Health and Human Services Committee
January 29, 2025
Committee Chair: Sen. Senator Brian Hardin | Bills Heard: 4 | Full Transcript (PDF)
LB118: Increase pharmacy technician to pharmacist ratio from 3:1 to 4:1
Introduced by: Sen. Brian Hardin | Testimony: 3 proponents, 0 opponents, 1 neutral | Read bill text (PDF)
Nebraska would allow pharmacists to supervise four technicians instead of three, joining 38 other states with less restrictive ratios. LB118 aims to free up pharmacists from administrative tasks so they can focus on clinical patient care like medication therapy management and counseling. Why it matters: Nebraska faces shortages of both pharmacists and technicians, particularly in rural areas where pharmacists may be the only healthcare professional available. The change could improve patient access to pharmacy services without sacrificing safety. What they're saying: Proponents noted that 24 states and D.C. have no ratio limits, and Governor Ricketts suspended Nebraska's ratio during the pandemic without reported safety problems. Pharmacists testified they currently spend significant time on insurance calls and administrative work that technicians could handle. The Nebraska Pharmacists Association, split 50-50 internally, recommended amendments requiring at least half of technicians to be certified and ensuring the on-site pharmacist retains authority to set appropriate ratios. By the numbers: 38 states have less restrictive ratios than Nebraska's current 3:1; over 750 RHOP graduates have completed the pipeline since 1989. What's next: No vote was taken. The bill advanced with discussion of potential amendments addressing certification requirements and pharmacist discretion.
Committee sentiment: Supportive: Sen. Riepe, Sen. Hansen, Sen. Meyer, Sen. Ballard, Sen. Quick
Sentiment estimated from questions and comments — not stated positions.
LB138: Establish tiered Medicaid reimbursement rates for pharmacy dispensing fees
Introduced by: Sen. Merv Riepe | Testimony: 3 proponents, 0 opponents, 0 neutral | Read bill text (PDF)
Nebraska would create a tiered Medicaid pharmacy reimbursement system based on prescription volume, extending last year's increase beyond independent pharmacies. LB138 builds on LB204's $10.38 dispensing fee for independent pharmacies by establishing volume-based tiers for larger chains while protecting rural pharmacies. Why it matters: Pharmacies have gone decades without meaningful reimbursement increases—the last adjustment before 2024 was in 2011. Rural pharmacy access is critical in areas where they serve as de facto primary care providers. What they're saying: Proponents argued the tiered structure is fairer than location-based definitions and that proposed rates are modest compared to other states. The Nebraska Pharmacists Association noted that a 2008 survey showed the actual cost of dispensing was $10.18, yet rates had only reached $4.65 by 2011. One testifier highlighted that some pharmacies don't even know what rate they're supposed to receive from different plans. By the numbers: $3.3 million General Fund impact; $5.4 million federal match. Dispensing fees ranged from $3.25-$5 before 2015. What's next: No vote was taken. Sen. Riepe acknowledged the significant fiscal impact and noted the bill addresses a fundamental equity issue in Medicaid reimbursement.
Committee sentiment: Supportive: Sen. Quick Skeptical: Sen. Hansen, Sen. Fredrickson
Sentiment estimated from questions and comments — not stated positions.
LB119: Codify the Rural Health Opportunity Program into state statute
Introduced by: Sen. Brian Hardin | Testimony: 4 proponents, 0 opponents, 0 neutral | Read bill text (PDF)
Nebraska would enshrine the Rural Health Opportunity Program into statute, formalizing a 35-year partnership that has produced 750+ healthcare professionals for rural communities. RHOP provides tuition waivers and guaranteed UNMC admission to rural residents attending state colleges, with two-thirds of graduates remaining in Nebraska and nearly half returning to rural practice. Why it matters: Nebraska faces a healthcare crisis in rural areas—13 counties lack primary care physicians. Codifying RHOP ensures the program survives leadership changes and signals state commitment to rural health workforce development. What they're saying: Proponents highlighted RHOP's proven success rate and noted that keeping rural students in-state increases the likelihood they'll practice in rural areas by 70% versus 25% for those who leave. The companion Kearney program boasts a 70% medical school admission rate versus 10% nationally. Sen. Riepe raised constitutional concerns about restricting benefits to rural residents and questioned whether UNMC can guarantee admission. Sen. Hansen asked whether the bill should allow urban students with rural connections to participate. By the numbers: 750+ RHOP graduates since 1989; 68% remain in Nebraska; 47% return to rural communities. Average pharmacist debt: $170,000. What's next: No vote was taken. Testifiers acknowledged the need for potential amendments clarifying eligibility and institutional flexibility.
Committee sentiment: Supportive: Sen. Fredrickson Skeptical: Sen. Riepe, Sen. Hansen
Sentiment estimated from questions and comments — not stated positions.
LB162: Establish Child Care Safety and Security Fund for emergency notification and training
Introduced by: Sen. Margo Juarez | Testimony: 4 proponents, 0 opponents, 1 neutral | Read bill text (PDF)
Nebraska would create an emergency notification system for child care centers, closing a safety gap that leaves thousands of young children without the alerts schools automatically receive. LB162 provides grants for child care providers to implement emergency notification, training, and reunification procedures modeled on Lincoln Littles' successful program. Why it matters: Child care centers currently have no formalized way to learn of nearby emergencies—armed pursuits, active shooters, gas leaks—while schools receive automatic alerts. Young children require specialized procedures to evacuate safely and reunify with parents. What they're saying: Proponents shared stories of emergencies where child care staff only learned of danger from parent calls or personal connections to law enforcement. Lincoln Littles has successfully implemented Standard Response Protocol and text alerts. Opponents questioned whether specialized training is necessary and why child care providers can't simply be added to existing school notification systems. Sen. Meyer noted that even small-town daycares have good security protocols and questioned the need for additional bureaucracy. By the numbers: $300,000 one-time appropriation; 18 online proponents, 1 opponent, 1 neutral. Fiscal note shows additional FTE positions at NDE and ESUs, though last year's version had no staff requirements. What's next: No vote was taken. Sen. Juarez acknowledged concerns about the fiscal note and committed to working with NDE and ESUs to clarify why staffing estimates changed from last year.
Committee sentiment: Supportive: Sen. Fredrickson Skeptical: Sen. Riepe, Sen. Meyer, Sen. Hansen
Sentiment estimated from questions and comments — not stated positions.
Session Notes
The committee heard four bills on January 29, 2025. Committee Chair Brian Hardin presided over LB118, LB119, and LB162. Vice Chair Fredrickson presided over LB138. Committee members present included Sens. Riepe, Meyer, Quick, Ballard, and Hansen. Research analyst Bryson Bartels and clerk Barb Dorn assisted. Pages were Sydney Cochran (UNL, business administration and U.S. history) and Tate Smith (UNL, political science). No votes were taken on any bills during the hearing. Multiple amendments were discussed for LB162, with some confusion about whether AM59 or AM67 was the current version. Several bills generated significant fiscal note questions, particularly LB138 ($8.7 million total impact), LB119 (minimal new costs claimed), and LB162 (discrepancy between last year's and this year's staffing estimates).
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