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Senate committee hears bill to let family members receive Medicaid pay for personal 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 with severe disabilities or chronic illnesses, subject to the same enrollment, background-check and agency requirements that apply to outside caregivers.
Senate Bill 185, presented by Senator Angie Taylor, would require the Department of Health and Human Services (DHHS) to reimburse family members who provide personal care services to Medicaid recipients under age 18 who have disabilities or chronic illnesses, subject to the same enrollment and oversight rules that apply to nonfamily caregivers.
Taylor said the bill grew out of constituent conversations, school-board experience and a roundtable with families that highlighted the financial strain on parents who quit jobs or lose income to provide daily 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," Taylor said.
Kirsten Coulom, chief for Long Term Services and Supports with Nevada Medicaid, told the committee that family caregivers would have to enroll through a personal care agency and undergo the same background checks and oversight as other caregivers. "Any family member would have to enroll through a personal care agency," Coulom said, explaining that the agency and Nevada's Bureau of Healthcare Quality and Compliance would oversee licensure and training requirements. Coulom and other Medicaid staff said the change would be implemented under the federal home- and community-based authorities (for example, a 1915(c) waiver or 1915(i) state plan option) required to permit family members to be paid.
Supporters — including the Children's Advocacy Alliance, Cure for the Kids Foundation, Special Olympics Nevada, Access for Kids Nevada and individual parents — said SB185 would reduce uncompensated family caregiving, help keep children at home and address a shortage of paid providers. Testimony included personal accounts of parents who left employment to care for medically complex children.
Committee members asked about training, monitoring, the scope of services covered and age limits. Medicaid staff said SB185 as drafted covers personal care services (activities of daily living such as bathing, dressing and grooming) and not skilled nursing or other clinical services, which are delivered through home-health or private-duty nursing arrangements. Medicaid staff also noted that federal Medicaid rules require quality assurance associated with the home- and community-based authority used to implement family-pay models.
Several witnesses suggested potential amendments, including expanding eligibility beyond age 18 and allowing other family caregivers (grandparents, adult siblings) to receive reimbursement. Senator Taylor said she was open to amendments and would work with stakeholders on technical details. No committee vote was recorded during the hearing.
