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Senator Taylor’s bill would let Medicaid reimburse family members for in‑home care of disabled children
Summary
Senate Bill 185 would require Nevada Medicaid to reimburse family members who provide personal‑care services to Medicaid‑eligible children under age 18 with severe disabilities or chronic illnesses; agency staff said family caregivers would enroll through personal‑care agencies and follow the same checks and training as paid caregivers.
Carson City — Senator Angie Taylor (R‑District 15) presented Senate Bill 185 in the Senate Health and Human Services Committee on Wednesday, a proposal to require Nevada's Department of Health and Human Services to reimburse family members who provide personal‑care services to Medicaid recipients under age 18 with severe disabilities or chronic illnesses.
Taylor said the bill was prompted by constituent stories and years of observation in local schools and suggested it would ease financial strain for families who otherwise must give up employment to provide full‑time care. "This bill seeks to alleviate some of the financial burden by requiring Nevada's Department of Health and Human Services to reimburse family members who provide the personal care services, to Medicaid recipients under the age of 18 who have been diagnosed with a severe disability or with a disability or chronic illness," she said.
Kirsten Coulom, chief for Long Term Services and Supports with Nevada Medicaid, described how the program would operate under existing Medicaid rules. Coulom said family members would enroll through a personal‑care agency and would therefore be subject to the same background checks, trainings and agency oversight required for other paid caregivers. She also said the bill would use federal home‑and‑community‑based authorities (testified as a Section 1915(c) waiver or a 1915(i) state plan option) to allow family caregivers to be paid while preserving enhanced quality assurance.
Committee members pressed on specifics: whether training and background checks would apply to family caregivers (Coulom said yes), whether the bill's age cap should extend beyond 18 to 21 (Coulom noted Medicaid often covers medically necessary services through age 21 under EPSDT), and how the state would address potential fraud or misuse (Medicaid surveillance and recoupment were described as existing enforcement tools; agencies would pursue education and then recoupment if necessary).
Multiple advocacy groups testified in support. Carissa Pierce of Children's Advocacy Alliance said the bill helps families keep children at home amid a provider shortage. Annette Logan Parker of Cure for the Kids Foundation and Terrence Thornton of Special Olympics Nevada also spoke in favor, citing the emotional and financial strain on caregivers. Chelsea Bishop of Access for Kids Nevada and Rebecca Acosta, a pediatric health advocate, described personal encounters with families who would benefit.
Witnesses and staff recommended possible amendments: extending coverage to older dependents (up to age 21), allowing reimbursement for non‑parent family caregivers (grandparents, adult siblings), and clarifying eligibility and medical‑necessity thresholds so the program targets children who would otherwise require paid personal‑care services.
The sponsor said she would consider amendments and return with revised language. The committee closed the hearing on SB 185 without a vote.
Why it matters: Supporters said family caregivers already provide most in‑home care for many medically complex children; the bill would recognize that work with Medicaid reimbursement while keeping agency oversight in place to reduce fraud risk.
