Bill would seek Medicaid waiver to add attendant care for frail elderly and create searchable in‑home care registry

Assembly Bill 338, presented March 17 in the Assembly Health and Human Services Committee, would require Nevada to apply for a federal Medicaid waiver to allow attendant care services for frail elderly individuals to be covered under the state’s home and community‑based services waiver and would require the Aging and Disability Services Division (ADSD) and the Division of Public and Behavioral Health to create a centralized online tool listing licensed personal‑care agencies.

The bill grew from interim work on services for older Nevadans, witnesses said, including a concern that services temporarily authorized during the COVID‑19 emergency — such as expanded meal funding — were no longer available. Proponents said the lack of easy, centralized information about available personal‑care providers makes it difficult for families to find and access help.

"Currently there is no attendant care in the frail elderly waiver," said Connie McMullen of the Personal Care Association of Nevada. She explained that qualifying rules differ between the ADSD waiver for frail elderly persons and the Medicaid state plan for attendant care; the latter’s eligibility standards can force seniors to "spend down" assets to qualify for services, she said.

The bill’s proposed website would list agencies’ contact information, service locations, services provided and levels of care, disciplinary actions, and the types of insurance accepted to help families compare options in one place. The Personal Care Association and other supporters argued the single‑site approach would reduce confusion and streamline access for caregivers searching for in‑home services.

Proponents also said aligning attendant care under the frail elderly waiver will permit federal financial participation for services including bathing, grooming, toileting, moving about, dressing and eating — basic assistance that helps people remain in their homes.

Supporters included the Nevada Association of Counties and AARP Nevada, which said the change would help seniors stay in place, reduce pressure on county social‑safety net resources and prevent unnecessary nursing‑home placements. AARP Nevada’s Jessica Padron said the measure would "remove barriers to care" and improve access to in‑home services.

The panel heard questions about program details but received no formal budgetary estimate during the hearing. The association representing personal‑care agencies said data from a June 2024 snapshot showed 2,680 ADSD consumers on the frail elderly waiver and 1,691 consumers receiving attendant care through the Medicaid state plan, which proponents cited as evidence of need.

No committee vote was taken. Sponsors said they would continue to work with stakeholders on implementation details and the website specifications.