Health and Human Services Committee
January 22, 2025
Committee Chair: Sen. Brian Hardin | Bills Heard: 4 | Full Transcript (PDF)
LB10: Prescription Drug Donation Program Cleanup
Introduced by: Sen. Jana Hughes | Testimony: 1 proponents, 0 opponents, 0 neutral | Read bill text (PDF)
Nebraska moves to implement prescription drug donation program after federal rule created unintended barrier. LB10 clarifies that the federal Drug Security Supply Chain Act doesn't apply to Nebraska's partnership with Iowa's SafeNetRx program, which collects unexpired medications from nursing homes and other facilities to redistribute to uninsured and underinsured Nebraskans. The bill also allows the governor to access the program during emergencies.
Why it matters: Nebraska currently incinerates 30,000 pounds of perfectly good prescriptions annually at $25 per pound—a $750,000 annual cost. The program could save state dollars while improving access to preventative medications for low-income residents. Iowa's 18-year-old program has even shown reduced recidivism when extended to individuals exiting the justice system.
What they're saying: - Sen. Riepe visited Iowa's facility and praised its quality control and nonprofit model, questioning whether DHHS truly needs two full-time employees to oversee Nebraska's program. - Josephine Litwinowicz emphasized the importance of ensuring individuals released from prison can access medications, particularly mental health medications.
What's next: No vote was taken. Sen. Hughes indicated she would work to resolve the funding issue ($528,000 previously zeroed out in the governor's budget) and requested swift scheduling. An amendment (AM12) addressing emergency language was distributed and will be considered.
Committee sentiment: Supportive: Sen. Merv Riepe, Sen. John Fredrickson, Sen. Glen Meyer Unclear: Sen. Mike Hansen
Sentiment estimated from questions and comments — not stated positions.
LB13: Childcare Subsidy Reimbursement: Enrollment-Based vs. Attendance-Based
Introduced by: Sen. Machaela Cavanaugh | Testimony: 23 proponents, 1 opponents, 1 neutral | Read bill text (PDF)
Nebraska childcare providers face financial instability under attendance-based subsidy reimbursement; federal law requires shift to enrollment-based model by 2026. LB13 would change how the state reimburses childcare providers for subsidy children—from paying only for days attended to paying for enrollment, matching how private-pay families are billed and aligning with federal requirements.
Why it matters: Providers can't predict or control daily attendance, making it impossible to budget for fixed costs like staff salaries and facility rent. A family childcare provider testified she lost $1,628 in one month when subsidy children got sick. The shift could increase provider willingness to accept subsidy children and improve access, especially for children with special needs—enrollment in subsidy programs for special needs children dropped 40% since 2019.
What they're saying: - Proponents: Federal law already requires this by August 1, 2026; LB13 implements it proactively and provides certainty. Enrollment-based billing is standard in private childcare and allows providers to maintain quality care despite absences. - DHHS: The $18 million annual cost is an unfunded federal mandate. Paying for non-attendance could reduce provider incentive to encourage children to actually attend.
By the numbers: 23 states already in compliance; Nebraska has temporary waiver until July 31, 2026. Current subsidy rate is 75% of market rate.
What's next: No vote taken. Sen. Cavanaugh indicated willingness to amend bill with August 1, 2026 operational date and expressed frustration that DHHS opposed the bill rather than working with her on solutions.
Committee sentiment: Supportive: Sen. John Fredrickson Skeptical: Sen. Merv Riepe Unclear: Sen. Mike Hansen
Sentiment estimated from questions and comments — not stated positions.
LB27: Dental Student Loan Repayment for Medicaid Providers
Introduced by: Sen. Beau Ballard | Testimony: 6 proponents, 0 opponents, 1 neutral | Read bill text (PDF)
Nebraska proposes loan repayment incentive to attract young dentists to serve Medicaid patients statewide. LB27 would authorize the Rural Health Advisory Commission to repay up to $60,000 in student loans for early-career dentists who commit to seeing a specified percentage of Medicaid patients. Unlike the existing rural health loan repayment program, this applies to dentists anywhere in the state—urban or rural.
Why it matters: Medicaid reimbursement is 40-50% of commercial insurance rates, making it financially difficult for dentists burdened with $300,000+ in student debt to accept Medicaid patients. Approximately 3,000 children are on waiting lists for dental care, primarily in western Nebraska. More dentists accepting Medicaid could expand access and reduce wait times.
What they're saying: - Proponents: A pediatric dentist testified she carries $350,000 in loans with $2,900 monthly payments for 13 years. She can't access the existing rural program because she practices in Omaha, yet she serves high percentages of Medicaid patients. A first-year dental student expressed concern that financial pressures may prevent her from owning a practice and serving diverse populations. - Sen. Meyer: Questioned whether program addresses the original goal of rural loan repayment—incentivizing relocation to underserved communities.
By the numbers: Nebraska has 1,017 dentists (down 35 from last year). Estimated program cost: $1.5 million annually plus administrative costs. Funding source: Medicaid Excess Profit Fund (~$45 million balance).
What's next: No vote taken. Sen. Ballard indicated openness to income ceiling amendment and noted the program is designed as a pilot.
Committee sentiment: Supportive: Sen. Merv Riepe, Sen. Mike Hansen, Sen. Dan Quick Skeptical: Sen. Glen Meyer
Sentiment estimated from questions and comments — not stated positions.
LB61: Medicaid Waiver Amendment for Memory Care Assisted Living Rates
Introduced by: Sen. Tanya Storer | Testimony: 9 proponents, 0 opponents, 1 neutral | Read bill text (PDF)
Nebraska faces surge in dementia cases but only 44 assisted living providers accept Medicaid for memory care—inadequate reimbursement rates are the barrier. LB61 would require DHHS to file a Medicaid waiver amendment establishing a separate, higher reimbursement rate for memory care assisted living services. Current rates ($3,100 urban/$2,800 rural monthly) haven't been adjusted in 30+ years and don't account for the specialized staffing (1:5-7 ratio vs. 1:15-20 for traditional assisted living) and training required for dementia care.
Why it matters: 35,000+ Nebraskans currently have Alzheimer's or dementia; that number is projected to increase 21% this year alone and reach 60,000 by 2050. Memory care costs average $8,000/month but providers receive $3,100-$3,140 from Medicaid—a $1,860 monthly shortfall per resident. Providers are closing (11% reduction since 2017) or refusing Medicaid patients, leaving vulnerable seniors with few options. Shifting care from nursing homes to memory care assisted living could offset some costs.
What they're saying: - Providers: One CEO reported $300,000 annual losses serving Medicaid memory care residents. Another testified she acquired a rural building perfect for memory care but couldn't make it financially viable. Only 44 of 280 assisted living providers statewide accept Medicaid for memory care. - LeadingAge Nebraska: South Dakota's base assisted living rate is $79.95/day vs. Nebraska's ~$68/day. Dementia is the sixth leading cause of death nationally and the most expensive condition.
By the numbers: 35,000 Nebraskans with dementia now; 42% lifetime risk for those over 55 (per recent NIH study). Only 44 providers accept Medicaid waiver for memory care. 22 Nebraska counties have zero nursing homes; 17 have no assisted living.
What's next: No vote taken. Sen. Storer urged committee to at least approve waiver application as first step, which would provide clearer fiscal picture. She indicated willingness to work on funding in future budget discussions.
Committee sentiment: Supportive: Sen. Mike Hansen, Sen. Glen Meyer, Sen. John Fredrickson Skeptical: Sen. Merv Riepe
Sentiment estimated from questions and comments — not stated positions.
Session Notes
Committee Chair Sen. Brian Hardin opened with procedural remarks and introduced committee members: Sen. Merv Riepe (District 12), Sen. John Fredrickson (District 20), Sen. Glen Meyer (District 17), Sen. Dan Quick (District 35), and Sen. Beau Ballard (District 21). Research analyst Bryson Bartels and committee clerk Barb Dorn assisted. Pages were Sydney Cochran (UNL, business administration/U.S. history) and Tate Smith (UNL, political science). Hardin noted approximately 600 bills have been introduced this session. The committee heard four bills: LB10, LB13, LB27, and LB61. No votes were taken on any bills during this hearing.
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