Senator John Wightman
With only ten working days remaining of the sixty day session the Legislature has been very busy on major legislation. This week my comments will report on three of the many controversial bills debated:
- L.B. 1092 which authorizes the use of bonds to finance highway construction, which I support.
- L.B. 916 to eliminate written practice agreement between physician and nurse practitioners, which I did not support; and,
- L.B. 526 that will allow optometrists to perform minor surgery and use certain pharmaceuticals, which I support.
L.B. 1092 would authorize the use of bond financing to accelerate the completion of highway construction projects. L. B. 1092 was introduced by Senator Dubas, Chair of the Transportation and Telecommunications Committee. Of the 50 states, only Nebraska and Wyoming have not allowed some bonding for highway construction since the construction of the original interstate highway system. The bonds would be repaid with revenue from the State Highway Capital Improvement Fund, which currently receives 25 percent of the state’s sales and use tax. To secure the debt, L.B. 1092 would pledge the revenue from all fuel taxes, motor vehicle registration fees and other highway user fees for the purpose of debt repayment. The interest rates are currently very low on such bonds and construction costs are increasing at rates of inflation that are higher than the interest rates on debt. It was argued that putting money into highway construction will put money into the economy and support jobs.
L.B. 1092 was changed by a committee amendment to reduce the amount of authorized debt to a maximum of $200 million from a maximum of $400 million, as originally provided in the bill. The amendment also reduces the time period during which the Highway Commission may issue bonds to two years and requires that the bonds carry a fixed interest rate which may be no higher than five percent. The bill advanced with 32 votes after overcoming a filibuster by Senator Chambers of Omaha.
L.B. 916 is a bill that was introduced by Senator Crawford of Omaha that would eliminate the currentrequirement for a nurse practitioner, to have an “integrated practice agreement” with a physician. Nurse practitioners have more training that a nurse and can perform more clinical tasks.It would remove the requirement that a nurse practitioner complete a minimum of 2,000 hours of practice under the supervision of a physician. Under L.B. 916 the nurse practitioner would be required to have only a “transition to practice agreement.” The supervising provider could be another nurse practitioner and that nurse practitioner may have only 10,000 hours of clinical experience
I am a supporter of physician directed primary health care. The physicians receive more training and are required to have a training residency which offers far more clinical experience than a nurse practitioner. I did not support L.B. 916, but it advanced with 29 affirmative votes based upon the prevailing argument that the current limitations are not needed and nurse practitioners do not have such restrictions in many other states, including several neighboring states.
L.B. 526 was introduced by Senator Howard of Omaha to allow optometrists to perform minor surgery and use additional pharmaceuticals. These minor surgeries have been allowed in the past to be performed only by ophthalmologists, who are medical doctors. Only four counties in the entire western half of Nebraska have resident ophthalmologists. The bill was opposed by physician and physician groups. The Health and Human Services Committee advanced the bill with an extensive amendment to clarify and narrow the language of the bill. The bill was further amended to require optometrists who perform minor surgical procedures or who administer injections to provide a standard of care to patients comparable to that provided by physicians licensed in this state to practice medicine and surgery. Based upon the information provided to me, it is my position that L.B. 526 will require the necessary training to safely provide these services, and will increase access to these minor surgical services in western Nebraska at a reasonable cost.
I look forward to receiving your input and the voicing of your concerns as we address these issues and many others during this year’s legislative session. Please contact me at my Lincoln office in the State Capital, District 36, Box 94604, Lincoln, NE 68509. My phone number is (402) 471-2642. My email address is email@example.com.