Committee hears bill to allow Medicaid reimbursement for medical respite care; Las Vegas center cites 52% housing placement rate

Senate Bill 54 would require Medicaid to provide coverage and reimbursement for medical respite (recuperative) care for individuals experiencing homelessness who need short‑term, post‑acute recovery but do not require hospital care.

Sabra Newby, deputy city manager for the City of Las Vegas, described the city’s existing Recuperative Care Center (RCC), a 40‑bed facility opened in August 2020 in response to COVID‑19. Lindy Cooksey, neighborhood services administrator, outlined services at the RCC: 24/7 clinical care, on‑site wound care, medication management and pharmacy storage, oxygen access, transport to secondary appointments (imaging, dialysis, substance use treatment), behavioral health assessment and hospice care. The RCC provides intensive case management, peer supports and assistance with benefits applications; Arcelia Barajas said the city has served more than 1,115 patients at the RCC and that 52 percent of patients discharged from the facility transitioned into some form of permanent functional housing.

Newby and Barajas explained funding history: the RCC began under CARES Act allocations, the city used ARPA funds and received HUD Continuum of Care awards ($750,000 allocated as $250,000 per year for three years). The city has secured additional ARPA funds for construction of a new, expanded RCC; the construction timeline will temporarily reduce services in fiscal year 2026 and, once expanded in fiscal year 2027, is projected to increase annual operating costs to about $7,000,000. Newby said the city supports SB 54 as a mechanism to leverage Medicaid reimbursement and reduce pressure on city general funds.

The bill directs the Department of Health and Human Services to establish program guidelines, to apply for any required Medicaid waiver or state plan amendment, and to set a reimbursement rate. The city asked the committee to consider delaying the effective date (the presenters proposed changing the start date from Jan. 1, 2026 to July 1, 2026) so DHHS has time to prepare waiver materials and address fiscal impacts.

Supporters included federally qualified health centers, county homelessness coordinators, health systems, and nonprofit providers. Several local governments and health systems described existing or adjacent programs and expressed willingness to participate if Medicaid reimbursement becomes available. No organized opposition was recorded during the committee hearing; several local public health and managed‑care stakeholders described current cooperation and emphasized program design as the key to success.

Committee members asked about statewide precedents and the waiver timeline; staff and presenters indicated a multi‑year waiver and implementation process is typical and that other states (e.g., Arizona, Washington cited by witnesses) provide partial precedent for Medicaid coverage of similar services.

SB 54 remained under committee consideration pending drafting of technical amendments and fiscal analysis.