The final week of public hearings in the Legislature is complete. We have also concluded 50 days of this 90 day session. So the work continues at a fast pace, including the fact that seven of my bills had their hearing this week.

Here is a recap of those bills. LB 415 would appropriate $1 million to the Emergency Medical Services Practice and the Statewide Trauma System Acts; and $150,000 for the statewide patient care reporting and trauma registry. Services included are EMS licensing, training, technical assistance and testing. The trauma system provides care, prevention activities, and aims to prevent unnecessary death and disability from trauma and reduce costs.​

The EMS and trauma program began with a bill by the late Senator Dennis Byers, in the “50 Cents for Life” act in the 1990’s. Funding over the years has not stayed consistent, so this bill would direct dollars from the state general fund for the programming. Training and licensing costs about $10,000 per EMS squad across the state. Without this added assistance, the cost inevitably falls back on local fundraisers.

I received my own EMT license in about 1985; back then you needed around 128 hours in the classroom, and that has risen to 200 hours, plus continuing education. Joining an EMT squad today is a tremendous commitment of time, plus passing a difficult test. In some rural areas, there is no one to turn to for medical help without those rural EMT squads. We are so thankful and supportive of those who go through the process in order to give back to their community.

LB 362 was introduced to raise behavioral health provider rates by increases of 5% for Behavioral Health
Aid, Medicaid Expansion and Juvenile Justice through the Supreme Court. We see examples in the news every day of the growing need for these interventions; we also need to recruit and retain competent providers in this field.

A group of bills heard on Thursday, LB 46, LB 128, 129, 130 and 131, all deal with health care services. The first one, LB 46, funds a study of the rates paid to home health care providers, skilled nursing services and private duty nursing services under the Medical Assistance Act. Again, vital resources whether you live in Lincoln or a smaller community in District 30.

The remaining four bills addressed reimbursement rates under Medicaid in Nebraska hospitals for inpatient and outpatient care; nursing homes and assisted living facilities. One of those, LB 130, creates a separate and distinct budgetary program within the Department of Health and Human Services, the Medicaid nursing facility services program.

Reimbursement increases are needed because provider rates have not kept pace with the inflation we have experienced in the past couple of years. Far too many health care centers across the state have had to close. In conversations with Bryan Health, we see that once a level of around 50% of patients are on Medicaid, that’s when hospitals begin to incur loss but cannot refuse care.

When provider rates are too low, the loss is made up for by persons who do have health insurance, through charges made to those insured patients. So this is an area where we can benefit everyone by boosting reimbursements. Safe and stable health facilities, staffed by qualified workers, are crucial to making large and small communities attractive places to live, for people of all ages.
Last week, a constitutional amendment proposal was introduced in committee by Ralson senator, Merv Riepe, to repeal the inheritance tax. LR23CA would have voters decide whether the state and any political subdivision shall continue to levy an inheritance tax. Nebraska is the only state where eliminating the inheritance tax would have no effect on the state’s revenue or income, but would impact counties.

While this sounds like a good idea, the end result is that if those funds are needed, it will fall 100% on property taxes. Inheritance tax began in the early 1900’s. In the 1960’s the taxing authority was given to counties to help with their budget. The amounts collected in each county have grown with property values. Totals vary but in general, Lancaster county gets about $6 million a year which goes into their general budget. Gage county takes in about $600,000 which is used for special projects. Hickory Road north of Beatrice is a good example: without the inheritance tax, it wouldn’t have been completed.

There are only a few states remaining that still have this tax and I am firmly behind eliminating the inheritance tax; but I am also determined to replace that lost revenue for counties with state funding. Without revenue from inheritance tax, a county will need to make up the deficit by cutting services or increasing property tax. I have introduced an amendment to LR23CA that is based on the five-year average of inheritance tax receipts for each county, with reimbursement from the state general fund.

On the floor this week, all of our time was taken up by LB 574. Called the Let Them Grow Act, the bill would prohibit the performance of gender altering procedures for individuals under the age of 19 and allow for civil action to be brought against violators of the act. Very strong feelings were expressed on both sides of this issue, not only this week but in previous debate on unrelated bills. As a result, debate on LB 574 took the full eight hours on General File and required 33 votes to invoke cloture (end debate). I agreed with parts of the bill and felt other sections went too far. An amendment has been filed that bans surgery but retains the therapeutic treatments, which I support. However, I do not know if an amendment is even possible, since opponents of the bill have said they will filibuster the remainder of the session.

With the end of hearings, the hard work for the Appropriations Committee begins. We will review agency budget requests, all bills before the appropriation committee, the Governor’s budget proposal and the state’s ongoing obligations. We also must factor in any Revenue Committee bills that reduce the state’s income. We are required by the state constitution to present a balanced budget on legislative day 70, which falls on May 2nd. With debate scheduled from morning into the evenings, our committee will meet through the lunch hour to hammer out this plan.

As always, I want to hear from you. My contact information is: mdorn@leg.ne.gov, 402-471-2620. Thank you.