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Getting paid to care for a family member in Nevada

Yes. In Nevada, a family member can be paid to give care through Home and Community Based Services Structured Family Caregiving (SFCG) Waiver. A spouse can be paid through Home and Community Based Services Structured Family Caregiving (SFCG) Waiver.

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Structured family caregiving

Home and Community Based Services Structured Family Caregiving (SFCG) Waiver

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Who qualifies

People 21 or older who are diagnosed with dementia or a related condition, live with their primary caregiver in the same private home, meet the level of care for nursing home placement, and are financially eligible.

The caregiver gives help with daily activities and household tasks. The waiver also covers case management and respite.

Source: Home and Community Based Services Structured Family Caregiving Waiver (Nevada Aging and Disability Services Division)Checked

Can a family member be paid

Yes. Yes. The primary caregiver may be a non-family member, a family member or a legally responsible individual. Relatives who are not legal guardians may be paid if they live with the person, or the person lives with them.

Only one caregiver provides SFCG to each person. Relative caregivers must meet the same requirements as other waiver providers, including a criminal background check and the required training.

Source: Application for 1915(c) HCBS Waiver NV.2426.R00.01, Structured Family Caregiving, as of July 1, 2025, Appendix C (approved application, Centers for Medicare & Medicaid Services, medicaid.gov)Checked

Can a spouse be paid

Yes. Yes. A spouse is a legally responsible individual, and legally responsible individuals may provide SFCG and respite. It must be the person's choice, they must live together, and the spouse must be enrolled through a waiver provider agency, pass a criminal background check and complete the required training, including training on dementia.

The paid caregiver cannot also be the person's designated representative.

Source: Application for 1915(c) HCBS Waiver NV.2426.R00.01, Structured Family Caregiving, as of July 1, 2025, Appendix C (approved application, Centers for Medicare & Medicaid Services, medicaid.gov)Checked

Can a legal guardian be paid

Yes. Yes. Nevada counts legal guardians as legally responsible individuals, and they may provide SFCG and respite on the same conditions as a spouse.

Source: Application for 1915(c) HCBS Waiver NV.2426.R00.01, Structured Family Caregiving, as of July 1, 2025, Appendix C (approved application, Centers for Medicare & Medicaid Services, medicaid.gov)Checked

Pay rate

Under Assembly Bill 208, the provider agency must give the SFCG caregiver a daily stipend of at least 65% of the per diem rate the agency is paid.

Source: Application for 1915(c) HCBS Waiver NV.2426.R00.01, Structured Family Caregiving, as of July 1, 2025, Appendix C (approved application, Centers for Medicare & Medicaid Services, medicaid.gov)Checked

Medicaid self-directed care

Self Directed Personal Care Services (PCS)

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Who qualifies

People with ongoing Medicaid or Nevada Check Up eligibility who need personal care that is medically necessary, who do not live in a hospital, nursing facility or group residential facility, and who do not have a legally responsible individual available and capable of giving the care. You, or a personal care representative, must be able to make choices about daily activities and be willing and able to recruit, hire, schedule, train and direct your personal care assistants.

Services go through an Intermediary Service Organization (ISO), which is the employer of record. You are the managing employer.

Source: Medicaid Services Manual Chapter 2600, Intermediary Service Organization (Nevada Division of Health Care Financing and Policy, effective July 1, 2026)Checked

Can a spouse be paid

No. No. Legally responsible individuals, who include spouses, may not be paid for providing self-directed personal care services.

Source: Medicaid Services Manual Chapter 2600, Intermediary Service Organization (Nevada Division of Health Care Financing and Policy, effective July 1, 2026)Checked

Can a legal guardian be paid

No. No. Legally responsible individuals, who include legal guardians, may not be paid for providing self-directed personal care services.

A personal care representative cannot be paid for that role, and your paid personal care assistant cannot be your representative.

Source: Medicaid Services Manual Chapter 2600, Intermediary Service Organization (Nevada Division of Health Care Financing and Policy, effective July 1, 2026)Checked

Medicaid waiver

Home and Community Based Services Waiver for the Frail Elderly (FE)

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Who qualifies

People 65 or older who are at risk of nursing home placement if services are not provided (they meet the level of care for nursing home placement) and are financially eligible.

Medicaid Services Manual Chapter 2200 says the waiver has a limited number of slots each year, and ADSD keeps a wait list when none are open.

Source: Home and Community Based Services Waiver for the Frail Elderly (Nevada Aging and Disability Services Division)Checked

Can a spouse be paid

Depends. Only for some services. A legally responsible individual, such as a spouse, may be paid for activities family caregivers would not ordinarily perform, and may give homemaker, respite, chore and adult companion services. It must be the person's choice, and the spouse must be an employee of an enrolled provider agency.

A legally responsible individual cannot give State Plan personal care services together with waiver services, because State Plan personal care does not pay legally responsible individuals.

Source: Medicaid Services Manual Chapter 2200, Home and Community Based Services Waiver for the Frail Elderly (Nevada Division of Health Care Financing and Policy, effective November 1, 2024)Checked

How to apply

Home and Community Based Services Structured Family Caregiving (SFCG) Waiver

How to apply

Fill out the OCL Program Application, found on ADSD's Program Policy web page, and send it to the Aging and Disability Services Division (ADSD) office nearest you. You, a community partner or a caregiver can fill it out. Once ADSD receives a completed, signed application, an ADSD intake specialist contacts the person to decide which services and program fit best. Once you are found eligible, an intake specialist case manager contacts you to make sure services meet your needs.

Source: Home and Community Based Services Structured Family Caregiving Waiver (Nevada Aging and Disability Services Division)Checked

Phone

(725) 281-3123

ADSD Intake Customer Service Team, for questions about the application.

Source: Home and Community Based Services Structured Family Caregiving Waiver (Nevada Aging and Disability Services Division)Checked

Self Directed Personal Care Services (PCS)

How to apply

To make a first request for personal care services, call Nevada Medicaid's fiscal agent. To self-direct, you can also contact your local Nevada Medicaid District Office or ADSD office, which gives you a list of enrolled ISOs to choose from.

The District Office and ADSD route is in the Medicaid Services Manual, Chapter 2600, section 2603.1B.

Source: Intermediary Services Organization (Nevada Medicaid)Checked

Phone

800-525-2395

Nevada Medicaid's fiscal agent: choose option 1, then option 4. TTY callers dial 7-1-1.

Source: Intermediary Services Organization (Nevada Medicaid)Checked

Home and Community Based Services Waiver for the Frail Elderly (FE)

How to apply

Fill out the OCL Program Application, found on ADSD's Program Policy web page, and send it to the Aging and Disability Services Division (ADSD) office nearest you. You, a community partner or a caregiver can fill it out. Once ADSD receives a completed, signed application, an ADSD intake specialist contacts the person to decide which services and program fit best.

Source: Home and Community Based Services Waiver for the Frail Elderly (Nevada Aging and Disability Services Division)Checked

Phone

(725) 281-3123

ADSD Intake Customer Service Team, for questions about the application.

Source: Home and Community Based Services Waiver for the Frail Elderly (Nevada Aging and Disability Services Division)Checked

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