The amount of stuff someone might do for you during the night is pretty minimal. Most people sleep at night. So someone comes over and stays in your house at night. If you need something then, a drink of water or whatever, that's what they're there to do. Kansas has been having night supports since at least 1990.
States can do that if they know what it is and how little it costs.
Another key is the Helen L. lawsuit. That suit, Steve Gold's case, is the best argument you can make. Helen L. sued the state of Pennsylvania on grounds of the ADA and won her freedom from a nursing home. We showed that case to our state HCFA people, and got the point across. Helen L. is the law.