Health agencies stress need for more stable funding – both state and federal

Funding, funding, funding.

That’s what a panel of health experts from Nevada Health Link, Southern Nevada Health District (SNHD), Division of Health Care Financing and Policy (DHCFP), and Immunize Nevada agreed Wednesday needs to be a focus for politicians and policymakers this year.

Despite Nevada’s extensive and pained history with health outcomes, the state has made some strides including having more people insured, a reduction in the teen birth rate, and an increase in the reimbursement rate providers receive from Medicaid during the 2023 state legislative session.

However, the bulk of those strides, like the increased enrollment through the state health exchange, Nevada Health Link, were made possible through the federal Inflation Reduction Act (IRA) passed by Congress and signed into law by President Joe Biden in 2022. Provisions in the IRA extended more generous eligibility requirements that were implemented during the pandemic, and similarly enhanced marketplace subsidies that were enacted under the American Rescue Plan Act until 2025. 

“The issue that is very common among nonprofits, especially, is funding. Funding, funding, funding. God, I can’t say that enough,” said Ireti Fawehinmi, a community health worker manager at Immunize Nevada, noting that Immunize Nevada lobbied the state legislatures for financial support.  

Panelists emphasized the need to improve health equity outcomes in a state that dropped from 35th in the nation in 2019 to 42nd in 2022 in America’s Health Rankings. Much-needed improvements are unrealizable without stable funding, but panelists noted that federal funding for new or expanded programs is often grants or temporary measures, like the expansion of Medicaid during the pandemic.

Fermin Leguen, the District Health Officer of the SNHD, noted that there’s very little state investment in public health, and most of that has been provided relatively recently. 

The state increased the SNHD funding this year after multiple years of trying, Leguen said. Clark County approved the district’s funding from property taxes for the current fiscal year by 5% from fiscal year 2021-2022 from $28.2 million to $29.7 million, accounting for over a third of SNHD’s general funding. 

The state Department of Health and Human Services also awarded the SNHD a grant of $874,990 this fiscal year. There was no state grant funding in the fiscal year 2021-2022, according to the SNHD fiscal year 2022-2023 adopted budget.

“We had been trying to [increase state funding] since 2015, 2016. I remember the first time around and the second time it failed and there was nothing. Now, for the first time, we did some good. It’s not even close to enough but it is a good first step,” Leguen said. 

Federal grants accounted for $104 million of the SNHD budget, $76.7 million is funded through property taxes determined by the Clark County Assessor’s Office and the Nevada Department of Taxation,  charges for services provided by SNHD, and interest earnings on investments that SNHD holds. 

About half of the $180.6 million that SNHD received in the 2022-2023 fiscal year went to salaries, taxes, and benefits, and the remaining $89 million that went to supplies and services were bolstered by multiple COVID-related grants the agency was awarded in the past two years, according to the SNHD budget..

Katie Charleson, the Silver State Health Insurance Exchange communications officer representing Nevada Health Link,  noted that with the expanded subsidies under the IRA scheduled to expire in 2025, Nevada Health Link and other state-based health exchanges are hoping Congress will make the bigger subsidies permanent.

Edit: A previous version of this story has been updated to clarify that Clark County approved the 5% increase in the property tax increase.