramifications are,” she said. “I want that to be the first informational piece and then we can go from there.”

Nevada’s health insurance exchange is another factor in the complex review

Another variable in the assessment is the Silver State Health Insurance Exchange now being readied in Nevada where residents will be able to shop for health insurance beginning Oct. 1, 2013. Nevadans between 100 percent and 400 percent of the federal poverty level will be eligible for subsidies when they purchase insurance.

The ACA rules appear to indicate that if Medicaid is not expanded, Nevadans who would have been covered in an expansion could go to the Exchange and receive a tax credit as long as all other requirements are met.

The Exchange is gearing up now with federal funds, but the state will have to pick up the cost of its operation when federal grants run out in 2015, Willden said.

Another issue is whether there are enough doctors and other medical providers to offer services to an expanded population, he said.

Willden said in May that as many as 150,000 additional Nevadans would be eligible for Medicaid if the law was upheld by the court, but that estimate was two years old and was made before the court said states could opt out of the expansion.

He estimated that bringing new residents onto the rolls would cost the state general fund an estimated $574 million between now and 2020.

But Kieckhefer said only $63 million of that cost estimate was due to the Medicaid expansion. The rest was due to those already eligible who were expected to enroll as a result of the mandate to obtain insurance.


Audio clips:

Mike Willden of Nevada Health and Human Services says his agency is trying to estimate the cost of a Medicaid expansion program through 2020:

071212Willden1 :22 the new eligibles.”

Willden says the goal is to get the data to the governor in the next couple of weeks.

071212Willden2 :13 opt out opportunity.”

State Budget Director Jeff Mohlenkamp says the pros and cons of a Medicaid expansion are being analyzed:

071212Mohlenkamp1 :19 we can consider.”

Mohlenkamp says Gov. Brian Sandoval will make the call on a Medicaid expansion but that he has not done so yet:

071212Mohlenkamp2 :16 for the state.”

State Sen. Ben Kieckhefer says he is concerned about the potential long-term financial obligation to the state:

071212Kieckhefer :26 reducing that deficit.”


Medicaid Caseload Will Expand By 150,000, Cost Nevada $574 Million if Federal Health Care Law Is Implemented

By Sean Whaley | 2:51 pm May 7th, 2012

CARSON CITY – The head of Nevada’s Department of Health and Human Services said today that as many as 150,000 more residents will be eligible for Medicaid coverage if the federal health care law is found constitutional by the U.S. Supreme Court.

Bringing new residents onto the rolls is expected to cost the state an estimated $574 million between now and 2020, said HHS Director Mike Willden in an interview on the Nevada NewsMakers television program broadcast today.

The estimate, which is about two years old, includes the cost to the state of serving new Medicaid eligibles, the cost of new information technology needed to implement the law and some increased payments to primary care physicians, he said.

The U.S. Supreme Court is expected to rule on the constitutionality of the health care law by June.

U.S. Supreme Court.

Nevada was one of more than two dozen states to challenge the constitutionality of the new law. Even so, Gov. Brian Sandoval has moved forward with implementation because it is the law of the land.

Willden said the new rules say that every man, woman and child living under 138 percent of the federal poverty level will be eligible for Medicaid, the cost of which is shared by the states and federal government.

“Our estimate in Nevada is, as I indicated, we have about 325,000 people on Medicaid or our Checkup program now, and we may see upwards of 150,000 more people eligible for Medicaid,” Willden said. “Because we pick up a group that we’ve never covered in Nevada, and that’s what we call childless adults. Nevada has never served childless adults.”

The other part of the expansion will come as Nevadans now eligible for Medicaid but who have not enrolled in the program will participate because of the individual mandate to have health insurance, he said.

Willden said he does not believe Nevada’s medical provider community will be able to accommodate the increased population seeking health care.

“As you know we’re one of the worst in the nation when it comes to primary care physicians ratios to population, specialists of various kinds ratios to population, and you bring in many, many more on Medicaid I don’t think there will be what we call adequate networks to provide that, so that will be a challenge,” he said.

Nevada will need to bring more physicians into the state, but will have to compete with other states to do so, Willden said. It could also lead to an examination and potential expansion of what types of medical care nurses and physician assistants are able to provide to patients, he said.


Audio clips:

DHHS Director Mike Willden says about 150,000 more Nevadans may be eligible for Medicaid:

050712Willden1 :22 served childless adults.”

Willden says Nevada’s medical community may not be able to handle the increase in the Medicaid eligible population:

050712Willden2 :23 be a challenge.”


Qualifications Of New Welfare Administrator Called Into Question

By Sean Whaley | 8:48 am December 14th, 2011

CARSON CITY – For the second time in two years questions are being raised about the qualifications of Diane Comeaux, a top state human services administrator, to do her job.

The director of the agency said he has complete faith in her abilities.

Mike Willden has appointed Comeaux, who currently serves as the administrator of the Division of Child and Family Services (DCFS), to the administrator position over the Division of Welfare and Supportive Services (DWSS). The appointment will occur in early 2012.

Willden, director of the Nevada Department of Health and Human Services (DHHS), said Comeaux’s experience is “pretty much unmatchable when it comes to administration.”

But Comeaux does not have a college degree. The state law listing the qualifications for the position says a college degree is required.

Nevada Child and Family Services Administrator Diane Comeaux

Willden acknowledged that Nevada Revised Statutes could be interpreted to mean that a college degree is required for Comeaux’s new position, but he said her administrative experience makes her qualified for the appointment.

Comeaux’s current position does not require a college degree but questions were raised about her qualifications for the job in an article published in November 2009 by the Nevada News Bureau.

In addition to her current position which she has held since June of 2008, Comeaux also worked as the deputy administrator of Medicaid and as the deputy administrator at Child and Family Services.

“Altogether she’s been 10 years in top ranked positions in DHHS,” Willden said. “And so, no bones, Diane doesn’t have a degree but she has years of experience as a state executive, and running DCFS is every bit as difficult and responsible as DWSS.”

State law regarding the top welfare position says that the administrator must be selected based on training, experience, and interest in the field; be a graduate from an accredited college; have at least three years of administrative experience; and possess qualities of leadership. The job description was changed by the Nevada Legislature in 2005.

But Willden said he has consulted with the state Human Resource Management Division and it was the interpretation of the agency that all of the listed requirements could be considered in making an appointment and that not all of the qualifications had to be met.

The legislative intent of Assembly Bill 13 of the 2005 session, a measure sought by DHHS to open up the applicant pool for the welfare position, also makes this clear, he said. Willden said he has not sought out a formal legal opinion on the question of Comeaux’s eligibility.

Minutes of a hearing on the bill in the Assembly Health and Human Services Committee in 2005 include this exchange:

“So the main gist of the bill is to broaden it so that you can have more people to pick from?” asked then-Assemblywoman Sheila Leslie, D-Reno.

“That’s correct,” said then-welfare administrator Nancy Ford. “Currently the statute says you have to have three years of experience running a public welfare agency, which is pretty restrictive. You also have the catchall ‘or equivalent training and experience.’ But it is pretty restrictive. This would help liberalize it to make our pool of candidates bigger.”

Willden said: “Yes, we’re interested in a college degree, but that has to be balanced with other training, experience, those types of things.”

Comeaux’s experience is worth more than a college degree, he said.

Willden also said that while the appointment of Comeaux is permanent, she is expected to serve in the job for only a brief period to assist with a couple of major initiatives the agency needs to accomplish in the next year. Comeaux is expected to retire before the 2013 legislative session begins, he said.

Comeaux could not be reached for comment for this story.

She is replacing Romaine Gilliland, who has announced he will retire early next year.

Comeaux has her supporters.

Lisa Ruiz-Lee, interim director of the Clark County Department of Family Services, describes Comeaux as an “extraordinary public servant” in the six years they have worked together. Comeaux has worked collaboratively with Clark and Washoe counties and other jurisdictions to improve the delivery of child welfare services, she said.

“And so I think that is one of Diane’s strengths, is that she really focuses on building solid, collaborative relationships and helping people to move forward in a consensus based, togetherness kind of a feel, and I think she does a great job at that,” Ruiz-Lee said.

Comeaux has tremendous expertise around public welfare, public service and managing government, she said. She will carry these same strengths into the Welfare Division arena, Ruiz-Lee said.

Assemblywoman April Mastroluca, D-Henderson, said she has found Comeaux to be a professional in their work together on child welfare issues. While deferring to Willden on the appointment, she said: “I have faith in Mike and his ability and if he has chosen Diane as the best person for the job then I don’t see a reason to question that if he has the backing that he needs from HR (Human Resources) to be able to do that.”

Willden said he picked Comeaux because of two major challenges facing the division in the coming year. One is the need for a new information technology project because of the new federal health care law, he said. A request for proposals for the project is going out shortly.

“Diane’s experience has been excellent over the years with regard to IT systems,” Willden said.

The other challenge is the fiscal administration of the welfare agency, he said.

“And Diane has a tremendous skill set there,” Willden said.

“So when I looked around as to what we might want to do, open that up and recruit again or look within at the talent we have, it was pretty clear to me that at least for the next year, it would very critical to have someone that knows what’s going on in IT and fiscal within the department issues,” he said. “So Diane was head and shoulders above.”

Amber Howell, currently deputy administrator at the Division of Child and Family Services, is being appointed as acting administrator of the agency until a search for a permanent replacement is completed, Willden said.


Audio clips:

HHS Director Mike Willden says Comeaux does not have a degree but has years of experience as a state executive:

12-12-11Willden1 :17 responsible as DWSS.”

Willden says a college degree has value but has to be balanced with training and experience:

121211Willden2 :10 types of things.”

Willden says Comeaux fits the bill for the challenges facing the welfare division:

121211Willden3 :25 and shoulders above.”

Assemblywoman April Mastroluca says she has faith in Willden to make the appointment to the position:

121311Mastroluca :15 to do that.”

Lisa Ruiz-Lee, interim director of the Clark County Department of Family Services, says Comeaux builds solid, collaborative relationships:

121311Ruiz-Lee :16 job at that.”




Acting Administrator Appointed For Nevada State Mental Health Programs

By Nevada News Bureau Staff | 5:01 pm October 3rd, 2011

CARSON CITY – Richard Whitley, administrator of the Nevada State Health Division, has been appointed to serve as acting administrator for the Nevada Division of Mental Health and Developmental Services.

The appointment by Mike Willden, director of the state Department of Health and Human Services, took effect Saturday. Whitley is replacing Dr. Harold Cook, who is retiring after 33 years of state service.

Health Division Administrator Richard Whitley has also been named acting administrator of the Nevada Division of Mental Health and Developmental Services.

The Division of Mental Health and Developmental Services oversees a public and private network of programs involving mental health, substance abuse and developmental disabilities. The agency also operates the Rawson-Neal Psychiatric Hospital in Las Vegas and the Dini-Townsend Psychiatric Hospital and the Lake’s Crossing Center forensic facility in the Reno-Sparks area.

Whitley was previously appointed as administrator of the Nevada State Health Division in January 2008. He led the Health Division through the agency’s regulatory changes that resulted from the hepatitis C outbreak associated with a surgical center in Las Vegas that was identified in 2008.

Whitley began state service as the senior psychologist for the Nevada Women’s Correctional Facility in 1986. A graduate of Willamette University, he holds a master’s degree in counseling psychology from Western Oregon University. He will continue his role as administrator of the Health Division.

Additionally, Dr. Tracey Green is being appointed as acting medical director for the Division of Mental Health and Developmental Services. Dr. Green currently serves as the state health officer, providing medical leadership for Nevada’s public health programs, a position she has held since July 2009. She is a board certified family physician and graduate of the University of Nevada, School of Medicine. Dr. Green will also continue in her role with the State Health Division.

“Combining forces with mental health and public health allows us to continue to provide evidence-based and cost-effective treatment spanning a continuum of care for Nevadans whose needs are both mental and physical,” Willden said. “I look forward to continuing the theme of collaboration that we are developing among Nevada’s Health and Human Services agencies.”

A search has been conducted to find a permanent replacement for Cook. Willden said he is evaluating his options.

Lawmakers, State Agencies Argue Over Budget Compliance

By Anne Knowles | 7:04 pm August 31st, 2011

Nevada lawmakers today approved money to cover the costs of the upcoming special election, received an update on the progress of the state’s health care insurance exchange and complained repeatedly that state agencies were thumbing their noses at the legislative process.

Sen. Sheila Leslie, D-Reno, saw passage of her bill regulating the use of leg hold traps./Nevada News Bureau file photo

The Interim Finance Committee approved more than 100 requests for funds from nearly every state agency, but reprimanded a handful who legislators said were not adhering to budgets passed during the last legislative session.

“This is some of the most blatant disregard of legislative intent that I’ve ever seen,” said Sen. Sheila Leslie, D-Reno. “I hope this doesn’t continue this interim. I know these are tough times, but we must follow the law.”

Assemblywoman Debbie Smith, D-Sparks, the committee chair, also voiced concern several times that issues before the committee should have been resolved during the budgeting process.

When about $33,000 was requested to hire a consultant to help the Nevada Department of Transportation track the state’s inventory of vacant lands in compliance with Assembly Bill 404, Smith asked Paul Saucedo, NDOT chief right-of-way agent, why NDOT had not submitted a fiscal note delineating the need for that money with the bill.

Smith then almost tabled a request from the Department of Tourism and Cultural Affairs (DTCA) because it was found that the department is now using a contract worker to do the work of a job eliminated when the budgets were approved by the legislature.

“This is a budget discussion and should have taken place then,” said Smith.

In the end, the DTCA request for $84,616 in federal National Endowment for the Arts money was approved because the agency would miss a deadline to request the federal grant money if the request was pushed to the committee’s next meeting.

“Let’s move it ahead so as not to lose the federal money,” said Assemblyman Pete Goicoechea, R-Eureka. “In the meantime, staff can work with them on this contract employee. We may pay $8,000 for a few months of the employee, but that’s better than losing $84,000.”

The committee was also concerned about a request to transfer about $4.5 million from the budget for the University of Nevada, Reno (UNR) to the University of Nevada School of Medicine budget. The university’s goal was to keep the school of medicine budget cuts to a minimum in order to expand the school’s class sizes from 62 medical students to 100 and expand its nursing class from 98 students to 196, said Mark Johnson, UNR president.

Johnson said higher education had made certain programs a higher priority and was trying to maintain them while eliminating some and making others self supporting.

“We wanted a more fair and equitable approach,” said Sen. Steven Horsford, D-Las Vegas referring to the legislative intent of higher education cuts. “I feel we are going backward by protecting one program at the expense of others.”

Secretary of State Ross Miller / Photo: Nevada News Bureau file photo.

The IFC also approved $539,137 to reimburse counties for costs incurred for the special election in the 2nd congressional district. Secretary of State Ross Miller said counties requested the money since none had budgeted for the special election. He said the money would cover fixed costs and would not be reduced by lower than anticipated turnout.

“This is the minimum amount needed to run it without jeopardizing the integrity of the election,” Miller told the committee.

Miller’s office requested the money from the state’s contingency fund, adding that $6 million the state has in reserve from the federal Help America Vote Act is not intended for special elections.

Lawmakers asked if the some of the money could come from an approximate $340,000 surplus in the Secretary’s office budget. Miller said his office is projecting a deficit, not a surplus and agreed to work with the Legislative Counsel Bureau staff to resolve the discrepancy in the budget projections of his office and the LCB.

The committee also received an update on the Silver State Health Insurance Exchange Nevada is building to meet requirements mandated by the Patient Protection and Affordable Care Act enacted by Congress.

The Department of Health and Human Services has received $1 million from the federal government for planning the exchange. HHS spent $320,000 in fiscal year 2011 and is rolling over the remainder into the next fiscal year. The department requested about $2.6 million of a $4 million establishment grant from the federal government to create a new agency and to fund four new positions – an executive director, operational officer, grants manager and executive assistant.

During the 2013 legislative session, the state will need to decide how to fund the exchange once federal support for it ends in 2015, said Michael Willden, HHS director.

Willden also said he was meeting with Gov. Brian Sandoval’s office later in the day about possible appointments to the board that will oversee the exchange.  The board will consist of five members appointed by the governor, one member appointed by the state Senate majority leader, and one member chosen by the Assembly speaker.

The IFC also approved a subcommittee’s recommendations yesterday to cut or delay several building and maintenance projects due to budget constraints.


$50 Million Budget Amendment Mitigates Cuts To Autism, Mental Health, Rural Counties

By Andrew Doughman | 4:29 pm April 26th, 2011

CARSON CITY – The governor has found $50 million that could erase some of the most controversial cuts in his $5.8 billion proposed budget.

The new revenue projections could mitigate an array of budget cuts to autism, mental health, emergency medical services and rural counties. Those services would have been eliminated or transferred to cash-strapped counties that may not have been able to fund them.

The money going to rural counties drew criticism from Senate Majortiy Leader Steven Horsford, D-Las Vegas, who called the governor’s recent trip to the Elko area a “blatant attempt to shore up a handful of votes from legislators whose districts will be crippled by this budget.”

“The governor is trying to cut deals to get votes,” Horsford said in a statement released this evening.

The budget amendment fulfills some of Gov. Brian Sandoval’s promises made to rural legislators. The amendment restores an additional $3.6 million to keep open Wells Conservation Camp in Elko.

The governor’s staff refuted claims that the budget amendment had to do with rural counties.

Sandoval’s senior adviser, Dale Erquiaga, said they made the decisions through “a combination of listening to the [budget] hearings and listening to legislators, both urban and rural.”

Added to a Mar. 28 amendment of $25.8 million, that leaves the budget about $86 million larger than when the governor submitted it. Improved economic conditions also mean at least an additional $72 million available as economists change their revenue projections for the state.

Today’s amendment amounted to about $60.7 total, but $10 million was split between correcting earlier estimates and establishing reserve, unappropriated account.

“The governor’s been listening and we realized there were some significant cuts to some of the camps and to mental health services and autism,” said Heidi Gansert, the governor’s chief of staff. “So when this money was made available, we went back through and did a careful evaluation of where we should add back.”

Mike Willden, director of the state’s Department of Health and Human Services, said he worked with the governor’s budget staff and his own staff to decide what programs deserved funding.

Democratic legislators suggested the possibility of changing where the money goes in the governor’s budget amendment.

“Now it’s in the hands of the Legislature to move things around,” said Assemblywoman Debbie Smith, D-Sparks. “…I’m not a real fan of making promises in this budget. We have an obligation to the whole state of Nevada.”

Speaker John Oceguera, D-Las Vegas, echoed his colleague’s comments about the Legislature’s role in deciding how and where the state spends its money.

He said, however, that while the new money is good news, the Legislature still has to fill what he claims is a $1.2 billion shortfall in the education budget.

Legislators are still waiting until next Monday, May 2, when an official group of economists will revise projections for the amount of revenue the state will collect during the next two fiscal years. A nascent economic recovery could mean the Legislature will have more money with which to craft a budget.

Today’s amendment comes after the state found savings from revised federal projections for Medicaid matching funds, reduced costs due to rooting out fraudulent billing and a reduced number of cases.

The good news has a bitter downside, though, since the federal projections are based on how poor a state is. This past month, the U.S. Bureau of Economic Analysis released a report showing Nevada’s per capita growth in income was last in the nation during 2010.

That figure means the federal government will give Nevada more aid than the governor had projected when his staff crafted the budget earlier this year.

Some of the largest “add-backs” to the budget are below:

  • Nursing homes should receive back $5 per Medicaid resident per day, meaning a $15 per day reduction rather than a $20 per day reduction. A legal analysis provided one month ago suggested such a cut could violate federal law.
  • The state will provide $3.3 million to restore 75 percent of funding to a welfare program that assists parents with disabilities.
  • $9.2 million could go back to a variety of northern and southern Nevada mental health services.
  • About $5.3 million could be returned to services providing for rural child welfare.
  • $3.4 million would revert to an account for substance abuse prevention and treatment.


AUDIO CLIP: Gov. Brian Sandoval’s chief of staff, Heidi Gansert, says $50 million is going back to cuts to autism and mental health services, which were decided through a careful process:

042611 Gansert :20