Session Review: Health and Human Services

The Health and Human Services Committee considered a variety of issues this session regarding the provision of health and human services in Nebraska, including a moratorium on new hospitals and updating the state’s anatomical gift law.

Senators approved a bill that provides for a temporary moratorium on the issuance of new hospital licenses in Nebraska.

LB999, sponsored by Lincoln Sen. Kathy Campbell, directs the state Department of Health and Human Services not to accept applications from or issue licenses to new hospitals from April 15, 2010, through Sept. 15, 2011. The bill makes an exception for critical access hospitals and any hospital that has begun construction prior to May 1, 2010.

Under the bill, the Legislature’s Health and Human Services Committee will conduct a study that examines referral practices, ownership disclosure, community benefit, the impact of federal health care reform, uncompensated and under-compensated patient care, different types of hospitals and limited-service facilities and compliance with the federal Emergency Medical Treatment and Active Labor Act. The committee will issue a report on the study to the Legislature by Dec. 31, 2010.

LB999 passed on a 41-6 vote.

Lawmakers also passed a bill that adopts the Uniform Anatomical Gift Act.

LB1036, sponsored by Omaha Sen. Brenda Council, makes existing Nebraska law governing anatomical gifts consistent with federal law and new technologies and practices regarding organ, tissue and eye donation.

Among other provisions, the bill:

• permits consent from persons who are reasonably available;
• provides for advance health care directive and anatomical gift conflict resolution;
• changes the allowable age for a minor to donate an organ from 13 to 16 years of age;
• imposes a standard of reasonable care for an individual to be covered by the act’s immunity provisions;
• adds the State Anatomical Board as an organization that may receive a gift of a body for research or education;
• allows a parent who is reasonably available to revoke or amend an anatomical gift designated by an unemancipated minor;
• adds health care agents, grandchildren and persons exhibiting special care to the list of agents who may authorize an anatomical gift; and
• specifies that medical personnel caring for an individual at the time of death are not included in the category of persons exhibiting special care who may authorize an anatomical donation.

LB1036 passed on a 48-0 vote.

An omnibus health bill approved this session makes various changes to health and human services provision in Nebraska.

LB849, sponsored by Papillion Sen. Tim Gay, is the Health and Human Services Committee’s annual “clean-up” bill, which:

• updates state law regarding references to the Federal Social Security Act;
• transfers decision-making authority on appeals from a hearing officer to the director of the division of developmental disabilities; and
• removes a requirement that governing boards for developmentally disabled specialized services include elected officials.

The bill was amended to include provisions from nine other bills.

LB25, introduced in 2009 by former Sen. Mike Friend of Omaha, adds children’s day health services to the definition of health care service under the Health Care Facilities Licensure Act.

LB702, introduced by Grand Island Sen. Mike Gloor, allows a longer time frame for written authorizations for the release of health information. Currently, a request is effective for 180 days. Under the bill, an authorization will expire in 12 months if it does not contain an expiration date or specify an event that causes the authorization to expire.

LB726, introduced by Wilber Sen. Russ Karpisek, requires four hours of annual education and training for direct care staff pertaining to the care or treatment outlined in the Alzheimer’s Special Care Disclosure Act. The four hours specified do not increase the aggregate hourly training requirement of the Alzheimer’s Special Care Unit, nor is the state Department of Health and Human Services responsible for the curriculum.

LB734, introduced by Gay, eliminates a requirement that municipal and private utility companies use certified mail to give notification of service termination to welfare recipients. Notification by first-class mail is required seven days prior to termination of utility service to any domestic subscriber.

LB766, introduced by Gloor, eliminates the July 1, 2010, termination date for the Nebraska Center for Nursing Act.

LB828, introduced by Gloor, redefines, limits and changes education requirements for medical radiographers under the Medical Radiography Practice Act.

LB857, introduced by Gay, consolidates the Modular Housing Units Cash Fund and the Manufactured Homes and Recreational Vehicles Cash Fund into a new Public Service Commission Housing and Recreational Vehicle Cash Fund. The bill also eliminates specified statutory dollar amounts for manufactured home and recreational vehicle seals and allows the commission to determine annually the amount charged for the seals. Currently, the fee is set in statute as not less than $10 and not more than $75.

LB930, introduced by Gloor, amends the Pharmacy Practice Act by defining prescription drugs and devices as those not carrying an FDA-approved prohibition on their sale except on the order of a licensed health care provider. The bill also specifies that the practice of pharmacy does not include a business or person who sells, delivers or distributes such devices.

LB941, introduced by Gay, adds to the practice of optometry the dispensing and sale of a contact lens containing an ocular pharmaceutical agent, which the FDA classifies as a drug and an optometrist or ophthalmologist is authorized to prescribe.

LB849 passed on a 43-0 vote.

Two bills advanced by the committee stalled during general file debate.

Senators voted in February to suspend the Legislature’s rules and allow introduction of a bill meant to address a gap in Medicaid eligibility for low-income, pregnant women. Legislative rules limit bill introduction to the first 10 working days of a legislative session, which ended this year on Jan. 21.

LB1110, sponsored by Campbell, would have established a program to continue to offer prenatal services to low-income women regardless of immigration status.

Under the bill, the state Department of Health and Human Services would have been required to establish a program under the Children’s Health Insurance Program (CHIP) solely for the unborn children of mothers who are ineligible for coverage under Medicaid. Eligibility for service would have been determined using an income budgetary methodology of no greater than 185 percent of the federal poverty guideline.

Benefits would have included laboratory testing, outpatient hospital care, pharmaceuticals and prescription vitamins, radiology, ultrasound and other necessary imaging, services related to conditions that could complicate the pregnancy and professional fees and hospital costs related to labor and delivery.

The bill would have required the department, within 30 days of passage of LB1110, to seek federal approval of a state plan amendment or waiver for Nebraska’s program.

Senators gave unanimous consent to bracket LB1110.

Lawmakers voted down a measure that would have changed provisions related to tuberculosis detection and prevention in Nebraska.

LB341, sponsored by Omaha Sen. Tanya Cook, would have permitted nurse practitioners to dispense tuberculosis medications that are provided through public health agencies and dispensed to a patient at no charge.

The bill failed to advance from general file on an 18-25 vote.

The committee also heard testimony on LB1106, introduced by Omaha Sen. Jeremy Nordquist, which authorizes the creation of school-based health centers. The bill became part of the Appropriations Committee’s budget package and was approved on a 49-0 vote.