Updated September 4, 2026. Quick answer: unclear from Nevada’s own published materials whether Self-Directed Personal Assistance Services (PAS) and the Structured Family Caregiving (SFCG) waiver permits family pay in every case. Whether a spouse specifically qualifies is not clearly stated in the materials reviewed this session.
How Nevada pays a family caregiver
| Program | Self-Directed Personal Assistance Services (PAS) and the Structured Family Caregiving (SFCG) waiver |
|---|---|
| Can a family member be paid? | Unclear. Not stated in the materials reviewed this session. |
| Can a spouse be paid? | Not clearly addressed in the materials reviewed this session. |
Why the spouse question is different
Federal Medicaid rule treats a spouse (and a parent paying for a minor child) as a “legally responsible relative”, someone already assumed to owe the care for free, so paying them is barred by default. A state has to build an explicit exception into its waiver or state-plan option to pay a spouse at all; the rule for any other relative (an adult child, a sibling, a grandchild) is looser and usually allowed. That is why the two rows above can carry different answers on the same page.
The going rate
Not published by the state in the materials reviewed this session.
How it works
ADSD confirms on its own site that PAS provides community-based, in-home services to help adults with severe physical disabilities avoid facility placement, and that a separate Structured Family Caregiving waiver exists for people with a dementia-related diagnosis, run through ADSD with case management and respite alongside the SFCG benefit itself. Beyond that description, the actual policy text on self-direction, provider hiring rules, and payment structure sits in ADSD policy manuals that could not be read this session.
What this doesn’t answer
This is the weakest-verified jurisdiction of the 25. The ADSD PAS program page was successfully read but contains only a general program description with no language on self-direction, family hiring, or spousal eligibility. Every PAS policy PDF tried returned corrupted or unreadable binary content. The DHCFP Structured Family Caregiving fact sheet and HCBS page both now redirect to a generic homepage with no retrievable content. Family and spouse eligibility are therefore marked Unclear rather than relying on secondary caregiver-site claims.
Sources
Read September 4, 2026.
Same question, other states: New Hampshire · New Jersey.
Related: the private-pay caregiver-agreement rule · the household-employee tax rules once you’re being paid · what family caregiving actually costs unpaid.
General information drawn from each state’s own Medicaid agency and public program materials, not legal, tax or financial advice. Medicaid self-direction programs are administered state by state and change by budget cycle and waiver renewal; this page cannot see your own state’s current program status or your family’s eligibility. We are not a law firm, a benefits counselor, or a fiduciary, and this is not personalized advice. We sell nothing on this page and earn nothing from it.