Senate Minority Leader James Settelmeyer is planning to introduce legislation this session that would allow Medicaid recipients to supplement state reimbursement rates with personal funds, a proposal he hopes will improve access to personal care services for patients.

Though still in bill draft request form, Settelmeyer said his aim is to allow patients to use a certain amount of their own money to boost Medicaid reimbursement rates for personal care services. He said he’s still working to determine how much people should be able to contribute, noting that if people are able to pay significantly more than Medicaid does, they might not need any state assistance at all.

Settelmeyer decided to propose the legislation after a wheelchair-bound constituent came to him. He said the man was unable to find someone to care for him at home at the current Medicaid rate and, as a result, has to spend his nights sleeping in a hospital.

“The ability to find someone to take care of him doesn’t really exist at the current rate of $9 to $10 an hour,” Settelmeyer said. “So what he was trying to do — because he does have the ability to work — and he's like, ‘I'd love to supplement that a little bit in order to get the rate up to like 12 bucks where I could actually hire somebody.’ But we don't allow that in the state of Nevada.”

The proposal comes as Gov. Steve Sisolak has included a bump in rates for personal care services, personal assistance services and Community Options for the Elderly programs in his budget. He has proposed raising the reimbursement rate from $4.25 per 15-minute service unit to $4.39 for every 15 minutes.

Settelmeyer acknowledged the proposal raises broader concerns about Nevada’s Medicaid reimbursement rates, which providers across the spectrum have long complained are too low. But Settelmeyer hopes the legislation would create a market of personal care service providers willing to offer their services at a higher rate, freeing up those at the lower rate for patients who are unable to supplement the Medicaid reimbursement rates.

“Why shouldn't there be the opportunity for people? Because we are running into a problem, individuals being able to find workers for that,” Settelmeyer said. “They're having problems finding people for below $10 an hour to change their undergarments."

He said he’s also exploring whether there is a way to “cut out the middleman a little bit” and allocate personal caregiver funds directly to patients so they can pay attendants directly.