Rural Advocacy is fighting for healthy people, healthy communities, and a healthy environment. We believe that the State of Nebraska can spend tax payer money more effectively by investing public resources in and focusing public policy towards initiatives that prevent illness, mortality, disability, and mental health problems among Nebraska rural population.
NeRHA’s 2012 Legislative Agenda
NeRHA Board Approved Positions
(Click on the bill number to get the latest status of the bill)
Support:
LB788 Campbell Change respiratory care practice requirements (In Committee)
Sections 38-3214 and 38-3215 require respiratory care services to be provided under the direction of a physician. This requirement does not reflect a regulatory change by the Centers for Medicare and Medicaid Services which affects the conditions for participation in these federal programs. LB 788 would amend Sections 38-3214 and 38-3215 to allow nurse practitioners and physician assistants to order respiratory services, provided that it is a part of their respective practice acts, is authorized by the hospital’s by-laws, and is in accordance with the hospital’s policies and procedures and state law.
LB825 Dubas Establish local offices for access to public benefit programs (In Committee)
To better serve applicants for public assistance benefits with access to direct contact with case workers in local offices. To provide “storefronts” for Access Nebraska, staffed by case workers, to assist in filing applications for public assistance benefits. Many applicants are elderly or disabled and are unable to use the automated telephone service and online application.
LB826 Dubas Change provisions relating to legislative consideration of proposed rules and regulations under the Medical Assistance Act (In Committee)
LB826 responds to concerns over cuts in Medicaid services and changes to policies without Legislative approval.
LB831 Howard Adopt the Genetic Counseling Practice Act (General File)
This bill would adopt the Genetic Counselors Licensing Act. With this legislation, Nebraska would provide a mechanism for licensure of individuals who have satisfied the training and certification requirements of the National Board of Genetic Counseling. Licensure would be housed under the Department of Health and Human Services, Public Health, Licensure; the Board of Medicine and Surgery would be charged with oversight of the licensing process. The legislation seeks to protect Nebraska’s residents by insuring that individuals performing this form of health counseling are appropriately trained.
The bill will not preclude other licensed health care providers from offering genetic counseling and genetic services within their own scopes of practice, but will prevent untrained or insufficiently trained individuals from claiming to be “genetic counselors.”
LB834 Gloor Changethe Nebraska Regulation of Health Professions Act
LB 834 expands the range of groups and individuals that come under the Act so that all professions which are or could be regulated by HHS are subject to review through the 407 process. This means that professions like nail technicians, funeral directors and veterinarians will now be eligible to apply for a change in scope of practice through the credentialing review process, commonly known as the “407” process. The Department has had requests for a 407 type review of such professions but does not have the statutory authority to do so. This bill gives them that authority. This bill retains the criteria for regulating new professions in Section 71-6221(1) and (2), but eliminates confusing and superfluous language. In the scope of practice criteria in Section 71-8221(3), the requirement that an applicant group must show that the current situation creates a“risk of harm” is removed but an applicant group must still show that the change does not create a new harm or danger to the public. The scope-of-practice criteria also require consideration of the benefit the change in scope of practice would bring to the public and what education and discipline are in place. Expanding the law to cover all groups that are or could be regulated by the Division of Public Health eliminates the need for a separate fund to support the credentialing review process. Therefore, the bill transfers money from the Nebraska Regulation of Health Professions Cash Fund that currently pays for expenses of the 407 process, to the Professional and Occupational Credentialing Cash Fund from which the administrative costs for all credentialing activity is paid.
LB835 Nordquist Adopt the Nebraska Health Benefit Exchange Act (In Committee)
This bill creates the Nebraska Health Insurance Benefit Exchange allowed under the federal Patient Protection and Affordable Care Act. LB 835 also changes the distribution of insurance premium tax revenue and provides an exemption from the State Personnel System.
LB958 Howard Provide for appropriations to the Nursing Faculty Student Loan Act (In Committee)
LB925 Fischer Referral Provide duties for the Department of Health and Human Services relating to contracts with providers under Budget Program No. 514, Health Aid (In Committee)
LB952 Nordquist Change appropriation provisions relating to the medical assistance program (In Committee)
It is the intent of LB 952 to prohibit the implementation of cuts to the Medicaid program proposed by the Department of Health and Human Services on December 1st in accordance with Nebraska Revised Statutes § 68-909 for the remainder of the 2011-2013 biennium budget. LB 952 prohibits the implementation of the following changes to the Medicaid program:
1. An increase in copayments on physical, speech, and occupational therapies;
2. An increase in copayments for nonemergency visits to the emergency department;
3. A limit of two hundred forty hours per year of home health services;
4. The elimination of private duty nursing services;
5. An increase in the level of care required to receive personal assistance services;
6. A limit for personal assistance services to three and one-half hours of service per day with a sixty-hour limit per month;
7. The elimination of oral nutritional supplements provided through the durable medical equipment program;
8. A limit to behavioral health therapy visits of sixty visits per year;
9. The elimination of dental services, including dentures, for adults;
10. The elimination of chiropractic services;
11. The elimination of eyeglasses for adults;
12. The elimination of hearing aids for adults;
13. The elimination of occupational therapy for adults; 14. The elimination of physical therapy for adults;
15. The elimination of speech therapy for adults;
16. A limit of prescription drugs to ten per month for adults;
17. A limit of inpatient hospital days to forty-five days or thirty days per year for adults; and,
18. A limit of physician visits for adults to twelve per year, excluding pregnancy-related visits.
LB1042 Campbell Authorize nurse practitioners to sign death certificates (In Committee)
LB 1042 is intended to authorize nurse practitioners to sign death certificates. Nurse practitioners can be primary care providers. In the event a nurse practitioner’s patient passes away, current law does not allow the nurse practitioner to sign the death certificate, even if the deceased was his or her patient for many years. Statute requires the medical portion of the death certificate to be signed by a physician or physician assistant within 24 hours of the death. If neither is available, the county attorney must be notified. This can make a difficult time for a family even more stressful.
LB1055 Hadley Appropriate funds for a Kearney Division nursing and allied health professions facility (In Committee)
LB1055 seeks an appropriation in the amount of $19,000,000, from the General Fund for FY2012 -13, to be made to the Board of Regents of the University of Nebraska for the construction of a new Kearney Division facility and related improvements for the University of Nebraska Medical Center College of Nursing and University of Nebraska Medical Center School of Allied Health Professions. LB1055 further declares that an emergency exists and that the act takes effect when passed and approved according to law.
LB1065 Fulton Appropriate facility construction funds for the Lincoln Division of the University of Nebraska Medical Center College of Nursing (In Committee)
LB1065 provides for a one -time General Fund appropriation of seventeen million dollars to the University of Nebraska Board of Regents to be used for new construction of a Lincoln Division of the University of Nebraska Medical Center College of Nursing. Expansion of the College of Nursing is a needed to help overcome Nebraska’s nursing shortage.
LB995 Heidemann Change provisions relating to county medical facilities and public hospitals (In Committee)
LB 995 updates and consolidates the statutes pertaining to county hospitals. By giving county hospitals more flexibility, the bill attempts to bring county hospitals more in line with their peer hospitals. LB 995 would authorize county hospital boards to obtain a line of credit or borrow money secured by the facility or its revenues, replacing the outdated warrant system currently in statute. The bill also gives county hospitals the authority to encumber hospital property, it would require county board approval if the sale, lease, exchange or encumbrance is of all or substantially all of the county hospital’s property.
Under LB 995, county hospital boards would have to receive approval from the county board, but not a vote of the people, for any improvements or additions to their facilities if the total cost is greater than 50% of the replacement cost of the facility. If general obligation bonds are to be used to build a new or replacement hospital, a public vote would still be required. LB 995 amends the County Purchasing Act to remove purchases of personal property or services by county hospitals, thereby allowing them to participate in group purchasing organizations. The bill also authorizes county hospitals to open clinics in communities outside of their jurisdiction, as currently allowed for hospital districts and nonprofit hospitals.
NeRHA’s 2011 Carryover Legislative Agenda
NeRHA Board Approved Positions
(Click on the bill number to get the latest status of the bill)
Support:
LB40 Hadley Change a sales tax exemption for health clinics (General File)
Corrects a technicality in current state statues that imposes a sales and use tax on rural health clinics. LB 40 strikes the word “two” in Neb. Rev. Stat. section 77-2704.12(1)(e)(ii) and replaces it with the word “one”, so that a sales tax exemption would be created for “any nonprofit” “health clinic when one or more hospitals or the parent corporations of the hospitals own or control the health clinic for the purpose of reducing the cost of health services or when the health clinic receives federal funds through the United States Public Health Service for the purpose of serving populations that are medically underserved.
LB51 Krist Require health clinics to have patient transfer agreements (Laid Over – March 9, 2011)
Legislative Bill 51 requires health clinics to have a patient transfer agreement in effect with a local hospital licensed under the Health Care Facility Licensure Act, establishes criteria necessary for the hospital to accept patients from health clinics, and allows clinical privileges for the physicians performing surgery at the health clinic. It, also, requires that a patient transfer agreement address procedures for appropriate transfer of patients, continuity of care, and support for maintaining emergency capacity, including on-call coverage. LB 51 requires a health clinic, prior to being licensed under the Health Care Facility Licensure Act, to have a patient transfer agreement in effect with a local hospital.
LB240 Nordquist Create the Nebraska Insurance Choices Exchange Task Force (In Committee)
It would create the Nebraska Insurance Choices Exchange Task Force to oversee development and implementation of the new health insurance exchange.
LB646 Christensen Redefine emergency medical service – removes the word “immediate” from the definition of Emergency medical service (General File)
Oppose:
LB52 Krist Change motorcycle helmet provisions and require eye protection (In Committee)
