Health and Human Services Committee
February 28, 2025
Committee Chair: Sen. Brian Hardin | Bills Heard: 4 | Full Transcript (PDF)
LB701: Doula Services Medicaid Reimbursement
Introduced by: Sen. Ashley Spivey | Testimony: 25 proponents, 1 opponents, 0 neutral | Read bill text (PDF)
Nebraska advances Medicaid coverage for doula services, addressing maternal health crisis with evidence-based support. Sen. Ashley Spivey's LB701 would require the Department of Health and Human Services to establish a stakeholder group to create a state plan amendment enabling Medicaid reimbursement for doula services—trained professionals who provide emotional, physical, and informational support during pregnancy, labor, and postpartum.
Why it matters: Nebraska ranks 19th nationally in maternal mortality, with 11% preterm birth rates and 93 preventable maternal deaths identified by the state's Maternal Mortality Review Committee. Doulas address this crisis: research shows they reduce cesarean rates by 39%, shorten labor by 25%, and decrease pain medication use by 60%, with potential cost savings exceeding $3,000 per birth. Thirteen states and Washington D.C. already cover doulas under Medicaid.
What they're saying: Proponents emphasized doulas' role in addressing racial disparities—Black women are 3-4 times more likely to die from pregnancy complications than white women. Dr. Sami Zeineddine, an OB/GYN, testified that CHI Health's pilot program demonstrates doulas create "proactivity instead of reactivity" in patient care. Testifiers highlighted doulas' ability to connect families with social services, housing, food assistance, and mental health resources. Sen. Matt Hansen noted the federal government and VA already recognize doula and midwifery services as cost-effective alternatives.
By the numbers: 25 online proponents; 1 opponent; 13 states plus D.C. currently cover doulas under Medicaid; 9 additional states implementing coverage; fiscal note: $16,000 year one, $120,000 year two, funded through cash fund rather than general funds.
What's next: No vote taken. Bill remains in committee with pending amendments addressing funding source and technical language clarifications.
Committee sentiment: Supportive: Sen. John Fredrickson, Sen. Glen Meyer, Sen. Dan Quick, Sen. Mike Riepe Unclear: Sen. Beau Ballard, Sen. Matt Hansen
Sentiment estimated from questions and comments — not stated positions.
LB454: Regional Behavioral Health Authority Flexibility
Introduced by: Sen. Dan Quick | Testimony: 5 proponents, 0 opponents, 0 neutral | Read bill text (PDF)
Nebraska removes red tape from behavioral health system to speed mental health and substance use services to communities. Sen. Dan Quick's LB454 eliminates the competitive bidding requirement for regional behavioral health authorities to expand services with existing providers and approve pilot projects, while expanding housing assistance to individuals with substance use disorders.
Why it matters: Current RFP process delays response to community mental health needs by months, discouraging small providers from applying due to lengthy documentation requirements. Regions already undergo extensive vetting and audits, making additional bidding unnecessary. Expanding housing assistance to substance use disorder population recognizes clinical overlap and aligns with federal priorities.
What they're saying: Dr. Thomas Janousek, DHHS Division of Behavioral Health Director, testified the change would "simplify the process" and enable regions to "target smaller providers who would lack the resources to respond to these lengthy requests." Chase Francl, CEO of Mid-Plains Center, provided real-world example: an emergency family support program was approved quickly without RFP, serving 50+ youth in crisis over four months. Had RFP been required, "the program would not be serving families as it is now, but instead be stalled in multiple month waiting period."
By the numbers: Regions have housed 734 people through housing programs with 64 on waitlist; problem-solving courts cost $11.94/day vs. $36.67/day for incarceration.
What's next: No vote taken. Committee considering DHHS technical amendment to provide flexibility for extending pilot projects beyond one-year limit.
Committee sentiment: Supportive: Sen. John Fredrickson, Sen. Glen Meyer Skeptical: Sen. Mike Riepe
Sentiment estimated from questions and comments — not stated positions.
LB255: Medication-Assisted Treatment for Problem-Solving Courts
Introduced by: Sen. Dan Quick | Testimony: 4 proponents, 1 opponents, 1 neutral | Read bill text (PDF)
Problem-solving courts seek $1 million for medication-assisted treatment as opioid epidemic persists. Sen. Dan Quick's LB255 would appropriate $1 million from the Opioid Treatment Infrastructure Cash Fund to enable problem-solving courts to provide MAT—FDA-approved medications combined with counseling—for individuals with opioid use disorders.
Why it matters: Individuals released from incarceration face greatest overdose death risk in first 2 weeks, yet Medicaid coverage may not begin for 30 days. Problem-solving courts currently lack funding for MAT despite evidence it reduces overdose deaths by 75% and is a best practice standard. Nebraska faces 47.9% increase in overdose deaths between 2019-2021.
What they're saying: Proponents emphasized cost-effectiveness: problem-solving courts cost $11.94/day vs. $41,000/year for incarceration; diverting 100 people annually saves $3.75 million. Bob Denton, Deputy Administrator for Adult Probation Services, testified courts "cannot prohibit" opioid-addicted individuals but "do not have funds to pay for those medications right now." However, Dr. Thomas Janousek, DHHS Division of Behavioral Health Director, opposed the bill, arguing the infrastructure fund should be reserved for capital construction of crisis stabilization and withdrawal management facilities, and that existing funding sources (Medicaid, State Opioid Response Grant) already cover MAT.
By the numbers: 76% of problem-solving court participants do not recidivate; Veterans Treatment Court has 87% completion rate; 213 overdose deaths in Nebraska January 2020-2021.
What's next: No vote taken. Sen. Quick indicated willingness to work with DHHS on amendment potentially using Opioid Recovery Trust Fund instead of infrastructure fund.
Committee sentiment: Supportive: Sen. John Fredrickson, Sen. Brian Hardin Skeptical: Sen. Mike Riepe
Sentiment estimated from questions and comments — not stated positions.
LB553: Dietitian Loan Repayment Program Expansion
Introduced by: Sen. Merv Riepe | Testimony: 15 proponents, 0 opponents, 2 neutral | Read bill text (PDF)
Nebraska expands loan repayment program to recruit dietitians to rural health deserts. Sen. Merv Riepe's LB553 would add licensed dietitian nutritionists to the Rural Health Systems and Professional Incentive Act, making them eligible for student loan repayment awards when practicing in underserved Nebraska communities—a benefit currently limited to pharmacy, occupational, and physical therapists.
Why it matters: Nebraska faces severe dietitian shortage and alarming chronic disease rates. The state has 9.7% diabetes prevalence (161,500 individuals, up 2% over 10 years) and 69% overweight/obesity combined (up 5%). Rural areas have second-highest obesity rates; Scotts Bluff County ranks #2 statewide for diabetes. Meanwhile, central and western Nebraska have only 20-30 dietitians compared to 200-300 in Omaha/Lincoln metro. Medical nutrition therapy delivers measurable returns: $1,500/year cost savings per patient, and for every $1 spent, $3.03 saved on medication alone.
What they're saying: Niki Kubiak, registered dietitian with Division of Public Health, testified dietitians are "the answer to the obesity epidemic" with personalized plans. Hannah Harrison, a graduate student, presented a map showing zeros and ones across rural counties and noted Great Plains Health in North Platte has only 3 dietitians with unfilled positions. Amy Volkman testified families drive 2.5+ hours from rural areas seeking pediatric dietitian services. Sen. Hansen raised concerns about GLP-1 medications (like Ozempic), noting rapid weight loss causes muscle loss and potential neurological issues—areas where dietitian guidance is essential.
By the numbers: 15 proponents, 0 opponents, 2 neutral testifiers; 44-54 age group has 74% combined obesity/diabetes rate; malnutrition affects 20-50% of hospital patients and increases mortality 3.5 times; 2-12 sessions of medical nutrition therapy yields 1-18 pounds weight loss.
What's next: No vote taken. Bill remains in committee with strong bipartisan support and no opposition testimony.
Committee sentiment: Supportive: Sen. Beau Ballard, Sen. Matt Hansen, Sen. Brian Hardin, Sen. Glen Meyer
Sentiment estimated from questions and comments — not stated positions.
Session Notes
Committee Chair Sen. Brian Hardin opened hearing with procedural instructions for testifiers. Committee heard four bills: LB701 (doula services), LB454 (behavioral health authority flexibility), LB255 (medication-assisted treatment), and LB553 (dietitian loan repayment). No executive session scheduled. Sen. Fredrickson served as Vice Chair during portions of hearing when Chair Hardin was managing testimony. Multiple senators noted this was a Friday afternoon hearing. No votes were taken on any bills during this hearing.
Generated by NE Wire Service | Source: Nebraska Legislature Transcribers Office This is an AI-generated summary. Verify all claims against the official transcript.