Session Review: Health and Human Services
Child welfare reform, licensure requirements and vaccine exemptions were among the measures considered by the Health and Human Services Committee this session.
Children and families
LB1173, introduced by the Health and Human Services Committee, creates a work group to find ways to improve the state’s child welfare system and ends privatization of child welfare services in Nebraska.
The group will include the directors of relevant divisions of the state Department of Health and Human Services, the state court administrator, the commissioner of education and representatives of the state’s federally recognized Indian tribes. It will seek input from individuals with experience within the child welfare system, providers, law enforcement, county attorneys and others.
The group will submit its model framework to the Health and Human Services Committee by Dec. 1, 2023, and will terminate Dec. 31, 2023.
LB1173 also includes provisions of four other bills:
• LB491, introduced by Omaha Sen. Machaela Cavanaugh, which removes DHHS authority to contract with a lead agency for case management in the department’s eastern service area of Douglas and Sarpy counties;
• LB541, introduced by Fremont Sen. Lynne Walz, which requires the Division of Children and Family Services to implement statewide tiers for a specialized level of care for foster care reimbursement and to partner with the Division of Medicaid and Long-Term Care to develop a plan for treatment family care services by Oct. 1, 2022;
• LB854, introduced by Omaha Sen. Jen Day, which requires the Division of Children and Family Services to immediately notify the Division of Public Health of any reports DHHS receives of alleged out-of-home child abuse or neglect by a child care provider or staff member; and
• LB932, introduced by Omaha Sen. Megan Hunt, which requires DHHS to notify youth in foster care and their guardians ad litem that the state is collecting Social Security benefits on their behalf, beginning Jan. 1, 2023. It also requires DHHS to provide documentation of the receipt, use and conservation of any Social Security benefits received upon request from the child beneficiary or their representative and upon termination of the department’s role as payee.
LB1173 passed 46-0 and took effect immediately.
LB741, introduced by Bennington Sen. Wendy DeBoer, allows the State Child Death Review Team to review stillbirths that occur after Jan. 1, 2023, to help identify preventable causes of stillbirths, defined as a death for which a fetal death certificate was issued by the state. The team is not required to review all stillbirths but the bill allows it or any agency that derives its authority from DHHS to access and analyze stillbirth data.
The measure, which passed on a 46-0 vote, also included provisions of four other bills:
• LB245, also introduced by DeBoer, which makes several changes to adoption law, including streamlining the notification and objection process for fathers and elimination of guardians ad litem;
• LB626, introduced by Omaha Sen. Tony Vargas, which separates the State Child and Maternal Death Review Team into the State Child Death Review Team and the State Maternal Death Review Team;
• LB901, introduced by Lincoln Sen. Patty Pansing Brooks, which requires DHHS to create materials on cytomegalovirus transmission, birth defects caused by the disease and available preventative measures and treatments; and
• LB1009, introduced by Plymouth Sen. Tom Brandt, which creates a nine-member Domestic Abuse Death Review Team appointed by the Nebraska attorney general. The team will investigate domestic abuse deaths to determine causes and contributing factors that led to an individual dying by homicide or suicide as the result of domestic violence.
Children with developmental disabilities are eligible for expanded services under LB376, introduced by Omaha Sen. Machaela Cavanaugh. The bill requires DHHS to apply for a three-year Medicaid waiver to start a family support program for developmental disability services.
The program, which will be implemented only if the federal Centers for Medicare and Medicaid Services approve the state’s waiver application or another funding mechanism is authorized, will:
• be administered by the DHHS Division of Developmental Disabilities;
• not exceed 850 participants;
• allow families to self-direct services;
• cap long-term services and supports at $10,000 per person;
• offer Medicaid eligibility for children with disabilities by disregarding parental income; and
• adopt an intermediate care facility institutional level of care.
Also included are provisions of LB1004, introduced by the committee, which require DHHS to engage a nationally recognized and independent consultant to evaluate Nebraska’s developmental disabilities system. The consultant must complete their report no later than Dec. 31, 2023.
LB376 passed on a 42-0 vote.
Licensure and credentialing
Lawmakers considered a number of changes to licensure and credentialing rules for various health professions this session.
LB436, introduced by Blair Sen. Ben Hansen, expands the scope of practice for licensed athletic trainers in Nebraska to include:
• injury prevention and wellness promotion;
• examination, assessment and medical opinion;
• health care administration;
• therapeutic intervention or rehabilitation of injuries and illnesses;
• therapeutic modalities; and
• immediate emergency care including administration of emergency drugs prescribed by a physician.
Under the bill, passed 45-0, athletic trainers cannot use joint manipulation or joint cavitation or prescribe medications but may employ “dry needling.”
LB752, introduced by Sen. John Arch of La Vista, authorizes respiratory therapists to engage in a broader range of allowable practices including the administration of all pharmacological, diagnostic and therapeutic agents for the treatment and diagnosis of cardiopulmonary disease for which the practitioner has been professionally trained or has obtained sufficient education or certification.
The bill also includes provisions of four other measures:
• LB15, introduced by Bellevue Sen. Carol Blood, which adopts the Occupational Therapy Practice Interstate Compact. Once in effect, the compact will allow licensed therapists to practice in other member states without having to obtain a separate license as is required currently;
• LB374, introduced by Bennington Sen. Wendy DeBoer, which creates the Alzheimer’s Disease and Other Dementia Advisory Council. The 17-member council will examine the needs of individuals living with dementia, services available for those individuals and their caregivers and the ability of health care providers and facilities to meet those needs;
• LB554, introduced by Blood, which adopts the Licensed Professional Counselors Interstate Compact which, when it becomes operative, will allow a licensed independent mental health practitioner with a certification in professional counseling to work in another state that is a member of the compact without having to obtain a new license in that state; and
• LB753, introduced by Arch, which requires Nebraska health care providers to obtain informed written consent prior to administering stem cell therapy. Patients are required to confirm that their health care provider has explained the treatment, that the treatment has not received approval from the U.S. Food and Drug Administration and that the patient understands that the treatment hasn’t received such approval.
Lawmakers passed LB752 on a 46-0 vote.
LB905, introduced by Fremont Sen. Lynne Walz, allows the state Board of Medicine and Surgery to develop educational material, policies and procedures to address perinatal and postnatal mental health disorders.
The bill, passed 44-0, also allows licensed health care professionals and advanced practice registered nurses to educate pregnant women about perinatal and postnatal mental health and to offer pregnant women and new mothers a mental health screening questionnaire.
LB716, introduced by Omaha Sen. Megan Hunt, would have allowed advanced practice registered nurses, certified nurse midwives and physician assistants to perform abortions. It did not advance from committee.
Pandemic measures
LB906, introduced by Blair Sen. Ben Hansen, requires the state Department of Health and Human Services to create and publish a form on its website to be filled out by employees seeking an exemption from an employer-mandated COVID-19 vaccination based either on a health care practitioner’s recommendation or the individual’s sincerely held religious belief, practice or observance.
The bill applies to entities with one or more employees, including state agencies and other political subdivisions. The federal government, any corporation wholly owned by the federal government, Indian tribes and bona fide private membership clubs, other than labor organizations that are exempt from federal taxation, are exempt from the bill’s provisions.
Under LB906, employers may require unvaccinated employees to wear personal protective equipment or submit to COVID-19 testing at the employer’s expense. Medicare-certified and Medicaid-certified providers or suppliers and federal contractors may require additional processes, documentation or accommodations as necessary to comply with federal law and Centers for Medicare and Medicaid Services regulations.
The bill passed on a 37-5 vote and took effect immediately.
All local public health departments in Nebraska would have needed state approval before issuing directed health measures under LB859, introduced by Sen. Robert Clements of Elmwood. The bill did not advance from committee.
Other measures
LB1068, sponsored by Gering Sen. John Stinner, updates a law passed by the Legislature in 2009 that funds efforts by the Behavioral Health Education Center of Nebraska to fill statewide behavioral health service needs, workforce education and professional training through established programs and practices.
The measure increases the number of residencies from two to 10 and provides up to 12 one-year, doctoral-level psychology internships, an increase from the current five. It also provides funds for up to 10 one-year mental health therapist internships or practicums in rural and underserved communities in Nebraska.
The bill, which passed 35-8 and took effect immediately, also included provisions of Blood’s LB1048 which requires the University of Nebraska to continue a study of the environmental and health effects of the AltEn ethanol plant in Mead.
LB698, introduced by Sen. Mark Kolterman of Seward, requires DHHS to provide Medicaid coverage for prescribed continuous glucose monitors by Jan. 1, 2023.
Lawmakers passed LB698 on a 46-0 vote.
LB121, introduced last session by Hunt, would have allowed individuals with felony drug convictions to receive SNAP benefits if they have completed their sentence or are on parole, probation or in post-release supervision. The bill advanced to select file and was debated this session but did not come up for a second-round vote.
