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Eighteen working days remain in this year's legislative
session. Scheduled adjournment is on April 17. Speaker Mike Flood has told senators that the session priorities are
the budget and legislation with “major public policy implications.” The
Legislature spent much of last week debating priority bills – most of which are
still on General File.
This week, senators began debating the
budget. Even though the state is in the middle
of a two-year budget cycle and most of the major decisions on the $6.8 billion
budget were made last session, lawmakers must decide this session how to
reconcile a $62 million budget shortfall that has resulted following a recent
revision of the state revenue forecast.
To ensure adequate time for the Legislature to address the
budget and priority bills, Speaker Flood has released his late night schedule
for the remainder of the session. Under the Speaker’s schedule, beginning March
25, the Legislature will work into the evening each night other than the last
day of the week. Late nights will last until 8:30 p.m. or later.
— Nebraska Chamber of Commerce Legislative Report, March 14,
2008.
New law changes medical lien provisions
Governor Dave Heineman signed LB 586 into law on March 10. The
law became effective immediately. As written, LB 586 states that when health
care services are provided to an injured person and that person claims damages
from a third party, medical liens for those services will be reduced by the
discount that would have been applied had the claim been submitted to the
injured person's insurer or health benefit plan for reimbursement. For more
information about LB 586,
click here. For further information on how this bill will affect your
hospital, contact David Burd, NHA's senior director of finance, at 402/742-8144
or dburd@nhanet.org.
Bills of interest to NHA members advance
The following "bills of interest" to NHA members have advanced
this month. Behind each bill number and description are the NHA's position and
the bill's current status.
LB 765 — Change provisions relating to certificates of need
NHA position: Monitor Status: Select File
LB 797 — Change provisions relating to Health and Human Services
NHA position: Monitor Status: Final Reading
LB 809 — Change provisions relating to metabolic screening
NHA position: Oppose Status: General File
LB 811 — State intent to appropriate $5 million to the public
transportation assistance program under the Nebraska Public Transportation Act
NHA position: Monitor Status: General File
LB 884 — Change provisions relating to the practice of pharmacy
NHA position: Monitor Status: General File
LB 889 — Provide construction alternatives for political
subdivisions
NHA position: Support Status: Select File
LB 902 — Change provisions relating to controlled substances schedules
and inventory
NHA position: Monitor Status: Select File
LB 948 — Adopt the Volunteer Emergency Responders Job Protection
Act
NHA position: Support Status: General File
LB 954 — Change provisions relating to HIV testing
NHA position: Support Status: General File
LB 960 — Appropriate funds for employee pay and benefits
NHA position: Monitor Status: General File
LB 962 — Change public body meeting provisions of the Open
Meetings Act
NHA position: Monitor Status: Final Reading
LB 1048 — Provide for issuance of birth certificates for
stillbirths
NHA position: Monitor Status: Select File
LB 1092 — Require seat belts on school buses
NHA position: Monitor Status: Select File
LB 1108 — Change licensure requirements for mental health practitioners
NHA position: Monitor Status: Select File
Bill would clarify certificate of need provisions
The Legislature gave first-round approval March 12 to a bill that
would clarify provisions relating to certificates of need (CON) for
rehabilitation and long-term care beds in Nebraska. Papillion Sen. Tim Gay said
he introduced LB 765 to clarify differing interpretations of current law
regulating Nebraska health care facilities’ ability to expand these two
categories of beds. Current law stipulates that a certificate of need is
required before a health care facility can increase long-term care or
rehabilitation beds by more than 10 percent of total bed capacity or ten beds,
whichever is less, over a two-year period.
Gay explained that since the passage of the 1997 law regulating
CON for these two categories of beds, the state Department of Health and Human
Services (DHHS) has interpreted the law to apply to the total long-term care bed
capacity or the total rehabilitation bed capacity, not the total bed capacity of
the entire facility. In a 2006 lawsuit, however, the court interpreted the
stipulation to mean the facility’s total bed capacity, Gay said.
A committee amendment, adopted 33-2, redrafted the bill
technically to divide the provisions relating to long-term care beds and
rehabilitation beds. Bayard Sen. Philip Erdman said that DHHS has interpreted
the law exactly as drafted in the amendment and that the Legislature has the
right to restore the previous interpretation of a law when the courts change it.
“We have the opportunity to respond,” he said. “LB 765 does
that.” Malcolm Sen. Carol Hudkins said the bill would restrict an entity’s
ability to expand services and bed capacity based on changes in the market. She
said existing facilities frequently reject referral patients who lack insurance
and those with complex medical histories or difficult family dynamics. Lawmakers
should ask themselves how the bill improves patient care, Hudkins said.
Scottsbluff Sen. John Harms expressed concern that the bill would
negatively impact rural health care facilities. Hospitals are critical to most
communities in rural America, Harms said, adding that Regional West Medical
Center is the single largest employer in his district. “I don’t want to exclude
these rural hospitals from growth,” he said.
But Kearney Sen. Joel Johnson noted that no rural hospitals
testified against the bill in committee. The bill’s provisions cover a very
small number of cases that require extraordinary services, he said, and those
services can be provided only by top quality staff in a very limited number of
facilities. In virtually all cases society is better served by open competition,
Johnson said, but not in this case.
Gay agreed, saying the bill allows limited expansion while
containing costs and ensuring quality of care. “This does not prevent growth,”
he said. “It’s controlled growth.” LB 765 advanced to select file 31-3.
— Nebraska Unicameral Update Online, March 12, 2008.
Appropriations Committee proposes budget changes
The Appropriations Committee released its budget adjustment
recommendations March 12.
The state budget is structured on a two-year basis, with the
budget enacted during legislative sessions held in odd-numbered years. Sessions
in even-numbered years fall during the midpoint of the budget cycle and are used
to make adjustments to the two-year budget.
The committee report proposes adjustments that would increase
general fund appropriations overall by $14.5 million through fiscal year
2008-09. Among the increases are:
$52.9 million for state aid to schools; $20 million for the
one-time replacement cost of the university and state college student
information system; $3.9 million for state employee health insurance; $3 million
for developmental disability provider rate increases; and $2.6 million for
behavioral health provider rate increases.
— Nebraska Unicameral Update Online, March 12, 2008.
Bill would prohibit doctors from marking up some lab tests
To Lincoln Sen. Tony Fulton, an ongoing dispute between two
medical specialties has a simple solution. Dermatologists should not be allowed
to mark up the cost of a lab test performed by pathologists. It might be good
for business, but it’s not good for medicine, he said.
And, it’s unethical, according to the American Medical
Association’s Code of Ethics. Fulton has waded into the issue again this
session, after a stalled attempt last year to end the mark-up practice of some
doctors, especially dermatologists. His bill (LB 1104) would prohibit marking up
a charge for anatomic lab tests, such as biopsies or pap smears, when the doctor
did not directly supervise or perform the lab service. Fulton calls the mark-up
an additional arbitrary and unnecessary cost for services rendered by someone
other than the doctor who ordered the test.
Read the full article.
— JoAnne Young, Lincoln Journal Star, March 17, 2008.
Bill would create birth certificate for stillborns
OMAHA — At her 37-week checkup, all was fine with Patricia Hill’s
pregnancy. But three days later, the baby boy she was carrying was dead and
doctors had to induce labor so she could deliver his body. “It was a beautiful
birth,’’ said Hill, a slight crack in her voice. “It was exactly what I wanted
except for that one crucial part — my son had died.’’
Hill, who gave birth to her stillborn son, Myles, on Nov. 24,
would later learn there was something else missing: a birth certificate.
Instead, she got a death certificate. Now, the 27-year-old Lincoln woman is
championing state legislation that would create a birth certificate for
stillbirth. If approved, parents of babies who die in the womb after 20 weeks
gestation may request a special birth certificate in addition to the death
certificate.
Hill said, “It’s only fair that these births are recognized. His
birth was everything to me.’’ About 25,000 pregnancies result in stillbirth in
the U.S. each year, according to the Centers for Disease Control and Prevention
(CDC). The cause is often unknown, but could be attributed to birth defects,
problems with the placenta or umbilical cord, or the mother’s health.
Read more.
— Timberly Ross, Associated Press, March 15, 2008.
Bill would make seat belts standard on school buses
It’s been argued for years. Is it safer to belt kids into school
buses? Or are they safe just the way they are in buses built to
“compartmentalize” them in well-anchored seats with high backs and good padding,
with wide aisles and the ability to absorb energy when kids are crashing around?
Sen. John Harms of Scottsbluff argued last week for the seat belts. And 32 other
senators agreed, advancing a bill (LB 1092) that would require school districts
to buy buses with seat belts as they add to their fleets.
Compartmentalization, Harms said, is overrated. Senators didn’t
seem to need too much convincing about the safety issue, but they did have
questions about the cost to school districts and how a district decides which
kids get to ride in the buses with and without seat belts during the years they
have both. Some of the senators were concerned about yet another unfunded
mandate for districts – the thing their constituents seem to fuss about most.
Harms estimated that seat belts could add up to $10,000 to the price of a new
school bus, which already cost more than $60,000. Property tax payers would
likely foot the bill for the increased costs.
Read the full article.
— JoAnne Young, Lincoln Journal Star, March 11, 2008.
Recession fears affect some lawmakers’ view of Super Advantage bill
(Lincoln Journal Star) — Senators on the Legislature's Revenue
Committee are looking at cutting back some of the benefits for one of Gov. Dave
Heineman's priorities, a bill to provide incentives to bring higher-paying jobs
to Nebraska. "This bill doesn't have a prayer unless we make some adjustments,"
Omaha Sen. Tom White said as the committee looked at potential changes to the
Super Advantage bill (LB 895). Said Sen. Abbie Cornett of Bellevue: "It's dead
the way it is. And it may be dead even if we fix it." Committee Chairman Sen.
Ray Janssen of Nickerson said the concern is the future cost of the bill:
Nebraska would lose an estimated $13 million a year in state tax revenue
starting in 2012.
To qualify for the incentives, companies would have to create
jobs that pay at least 150 percent of the state average wage, or 200 percent of
the average wage in the county where the job is located, whichever is greater.
The average state wage is $33,800. That means companies would have to create
jobs paying at least $50,700. The committee is considering several changes,
including reducing the credit allowed, sunsetting the bill after five years,
reducing the entitlement period and eliminating the ability of companies to use
the credit against property taxes. Senators said they will look at the issue
again this week after they get estimates on what the savings might be if they
change the bill.
— Nebraska Chamber of Commerce Daily Update, March 10, 2008.
Bill would provide construction alternatives for political subdivisions
Senators advanced a measure March 12 that would allow some
political subdivisions to utilize construction alternatives for certain public
projects. LB 889, sponsored by Norfolk Sen. Mike Flood, would broaden the
Nebraska Schools Construction Alternatives Act to allow political subdivisions
to enter into design-build or construction management at risk contracts. Flood
said escalating construction costs and compressed time schedules have allowed
for the growth of these alternative construction delivery methods. The bill
resulted from a desire by community and state colleges to use these alternative
methods, he said. A committee amendment, adopted 34-0, would narrow the
political subdivisions authorized to use the act to counties, cities, villages,
school districts and community and state colleges.
Read more.
— Nebraska Unicameral Update Online, March 12, 2008.
Nebraska governor signs bill allowing more info on state wards
LINCOLN — A bill was signed into law Monday to allow Nebraska
Department of Health and Human Services (DHHS) officials to release more
information to the public when a child is hurt or killed in foster care. In
signing the measure, Gov. Dave Heineman praised Legislative Bill 782, introduced
by State Sen. Gwen Howard of Omaha, for striking a balance between open
government and appropriate levels of confidentiality for foster children.
"This greater transparency will increase confidence and
accountability in the work of the department in fulfilling its role of
protecting the children of Nebraska," Heineman said.
The bill is not retroactive. Had it been in place last year,
it would have allowed state officials to provide more information about the care
given Von Maur killer Robert Hawkins while he was a state ward, and more
information about the case of Davion Winrow, a 1-year-old state ward who died
last year.
A former state ward, Joleet "Joey" Poole, was caring for
Davion on the day of his death and was charged with felony child abuse resulting
in death.
The new law, which takes effect immediately, would let DHHS
officials reveal why a child was taken from his or her family and placed in
foster care, the foster homes or other locations, plus the services provided to
the child. The information can be provided in situations that meet at least one
of the following criteria:
• The abuse or neglect suspect has been charged with a crime
relating to the child.
• Some information about the case already has become public.
• The case involved a child's death or near-death.
• A child is missing from his or her foster home or other
placement location.
— Leslie Reed, Omaha World-Herald, March 11, 2008.
For more information about health-related legislative bills or resolutions, contact: Bruce Rieker, vice president, advocacy at (402) 742-8146 or brieker@nhanet.org.
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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