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The legislature made good progress last week advancing a number of bills from both general and select files.
The “Choose Life” license plate bill (LB46) that has consumed hours of debate time over the past few weeks passed on final reading with a vote of 38-0. The bill was signed into law on April 5th by Gov. Pete Ricketts during a special signing ceremony.
The Revenue Committee completed work on its tax reform package and sent two bills (LB481 and LB640) to the floor. It is likely to be several weeks before the bills are debated.
I think both bills will make positive and much needed changes to the tax structure in the state. This week I am focusing on LB640 which deals with property taxes and school funding and next week I will take up LB481 which deals with a range of tax issues including income tax rates, how property taxes are assessed, and changes to the state’s Earned Income Tax Credit.
LB640 was introduced by North Platte Sen. Mike Groene and I selected it as my personal priority bill. The intent of LB640 is to reduce the amount of property taxes going to school funding potentially reducing property tax bills, especially in areas where the property tax base is mostly agricultural land.
It is an understatement to say that the way we figure school funding in this state is complicated, confusing and hard to understand; trying to explain LB640 is much the same. If implemented in its current form the bill would make three major changes: capping the amount of property taxes used to fund schools; lowering the maximum school district levy; and redirecting money from the Property Tax Credit Cash Fund to make up the difference and provide property tax relief.
Property taxes have always been the primary source of funding for Nebraska’s schools. Today property taxes make up between 32 percent and 80 percent of total revenue depending on the school district. The goal is to eventually cap the property tax portion at 40 percent.
LB640 takes a step in that direction and would place a 55 percent cap on the amount that property taxes contribute to school funding. The difference between the total amount of revenue now collected and the 55 percent cap, the “property tax gap,” will be split between the state and individual school districts.
The state will contribute 75 percent of the amount needed to close the gap with money taken from the Property Tax Credit Cash Fund. If the balance in the Property Tax Credit Cash Fund is less than the amount needed for school district relief aid, individual school district aid will be reduced proportionately.
School districts receiving aid must reduce their spending by an amount equal to 25 percent of the property tax gap unless the school board, after holding a public hearing, overrides the reduction by a two-thirds majority vote. The 159 unequalized districts along with 26 districts that receive minimal equalization will see the biggest impacts.
Next, the bill would lower the maximum school district property tax levy from $1.05 per $100 of property value to $.987 per $100 of property value which in turn lowers the local effort rate in the TEEOSA formula. The difference will be offset with money from the Property Tax Credit Cash Fund paid in the form of property tax relief aid to citizens in equalized districts.
The Property Tax Credit Cash Fund was established in 2007 to provide property tax relief to real property owners across the state in the form of a property tax credit and today it contains $221 million. This bill will significantly impact the fund because the money to pay for LB640 will come from redirection of those dollars.
If LB640 is implemented both urban and rural areas will feel the effects. Rural areas will pay slightly less toward school funding and receive increased state aid to make up the difference. Urban areas will receive less in property tax credits. While it is easy to frame changes like this in terms of winners and losers if you think about the system we have now we already have winners and losers. LB640 is not intended to benefit one area at the expense of the other, it is intended to make the system fairer for everybody while still adequately funding our public schools.
Please feel free to contact me and my staff about your legislative concerns or other issues you would like to discuss. My email address is firstname.lastname@example.org and our telephone number is 402-471-2630.
This week in the legislature two school-related bills garnered a lot of attention and sparked some intense debate.
On Tuesday, March 14, the Education Committee held a public hearing on a bill introduced by Sen. Tyson Larson of O’Neill that would allow creation of independent public schools, also known as charter schools.
LB 630, the Independent Public Schools Act, would permit nonprofit organizations and certain other entities to establish independent schools in any school district with a school the State Board of Education has identified as significantly underperforming. Level of performance is determined by evaluating several factors including graduation rates and test scores.
The bill would create an eight-member commission to grant and oversee charter school compacts. The bill would also authorize school districts to grant and administer compacts for charter schools to operate within their boundaries.
The schools would be independent of any school board and would be managed by a board of trustees. Each charter school would receive state aid equal to the number of enrolled students multiplied by the statewide average funding per formula student amount. They would be open to all students through a lottery system.
The debate over whether or not to permit charter schools elicits strong emotions on both sides of the issue. At its core though, no matter which side you come down on, is the belief that every child in Nebraska must receive a high quality education that will prepare them to become successful adults and equip them with the skills they need to get good jobs and be productive members of society.
Personally, I am a strong supporter of the education provided in the state’s public schools. This is not to say that all public schools are excelling, clearly there are some that are not. But overall our public schools do a good job and I think it’s important that we give them credit for the work they do.
I have introduced several bills this session that call for significantly changing the way we fund public education by reducing the current heavy reliance on property taxes. This is in no way a reflection on the quality of public education in the state. I am not trying to take money away from the public schools. I am simply hoping we can come up with a different funding mechanism that will still adequately support our schools while sharing the economic burden more fairly.
Very soon the Revenue Committee, of which I am Vice Chair, will be putting out its proposed tax package and I’m sure I will have some additional comments on education funding at that time.
LB 62 introduced by Sen. Jim Scheer of Norfolk was filibustered for a second time by Omaha Sen. Ernie Chambers. The bill would repeal a law prohibiting public school teachers from wearing religious garb at school. The prohibition was passed by Nebraska in 1919 and requires school boards to suspend a teacher for one year for a first violation and terminate their employment upon a second violation.
Sen. Chambers also staged a filibuster against the bill on General File. First round debate was ended by a cloture vote on Feb. 22 after two days of protracted discussion. Senators then voted 36-1 to advance the bill to Select File. The second round filibuster was ended by another successful cloture vote and the bill was advanced to Final Reading on a vote of 41-1. It is likely Sen. Chambers will again waste a significant amount of time with a filibuster against the bill on Final Reading.
Having passed the halfway point in this legislative session with only 14 bills being sent to the governor, there is a significant backlog of legislation to get to and time is rapidly winding down. In addition, we still need to pass a budget and with the revenue shortfall and anticipated budget cuts, this promises to be no easy task. The Appropriations Committee has until April 24 (the 70th legislative day) to place the appropriations bills on General File. The legislature is required to pass all appropriations bills by the 80th legislative day which is May 10 this year.
Please feel free to contact me and my staff about your legislative concerns or other issues you would like to discuss. My email address is email@example.com and our telephone number is 402-471-2630.
In the legislature this week several hours of debate were devoted to a proposal to change Nebraska’s mandatory minimum sentencing guidelines.
Mandatory minimum sentencing laws require judges to give fixed prison terms to persons convicted of specific crimes, most often drug offenses.
A bill introduced by Omaha Sen. Ernie Chambers, would have eliminated the mandatory minimum sentences for Class IC and Class ID felonies.
Currently a person convicted of a Class IC felony is subject to a sentence ranging from five to 50 years in prison. Class IC felonies include robbery, use of a deadly weapon to commit a felony, and possession of certain amounts of illegal substances. Conviction for a Class ID felony, examples of which include possession of certain amounts of illegal substances and assault on a police officer or health care professional, carries a sentence of between three and 50 years.
Unlike some of the other bills the legislature has taken up this session that have consumed entire days with little to show, this bill prompted good debate.
Supporters of the legislation argued that inflexible sentencing laws are unfair, preventing judges from fitting the punishment to the individual and the circumstances of their offense. Further that they have resulted in significant prison overcrowding and increased costs to taxpayers. In addition, incarcerated individuals are more likely to behave badly because they are not eligible to have their sentences shortened for good behavior.
Opponents of the bill contended that removing sentencing discretion from judges actually ensures fairness because it results in greater consistency for individuals convicted of the same crime. Mandatory minimum sentences also serve as a deterrent to crime as individuals are more likely to consider the potential consequences of their actions. Finally, mandatory minimum sentences improve public safety as longer sentences keep criminals off the streets.
In the end, Sen. Lou Ann Linehan of Elkhorn offered an amendment to the bill eliminating mandatory minimum sentences for Class IC and ID drug offenses only, specifically for manufacturing between 28 and 139 grams of cocaine, heroin or methamphetamine with the intent to distribute.
The amendment was adopted on a vote of 29-9 and the bill then advanced to select file 25-22. It still faces two more rounds of voting plus surmounting a possible gubernatorial veto before it can become law.
I am personally in opposition to the bill. At the end of the day these individuals have been convicted of serious crimes and should bear the associated consequences. Judges continue to have a wide range of sentencing options that take into account the individual circumstances of the convicted offender.
March 9 was the deadline for senators and committees to identify their priority bills. Bills with priority status are generally scheduled for debate ahead of other bills. Each senator may select one priority bill, each committee may select two priority bills, and the Speaker may select up to 25 priority bills.
I designated LB 640, introduced by Sen. Mike Groene of North Platte, as my priority bill. The bill caps the property tax contribution for school funding at 60% and provides tax relief in equalized school districts by lowering the maximum levy from 1.05 to 1.00.
Four of my bills have been designated as priority bills. Three bills, LB 144 which changes valuation of agricultural and horticultural land for calculating state aid to schools, LB 161 changing provisions of the Nebraska Advantage Act, and LB 265 which provides for a minimum amount of state aid based on the number of students in a local school system were designated as priorities by other senators. The Transportation & Telecommunications Committee prioritized LB 339 which creates a Department of Transportation by merging the Department of Aeronautics into the Department of Roads. Additional bills may receive priority status as the Speaker priority bills have yet to be announced.
Please feel free to contact me and my staff about your legislative concerns or other issues you would like to discuss. My email address is firstname.lastname@example.org and our telephone number is 402-471-2630.
By the time you read this column, the Legislature will have already adjourned for the year.
If you’ve been keeping up with legislation that has been discussed here in Lincoln, I probably don’t need to tell you how they ended up because of all the media coverage. So what I thought I’d do is to let you know how the bills I introduced or prioritized fared this year.
I designated LB 897 as my priority. It was introduced by Sen. Brett Lindstrom and allowed certain public power agencies to hedge fuel costs or generated electricity.
A bill I introduced last year had since been held over in the Judiciary Committee. LB 275 clarified existing statutory language that created loopholes in our license revocation law. In fact, it was the Merrick County Attorney who recognized the problem and asked me to introduce it.
Many times, Senators are asked to introduce particular bills because of the committee they are members of. LB’s 735, 785, 814, and 996 are examples of that. Those bills all dealt with issues under the jurisdiction of the Transportation and Telecommunication Committee, where I am a member.
LB 735 allowed the articulated buses operated by the Metropolitan Transit Authority in Omaha to exceed the current forty-foot length limit to sixty-five feet. LB 785 was brought to me by the Director of the Department of Motor Vehicles, and is an attempt to address complaints and to find better ways of streamlining the department statewide. LB 785 was amended into LB 311, another transportation bill that was further along in the legislative process. I introduced LB 814 because a constituent came to me and asked if I would consider changing the mileage requirement for School Permits. After some consideration, instead of changing the mileage requirement of living more than 1.5 miles from school, I just eliminated it. A representative of the Cummins Engine Company asked if I would introduce LB 996. The bill corrects a technicality when dealer statutes were put in place in 2009. LB 996 will allow Cummins to continue to operate just as they do now with two locations in Kearney and Omaha.
I also serve as a member of the Natural Resources Committee, for that reason, I was asked to introduce LBs 736 and LB 737. LB 736 clarifies a definition in the Community-Based Energy Development Act (C-BED) to ensure all Nebraska electric utilities have the option of negotiating a contract for energy output from a C-BED project. LB 737 expands eligible funded activities for public entities seeking low-interest loans through the Clean Water State Revolving Fund. It also increases loan terms from 20 to 30 years.
The Executive Director of the Nebraska Association of County Officials asked if I would consider introducing LB 784, which was heard before the Government, Military and Veterans Affairs Committee. While I am not a member of that committee, a county official from Hall County had recommended this change to the association. LB 784 allows counties to use the tax dollars that are currently being budgeted for and generated at a more appropriate time. The bill makes it clear that counties can use the resources available for roads during the late summer – prime time to build and maintain roads – rather than being limited to a proportion of their road budget during this time.
All of the above bills were successfully passed by the Legislature and signed into law by the Governor.
In order to try and add another layer of oversight to Tax Increment Financing (TIF) projects, I introduced LB 1042. LB 1042 would have additionally required approval by the County Board of Equalization of the county affected by the TIF project before approval of the governing board of the municipality. Also, LB 1042 would have required the Tax Equity and Educational Opportunities Support Act (TEEOSA) to use the full value of all property. By using the full value of these projects verses the base value (which they use now), there would have been a $21,000,000 savings in equalization money needed in the next fiscal year. However, the committee indefinitely postponed the bill.
The 2016 session has ended, but my Lincoln office will continue to be open. Please contact me or my staff if you have concerns or questions about state issues. My email is email@example.com and our telephone number is 402-471-2630.
A bill that would have legalized medical cannabis was defeated last week. LB 643 was sponsored by Sen. Tommy Garrett with an amendment from Senator Howard and made his priority both last year and this year. The bill was filibustered on the second round of consideration and failed to get the required 33 votes needed to end the extended debate. The measure will not be considered again this session. Sen. Garrett is not sure if he will bring it back next year.
Under LB 643 as amended, it still only allowed medical cannabis in a pill, oil or liquid form and smoking medical cannabis is still strictly prohibited. The intent of medical cannabis is to provide relief for those who are suffering and who have not been helped by conventional medicine.
The range of qualifying conditions is limited. For example, if a patient’s qualifying condition is cancer, they must exhibit severe chronic pain, severe nausea and wasting, known as cachexia, in order to be a candidate to participate under the Medical Cannabis Act. Other examples of conditions include, ALS, epilepsy and Parkinson’s disease and only a medical provider can certify a qualifying condition.
As amended, LB 643 requires the Department of Health and Human Services (DHHS) to create a patient registry. Patients must apply for enrollment by providing proof of a qualifying medical condition from a medical doctor along with proof of informed consent and signed disclosures regarding liability. For patients with physical or developmental disabilities who are unable to self-administer, registered caregivers are allowed. These caregivers would also go through a registry process with the DHHS. They must be at least 21 years of age and pass a criminal background check. All data collected on patients are considered medical records and therefore HIPAA protected.
Manufacturing and dispensing of medical cannabis will be highly regulated. Manufacturers must apply and be registered through the DHHS. One manufacturer is allowed per congressional district and each manufacturer may only operate one location. Products would be sent to a third party lab contracted by the manufacturer to test the product for labeled content and any contamination. The product would then be sent to a licensed dispensary that would not be affiliated with the manufacturer.
Sen. Garrett has insisted he was trying to be an advocate for families, children and veterans that wanted the opportunity to have the treatment they thought was right for them. He believed the majority of Nebraskans think the bill is a good idea. Sen. Sara Howard said it’s just there to alleviate human suffering.
Opponents were firm in their position that marijuana-derived medicines should go through the same federal approval process as other pharmaceutical drugs. Senator Chambers when asked responded that as far as he knew the Legislature had never in his memory approved a specific drug for use by people. Others opponents feared that a push for recreational marijuana wouldn’t be far behind if they voted to allow the drug to be used as a medicine. Attorney General Doug Peterson, Gov. Pete Ricketts and the Nebraska Medical Association were among those also opposed.
Last year, Senator Sue Crawford, was successful in getting her bill, LB390 passed that required the University of Nebraska Medical Center to create the Medical Cannabidiol Pilot Study on the efficacy of cannabidiol to treat patients with intractable seizures and treatment resistant seizures. The study is to include at least two neurologists, one of which is to be a pediatric neurologist. Sen Crawford, has indicated that UNMC has recently received the permits needed for their drug testing trials that will be conducted at UNMC regarding the effects of these drugs on patients. We should see results from this by next year.
To me, LB 643 is beyond the scope and ability of what the Legislature should be doing. We are not qualified to determine the quality, safety or effectiveness of a product that would be given to adults and children and I could not support approval of a product that has not passed the channels of approval all other drugs must go through.
A bill that on its face appears to be an innocuous proposal, has been far from that if you look at the history of the debate that has taken place so far. Anyone who has followed the legislature over the years would say that Senator Chambers usually will disagree with any attempt to raise fees that the Nebraska Game and Parks Commission charges, especially park permits.
LB 745 would allow price increases for the numerous hunting, fishing licenses and state parks permits in Nebraska. The bill is scheduled for second-round debate in the next few days.
The debate has been carried out by Senator Ernie Chambers, who wants to remove the authority of the Game and Parks Commission to allow mountain lion hunting. He has continuously vowed to delay the implementation of the bill. And has. In the first round of debate, Chambers filed several motions to delay the vote to advance the bill. After six hours of debate, LB 745 was advanced 39-3. Seventeen more motions have already been filed by Chambers for the second round, which will take up approximately four more hours of what little time we have left in the session.
The Game and Parks Commission needs the Legislature’s approval to increase the fee range for hunting, fishing and park permits. To actually raise the cost of individual permits, the nine-member board of commissioners then would have to conduct public hearings and vote.
If the commission enacted all of the fee increases included under LB 745, an estimated $5 million in new annual revenue would be taken in. Sen John McCollister, who made the bill his priority for this session, said the agency has not raised the cost of most permits for at least seven years. Permit fees supply the majority of the commission’s annual budget. Senator Chambers argues that these fees are already too high and disproportionally effects lower income people that want to use the park facilities.
LB 745 would allow the commission to raise the state park entry fee from $25 to $35 for an annual permit and from $5 to $7 for a daily permit. Prices could only be increased at 6% per year average until the cap is reached. The proposal would allow increases in many other permits and fees as well.
Over the years, Senator Chambers has introduced bills and amendments that would take away the authority of the Game and Parks Commission to use hunting as a tool to manage mountain lions, and each time it has been voted down by the Legislature. He has vowed to bring up the topic again and again as debate continues on this bill and others during the lingering days of the session.
Senator Chambers has argued that it is wrong to hunt mountain lions in the state when its populations are relatively low. Game and Parks is currently conducting a more in-depth study to try and determine what the current population is and then determine if and when control may be needed. In the only hunting season for mountain lions so far, hunters have killed 14 big cats. Game and Parks will not have a hunting season until this study is completed. I firmly believe that the authority to manage all wild game should remain with Game and Parks biologists who have the expertise to make these decisions.
We are in the last days of the session and are debating bills on the floor from 9:00 am to 7:00 pm and you can tell that the body is getting tired and tempers can flare rather quickly. Any hint of a filibuster seems to bring compromise rather quickly. We will see what the last days of the session bring.
High profile incidents of police misconduct have recently generated intense media attention in the United States. Police departments and policy makers throughout the country have begun to use body cameras to create an objective record of interactions with the public. The mere presence of body cameras fundamentally changes the dynamics of law enforcement encounters for both police and the public. By creating an objective visual record, body cameras have the potential to protect the public from police officer misconduct, provide officers a defense to allegations of misconduct, assist in police training and help prosecutors secure convictions by supplying visual evidence.
LB 1000, introduced by Sen. Health Mello, would require the Nebraska Crime Commission to develop a model policy on body-worn cameras and make it available to law enforcement agencies. It would also require all law enforcement agencies that use body-worn cameras to either adopt the Crime Commission’s model policy or adopt their own policy. If a law enforcement agency adopts its own policy, it could go above and beyond the Crime Commission policy, but it must be consistent with the Crime Commission policy. The bill would also require law enforcement agencies to provide their policies, and annual updates to their policies, if any, to the Crime Commission.
Before 2015, only four states had enacted laws related to body cameras. But just last year, at least 37 states considered legislation on some aspect of body cameras for law enforcement officers and fifteen states enacted new laws. Altogether, 19 states and the District of Columbia have some kind of body camera law on the books. Instead of mandating body cameras, most of the legislation gives individual departments discretion over whether they will use them or not. However, if police do decide to use body cameras, most state laws, including the provisions of LB 1000, set up a policy framework that governs their use.
One of the roadblocks our state and local law enforcement agencies have encountered, is the cost. The Legislative Fiscal Note shows an expenditure of $48,000 for fiscal year 2016-17 and $108,000 for fiscal year 2017-18. That includes only the data storage costs for one year, based on 100 officers wearing cameras in FY 2017 and 200 in FY 2018. The 2018 costs also include retaining 25% of recordings longer than one year, which is the Nebraska State Patrol’s current retention policy. The agency also notes that if 400 officers were to be equipped with body worn cameras, the first year of data storage costs would total $192,000 and the second year would total $240,000. The Patrol notes that these are only storage costs and do not reflect the cost of purchasing body cameras, which are relatively expensive, and the training that must be done so that everyone understand the policies and regulations that must be met when using these cameras.
Body cameras over the next few years will change the nature of policing in unexpected ways. When implemented correctly, body cameras can help promote accountability and transparency, and they can be useful tools for improving training, preserving evidence, and documenting encounters with the public. Just the fact that an officer is wearing a camera could be a factor in de-escalating a confrontation between an officer and the subject. One thing we must remember is that there will be unintended consequences of using cameras. What happens when an officer is on a call and his camera fails to operate properly? Cameras can only capture what it is pointed at, not what may be happening behind the officer or off to the side or out of camera range. What happens if data is lost during transfer from camera to storage? Would there be a chance that embarrassing video taken of a subject that did not result in an arrest could be released to the public? As more and more departments begin using cameras we will begin to understand the consequences of adopting this technology.
LB 1000 has been designated a Speaker Priority bill and has been advanced to the first stage of debate for consideration by the full body of the Legislature. With a priority designation, we should see the bill on the agenda soon.
Have a wonderful Easter Holiday!
A subject that has been introduced three times, by Senator Bloomfield and by many Senators in prior legislative sessions, is the repeal of the mandatory motorcycle helmet law.
LB 900, introduced by Sen. Dave Bloomfield makes several changes to our current helmet law. It does the following:
The Motorcycle Safety and Brain Injury Trust Fund, as proposed by the Transportation Committee amendment, is a nine member body – three members from the following areas of medicine: general practice; neurological medicine and surgery; orthopedic surgery, or psychiatry, plus the members listed in LB 900 as introduced.
It is estimated by the Legislative Fiscal Office that the increased $19 registration fee will generate $1,056,550, based on 55,608 motorcycles registered in 2014.
The Fund is to be used for expenses related to meeting the needs of individuals with a brain injury, who are not eligible for the Traumatic Brain Injury Waiver program within the Department of Health and Human Services or do not meet the income guidelines for the program, motorcycle awareness and education programs and administrative expenses of the Motorcycle Safety and Brain Injury Trust Fund.
In order to apply for funds from the program, applicants must authorize Health and Human Service to provide Traumatic Brain Injury Waiver application materials to the brain injury services program. If a functional assessment for the Traumatic Brain Injury program has not been completed, then the brain injury program may contract with Health and Human Services for the assessment.
The fines which can be imposed when a person is found guilty of a traffic infraction due to violating requirements for a motorcycle license are increased from a range of $10 to $100 to a range of $50 to $150. Fines accrue to the county where the violation occurs.
The public hearing held by the Transportation and Telecommunications Committee was on February 1, 2016. There were many testifiers on both sides of the issue. It was voted out of Committee on a vote of 6-1, and one not voting.
As I am writing this column the bill is being filibustered. A cloture vote was just taken and was three votes short of the thirty three required, so another bill dies by filibuster.
Riding a motorcycle is dangerous whether you wear a helmet or not. The number one reason for brain injuries is from falls. I didn’t like the creation of the brain injury trust fund and the creation of another board but these were the compromises that were made by Senator Bloomfield to try and get enough votes to invoke cloture.
Most supporters basically felt that wearing a helmet goes back to personal responsibility of individuals and freedom of choice. There are many dangerous recreational activities that people take part in. Is it the state’s responsibility to protect us from ourselves? Should we require all bicycle riders to wear helmets? Since all types of brain injuries will have access to the trust fund the amount of dollars collected in the trust fund will cover very little of the costs related to brain injuries. Arguments over the economic benefits of more riders coming through Nebraska on their way to Sturgis, better rider awareness of their surroundings and thus fewer accidents, versus the possible costs of higher medical care due to increased number of head injuries were debated for six hours.
I am sure in the future, another senator will try to repeal the motorcycle helmet law once more.
One of the more interesting proposals that takes us full circle in how we access our primary care physician will soon be debated by the Legislature.
LB 817, introduced by Sen. Merv Riepe, creates the Direct Primary Care Agreement Act. Direct Primary Care (DPC) is a medical care delivery contract between a patient and a primary care practitioner (physician or licensed nurse practitioner). The patient-practitioner relationship generally includes an agreement where a patient pays a monthly retainer for unlimited office visits and a set scope of practice that spells out what services are included. Direct Primary Care enhances the patient-practitioner relationship.
Direct Primary Care is an innovative health care reform model which can improve access to medical care, reduce the use of emergency departments for non-emergent primary care use and reduce health care costs. Since office visits are free, people tend to visit their doctor sooner when they start to feel sick and thus treatment is cheaper and less patients require hospitalization. It is in the doctor’s best interest to spend a little extra time with a patient so that the correct diagnosis is made so the patient does not return for another office visit.
DPC practices exist in 42 states and currently 13 other states are considering legislation. Passage of LB 817 is to guarantee in statute that DPC is not insurance and does not function as a health plan.
Some of the benefits of a Direct Primary Care system include:
A free-market option in health care;
Happier practitioners (better work-life balance; connection with patients; no insurance to bill; keeping seasoned practitioners from retiring too early out of frustration because of the excessive staff time and paper work that is required with insurance, Medicare and Medicaid; revitalizing primary care as being very important; and encouraging medical students and residents to become primary-care physicians);
Happier patients (focus on prevention; monitoring of chronic conditions; improved patient-practitioner relationship); and
Better health outcomes (a DPC provider in Washington State reported reductions of 14 percent in emergency room visits, 60 percent in inpatient stays and 14 percent in specialist visits, for an average saving of over 19 percent per patient).
Opponents say DPC will result in fewer practitioners available to the public because the model leads to a reduced patient panel size per doctor. In Nebraska, this is especially concerning given the shortage of primary-care practitioners. Practitioners are not indentured servants and may elect to retire earlier than desired because the bureaucracy in medicine has provided too many challenges. Panel sizes may be smaller, but if DPC practitioners are able to improve their work-life balance, the net gain could be more practitioners available to serve for additional years.
LB 817 enables, not mandates, DPC. This will establish DPC in statute to ensure its long-term viability and provide consumer protection language. The legislation will seek to minimize regulation and be at no cost to the state.
I attended a presentation that a physician from Colorado gave this last December. With his practice he had around 50% of his patients on direct primary care contracts and the balance were traditional patients. His price for DPC was around $75 a month and included a tele-health option where he could, because of the personal relationship with his patients, diagnose and prescribe medicine using a smartphone while they were traveling anywhere in the world. Because he does not file any insurance claims on DPC patients he requires less staff time and doesn’t have to wait months for insurance claims to be settled. The patients are happy because they can always consult with the same caregivers. This could be a program for small businesses who want to offer an extra benefit to employees who may have extremely high out-of-pocket costs on their traditional insurance plans.
Now that the deadline for designation of priority bills has passed, we can start looking ahead to the bills that we will be addressing the last half of our short session. One of the bills that has already drawn some attention from the press is a bill that would require the University of Nebraska to publicly release just one finalist for top leadership jobs. This bill was advanced from the Government, Military and Veterans Affairs Committee and was designated a priority by Senator Burke Harr of Omaha.
LB 1109 updates the current search process used by the Board of Regents regarding the University of Nebraska President or campus Chancellor positions. It also accomplishes the following:
The bill would specifically exempt the University from current public records law, which requires that four finalists be named. Only a single priority candidate, and his or her application, resume and other documents, would be announced under the provisions of LB 1109.
Proponents of LB 1109, including University President Hank Bounds, feel the bill balances solving a problem the University faces in attracting the best candidates while maintaining an open selection process. During the public hearing, President Bounds said the candidate pool of applicants for replacing University of Nebraska-Lincoln Chancellor Harvey Perlman, was a fraction of the size of what he expected, and blamed the low number on the public process. The bill’s introducer, Sen. John Murante said numerous candidates won’t even apply for leadership positions because they would be outed as a finalist, putting their current jobs at risk.
Opponents, including Sen. Beau McCoy, a member of the Government Committee who voted against advancing the bill, said he takes issue with naming just one finalist because that doesn’t allow Nebraskans to compare the candidates. That breeds secrecy, he said.
Sen. Mike Groene, also a member of the Committee has vowed to fight LB 1109, arguing that the proposal goes in the opposite direction of the public’s increasing demand for more government openness. He said, transparency in government is never a wrong choice.
I think we need to look at the entire hiring process when looking at the merits of this bill. Currently we elect our Board of Regents, whose job is to oversee our university system, in a very public election. Should we not trust this group plus the many others involved in the selection process? Maybe we need to look at the makeup of the current committee that does the selection, but I do believe we should trust this group to make the initial selection.
One of the main issues is whether we are attracting the best qualified candidates. If I was currently happily working at a great company but felt that I could no longer grow my career and I applied at another firm but I did not get that position, would I want my old company to know that I was thinking of leaving? I really think that we could attract more qualified candidates if we didn’t disclose the names of those who come in second. Making the names public subjects them to the possibility of losing their current job when they may be perfectly content to stay and only thought of leaving because it would have been the opportunity of a lifetime or a chance to really grow their career.
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