Legislative & Ethics Update

Beth Ann Brooks, MD, MSA

Legislative Update

This summer NPS executives along with Legislative Co-Chair, Kayla Pope, and I had several discussions with American Psychiatric Association (APA) government affairs staff; the Nebraska Department of Insurance; an interested Nebraska senator’s office, and our NPS lobbyist, Korby Gilbertson, regarding enforcement of the federal Mental Health Parity and Addiction Equity Act of 2008.  The State is working with a national coalition to develop a common compliance reporting template.  It appears NE LB 44-710.03(13) which was passed in 2013 is sufficient because it requires Nebraska insurers to comply with federal law where federal law preempts Nebraska law (present and any future).

The 2019 Nebraska Unicameral convenes on January 9, with 11 new senators elected in November and two additional newcomers after Governor Ricketts appoints replacements for Senators Murante (Gretna) and Watermeier (Syracuse) who both ran for other offices and won.  The composition of the Unicameral is expected to be slightly more moderate, but deadlocks may be more likely and require true across-the-aisle negotiation in any contentious issues.  It is anticipated there will be strong competition for various committee chairs, including DHHS (open because Senator Merv Riepe of Ralston lost his bid for re-election), Education, Executive Board leadership, Judiciary (Senator Laura Ebke of Crete also was not re-elected), and Revenue.

Legislative bills have to be introduced during the first 10 days of the upcoming 90-day legislative session, and we anticipate bills attempting to alter scope of practice for select professional groups will be introduced.  Because every bill receives a hearing from the legislative committee to which it is assigned, it is important to keep abreast of bills that can affect our patients and the profession of psychiatry.  We will inform you of any bills requiring letters of opposition and/or in-person testimony at committee hearings, but please note that hearing dates often are scheduled with minimal advance notice.  Once a committee votes to take a bill out of committee, the entire Legislature debates the bill; any bill must clear three different rounds of debate before it can be sent to the Governor for his signature or veto.  If the Governor does not approve a bill, the Legislature can override the bill with 30 votes.  All introduced bills can be found at www.nebraskalegislature.gov.

The state-wide initiative for Medicaid expansion passed by more than 42,000 votes.  Those citizens who earn up to 138 percent of the federal poverty level ($16,753 for a single person or $34,638 for a family of four) now will be eligible, making Medicaid more available to single adults and couples without minor children who cannot qualify for Medicaid now, as well as parents and disabled individuals with incomes higher than the current “traditional Medicaid” cutoff.  The funding for its implementation undoubtedly will add to what are anticipated to be tense budget and tax reform discussions.

A source of new funds is the collection of on-line sales tax, but that revenue’s designation also will be heatedly debated; anticipated proposals are property tax relief versus shoring up funding for Corrections, DHHS, and the University.

Ethics Update

After no ethics complaints for several years, there were three issues raised this year; all have been resolved according to American Psychiatric Association protocol.  Thank you to those members who served as investigating officer and on the hearing panel.  The APA offered an Ethics webinar on November 17 which provided valuable information to use when future complaints arise.