When a baby in Nevada is born affected by opioids, state rules say there has to be a plan: services for the infant, and treatment for the mother or caregiver. A state agency under Governor Joe Lombardo is supposed to make sure those plans actually happen. Nevada's own auditors found it wasn't.
What the audit found
Nevada's Legislative Counsel Bureau issued a performance audit of the state's opioid response on April 15, 2026. It found that the Division of Public and Behavioral Health's "oversight of infant care plan preparation and administration was lacking for opioid exposed infants."
The auditors looked at 20 of those infant care plans. According to the audit and American Journal News:
- In 9 of 20 (45%), there was no record that the mother was referred to substance use treatment.
- In 20%, there was no record of any services or referrals for the baby at all.
- There was no evidence the health division reviewed or monitored whether the plans were carried out.
That division answers to the governor. It handled more than $115 million in federal opioid money between 2018 and 2023, the audit says — and it fell short on more than babies. In five of 17 grant contracts the auditors checked, the recipient hadn't filed required progress reports, and 15 of 64 entities that needed a state site visit (23%) never got one.
Why it matters
A plan on paper doesn't help a newborn in withdrawal or a mother trying to get clean. The whole point of the rule is follow-through — and that's the part no one could show was happening. American Journal News notes that failing to meet these requirements could also put federal opioid prevention money at risk.
The stakes in Nevada are real. The state recorded a provisional 1,056 drug overdose deaths last year, according to CDC figures cited by American Journal News, and its decline has lagged the national drop.
The deadline that passed
The audit's sample reached back to 2021, before Lombardo took office in January 2023, so not every lapse is his. What happens next is.
His health division accepted all 16 of the auditors' recommendations. The audit set a deadline: a 60-day plan for corrective action was due July 11, 2026. American Journal News reports the Lombardo administration still had not provided an update on the shortcomings or a plan to fix them.
What the record shows
A Nevada legislative audit found the health division under Joe Lombardo couldn't show it reviewed or monitored care plans for opioid-exposed infants, and in 45% of the plans sampled there was no record the mother was offered treatment. The division accepted every recommendation, and its corrective plan was due July 11 — but American Journal News reports the administration has not provided an update or a plan.
Source
- Lombardo administration fell short on infant opioid care — American Journal News
