Legislative Update 5/17/2021: Patient Advocacy, Mask Guidelines, Access to Care, Mental Health, Nebraska Legislature

US capitol

This is the legislative update for May 17, 2021. View all updates here.

The May 17, 2021 legislative update includes highlights on patient advocacy and from federal, state, and local legislatures.

Patient Advocacy: New Tax Credit Available to Families

On July 15, more than 65 million children’s families will start receiving an enhanced child tax credit — monthly payments of up to $300. The temporary benefit, which will be sent to 39 million households and covers 88% of children in the US, stems from President Joe Biden’s $1.9 trillion American Rescue Plan.

Here are the highlights:

  • The Internal Revenue Service (IRS) will send the payments on the 15th of the month, unless it falls on a holiday or weekend, through December.
  • Eligible parents will receive $300 a month for each child under age 6, and $250 for each child ages 6 to 17.
    • The payments target single parents with annual incomes up to $75,000, heads of households earning $112,500 and joint filers making up to $150,000 a year.
  • To reach low-income households that don’t typically file taxes, the agency is setting up a portal to allow them to submit their information. This will allow them to claim both the enhanced child tax credit and stimulus payments they might have missed.

With extra funds available to middle-to-lower income families, lawmakers expect the tax credit alone will cut child poverty nearly in half, lifting more than 5 million children out of poverty this year.

Federal Updates

CDC’s Mask Guidelines

Last week, the Centers for Disease Control and Prevention (CDC) eased indoor mask-wearing guidance for fully vaccinated people, allowing them to safely stop wearing masks inside in most places.

The new guidance still calls for wearing masks in crowded indoor settings like buses, planes, hospitals, prisons, and homeless shelters. However, it will help clear the way for reopening workplaces, schools, and other venues — removing the need for masks or social distancing for those who are fully vaccinated.

The guidance has created some confusion in states with mask mandates. In Nebraska, only two cities remain under a mask mandate — Lincoln and Omaha. Omaha City Council members have signaled they are going to allow the mask mandate expire on May 25, and it appears that the Lincoln City Council members are prepared to let their mandate expire on May 21.


Accelerating Kids’ Access to Care Act

A piece of legislation was reintroduced last week: The Accelerating Kids’ Access to Care Act (S. 1544), which would improve access to care for children enrolled in Medicaid and CHIP who must travel out of state to access essential care.

Currently, in the case of families who are required to travel out-of-state for their healthcare, out-of-state providers are required to enroll in the child’s home state Medicaid program before they can provide care to that child. However, this process is inconsistently administered across states, and can be both time-consuming and burdensome. Unfortunately, it can result in delays to children accessing care.

The Accelerating Kids’ Access to Care Act would create a voluntary streamlined screening and enrollment pathway to remove the burdensome processes providers must currently navigate to enroll in multiple Medicaid programs. Providers who opt to use this pathway and are screened successfully can be enrolled in other state Medicaid programs, as well.

If the Accelerating Kids’ Access to Care Act sounds familiar, that’s because this legislation — introduced by Sens. Michael Bennet, D-Colo., Charles Grassley, R-Iowa, Sherrod Brown, D-Ohio, and Rob Portman, R-Ohio, and H.R. 3089, introduced by Reps. Katherine Clark, D-Mass., and Jaime Herrera Beutler, R-Wash. — was previously introduced in the 116th Congress.

Mental & Behavioral Health

Last week, there was a big focus on mental and behavioral health needs for Americans.

Specifically, on May 12, the Senate Finance Health Care Subcommittee held a hearing entitled, “The COVID-19 Pandemic and Beyond: Improving Mental Health and Addiction Services in Our Communities.” Committee members and witnesses discussed the impact the pandemic has had on Americans’ mental health and access to mental health and substance use disorder treatment. Witnesses also highlighted how telehealth flexibilities have enabled access to care in some underserved communities and have improved care continuity.

In his opening remarks, Ranking Member Steve Daines, R-Mont., emphasized the likely long-lasting impact of the pandemic on mental health and the importance of preparing to meet the increased need for mental health care the pandemic has driven.

The same day as the Senate hearing, the House passed several noteworthy bills aimed at suicide prevention, and child and adolescent mental health:

Child and Adolescent Mental Health Principles

Additionally, the Children’s Hospital Association (CHA) joined allied groups in the Child and Adolescent Mental Health Coalition in endorsing Child and Adolescent Mental Health Principles. The Principles outline existing challenges and specific actionable opportunities to improve and enhance mental health services for children for a variety of topics.

Topics include:

  • Prevention
  • Early identification and intervention
  • School-based mental health
  • Integration
  • Strengthening the workforce, including the Children’s Hospitals Graduate Medical Education Program (CHGME)
  • Insurance coverage and payment
  • Telehealth
  • Parity
  • Justice-involved youth
  • COVID-19

The COVID-19 principles are a new addition to the list. These principles highlight how the COVID-19 pandemic has exacerbated the child and adolescent mental health crisis. CHA provided language for a new section on opportunities to address the growing crisis care and emergency department boarding situation in hospitals, including the expansion of access to step-down services (Translation: a transitional phase after a patient receives acute care), when necessary

The Child and Adolescent Mental Health Coalition will meet to discuss an advocacy strategy for these priority areas going forward.

State Updates

Nebraska Legislature

Speaker Mike Hilgers (R-Dist. 21, Lincoln) announced last week his intent to adjourn sine die (Translation: the final adjournment of an annual or the two-year session of a Congress) on Thursday, May 27. This is a few days earlier than scheduled to allow time this Fall to reconvene to redistrict the state using 2020 US Census data, which is a requirement for the Legislature every 10 years.

With (very) limited time left, we are working with key senators to advance legislation on our priority list, including LB529. This legislation would generate a list of all social workers in each school building. LB529 is third on the agenda for Tuesday, May 18.

With the sine die date in mind, we now know the effective date for Senator John Arch’s (R-Dist. 14, Ralston) telehealth legislation LB400: Aug. 27, 2021.

This telehealth bill was a product of months of work with the Senator to maintain key flexibilities for telehealth post-public health emergency. The bill would allow individuals to receive audio-only telehealth for behavioral health services and to receive telehealth services with verbal approval during a patient’s first telehealth visit (written approval be received within 10 days of a patient giving verbal consent).

In addition, LB400 would prohibit insurers from excluding coverage solely based on a patient’s originating location. An amendment adopted on General File (Translation: when a bill has been read and is awaiting debate) narrowed the definition of “audio only behavioral health” services to individual services provided to established patients only.

Other Legislative Activity

COVID-19 Liability

Senators gave first-round approval last week to a proposal intended to provide COVID liability protections.

LB139, sponsored by Senator Briese (R-Dist. 41, Albion), would provide “safe harbor” from potential lawsuits alleging that a protected individual or organization — including healthcare providers, first responders, schools, and businesses — exposed an individual to COVID-19 infection.

The adopted Judiciary Committee amendment narrows the safe harbor protections proposed in the original bill to prohibit civil actions, as long as the protected individual or organization was acting in compliance with federal public health guidelines.

Senator Steve Lathrop (D-Dist. 12, Ralston) offered an amendment containing provisions of his LB53 that would implement a health care crisis protocol developed by the Nebraska Medical Emergency Operations Center. The protocol would establish criteria for the triage and application of medical services and resources under extraordinary circumstances, when the level of demand for services exceeds the available resources required to deliver the generally accepted standard of care.

Senators voted 39-3 to advance LB139 to Select File. The bill is scheduled for a second round of debate on Tuesday.

Medical Marijuana

A bill to approve certain forms of cannabis for medical use did not advance on Wednesday, failing to overcome a cloture vote (Translation: a procedure where legislators vote to place a time limit on the consideration of a bill) by two votes.

LB474, introduced by Senator Wishart (D-Dist. 27, Lincoln), would create a framework for legalizing medical cannabis use in Nebraska. Wishart reported that a constitutional amendment to legalize medical cannabis received overwhelming support from Nebraskans, but it was blocked by a last-minute legal challenge from appearing on the 2020 general election ballot.

During debate, Wishart and another state senator were working on an amendment to encourage more support. They considered an amendment to require medical cannabis to be monitored via the state’s prescription drug monitoring program (PDMP), which led the nation in opioid oversight and control.

Senator Wishart is gathering signatures to get the medical marijuana decision on the 2022 ballot in Nebraska.

Children’s continues to monitor over 300 legislative bills that directly or indirectly impact the overall well-being of the children in Nebraska. For more information on how you can help advocate for the needs of children or to collaborate with Children’s, please contact Liz Lyons at llyons@childrensomaha.org or 402-955-4139.

Local Updates

Omaha General Election Results

That’s a wrap on Omaha’s city elections!

Mayor Jean Stothert made history as she accepted her third consecutive term as Mayor of Omaha — the first time any Mayor successfully won a third term.

There was one upset in District 2, where Councilman Ben Gray failed to advance to a third term by challenger Juanita Johnson.

District 3 was left vacant when Councilman Chris Jerram decided to not seek another term. The seat is now held by Danny Begley.

City Council Candidates:

  • District 1: Pete Festersen (incumbent) and Sarah Johnson
  • District 2: Ben Gray (incumbent) and Juanita Johnson
  • District 3: (Open seat, City Councilman Chris Jerram not seeking reelection) Danny Begley and Cammy Watkins
  • District 4: Vinny Palermo (incumbent) and Becky Barrientos-Patlan
  • District 5: Kathleen Kauth and Don Rowe (appointed incumbent Colleen Brennan was defeated in the Primary)
  • District 6: Brinker Harding (incumbent) and Naomi Hattaway
  • District 7: Aimee Melton (incumbent) and Sarah Kohen

Hearings Children’s is Monitoring This Week

Tuesday, May 18

Wednesday, May 19

Thursday, May 20

(Sources: CHA, Congress.gov, Modern Healthcare, NHA, AHA, Nebraskalegislature.gov, Peetz & Co.)


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