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Legislative
Wrap-Up: 2007 by the numbers...
First Session of the 100th Legislature
- 90-day first session convened on January 3, 2007
- 22 of the 49 senators were new due to term limits
- 705 legislative bills were introduced
- 129 bills were identified as “of interest” to NHA members
- Of those 129 bills, the NHA:
- The Unicameral’s disposition of those 129 bills:
- 33 were indefinitely postponed
- 51 were carried-over to second session
- 17 were amended into other bills that became law
- None of the bills opposed by NHA became law
- The NHA testified 58 times before 9 of the 14 standing legislative
committees
- The first session adjourned on May 31, 2007
2007 Legislative Interim
- 123 legislative interim study resolutions (ISRs) were introduced
- 48 of the ISRs are "of interest” to the NHA members
- ISRs of interest were assigned to committees as follows:
- Appropriations: 1
- Banking, Commerce and Insurance: 5
- Business and Labor: 2
- Education: 1
- Government, Military and Veterans Affairs: 3
- Health and Human Services: 23
- Judiciary: 5
- Natural Resources: 2
- Revenue: 1
- Transportation and Telecommunications: 4
- Urban Affairs: 1
- Meetings and hearings on ISRs will be held during the summer and fall
Second Session of the 100th Legislature
- The 60-day second session will convene on January 9, 2008
- New bills will be introduced
- New bills and carry-over legislation will be debated
The 101st Legislature — January 2009 - January 2001
- Because of term limits, at least 15 new senators will be elected in 2008
Legislative
bills signed into law this session:
The following bills of interest were signed into law during the 2007
legislative session.
Appropriations Committee
LB
321: Appropriate funds for state government expenses.
Sponsor: Appropriations Committee – NHA position: Monitor
Effective Date: July 1, 2007
LB 321 is the mainline budget bill that limited the state’s spending growth to an average of 4.3 percent for the next two fiscal years. Annual provider rate increases included in this bill are:
- Hospitals – 1.95 percent
- Long term care providers – 2.5 percent
- Long term care providers – 2.5 percent
- Assisted living facilities – 2.0 percent
- Behavioral health providers – approximately 2.0 percent (rates vary by treatment)
Funding to replace lost federal funds for Area Health Education Centers (AHECs) and money for the nursing faculty loan program were not included in this budget.
LB
542: Create the Children’s Behavioral Health Task Force.
Sponsor: Sen. John Synowiecki – NHA position: Support
Effective Date: May 25, 2007
Creates the Children’s Behavioral Health Task Force to study children’s behavioral health policy in the state. The task force will prepare a report and recommendations for a statewide behavioral health plan and present it to the Legislature by December. LB 542 also establishes evaluation and treatment procedures for the behavioral health centers in Kearney and Geneva that require those centers to evaluate each patient and develop individualized plans of treatment that may or may not include a referral to the Hastings Regional Center.
Business and Labor Committee:
LB
255: Change the Nebraska Wage Payment and Collection Act.
Sponsor: Sen. Kent Rogert – NHA position: Support
Effective Date: April 3, 2007
LB 255 addresses a critical issue to all Nebraska employers: the treatment of accrued employee fringe benefits, including sick leave, upon employment separation. In response to the Nebraska Supreme Court’s 2006 ruling in Roseland v. Strategic Staff Management, LB 255 states: “Paid leave, other than earned but unused vacation leave, provided as a fringe benefit by the employer shall not be included in the wages and payable at the time of separation… unless the employer and the employee or the employer and the collective-bargaining representative have specifically agreed otherwise.”
LB:
588: Change provisions relating to the workers’ compensation hospital fee schedule, payment of providers and disability compensation.
Sponsor: Sen. Abbie Cornett – NHA position: Support
Effective Dates: January 1, 2008 and January 1, 2010
This bill modifies workers’ compensation payments for Nebraska’s largest hospitals. The new hospital fee schedule is for in-patient services only and is hospital specific. Effective January 1, 2008, the new fee schedule will be based on a factor of 150 percent of Medicare with a 2.5 outlier (stop-loss threshold). Trauma services for injuries requiring immediate medical treatment to prevent death or permanent disability are excluded from the fee schedule until January 1, 2010. Out-patient services, rehabilitation and all services provided by critical access hospitals will remain discount from charge. LB 588 also contains a prompt payment provision and a requirement that the workers compensation court consider an employee’s loss of earning capacity if simple member disability alone does not accurately assess the combination of member impairments from the same accident or illness.
Health and Human Services Committee:
LB
236: Provide for and change regulation of perfusionists, optometrists, pharmacy technicians and in-home personal service providers.
Sponsor: Sen. Joel Johnson – NHA position: Support
Effective Date: September 1, 2007
This bill requires perfusionists to be licensed and requires the completion of continuing competency activities on an annual basis. It also requires and provides for the registration of optometrists and pharmacy technicians.
Under LB 236, in-home personal services agencies can provide services without being licensed as a home health agency provided they follow the requirements of the bill including appropriate background checks and training. Caregivers may not perform any actions requiring nursing or medical judgment. In-home personal care agencies are exempt from medication aide regulations provided that their workers only provide reminders to take medications or assist clients in the delivery of non-therapeutic topical applications.
LB
247: Change provisions relating to drugs, adoption, certain credentialed health professionals, child care and health benefit coverage.
Sponsor: Sen. Joel Johnson – NHA position: Monitor
Effective Dates: June 1, 2007 and December 1, 2008
This bill incorporates many legislative provisions. It makes technical changes to the Uniform Controlled Substances Act and the Pharmacy Practice Act. Colorectal cancer screenings are required to be covered by insurance. Proof of childhood immunization for invasive pneumococcal disease is mandated. A new licensure category for independent mental health practice is created. Changes were made to statutes relating to audiology and speech-language pathology, dental hygienists, and adoption. Modifications, specific to assisted living and long term care facilities, that pertain to the conditions under which dispensed drugs or devices may be returned to the dispensing pharmacy were also included in the final version of this bill.
LB
292: Authorize transfers of funds for medical assistance payments and change tax rate for intermediate care facilities.
Sponsor: Sen. Tom Hansen – NHA position: Support
Effective Date: September 1, 2007
LB 292 allows county boards to transfer general assistance funds to Health and Human Services prior to those payments being made to providers who serve Medicaid recipients or low-income uninsured persons and who meet federal and state disproportionate share payment requirements. These inter-governmental transfers will be considered an additional part of the state’s match resulting in more federal funding for the Disproportionate Share Hospital (DSH) program in Nebraska.
This bill also amends provisions related to the Intermediate Care Facilities/Mentally Retarded (ICF/MR) Reimbursement Protection Act by lowering the 6 percent tax to 5.5 percent thereby conforming state law to the newly adopted federal Tax Relief and Health Care Act of 2006.
LB
296: Reorganize the Health and Human Services System.
Sponsor: Sen. Joel Johnson, Request of the Governor – NHA position: Monitor
Effective Date: July 1, 2007
Legislative bill 296 reorganized the current HHS system into a single department under a chief executive officer, Christine Peterson, who will oversee six separate divisions. Those divisions will be divided by services for public health, Medicaid, children and family services, behavioral health, developmental disabilities and veterans’ homes.
LB
374: Change repayment provisions for rural health education loans.
Sponsor: Sen. Joel Johnson – NHA position: Support
Effective Date: July 1, 2007
This changes repayment provisions for rural health education loans designed for medical, dental, physician assistant and graduate-level mental health students. Previously, the law required a borrower who receives a student loan under the Nebraska Rural Health Systems and Professional Incentive Act but who does not practice in a designated health professional shortage area; practices a specialty other than an approved specialty in Nebraska; or practices outside of Nebraska to repay 100 percent of the loan principal with interest at a rate of 24 percent simple interest per year from the date the loan was granted. LB 374 requires the borrower to repay 150 percent of the outstanding loan principal with interest at a rate of 6 percent per year from the date of default.
LB
463: Adopt the Uniform Credentialing Act.
Sponsor: Sen. Joel Johnson – NHA position: Support
Effective Dates: September 1, 2007 and December 1, 2008
LB 463 is a recodification of the Uniform Licensing Law (ULL) and it adopts the Uniform Credentialing Act (UCA). It includes all regulated health care professions and occupations credentialed by the Nebraska Department of Health and Human Services. The bill clarifies the requirements necessary to obtain, renew or reinstate a license or voluntarily surrender a license. It also outlines behavior that will constitute grounds for disciplinary action and the processes for filing a complaint for violation of the law, including investigations, confidentiality and the process for imposing disciplinary action.
LB
482: Adopt the Autism Treatment Program Act.
Sponsor: Sen. Joel Johnson – NHA position: Monitor
Effective Date: July 1, 2007
Legislative bill 482 creates a pilot program to provide intensive early intervention for autistic children in Nebraska. The program is funded through a combination of private contributions and transfers from the Nebraska Health Care Cash Fund. The bill requires the state Department of Health and Human Services to apply for a Medicaid waiver or an amendment to an existing waiver for provision of autism treatment.
Judiciary Committee:
LB
97: Change provisions relating to the Concealed Handgun Permit Act.
Sponsor: Sen. Mike Flood – NHA position: Support
Effective Date: September 1, 2007
The original version of LB 97, introduced by Speaker Mike Flood (Norfolk), was intended to repeal provisions related to the settlement of escrow funds. Through a procedural move, Amendment 1485 was inserted into this bill. The amendment added parochial schools, universities and community colleges to the existing list of places where concealed handguns are prohibited. During debate, Sen. Ernie Chambers (Omaha) successfully offered a floor amendment that would add hospitals to the list of areas where carrying a concealed handgun will be prohibited.
LB
373: Provide for inadmissibility of apologies regarding medical care as evidence.
Sponsor: Sen. Dianna Schimek – NHA position: Support
Effective Date: September 1, 2007
In any civil action brought by an alleged victim of an unanticipated outcome of medical care, any statements by a health care provider expressing apology or sympathy are not admissible as evidence of an admission of liability or as evidence of an admission against interest. A statement of fault which is part of or in addition to any such communication is admissible.
Revenue Committee:
LB
304: Change qualifications for tax credits relating to long-term care insurance.
Sponsor: Sen. Tim Gay – NHA position: Support
Effective Date: September 1, 2007
Reduces the age at which taxpayers may make tax deferred payments out of a long-term care savings account to pay the premiums of a long-term care insurance policy from 62 to 50. As amended by a Revenue Committee amendment, the bill also would allow qualified withdrawals at any age for long-term care expenses that have been incurred and allow taxpayers to have long-term care accounts for the benefit of any person for whom the owner of the account has an insurable interest.
Legislation carried over to 2008:
The following bills were carried over to the 2008 legislative session.
Banking Committee:
LB
647: Change provisions relating to insurance coverage of mental health and physical health conditions.
Sponsor: Sen. Joel Johnson – Status: Held in committee
NHA position: Support
LB 647 addresses the issue of mental health parity. It requires that when a health insurance plan in the State of Nebraska provides coverage for a diagnosis of a physical illness, it must provide at least the same level of coverage for the diagnosis of a behavioral health illness, including mental and substance abuse illnesses.
Health and Human Services Committee:
LB
308: Adopt the Automated Medication System Act.
Sponsor: Sen. Arnie Stuthman – Status: Held in committee
NHA position: Support
LB 308 would allow, but not require, the use of automated medication systems and telepharmacy to aid in improving patient safety and eliminating waste. Automated medication systems, including robotic computer systems, that store and package medications, while collecting and maintaining transaction information may be used in hospitals, pharmacies and nursing homes but must be stocked by a pharmacist, pharmacy intern or pharmacy technician. The pharmacist in charge would be responsible for the use and care of the automated medication system. Those using this system must develop and maintain a policy and procedure manual that includes compliance with a quality assurance program.
LB
395: Adopt a new Nebraska Clean Indoor Air Act (statewide smoking ban).
Sponsor: Sen. Joel Johnson – Status: Advanced to Final Reading
NHA position: Support
The original version of LB 395 called for a statewide ban on smoking in public areas and places of employment. It exempted most private residences, some guest rooms/suites, and smoking related research facilities. As the bill advanced, an “opt-out” provision was added that allowed cities and counties to opt-out of the proposed ban.
As lawmakers were faced with a final-round vote with just two days left in the session, the bill’s sponsor, Sen. Joel Johnson, decided to pull it from the agenda because of concerns it could lead to a patchwork of local smoking laws across Nebraska.
Judiciary Committee:
LB
65: Change the Statute of Repose for the Nebraska Hospital-Medical Liability Act.
Sponsor: Sen. Arnie Stuthman – Status: Held in committee
NHA position: Oppose
LB 65 would change the 10 year Statute of Repose for the Nebraska Hospital-Medical Liability Act to 20 years. Currently, any action to recover damages based on alleged professional negligence shall be commenced within two years after the alleged act or omission; provided, if the cause of action is not discovered and could not be reasonably discovered within such two-year period, then the action may be commenced within one year from the date of such discovery; but in no instance may such action be commenced more than 10 (LB 65 would change this to 20) years after the date of rendering or failing to render such professional services.
LB
157: Provide for leaving an infant with a firefighter or hospital staff member.
Sponsor: Sen. Arnie Stuthman – Status: On General File
NHA position: Oppose
This bill proposes to allow parent(s) to anonymously abandon an infant child 72 hours old or younger at a fire station or hospital without risk of prosecution for child abandonment. An on-duty firefighter or hospital employee would be required to accept custody of that child, take the necessary steps to preserve the health and safety of the child and notify law enforcement within four hours.
LB
586: Change medical lien provisions.
Sponsor: Sen. Abbie Cornett – Status: On General File
NHA position: Oppose
When health care services are provided to an injured person, and that person claims damages from a third party, medical liens for those services would be reduced by the discount that would have been applied had the claim been submitted for reimbursement to the injured person’s insurer or health benefit plan. The committee amendment to LB 586 incorporates the provisions of LB 220 which provides chiropractors with the authority to assert a medical lien just as other health care providers would be permitted to do.
Natural Resources Committee:
LB
534: Change provisions relating to urban storm water drainage.
Sponsor: Sen. DiAnna Schimek – Status: Held in committee
NHA position: Oppose
LB 534 would authorize cities to utilize a system similar to water rates and sewer rates for financing storm water management improvements based upon the amount of a property owner’s impervious surfaces – hard surfaces such as parking lots and roofs. In addition to authorizing a user charge to be applied by cities, the bill would also allow county boards to establish storm water management areas and implement storm water management programs. To fund the cost of capital improvements and maintenance costs in a county’s storm water management area, counties could adopt a system of storm water management charges to be charged against real property. Fees would be imposed on the quantity of runoff water, regardless of whether it is clean or contains dirt, fecal matter or other pollutants.
Revenue Committee:
LB
575: Exempt assisted-living facilities from sales and use taxes.
Sponsor: Sen. Lowen Kruse – Status: On General File
NHA position: Support
LB 575 provides a sales and use tax exemption to non-profit, licensed assisted-living facilities. Current law provides nursing homes and intermediate care facilities with a sales tax exemption. By definition, assisted living facilities have replaced intermediate-care facilities and LB 575 is intended to make the necessary changes in statute to provide that tax exempt status to assisted-living facilities.
Transportation Committee:
LB
253: Adopt the Motorcycle Safety and Training Act and change motorcycle helmet provisions.
Sponsor: Sen. Kent Rogert – Status: On General File
NHA position: Oppose
Currently, all motorcycle or moped operators are required to wear protective helmets on Nebraska’s highways. LB 253 would change those provisions. Individuals under the age of 21 would continue to be required to wear a protective helmet while those 21 or older could waive this requirement by successfully completing a motorcycle safety course. Those riders exempt from the helmet requirement would still be required to wear eye protection.
Upon enactment, those operators 21 years of age or older would be exempt from the requirement to wear a protective helmet, provided they wear eye protection and already have a motorcycle license. Those individuals would not be required to carry proof of successful completion of a motorcycle safety course.
LB
401: Provide for notations on drivers’ licenses and state identification cards regarding advance medical directives.
Sponsor: Sen. DiAnna Schimek – Status: Held in committee
NHA position: Support
The goal of LB 401 is to raise awareness of advance medical directives and living wills. The use of advance directives helps medical professionals and families make decisions. This bill would provide for a notice to be placed on the front of a driver’s license, similar to the organ donation designation. This would not be the directive itself, but simply demonstrate that such a document exists.
Interim study resolutions:
Over 120 interim study resolutions were adopted by the Legislature with nearly 50 of them of interest to NHA members. The most significant include:
LR
119: Price Transparency.
Committees: Banking, Commerce and Insurance and Health and Human Services
Purpose: To review the availability of cost estimates in health care pricing and determine the need to carry out legislation to provide good faith estimates of costs by health care providers and insurers to consumers upon request. The Banking, Commerce and Insurance and Health and Human Services Committees will consider input from the Departments of Insurance and Health and Human Services and other interested parties, including insurers and health care providers, as the committees deem necessary and beneficial.
LR
158: Development of voluntary emergency medical personnel.
Committee: Health and Human Services
Purpose: To examine and provide recommendations relating to the development and utilization of voluntary emergency medical personnel to assist in responding to natural disasters or in the event of a flu pandemic. Study recommendations shall include, but not be limited to, consideration of: training and competency, liability, planning and coordination with related federal and state programs.
LR
202: Harmonize Nebraska’s State Children’s Health Insurance Program (SCHIP) with the federal CHIP.
Committee: Health and Human Services
Purpose: Many factors have caused health care premiums to increase dramatically, making it difficult for employers and low- to middle-income families to maintain coverage. This study would review the availability of insurance and types of coverage provided, particularly for jobs with wages that bring families to an income level of at least 200 percent to 400 percent of the poverty level. This review will include the number of employers offering coverage, the types of coverage offered, the cost to employees, the number of Nebraskans not employed by employers offering affordable coverage, and the number of those households that have children.
LR
203: Examine Nebraska’s statewide behavioral health services.
Committee: Health and Human Services
Purpose: In 2004, Nebraska reformed its delivery of behavioral health services, moving those services from regional centers to community-based sites and increasing the focus on recovery, thereby requiring providers to have new competencies and the state to “promote activities in research and education to improve the quality of services, the recruitment and retention of behavioral health professionals, and the availability of behavioral health services”. The U.S. Department of Health and Human Services currently designates over 95 percent of Nebraska’s counties as Mental Health Professional Shortage Areas. Further, 90 of the 93 counties are designated as Psychiatric Shortage Areas. The purpose of this study is to examine the need for a statewide behavioral health workforce development plan and adequate funding to implement the plan.
LR
205: Evaluate the Nebraska Behavioral Health Services Act.
Committee: Health and Human Services
Purpose: To conduct additional research and provide for the development of additional recommendations and the possible introduction of appropriate legislation in the 2008 legislative session relating to the implementation of LB 1083 passed in 2004 and the Nebraska Behavioral Health Services Act. This study will be conducted in consultation with the Department of Health and Human Services and the Division of Behavioral Health Services.
LR
207: Analyze the Medicaid Reform Plan and the Medical Assistance Act.
Committee: Health and Human Services
Purpose: To conduct additional research and provide for additional recommendations and the possible introduction of appropriate legislation in the 2008 legislative session relating to the implementation of the Medicaid Reform Plan and the Medical Assistance Act. This study will be conducted in consultation with the Governor and the Department of Health and Human Services.
For more information about these or any other bills or resolutions, contact: Bruce Rieker, vice president, advocacy at (402) 742-8146 or brieker@nhanet.org.
The NHA staff thanks everyone who participated in the development of public policy during the 2007 legislative session. Your efforts of attending NHA meetings, participating in conference calls, and contacting policymakers to advocate a position on behalf of Nebraska’s hospitals are invaluable. Together we are the influential voice for health care.
Throughout the 2008 legislative session, hospitals will need “champions” in the Legislature to deal with Medicaid, workers’ compensation, behavioral health reform, and all other issues that impact the operations and success of hospitals. Hospitals must be prepared for discussions vital to the communities they serve and to the mission of hospitals across the state. Later this year you will receive
NHA 2008 Advocacy Strategies —Engage, Educate and Empower. This free resource will be a handy guide book intended to reinforce your grassroots advocacy efforts. For more information, contact the Nebraska Hospital Association at (402) 742-8140.
NHA Rotunda Review is published by the Nebraska Hospital Association, 3255 Salt
Creek Circle, Lincoln, NE 68504. Phone (402) 742-8140, Fax (402) 742-8191. Visit our Web site at
http://www.nhanet.org. Christy Rasmussen, editor, at
402/742-8151, or email, crasmussen@nhanet.org.
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