Expanded Medicaid coverage for psychological services broadened, advanced

A measure intended to increase access to psychological services by expanding Medicaid coverage was amended to include provisions of five additional bills before advancing from the first round of debate April 2.

Under LB332, as introduced by Gering Sen. Brian Hardin, the state Department of Health and Human Services would be required to provide Medicaid coverage for psychology services provided by qualified advanced-level practitioners who are supervised by a licensed psychologist.

Hardin said the bill would provide coverage for psychological services by doctoral psychology interns who have completed four of the required six years of graduate-level training. Increasing access to mental health services is important, he said, because individuals with mental illness who lack treatment often find themselves on the streets or in jail.

“Mental health is not a partisan issue — it is a public health issue, an economic issue and a moral obligation,” Hardin said.

A Health and Human Services Committee amendment, adopted 29-0, would add provisions of the following four bills heard by the committee this session:
• LB154, also sponsored by Hardin, which would change provisions related to hearing instrument specialists;
• LB515, introduced by Sen. Dan Quick of Grand Island, which would provide requirements for certain prescription refills;
• LB555, sponsored by Ralston Sen. Merv Riepe, which would create the position of assistant funeral director; and
• LB697, introduced by Sen. Paul Strommen of Sidney, which would change requirements relating to compounding and delegated dispensing permits under the Pharmacy Practice Act.

“Rural Nebraska can be considered a desert for many services and medical care is no exception,” Hardin said. “The package of LB332 aims to help increase access to health care services for all of Nebraska and particularly our rural communities.”

Provisions of LB154 would allow a licensed hearing instrument specialist to provide cerumen — or earwax — removal, provide tinnitus care and dispense and fit hearing instruments. Under the bill, a licensed hearing instrument specialist would be required to have an arrangement with a medical liaison. The amendment also provides examination and hearing assessment requirements.

Hardin said some concern was expressed during the public hearing on LB154 that hearing aid specialists would not be qualified to do cerumen management and that work was ongoing regarding possible amendments to satisfy those concerns.

The amended provisions of Quick’s LB515 would allow a pharmacist to provide emergency refills of maintenance medication in certain circumstances. The amendment would add new conditions for dispensing emergency refills if failure to do so would disrupt a patient’s drug therapy.

Among other provisions, the measure would limit such refills to no more than a seven-day supply unless packaging requirements prevent it and prohibit dispensing to the same patient more than once in any six-month period.

The provisions of Riepe’s LB555 would create the role of assistant funeral director under the Funeral Directing and Embalming Practice Act.

Under the amendment, assistant funeral directors would be permitted to assist funeral directors in their duties but would be prohibited from engaging in any aspect of embalming. Assistant funeral directors would be required to have a collaborative agreement with a licensed funeral director.

The provisions of Strommen’s LB697 would add three members to the Board of Pharmacy: a pharmacy technician, a pharmacist and a member of the public. The measure also would clarify provisions of the Pharmacy Practice Act related to compounding and delegated dispensing permits for public health clinics.

Hardin offered an amendment to the committee amendment to add provisions of his LB119 to the package. Those provisions relate to the Rural Health Opportunity Program, which encourages students to pursue health care professions in rural communities.

RHOP, which recruits high-performing high school students and provides financial support for them to attend state colleges, began in 1989, Hardin said, and the amendment would codify the program in state law.

RHOP students receive a full tuition waiver for all coursework, he said, and guaranteed admission to the University of Nebraska Medical Center if they meet program requirements.

The amendment would not provide additional funding for the program.

After adopting the Hardin amendment 28-0, lawmakers advanced LB332 to select file on a 29-0 vote.