SB185 - Revises provisions relating to Medicaid reimbursement for care of disabled or chronically ill children. (BDR 38-760)

- 83rd Session (2025) Senate Bill No. 185–Senators Taylor; and Krasner CHAPTER.......... AN ACT relating to health care; requiring reimbursement under Medicaid to family members who provide personal care services to certain recipients of Medicaid; making an appropriation; and providing other matters properly relating thereto. Legislative Counsel’s Digest: Existing law requires Medicaid to cover certain home and community-based services for persons with physical disabilities, including personal care services in the home. (NRS 422.272407, 422.396) Section 1 of this bill requires the Department of Health and Human Services to reimburse a member of the family of a recipient of Medicaid for providing personal care services to the recipient, so long as the recipient: (1) is less than 18 years of age; (2) is eligible under Medicaid to receive coverage for personal care services; and (3) has been diagnosed with a disability or chronic illness that renders the recipient unable to perform activities of daily living without assistance. Section 2 of this bill makes a conforming change to require the Director of the Department to administer the provisions of section 1 in the same manner as other provisions relating to Medicaid. Section 2.5 of this bill makes an appropriation to and authorizes expenditures by the Division of Health Care Financing and Policy of the Department for certain costs associated with the Department reimbursing a member of the family of a recipient of Medicaid for providing personal care services to the recipient pursuant to section 1. EXPLANATION – Matter in bolded italics is new; matter between brackets [omitted material] is material to be omitted. THE PEOPLE OF THE STATE OF NEVADA, REPRESENTED IN SENATE AND ASSEMBLY, DO ENACT AS FOLLOWS: Section 1. Chapter 422 of NRS is hereby amended by adding thereto a new section to read as follows: 1. The Department shall reimburse a member of the family of a recipient of Medicaid described in subsection 2 for providing personal care services that are covered by Medicaid to the recipient. 2. Reimbursement is available under this section for personal care services provided to a recipient of Medicaid who: (a) Is less than 18 years of age; (b) Is eligible under Medicaid to receive coverage for personal care services; and (c) Has been diagnosed with a disability or chronic illness that renders the recipient unable to perform activities of daily living without assistance. – 2 – - 83rd Session (2025) 3. The Department shall apply to the Secretary of Health and Human Services for any waiver of federal law or apply for any amendment of the State Plan for Medicaid that is necessary for the Department to receive federal funding to reimburse a member of the family of a recipient of Medicaid for providing to the recipient personal care services that are covered by Medicaid. 4. As used in this section, “personal care services” means the services described in NRS 449.1935. Sec. 2. NRS 232.320 is hereby amended to read as follows: 232.320 1. The Director: (a) Shall appoint, with the consent of the Governor, administrators of the divisions of the Department, who are respectively designated as follows: (1) The Administrator of the Aging and Disability Services Division; (2) The Administrator of the Division of Welfare and Supportive Services; (3) The Administrator of the Division of Child and Family Services; (4) The Administrator of the Division of Health Care Financing and Policy; and (5) The Administrator of the Division of Public and Behavioral Health. (b) Shall administer, through the divisions of the Department, the provisions of chapters 63, 424, 425, 427A, 432A to 442, inclusive, 446 to 450, inclusive, 458A and 656A of NRS, NRS 127.220 to 127.310, inclusive, 422.001 to 422.410, inclusive, and section 1 of this act, 422.580, 432.010 to 432.133, inclusive, 432B.6201 to 432B.626, inclusive, 444.002 to 444.430, inclusive, and 445A.010 to 445A.055, inclusive, and all other provisions of law relating to the functions of the divisions of the Department, but is not responsible for the clinical activities of the Division of Public and Behavioral Health or the professional line activities of the other divisions. (c) Shall administer any state program for persons with developmental disabilities established pursuant to the Developmental Disabilities Assistance and Bill of Rights Act of 2000, 42 U.S.C. §§ 15001 et seq. (d) Shall, after considering advice from agencies of local governments and nonprofit organizations which provide social services, adopt a master plan for the provision of human services in this State. The Director shall revise the plan biennially and deliver a – 3 – - 83rd Session (2025) copy of the plan to the Governor and the Legislature at the beginning of each regular session. The plan must: (1) Identify and assess the plans and programs of the Department for the provision of human services, and any duplication of those services by federal, state and local agencies; (2) Set forth priorities for the provision of those services; (3) Provide for communication and the coordination of those services among nonprofit organizations, agencies of local government, the State and the Federal Government; (4) Identify the sources of funding for services provided by the Department and the allocation of that funding; (5) Set forth sufficient information to assist the Department in providing those services and in the planning and budgeting for the future provision of those services; and (6) Contain any other information necessary for the Department to communicate effectively with the Federal Government concerning demographic trends, formulas for the distribution of federal money and any need for the modification of programs administered by the Department. (e) May, by regulation, require nonprofit organizations and state and local governmental agencies to provide information regarding the programs of those organizations and agencies, excluding detailed information relating to their budgets and payrolls, which the Director deems necessary for the performance of the duties imposed upon him or her pursuant to this section. (f) Has such other powers and duties as are provided by law. 2. Notwithstanding any other provision of law, the Director, or the Director’s designee, is responsible for appointing and removing subordinate officers and employees of the Department. Sec. 2.5. 1. There is hereby appropriated from the State General Fund to the Division of Health Care Financing and Policy of the Department of Health and Human Services to carry out the provisions of section 1 of this act the following sums: For the Fiscal Year 2025-2026 .................................. $135,086 For the Fiscal Year 2026-2027 .................................. $414,251 2. Expenditure of the following sums not appropriated from the State General Fund or the State Highway Fund is hereby authorized by the Division of Health Care Financing and Policy of the Department of Health and Human Services for the same purposes as set forth in subsection 1: For the Fiscal Year 2025-2026 .................................. $306,334 For the Fiscal Year 2026-2027 .................................. $616,026 – 4 – - 83rd Session (2025) 3. Any balance of the sums appropriated by subsection 1 remaining at the end of the respective fiscal years must not be committed for expenditure after June 30 of the respective fiscal years by the entity to which the appropriation is made or any entity to which money from the appropriation is granted or otherwise transferred in any manner, and any portion of the appropriated money remaining must not be spent for any purpose after September 18, 2026, and September 17, 2027, respectively, by either the entity to which the money was appropriated or the entity to which the money was subsequently granted or transferred, and must be reverted to the State General Fund on or before September 18, 2026, and September 17, 2027, respectively. Sec. 3. 1. This section becomes effective upon passage and approval. 2. Section 2.5 of this act becomes effective on July 1, 2025. 3. Sections 1 and 2 of this act become effective: (a) Upon passage and approval for the purpose of adopting any regulations and performing any other preparatory administrative tasks that are necessary to carry out the provisions of this act; and (b) On January 1, 2027, for all other purposes. 20 ~~~~~ 25