Health services package expanded to include SNAP extension, advanced

An omnibus health services proposal was expanded to include several additional measures, including a SNAP benefit extension, before advancing from the second round of debate April 25.

LB227, sponsored by Blair Sen. Ben Hansen, would require the state Department of Health and Human Services to provide Medicaid reimbursement to a hospital at 100 percent of the statewide average nursing facility per diem rate for Medicaid enrollees who meet certain criteria.

The bill was amended during the first round of debate to include provisions of more than a dozen measures related to pharmacy practice and health profession licensure.

Sen. Jen Day of Omaha offered an amendment during select file debate, adopted 27-3, to add an amended version of her LB84 related to Supplemental Nutrition Assistance Program benefits. SNAP eligibility in Nebraska currently is set at 165 percent of the federal poverty level, but is scheduled to drop to 135 percent of FPL on Oct. 1, 2023.

Day’s bill originally would have made the 165 percent threshold permanent. Her amendment instead would extend the current sunset date until Oct. 1, 2026. DHHS has indicated its ability to absorb the cost of administering the current eligibility level until that time, she said, and the benefits themselves are entirely federally funded.

Day said the eligibility cap was increased temporarily during the COVID-19 pandemic — increasing participation by approximately 4,500 families — and should be extended due to continued food insecurity related to inflation and lagging wages.

“If you’re someone living on the brink, what once was enough to barely get by is no longer sufficient,” Day said. “Following a major spike in hunger related to the COVID-19 pandemic, many Nebraskans still struggle to put food on the table for themselves and their families.”

Sen. Mike Jacobson of North Platte supported the amendment, saying food insecurity is a serious issue in his district and across the state.

“We are dealing with significant food inflation,” he said.

Also amended into the proposal was LB586, originally introduced by Seward Sen. Jana Hughes and prioritized by Ralston Sen. Merv Riepe, who offered the amendment. The provisions would provide $3 million in general funds in fiscal year 2023-24 and $3 million in FY2024-25 to incentivize and expand opportunities for nursing education and the training of nursing faculty.

Riepe said the state faces a critical shortage of nurse educators, which in turn leads to a shortage of nurses in the field. Nebraska is projected to be short more than 5,400 nurses by 2025, he said.

“Nebraska is in a health care workforce crisis,” Riepe said, adding that the amendment also requires the Nebraska Center for Nursing to establish a committee of experts to determine the most effective way to use the resources allocated to train more nurses.

The amendment was adopted on a 27-0 vote.

Another amendment, offered by Fremont Sen. Lynne Walz and adopted 29-0, added her LB286. The amendment provides confidentiality to physicians who participate in a wellness program unless a peer coach determines that the physician’s condition constitutes a danger to public health and safety.

Walz said the Nebraska Medical Association provides a voluntary, confidential peer support system for physicians in the state who are facing marriage, financial or other stressors. Many doctors don’t use the service, however, out of fear of career repercussions, she said.

“While symptoms of workplace fatigue are not likely to rise to the criteria of reportable conduct,” Walz said, “this fear is a very real barrier to physicians seeking support for dealing with stress and burnout.”

Finally, Hansen also offered an amendment on select file, adopted 32-0, that added the provisions of four additional bills:
• LB261, sponsored by Riepe, which would change requirements of a split apprenticeship for individuals studying mortuary science by allowing the apprentice license to be completed while attending a mortuary science school;
• LB245, sponsored by Walz, which would increase the per diem reimbursement for members of the Board of Barber Examiners from $75 to $150;
• LB345, sponsored by Omaha Sen. Christy Armendariz, which would define palliative care as specialized medical care for people living with a serious illness that carries a high risk of mortality or negatively impacts quality of life; and
• LB357, sponsored by Walz, which would increase the maximum monthly support allowable under the Disabled Persons and Family Support Act from $300 to a maximum of $400 for eligible individuals and from $150 to $200 for an additional disabled family member.

Following adoption of the select file amendments, senators advanced LB227 to final reading by voice vote.