28-03-2025
City, state officials discuss expanding Medicaid to cover medical respite for unhoused
The Recuperative Care Center offers unhoused individuals a place to stay after being discharged from the hospital. (Photo: Michael Lyle/Nevada Current)
As potential federal cuts to Medicaid loom, City of Las Vegas officials are asking state lawmakers to expand Medicaid to pay for medical respite care for unhoused people.
Senate Bill 54, heard Tuesday by the Senate Health and Human Services Committee, would require the state's Department of Health and Human Services to apply for a federal waiver and amend the state Medicaid plan to cover medical respite care for people experiencing homelessness.
The bill would also require DHHS to adopt guidelines for respite care for unhoused populations.
Though Democratic legislators have been publicly fretting that congressional Republicans will drastically cut Medicaid spending to help pay for tax cuts requested by President Donald Trump, state lawmakers on the panel Tuesday didn't directly discuss the prospect, though there were oblique references noting the Senate Finance Committee will be tasked with approving state Medicaid spending details.
When unhoused people are injured or dealing with an illness not deemed serious enough for a hospital stay, they are forced to heal while unsheltered.
Sabra Newby, the deputy city manager for the City of Las Vegas, said authorizing federal reimbursements for services would 'improve health outcomes, reduce unnecessary hospital stays and readmissions, and strengthen Nevada's continuum of care for its most vulnerable residents.'
'Medical respite care offers short term, residential community-based support specifically for homeless individuals who need a safe and sanitary place to heal,' Newby said.
The Recuperative Care Center in the Corridor of Hope, the area in downtown Las Vegas that offers homeless services, opened in 2020 during the Covid pandemic to offer some medical respite care.
The city used funding provided by the American Rescue Plan Act, signed into law by President Joe Biden in 2021, to expand and maintain the 40-bed facility. It also relies on general fund dollars to operate the facility.
The city contracts with the federally qualified Hope Christian Health Center to operate the facility within the homeless services corridor.
City officials told state lawmakers the facility has served 1,115 patients, with the majority referred by hospitals. More than half of those transition into 'some sort of permanent functional housing at their discharge,' said Lindy Cooksey, a neighborhood outreach specialist with the city.
The city plans to temporarily reduce capacity starting this summer as the center goes through construction to double capacity, which is expected to be complete by 2027.
Once the expansion is complete, the estimated annual operating budget is expected to be $7 million.
'Covering the cost for the entirety of this program would place a significant burden on the city's general funds,' said Arcelia Barajas, the director of Neighborhood Services with the City of Las Vegas. 'Although respite care for homeless individuals is fairly new to Nevada, it is a best practice nationally and funded through various avenues with the most common being Medicaid.'
The bill, if passed, would not cover the entire budget of the center but 'reduce the strain' of the city's budget, Barajas said.
Democratic state Sen. Fabian Doñate of Las Vegas, the committee's chair, noted other states have obtained federal waivers for homeless respite housing, and those models hopefully would serve as a template for expediting federal approval.
Republican state Sen. Robin Titus, whose district includes all or parts of six rural counties, asked whether the bill would only apply to services offered at the Las Vegas-based center or would apply to communities throughout the state.
Newby said theoretically it could apply throughout the state but she was 'unaware of any other place that provides these services.
Local governments and health providers alike supported the legislation.
Joanna Jacob, a lobbyist with Clark County who testified in support of the bill, said the county used covid relief dollars to convert motels into noncongregate shelter space. Two of the motels offer respite care, she said.
'There is enough need in our community that we need to build additional resources,' Jacob said.
Cadence Matijevich, a lobbyist with Washoe County, said while the county doesn't have a stand alone respite center, it does provide similar services to what Las Vegas offers. She said the county would also benefit if Medicaid covered costs to cover respite services.
The committee took no action on the bill.
