2 015 legislative review nhca legislative review

TABLE OF CONTENTS

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NALA Government Relations Committee ...... 1 NNFA Government Relations Committee ...... 1 LPNAN Legislative Committee ...... 1 Introduction ...... 2 The 104th ...... 3 Bills of Interest Signed into Law ...... 4-6 Bills of Interest Withdrawn ...... 7 Bills of Interest to be Carried Over to 2016 Session ...... 8-15 2015 Interim Study Resolutions ...... 16-17 LR 181 ...... 18-19 Aging Nebraskans Task Force ...... 20 Advocacy is a Year-Round Process ...... 21

June 2015 nehca.org nhca legislative review

nebraska nursing facility association NALA GOVERNMENT RELATIONS COMMITTEE nebraska Deb Welk, Chair, Immanuel Communities, Omaha assisted living association Kelly Anderson, Golden LivingCenter – Sidney, Sidney John Croghan, The Landing at Williamsburg Village, Lincoln nebraska Dee Fritz, The Evergreen, O’Neill health care learning center Terrence Hoffman, Wakefield Health Care Center, Wakefield Mark Iverson, Immanuel Village, Omaha licensed practical nurse Dawn Jacobs, Golden LivingCenter – Scottsbluff, Scottsbluff association of nebraska Barb Nuxoll, Stone Hearth Estates, Gothenburg Jayne Prince, The Willows, Neligh Sandra Whitley, Ensign Facility Services, Mission Viejo, Calif. nebraska hospice & Melissa VanDeWalle, Golden LivingCenter – Fullerton palliative care association Linda Zinnell, Seneca Sunrise, Ravenna Ex Officio, Carol Ernst, Eastmont Towers Community, Lincoln nebraska Ex Officio, Heath Boddy, Nebraska Assisted Living Association health care foundation NNFA GOVERNMENT RELATIONS COMMITTEE Shari Terry, Chair, Vetter Health Services, Elkhorn Linda Anderson, Countryside Home, Madison Jalene Carpenter, South Haven Living Center, Wahoo Sharon Colling, Lantern Health Services, Waverly Dianna Epp, Good Samaritan Society – Syracuse, Syracuse Amy Fish, Lancaster Rehabilitation Center, Lincoln Pamela Griffin, Birchwood Manor, North Bend Dawn Jacobs, Golden LivingCenter – Scottsbluff, Scottsbluff Mitch Jevne, The Ambassador Omaha, Omaha Charliss Marshall, Sunrise Country Manor, Milford Theresa Parker, Southeast Community College, Lincoln Roy Schneider, Duff Memorial Nursing Home, Nebraska City Melissa VanDeWalle, Golden LivingCenter – Fullerton Sandra Whitley, Ensign Facility Services, Mission Viejo, Calif. Ex Officio, John Turner, Immanuel Fontenelle, Omaha Ex Officio, Heath Boddy, Nebraska Nursing Facility Association LPNAN LEGISLATIVE COMMITTEE Maxine Guy, Chair, Omaha Janet Andrew, Auburn Tim Summerlin, Lincoln Judy Wolverton, Omaha

June 2015 - 1 - nehca.org nhca legislative review

INTRODUCTION

The Nebraska Health Care Association’s legislative agenda is directed by our members. The legislative bills listed and described in this report are those for which the Nebraska Nursing Facility Association and the Nebraska Assisted Living Association’s Government Relations Committees and the Licensed Practical Nurse Association of Nebraska’s Legislative Committee recommended official positions. These committees are comprised of individual members of each association.

2015 marked the opening session for the 104th Legislature. It was a 90-day session that convened on Wednesday, Jan. 7, 2015, and adjourned sine die one day early on May 29, 2015. The term sine die means without setting a future date for reconvening. In other words, they could be called back into a special session by the Governor or two-thirds (33) of the Legislature before next January, if necessary.

This year, 663 legislative bills were introduced; and each one was heard by the proper standing committee. NHCA staff and representatives from its family of associations testified before four standing committees on 14 separate issues and monitored an additional 29 bills. As you might guess, many other bills did not require testimony, but did require behind-the-scenes work with policy makers, their staff, and other stakeholders.

This year, the Nebraska Health Care Association’s top legislative priority was securing an increase in Medicaid provider rates. NHCA lobbied the Legislature for a larger increase than the 2 percent initially proposed by Gov. Pete Ricketts and successfully secured a 2.25 percent increase in the version of the budget that was passed and signed into law. We were very fortunate to once again have such a good session – but it would not have been possible without the engagement and strong support of the membership. THANK YOU!

June 2015 - 2 - nehca.org NEBRASKA’S 104TH LEGISLATURE

Dist. Senator Hometown Year Appointed Year Elected Years Re-elected Term Limited 17 Bloomfield Hoskins 2010 2012 N/A 2016 25 Campbell Lincoln 2008 2012 2016 27 Coash Lincoln 2008 2012 2016 13 Cook Omaha 2008 2012 2016 35 Gloor Grand Island 2008 2012 2016 21 Haar Malcolm 2008 2012 2016 37 Hadley Kearney 2008 2012 2016 39 McCoy Omaha 2008 2012 2016 5 Mello Omaha 2008 2012 2016 7 Nordquist Omaha 2008 2012 2016 47 Schilz Ogallala 2008 2012 2016 41 Sullivan Cedar Rapids 2008 2012 2016 16 Brasch Bancroft 2010 2014 2018 8 Harr Omaha 2010 2014 2018 10 Krist Omaha 2009 2010 2014 2018 40 Larson O’Neill 2010 2014 2018 22 Schumacher Columbus 2010 2014 2018 14 Smith Papillion 2010 2014 2018 29 Bolz Lincoln 2012 2020 11 Chambers Omaha 2012 1970, 1972, 1976, 1980, 1984, 2020 1988, 1992, 1996, 2000, 2004 45 Crawford Bellevue 2012 2020 43 Davis Hyannis 2012 2020 9 Howard Omaha 2012 2020 23 Johnson Wahoo 2012 2020 31 Kolowski Omaha 2012 2020 49 Murante Gretna 2012 2020 33 Seiler Hastings 2012 2012 2020 19 Scheer Norfolk 2012 2020 15 Schnoor Scribner 2014 N/A 2020 1 Watermeier Syracuse 2012 2020 30 Baker Lincoln 2014 2022 6 Craighead Omaha 2014 2022 32 Ebke Crete 2014 2022 34 Friesen Henderson 2014 2022 3 Garrett Bellevue 2013 2014 2022 42 Groene North Platte 2014 2022 26 Hansen Lincoln 2014 2022 4 Hilkemann Omaha 2014 2022 44 Hughes Venango 2014 2022 2 Kintner Papillion 2012 2014 2022 24 Kolterman Seward 2014 2022 38 Kuehn Heartwell 2014 2022 18 Lindstrom Omaha 2014 2022 20 McCollister Omaha 2014 2022 46 Morfeld Lincoln 2014 2022 28 Pansing Brooks Lincoln 2014 2022 12 Riepe Omaha 2014 2022 48 Stinner Gering 2014 2022 36 Williams Gothenburg 2014 2022

June 2015 - 3 - nehca.org nhca legislative review – bills of interest signed into law

BILLS OF INTEREST SIGNED INTO LAW In Numerical Order

LR 33: Provide the Executive Board appoint a special committee to be known as the ACCESSNebraska Special Investigative Committee of the Legislature Sponsor: Bob Krist (Omaha, LD 10) NNFA/NALA Position: Support Effective Date: March 2, 2015 This resolution authorized the continuation of the ACCESSNebraska Special Legislative Committee of the Legislature, which was originally established in 2014. This special committee will provide legislative oversight of the continual improvement of the ACCESSNebraska system.

LB 37: Adopt the Prescription Drug Safety Act and change and transfer pharmacy, prescription and drug provisions Sponsor: Bob Krist (Omaha, LD 10) LPNAN Position: Monitor NNFA/NALA Position: Monitor Effective Date: Aug. 30, 2015 This bill created the Prescription Drug Safety Act to provide rules for the prescribing, storage, dispensing, and record keeping of noncontrolled prescription drugs. The bill updated many provisions and definitions within the Pharmacy Practice Act and deleted outdated language and unnecessary references. It also transferred language from the Drug Product Selection Act provisions into the Pharmacy Practice Act and added sections relating to hospital pharmacy, compounding and reconstitution requirements and standards, prescription and chart orders, electronic prescribing requirements, and pharmacist supervision of technicians and pharmacist interns. Lastly, it removed the requirements for written control procedures for pharmacy technicians, harmonized statutes found throughout the various pharmacy acts, and required certification of pharmacy technicians by Jan. 1, 2017.

LB 90: Change provisions for directed review under the Nebraska Regulation of Health Professions Act Sponsor: Kathy Campbell (Lincoln, LD 25) LPNAN Position: Monitor Effective Date: Aug. 30, 2015 LB 90 simply permits the chairperson of the Health and Human Services Committee, in consultation with the committee members, to ask for a directed review of regulation of a profession or scope of practice.

LB 107: Eliminate integrated practice agreements and provide for transition-to-practice agreements for nurse practitioners Sponsor: (Bellevue, LD 45) LPNAN Position: Monitor NNFA/NALA Position: Monitor Effective Date: Aug. 30, 2015 LB 107 removed barriers to entry and accreditation for nurse practitioners in Nebraska. It was the reintroduction of the nurse practitioner bill that easily passed through the Legislature in 2014, only to be vetoed by former Gov. Heineman at the last minute. This year, the Legislature quickly passed the bill, and Gov. Ricketts wasted no time in signing it.

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LB 129: Require criminal background checks for applicants for an initial nursing license Sponsor: Burke Harr (Omaha, LD 8) LPNAN Position: Monitor NNFA/NALA Position: Monitor Effective Date: Aug. 30, 2015 This bill simply requires criminal background checks for new nursing license applicants, at their own expense.

LB 264: Provide for issuance of credentials under the Uniform Credentialing Act based on military education, training or experience Sponsor: (Lincoln, LD 46) LPNAN Position: Monitor NNFA/NALA Position: Monitor Effective Date: Dec. 15, 2015 This new law will permit boards to accept military experience toward the minimum standards for credentialing.

LB 315: Change provisions relating to Medicaid recovery audit contractors Sponsor: (Omaha, LD 9) NNFA/NALA Position: Support Effective Date: Aug. 30, 2015 LB 315 sets forth guidelines for Recovery Audit Contractors when conducting audits required by the Affordable Care Act. These guidelines ensure that audits are not onerous and overreaching for providers. Of note, the bill provides for payments to providers for any underpayment identified during such audits.

LB 320: Adopt the Aging and Disability Resource Center Act Sponsor: (Lincoln, LD 29) LPNAN Position: Monitor NNFA/NALA Position: Support Effective Date: May 27, 2015 The intent of LB 320 is to create Aging and Disability Resource Centers, which would serve as information clearinghouses for older and disabled Nebraskans and their family members. Information and services provided would include, but not be limited to: information and referral, options counseling, streamlined eligibility determination for public programs, person-centered transition support when moving from one setting to another (such as when an individual moves from a hospital back into a home setting), strategic partnerships with providers, and quality assurance. Portions of LB 405 were amended into this bill before it was passed, and the term of service of the Aging Nebraskans Task Force was extended six months to Jan. 1, 2017.

LB 366: Change the personal needs allowance under the Medical Assistance Act Sponsor: (Lincoln, LD 28) NNFA/NALA Position: Support Effective Date: Aug. 30, 2015 The intent of LB 366 was to raise the personal needs allowance for Medicaid eligible aged, blind and disabled persons from at least $50 to at least $75 per month. The bill was amended during debate to lower the increase to at least $60.

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LB 390: Provide for medical use of cannabidiol and naloxone and change controlled substances schedules and transfers to the Nebraska Health Care Cash Fund Sponsor: Sue Crawford (Bellevue, LD 45) LPNAN Position: Monitor Effective Date: May 27, 2015 This bill was one of two introduced this year that dealt with medical marijuana. LB 390 provides access to cannabidiol oil, or CBD oil, to patients with intractable epilepsy who are under the care of a neurologist at the University of Nebraska Medical Center.

LB 452: Provide advertising requirements under the Uniform Credentialing Act Sponsor: Bob Hilkemann (Omaha, LD 4) LPNAN Position: Monitor NNFA/NALA Position: Monitor Effective Date: Aug. 30, 2015 LB 452 creates a baseline by which all health occupations and professions regulated under the Uniform Credentialing Act can follow as a guide in their health care advertisements. This basis would help streamline and standardize health care advertisements and result in less patient confusion. The bill is intended to assure that patients have accurate information about the credentials of the health care providers they select for their medical care.

LB 607: Adopt the Home Care Consumer Bill of Rights Act* Sponsor: Heath Mello (Omaha, LD 5) LPNAN Position: Monitor Effective Date: May 27, 2015 LB 607, as introduced, would have created the Home Care Consumer Bill of Rights to protect the rights of individuals who receive in-home care services. However, it was amended to become an entirely different bill. Sen. Heath Mello agreed to the amendment in order to allow for a compromise on aid to dependent children – an issue initially addressed by LB 89, a bill that was vetoed by Gov. Ricketts. In his veto message, the Governor indicated that he would sign a compromise bill with a sustainable solution. Senators responded with the new, amended version of LB 607. Sen. Mello plans to reintroduce a Home Care Consumer Bill of Rights Act next year.

*After the bill was amended, the one-liner was changed to: “Change provisions relating to aid to dependent children and create the Intergenerational Poverty Task Force.”

LB 657: Appropriate funds for state government expenses Sponsor: Speaker Hadley (Kearney, LD 37), at the request of the Governor Effective Date: May 20, 2015 This was the mainline budget bill for the biennium that begins July 1, 2015, and ends on June 30, 2017. It included the budget recommendations for all state operations and aid programs. Most importantly, this bill included the 2.25 percent annual increase in Medicaid provider rates for nursing facilities and assisted living facilities that was put forward by the Appropriations Committee. Not all Medicaid providers received this high of an increase.

NHCA monitors the budget bills every legislative session to protect and increase Medicaid provider rates for our members.

June 2015 - 6 - nehca.org nhca legislative review – bills of interest withdrawn

BILLS OF INTEREST WITHDRAWN In Numerical Order

LB 50: Change provisions relating to Medicaid covered services Sponsor: Jim Scheer (Norfolk, LD 19) Date Withdrawn: Jan. 26, 2015 LPNAN Position: Monitor NNFA/NALA Position: N/A LB 50 would have eliminated Medicaid optional services in Nebraska, including nursing facility care for anyone under the age of 21 and hospice services. The bill was withdrawn before its public hearing and before the NNFA/NALA Government Relations Committee could recommend an official position to the Board of Directors.

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BILLS OF INTEREST TO BE CARRIED OVER TO 2016 SESSION Listed by Committee

APPROPRIATIONS COMMITTEE

LB 332: Appropriate funds for the statewide prescription drug disposal project Sponsor: John Kuehn (Heartwell, LD 38) NNFA/NALA Position: Monitor Status: In Committee, portions amended into the mainline budget bill (LB 657), which passed The intent of this bill was to appropriate $600,000 for fiscal year 2016-17 and $600,000 for fiscal year 2017‑18 to the Department of Health and Human Services to contract for services for the implementation of a statewide drug disposal project. That same amount was added into the budget bill for this purpose.

LB 593: Appropriate funds to the University of Nebraska to study current health data systems Sponsor: Jeremy Nordquist (Omaha, LD 7) NNFA/NALA Position: Monitor Status: In Committee, portions amended into LB 657, the mainline budget bill, which passed This bill would have appropriated $250,000 from the General Fund for fiscal year 2015-16 to the University of Nebraska to provide funds to the University of Nebraska Medical Center to study current health data systems available to the State of Nebraska and make recommendations about health data systems that are currently unavailable that would be beneficial to the state for purposes of increasing efficiency and effectiveness of public health care dollars spent in the state. The Legislature instead amended this money into the mainline budget bill to provide for a contract for this purpose, issued by the state (but not necessarily to be awarded to the University of Nebraska), the parameters of which will be determined at a later date.

BANKING, COMMERCE AND INSURANCE COMMITTEE

LB 11: Change participation and reimbursement provisions under the Managed Care Plan Network Adequacy Act Sponsor: Bob Krist (Omaha, LD 10) NNFA/NALA Position: Support Status: In Committee This bill would have prohibited managed care organizations from denying participation/reimbursement to a provider providing services to a covered person solely based on a family relationship between the provider and the covered person.

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BUSINESS AND LABOR COMMITTEE

LB 158: Deny compensation under the Nebraska Workers’ Compensation Act in situations of false representation Sponsor: John McCollister (Omaha, LD 20) NNFA/NALA Position: Monitor LPNAN Position: Monitor Status: In Committee LB 158 would reinstate the defense of employee misrepresentation for employers to avoid having to pay benefits arising from an injury or condition resulting from misrepresentations made by the employee when applying for a position with the employer. These provisions would reinstate an affirmative defense that was established in favor of employers under the Hilt Truck Lines, Inc. v. Rajean Jones Supreme Court decision.

LB 251: Adopt the Veterans Subsidized Training and Employment Act Sponsor: Jeremy Nordquist (Omaha, LD 7) NNFA/NALA Position: Monitor Status: In Committee The intent of LB 251 is to help veterans gain employment by providing companies who hire unemployed veterans in Nebraska with a wage subsidy of up to $12,000 for the first six months to cover the training costs associated with hiring a new employee.

LB 363: Provide time limits and penalties for late medical payments under the Nebraska Workers’ Compensation Act Sponsor: Jeremy Nordquist (Omaha, LD 7) NNFA/NALA Position: Oppose Status: In Committee LB 363 requires that medical payments payable under the Nebraska Workers’ Compensation Act shall be payable within 30 days after notice has been given or within 30 days after the entry of a final order, award or judgement of the compensation court. It adds 50 percent to the payable amount if the medical payment is delinquent 30 days or more.

LB 388: Provide annual adjustments for total disability income benefits under the Nebraska Workers’ Compensation Act Sponsor: (Lincoln, LD 26) NNFA/NALA Position: Oppose Status: In Committee LB 388 would apply only to those who were injured on their job and whose injuries were determined by the Workers’ Compensation Court to have resulted in total disability. Current law provides a formula for the annual calculation of the maximum weekly benefit; and although the Legislature has recognized the necessity of annually updating the allowable maximum, there is no such updating for the worker once his or her compensation has been set. The bill would simply apply the same formula used to calculate the maximum benefits to the actual award of benefits on an annual basis.

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LB 429: Provide for medical utilization and treatment guidelines under the Nebraska Workers’ Compensation Act Sponsor: Jim Smith (Papillion, LD 14) NNFA/NALA Position: Monitor Status: In Committee Under LB 429, medical, surgical and hospital services provided under the Nebraska Workers’ Compensation Act would be in accordance with the official disability guidelines published by the Work Loss Data Institute and would be presumed to be reasonable and necessary. Workers’ compensation insurers, risk management pools, or self-insured employers would be responsible for services that fall outside the guidelines unless prior authorization is obtained. Also, the bill provided that any party could request a finding by an independent medical examiner if payment is denied for services on the basis the services fall outside the guidelines or prior authorization is denied. Under the bill, it would be a rebuttable presumption that the findings of the independent medical examiner are correct.

LB 493: Adopt the Healthy and Safe Families and Workplaces Act Sponsor: Jeremy Nordquist (Omaha, LD 7) NNFA/NALA Position: Monitor Status: In Committee The intent of LB 493 is to require businesses to provide employees a minimum of one hour of paid sick and safe time for every 30 hours worked, up to 40 hours per year.

LB 556: Waive workers’ compensation as the exclusive remedy if an employer is willfully negligent Sponsor: (Omaha, LD 31) NNFA/NALA Position: Oppose Status: In Committee LB 556 would, at the option of the employee, make the exclusive remedy protection for the employer inapplicable in cases where the Nebraska Workers’ Compensation Court has made a determination that the injury is due to the willful negligence of the employer.

LB 599: Provide a minimum wage for certain young student workers Sponsor: Laura Ebke (Crete, LD 32) NNFA/NALA Position: Monitor Status: Final Reading Under this bill, it would be permissible to pay a high schooler, age 18 or younger, and who is not in a vocational training program, $7.25 per hour for a quarter of the hours they are being paid. The bill failed to get enough votes to pass on Final Reading.

LB 611: Require private employers to use the E-Verify Program Sponsor: Bill Kintner (Papillion, LD 2) NNFA/NALA Position: Monitor Status: In Committee LB 611 would require employers in the private sector to use e-verify for new hires or be subject to a civil penalty no more than $2,000.

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GOVERNMENT, MILITARY AND VETERANS AFFAIRS COMMITTEE

LB 61: Change funding for county offices relating to administration of public assistance programs Sponsor: Kate Bolz (Lincoln, LD 29) NNFA/NALA Position: Monitor Status: In Committee The goal of LB 61 is to seek to repeal a provision in statute that currently requires counties to pay for rental costs or provide space to the Department of Health and Human Services for services that were provided by counties prior to those responsibilities being transferred to the state. The purpose is to provide fairness to counties across the state and to provide accountability and transparency to the Department of Health and Human Services.

LB 111: Require identification to vote Sponsor: Tyson Larson (O’Neill, LD 40) NNFA/NALA Position: Monitor Status: General File This bill was one of two voter identification proposals. It requires an up-to-date state-issued photographic identification in order to vote. Under the bill, the Department of Motor Vehicles would offer a state identification card at no cost to a voter if he or she indicates that he or she is indigent. Voters casting ballots in elections held by mail or who vote early would not be required to provide a government- issued photographic identification unless it is their first time voting. A voter who does not present a government-issued photographic identification at the polls would be permitted to cast a provisional ballot. The bill was filibustered by opponents and ultimately bracketed until June 5, which was originally scheduled as the last day of the 2015 session. This effectively stopped the bill for the year. Technically, supporters may proceed from this point next session.

LB 121: Require voter identification and secret-ballot envelopes Sponsor: Paul Schumacher (Columbus, LD 22) NNFA/NALA Position: Monitor Status: In Committee This was the second voter identification bill (the first to be introduced was LB 111, above). One of the main differences between the two is that LB 121 permits a voter to use an identification that has been expired for up to five years from the date of the election. Under the bill, secret-ballot envelopes would be provided to voters who do not, or cannot, cast and directly deposit his or her ballot into a secured ballot box at a polling place.

HEALTH AND HUMAN SERVICES COMMITTEE

LB 21: Provide requirements for rate increases for providers of behavioral health services as prescribed Sponsor: Bob Krist (Omaha, LD 10) NNFA/NALA Position: Neutral Status: General File LB 21 outlines a process under a behavioral health managed care system requiring the managed care company to report any of their own rate adjustments to the Division of Medicaid and Long-Term Care, the Division of Behavioral Health, and the Legislature’s Appropriations Committee, which would show how the increased funds were distributed by billing code and that the funds were used solely for the rate increase, as intended by the Legislature. The Nebraska Health Care Association offered an amendment at the hearing that would have applied this process to all future managed care contracts, but the committee advanced the bill to general file without the amendment.

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LB 333: Adopt the Health Care Transformation Act Sponsor: Mike Gloor (Grand Island, LD 35) LPNAN Position: Monitor NNFA/NALA Position: Monitor Status: In Committee This bill is a result of the LR 22/LR 422 process, which focused on developing innovative health care programs in the primary care sector by creating the Program of Health Care Transformation in the Department of Health and Human Services to assist with that task. The bill creates an advisory commission to advise state government on this transformation. LB 333 encourages innovative health care programs such as patient-centered medical homes and promotes care coordination.

LB 353: Change credentialing provisions for nursing home administrators Sponsor: Kathy Campbell (Lincoln, LD 25) NNFA/NALA Position: Neutral Status: In Committee LB 353 would amend the Nursing Home Administrator Practice Act to require a nursing facility administrator to have a bachelor’s degree, beginning in 2017.

LB 405: Create the Alzheimer’s and Related Disorders Advisory Work Group and provide for a state plan Sponsor: Al Davis (Hyannis, LD 43) NNFA/NALA Position: Support Status: General File, portions amended into LB 320, which passed LB 405 was a recommendation of the Aging Nebraskans Task Force. The purpose of the bill was to create a working group to develop an Alzheimer’s State Plan. It was later amended into LB 320 and transferred the responsibility of developing the State Plan from the initially-proposed working group back to the Aging Nebraskans Task Force.

LB 440: Provide for a study of rates for care by an Alzheimer’s special care unit Sponsor: Adam Morfeld (Lincoln, LD 46) NNFA/NALA Position: Support Status: In Committee LB 440 is another product of the Aging Nebraskans Task Force. The bill directs the Division of Medicaid and Long-Term Care to contract for a study to determine an appropriate rate for memory care in assisted living facilities. Staff from the Nebraska Health Care Association assisted with the drafting of this bill.

LB 472: Adopt the Medicaid Redesign Act Sponsor: Kathy Campbell (Lincoln, LD 25) LPNAN Position: Monitor NNFA/NALA Position: Monitor Status: General File This bill was the 2015 proposal dealing with Medicaid expansion. It was intended to begin a redesign of Medicaid to increase economic efficiencies and better serve all Medicaid clients. LB 472 allows the Governor to work with the federal government to create a coverage plan. It also establishes a Medicaid Redesign Task Force to make recommendations for that process. The bill was filibustered by opponents and ultimately bracketed until June 5, which was originally scheduled as the last day of the 2015 session. This effectively stopped the bill for the year. Technically, supporters may proceed from this point next session.

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LB 490: Adopt the Provider Orders for Life-Sustaining Treatment Act Sponsor: Dan Watermeier (Syracuse, LD 1) LPNAN Position: Monitor NHPCA Position: Support NNFA/NALA Position: Support Status: In Committee LB 490 would adopt the Provider Orders for Life-Sustaining Treatment Act. Under the bill, the Department of Health and Human Services is directed to adopt rules and regulations establishing a standardized format for a Provider Orders for Life-Sustaining Treatment (POLST) form and develop standards for training health care professionals and educating the public on the use of the form.

LB 499: Provide duties for the Department of Health and Human Services relating to behavioral and mental health services Sponsor: Bob Krist (Omaha, LD 10) NNFA/NALA Position: Monitor Status: In Committee LB 499 authorizes the Department of Health and Human Services to re-establish the provision of behavioral and mental health services throughout the state. It also authorizes the department to collaborate with the Department of Correctional Services, the Administrative Office of Probation, and the Office of Juvenile Services when re-establishing such services.

LB 516: Create the Brain Injury Council and the Brain Injury Trust Fund and provide powers and duties Sponsor: Kate Bolz (Lincoln, LD 29) NNFA/NALA Position: Monitor Status: In Committee LB 516 creates the Brain Injury Council, which includes 13 public members appointed by the Governor (six of which can come from health-related organizations, among other groups) and makes recommendations to DHHS on ways to improve services, encourage community outreach prevention and awareness, oversee programs created under the federal Traumatic Brain Injury Act of 1996, and provide fiscal oversight for the Brain Injury Trust Fund (also created by this bill).

LB 518: Provide for changes to the medical assistance program Sponsor: Merv Riepe (Omaha, LD12) NNFA/NALA Position: Monitor Status: In Committee LB 518 would review the medical assistance program provided under the Medical Assistance Act by providing incentives through free market qualified health care services to benefit recipients under the program through a 24-hour hotline operated by the Department of Health and Human Services.

LB 549: Adopt the Health Care Transformation Act Sponsor: Kathy Campbell (Lincoln, LD 25) LPNAN Position: Support NNFA/NALA Position: Support Status: In Committee LB 549 creates the Health Care Transformation Act to encourage collaboration among all health care system stakeholders in the state to create a 15-year vision to include the Building Blocks of Health Care. The Building Blocks assure health care is available for all; support effective models of health care delivery, financing and payment; assure public transparency of health care quality and patient safety; establish and support a statewide database; utilize population health-based interventions; promote personal responsibility for wellness; address health care workforce shortages; and coordinate statewide health planning.

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JUDICIARY COMMITTEE

LB 643: Adopt the Medical Cannabis Act Sponsor: Tommy Garrett (Bellevue, LD 3) LPNAN Position: Monitor Status: General File This was the second of two bills introduced this year that dealt with medical marijuana. The purpose of LB 643 is to allow and regulate the use of cannabis for medical treatment.

REVENUE COMMITTEE

LB 228: Change corporate income tax rates Sponsor: Dan Watermeier (Syracuse, LD 1) NNFA/NALA Position: Monitor Status: In Committee LB 228 would align the two corporate income tax rates with the top two individual income tax rates. The corporate income tax rate on the first $100,000 of taxable income would decrease from 5.58 percent to 5.01 percent; and for taxable income in excess of $100,000, the corporate income tax rate would be lowered from 7.81 percent to 6.84 percent.

LB 396: Allow an income tax credit for certain long-term care insurance policy premiums Sponsor: Merv Riepe (Omaha, LD 12) NNFA/NALA Position: Support Status: In Committee LB 396 would allow a nonrefundable income tax credit equal to 25 percent of premiums paid for a long-term care insurance policy. The total credit cannot exceed $250 for individual policies and $500 for joint policies. The credit may be claimed for a maximum of three years. Under LB 396, the credit would not be allowed if the taxpayer used the adjustment of federal gross income for contributions made pursuant to the Long-Term Care Savings Plan Act in the same tax year.

LB 476: Provide duties for county assessors and the Property Tax Administrator relating to tax-exempt real property Sponsor: Al Davis (Hyannis, LD 43) NNFA/NALA Position: Monitor Status: In Committee LB 476 requires that each county assessor annually compile a list of tax-exempt real property within the county, estimate the market value of each parcel, and submit the list to the Property Tax Administrator. The administrator would then prepare an annual report listing all tax exempt real property in the state with estimated market value and location within each county, city, village, and school district. The administrator would submit the report to the Legislature electronically on or before Dec. 31 of each year.

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LB 510: Provide an income tax credit to employers of public assistance recipients Sponsor: Tanya Cook (Omaha, LD 13) NNFA/NALA Position: Monitor Status: General File LB 510 would create a nonrefundable business tax credit that would aim to encourage and reward investments that Nebraska employers make in their employees by allowing them to claim a credit of 20 percent of their annual expenditures made to provide tuition at a Nebraska public institution of postsecondary education, child care services, and transportation to and from work for eligible employees.

LB 573: Adopt the Health Enterprise Zone Act and provide for tax credits Sponsor: Al Davis (Hyannis, LD 43) NNFA/NALA Position: Monitor Status: In Committee The Health Enterprise Zone Act would target state resources and provide tax incentives to reduce health disparities, improve health outcomes, and reduce health costs and hospital admissions in specific areas of significant need in the state. Preference would be given to counties with 100 or fewer residents per square mile.

June 2015 - 15 - nehca.org nhca legislative review – 2015 interim study resolutions

2015 INTERIM STUDY RESOLUTIONS

During the legislative session, senators and standing committees introduced interim studies (also known as legislative resolutions, hence the prefix “LR”), which are resolutions authorizing a committee to study an issue following adjournment of a legislative session.

Generally speaking, senators, their staff, and the committee to which the interim study is referenced work on it throughout the interim. Not all interim studies will have a public hearing. Committees usually rank each study in order of priority. The interim studies that receive the highest rankings will receive the most attention. Interim study hearings typically occur in late summer and during the fall.

This year, NHCA staff worked with Sen. to introduce LR 181, which focuses on identifying and potentially improving state policies that serve as barriers to full-time employment. We will be reaching out to you in the months to come for input as to how your facility has been affected by these policies.

In all, 129 legislative interim study resolutions were introduced. The following 33 LRs have been identified by NHCA staff as interim studies that may be “of interest” to NHCA membership (listed in numerical order):

LR 22 (Gloor) Interim study to monitor medical care transformation in Nebraska, including the health care delivery process of a patient-centered medical home

LR 38 (Seiler) Interim study to examine statutes governing prisons and parole to ensure the Board of Parole is independent from the Department of Correctional Services

LR 39 (Seiler) Interim study to examine certain acts to ensure the evaluation procedures regarding potentially mentally ill and dangerous inmates and potentially dangerous sex offenders are clear and consistent

LR 152 (Crawford) Interim study to examine the Local Option Municipal Economic Development Act

LR 159 (Crawford) Interim study to examine issues surrounding handicapped parking

LR 174 (Crawford) Interim study to examine issues surrounding the Nebraska Energy Code

LR 181 (Kolterman) Interim study to examine how to build Nebraska’s workforce, especially in high-need areas, and support personal responsibility and professional growth for all Nebraskans

LR 182 (Kolterman) Interim study to investigate and make recommendations regarding what can be done to provide Nebraska consumers the necessary information to enable them to make informed decisions as to which health care plan to purchase

LR 185 (Crawford) Interim study to examine issues faced by Nebraska’s licensed mental health practitioners, doctoral-level graduate students, nurses, and psychiatrists

LR 198 (Krist) Interim study to examine how the state can assist individuals who are blind or have other disabilities to achieve personal independence through gainful employment

LR 222 (Crawford) Interim study to examine issues relating to family and medical leave

LR 223 (Crawford) Interim study to examine strategies and ideas to ensure more adults have the education and skills needed to fill positions for in-demand industries in Nebraska

LR 227 (Harr) Interim study to examine opportunities to train Nebraska’s youth for the workforce while addressing both educational and workforce needs

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LR 229 (Harr) Interim study to examine Nebraska’s unemployment insurance laws and unemployment insurance program

LR 231 (Howard) Interim study to examine the effectiveness of the prescription drug monitoring program currently housed within the Nebraska Health Information Initiative

LR 239 (Mello) Interim study to examine issues surrounding the implementation of the federal Workforce Innovation and Opportunity Act in Nebraska

LR 246 (Harr) Interim study to analyze the effectiveness of vocational rehabilitation in workers’ compensation cases in Nebraska

LR 250 (Campbell) Interim study to examine issues under the jurisdiction of the Health and Human Services Committee

LR 254 (Coash) Interim study to examine public charitable corporations in Nebraska

LR 257 (Kuehn) Interim study to examine how to create a sustainable and adequate stream of state funds to local public health departments to ensure the departments are able to meet their core responsibilities and functions

LR 262 (Bolz) Interim study to examine creation of a separate program within the budget of the Department of Health and Human Services for long-term care expenditures made from all funding sources

LR 274 (Mello) Interim study to examine the feasibility of using pay-for-success financing in Nebraska

LR 275 (Mello) Interim study to examine issues surrounding the affordability, delivery and taxation of child care in Nebraska

LR 279 (Campbell) Interim study to examine issues under the jurisdiction of the Judiciary Committee

LR 291 (Campbell) Interim study to examine stroke systems of care

LR 294 (Murante) Interim study to examine issues under the jurisdiction of the Government, Military and Veterans Affairs Committee

LR 297 (Mello) Interim study to examine career technical education in Nebraska

LR 305 (Mello) Interim study to examine issues under the jurisdiction of the Appropriations Committee

LR 306 (McCollister) Interim study to examine ways in which Medicaid expansion could be implemented in Nebraska under the federal Patient Protection and Affordable Care Act for medical assistance for newly eligible individuals

LR 310 (Harr) Interim study to examine services provided by community paramedics

LR 324 (Kolterman) Interim study to analyze the ability of employers or associations to enter into contracts with an agent or broker for compensation to be paid to the agent or broker for the sale of a health benefit plan

LR 333 (Watermeier) Interim study to examine methods to improve government efficiency

LR 335 (Hansen) Interim study to examine the most recent report published by the Presidential Commission on Election Administration

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LR 181

NHCA has worked with Sen. Mark Kolterman of Seward to introduce LR 181, an interim study focusing on identifying and potentially improving state policies that serve as barriers to full-time employment. The topic has been a point of discussion at many NNFA/NALA board meetings and district meetings over the past year. This interim study will fit nicely with the goals of the Workforce Task Force that was recently commissioned by the NNFA/NALA board of directors. The Workforce Task Force will meet throughout the year.

LR181 LR181 2015 2015

ONE HUNDRED FOURTH LEGISLATURE

FIRST SESSION LEGISLATIVE RESOLUTION 181

Introduced by Kolterman, 24.

PURPOSE: The purpose of this resolution is to study how to build Nebraska's

workforce, especially in high-need areas, and support personal responsibility

and professional growth for all Nebraskans. A first step in accomplishing this

purpose is to identify and, if applicable, propose changes to state policies

that serve as barriers to full-time employment. Some Nebraskans are forced to

continue dependency on state-funded benefits rather than risk losing these

supports if their work hours or income levels exceed the limits for these

programs. While these programs fill an important need for families across the

state, there may be improvements that can be made in order to enable workers to

stay and grow within the workforce.

The study shall include, but not be limited to, the following issues:

(1) Examining current state-funded financial assistance programs offered

by the Department of Health and Human Services, including medicaid and other

joint federal and state programs in which the state has discretion in setting

limitations;

(2) Examining similar programs in other states; and

(3) Identifying potential improvements that can be made to current

programs that would benefit Nebraska employers and employees, expand the

available workforce in high-need areas, and contribute to the economic growth

of Nebraska.

NOW, THEREFORE, BE IT RESOLVED BY THE MEMBERS OF THE ONE HUNDRED FOURTH

LEGISLATURE OF NEBRASKA, FIRST SESSION:

1. That the Health and Human Services Committee of the Legislature shall

be designated to conduct an interim study to carry out the purposes of this

resolution.

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LR181 LR181 2015 2015

2. That the committee shall upon the conclusion of its study make a report

of its findings, together with its recommendations, to the Legislative Council

or Legislature.

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AGING NEBRASKANS TASK FORCE

The Aging Nebraskans Task Force was established by LB 690 in 2014 to develop and facilitate implementation of a statewide strategic plan for addressing the needs of the aging population of the state. The Nebraska Health Care Association was involved in a series of meetings with the Task Force and other stakeholders, which resulted in a report that was issued to the Legislature before the 2015 session began. Their report outlined several key policy recommendations regarding long-term care services, workforce development, financial planning, care for individuals with Alzheimer’s disease or other dementia, and cost containment. These recommendations resulted in the introduction of the following legislation in 2015:

• LB 320, which would create Aging and Disability Resource Centers to serve as an information clearinghouse for citizens who are aging and/or disabled.

• LB 405, which deals with the creation of an Alzheimer’s State Plan to address Nebraska’s growing population of individuals with Alzheimer’s.

• LB 440, which would direct the Division of Medicaid and Long-Term Care of the Department of Health and Human Services to contract for a study to determine an appropriate rate for memory care in assisted living settings.

• LB 607, which would adopt the Home Care Consumer Bill of Rights Act.

The task force will continue its work this interim and will likely focus on the creation of the Alzheimer’s State Plan, the reintroduction of a consumer bill of rights, further examination of an appropriate rate for memory care in assisted living settings, and general workforce issues. NHCA will continue to serve as a resource to the task force and advocate on your behalf.

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ADVOCACY IS A YEAR-ROUND PROCESS AND PARTICIPATION IS THE KEY

As you can see, effective advocacy is a year-round effort. In fact, it has never been more important to be a strong advocate for health care. Legislation and government regulation will continue to burden our professions in the years to come. Pressures on reimbursement and licensure in the new biennium will force our industry to make changes in the way we operate every day. Therefore, health care leaders must be proactive in the process of developing public policy. You can help make a difference by getting involved.

We at the Nebraska Health Care Association encourage members of all family associations to be an advocate, and there are several ways to do so. Consider the following:

• Annual Legislative Day. The Nebraska Health Care Association hosts this special event in Lincoln every winter. Members of all family associations are strongly encouraged to attend. The agenda usually includes presentations on key legislation and regulatory issues. The event provides you with an opportunity to meet with state senators and in doing so, advances our collective goals. The annual Care PAC awards are presented at the reception following the program. Next year’s Annual Legislative Day will be held on Wednesday, March 2, 2016. Be sure to mark your calendar!

• Serve on the Government Relations/Legislative Committee of your association. We need your input on issues if we are to effectively advocate on your behalf. You can play a key role. Be a leader for your industry. Contact the NHCA office for additional information.

• Care PAC. Participation in Care PAC is really an investment in your profession. With the 2016 election cycle right around the corner, there literally never has been a better time to make that investment. Encourage staff at your facility to join the collective voice. The Care PAC Participation Guide is available on the NHCA website.

• Host your senator or candidate at your facility. This is by far the best way to show elected officials and candidates what our industries are all about. It’s your chance to tell your story about how you are impacted by the decisions they make! The NHCA Guide to Facility Visits can help you arrange such a visit. This resource is available on the NHCA website under the Government Affairs tab.

• Communicate with your senator. There are several ways to communicate with your senator: through letters, emails or phone calls. Learn which one your senator prefers. They truly value input from constituents.

• Visit their Lincoln office. Take a moment to familiarize yourself with the Capitol building; it’s a fascinating piece of history. Request a sit-down meeting with your senator. Get to know his/her staff. Leave a “talking points” sheet with them for their reference.

• VOTE! It’s your right; don’t take it for granted!

June 2015 - 21 - nehca.org For additional information, contact: Nick Faustman, Vice President of Government Affairs Nebraska Health Care Association 1200 Libra Drive, Suite 100, Lincoln, NE 68512 402-435-3551 [email protected]