Legislative Update 8/23/2021: Budget resolution, mental health legislation, Nebraska state legislation

US capitol

This is the legislative update for August 23, 2021. View all updates here.

The August 23, 2021 legislative update includes highlights from both federal and state legislatures.

Federal Updates


Budget Resolution

The Senate is on their August recess, but the House will be in session for a few days next week to consider the budget resolution.

House Democrats are preparing to take the first steps toward adopting a roughly $3.5 trillion spending plan that would enable sweeping changes to the nation’s health care, education, and tax laws. However, new divisions among lawmakers are threatening to slow down the package’s swift advance.

The budget blueprint encompasses many policy promises from President Joe Biden’s 2020 campaign, including pledges to expand Medicare to allow for vision and dental benefits, rethink immigration, and dedicate more funding to combat climate change.

Adopting the budget this week would inch Congress closer to delivering on President Biden’s broader economic agenda. While there is wide-ranging support for some of the new spending, the liberal and centrist Democrats remain at odds over how exactly to proceed.

Congress is required to pass the Fiscal Year (FY) 2022 budget by September 30 or risk a government shutdown.

Mental Health Legislation

Senate Finance Committee Chairman Ron Wyden (D-Ore.) and Ranking Member Michael Crapo (R-Idaho) recently sent a letter to committee members announcing their goal of developing a bipartisan legislative package on mental health this year and inviting committee members to provide input on policies to improve behavioral health.

Children’s will be reaching out to US Senator Ben Sasse (R-NE) who sits on the committee to formalize our suggestions to improve mental health care for children.

Existing mental health legislation include:

  • The Children’s Mental Health Infrastructure Act of 2021 (H.R. 4943), which would provide $2 billion a year for five years for grants to children’s hospitals for increasing their capacity to provide pediatric mental health services, including building new sites of care, converting existing space for psychiatric use, and other uses.
  • The Helping Kids Cope Act of 2021 (H.R. 4944) would provide $500 million a year for five years to support grants to children’s hospitals and other providers for activities to support pediatric behavioral health care integration and coordination to meet local community needs. It would also provide $100 million annually for five years for grants to children’s hospitals and other providers to support workforce training for a range of pediatric behavioral health professionals.
  • The Child Suicide Prevention and Lethal Means Safety Act (H.R. 5035), recently introduced by House Rep. Lauren Underwood (D-Ill), would support training programs to help healthcare workers identify patients at high risk for suicide or self-harm.

State Updates

Nebraska Legislature

The Nebraska Legislature adjourned in May a few weeks ahead of schedule to allow for a robust 2-week debate on redistricting (which will begin on September 13).

During the (almost) 90-day session, 684 bills were introduced and 200 were approved by Nebraska senators.

Some of the bills had an emergency clause (e-clause), which means they went into effect immediately after being signed. The others will go into effect this Friday, August 27.

As of Friday, August 27, the following bills will become law:

  • LB400, introduced by Sen. John Arch (R-Dist. 14, Ralston): Changes requirements related to coverage of telehealth by insurers and Medicaid.
    • Under this new law, providers may offer telehealth services to any location, a provision made possible during the public health emergency (PHE) and will be maintained for access to care. Additionally, audio-only behavioral health appointments must be covered by insurance carriers. Verbal consent to treat must be available for any telehealth appointment, a change from the previous rule requiring written consent.
  • LB487, introduced by Sen. Arch (R-Dist. 14, Ralston): Provides payment parity (Translation: fully-insured private plans reimburse and cover telehealth services equally to how they would do so for in-person visits) for behavioral health offered by telehealth, with the exception of audio-only.
  • LB388, introduced by Sen. Curt Friesen (R-Dist. 34, Henderson): Provides increased access to high-speed internet. Service will be provided with a $40 million commitment to expand the infrastructure in rural areas.
  • LB322, introduced by Sen. Matt Williams (R-Dist. 36, Gothenburg): Extends the Safe2HelpNE hotline statewide for K-12 students and teachers to seek help for themselves or others who have suicidal thoughts. The hotline connects callers to crisis counselors trained in de-escalation techniques to all public and private schools across the state.
  • LB452, introduced by Sen. Terrell McKinney (D-Dist. 11, North Omaha): Provides that schools begin requiring students to complete a personal finance or financial literacy course before graduating.
  • LB396, introduced by Sen. Tom Brandt (R-Dist. 32, Brainard): Creates a “farm to school” program providing for farmers and producers in Nebraska to supply school breakfasts and lunches.
  • LB14, introduced by Sen. Carol Blood (D-Dist. 3, Bellevue): Formally adopting the Audiology and Speech Language Pathology Interstate Compact.
  • LB26, introduced by Sen. Justin Wayne (D-13, Omaha): Providing a sales and use tax exemption for residential water service.
  • LB100, introduced by Sen. Lynn Walz (D-Dist. 15, Fremont): Disallows a multiple procedure payment reduction (Translation: a policy enacted by Medicare and many private insurers that says that when a clinician performs multiple procedures during one visit, they only get paid the full reimbursement for the highest-valued procedure) to physical, occupational, and speech therapy services.
  • LB154, introduced by Sen. Justin Wayne (D-13, Omaha): Creates a statewide tracking system at the Nebraska Department of Education (NDE) to track student discipline and break it down by demographic. Schools must report expulsions, restraints, suspensions, and the offense.
  • LB166, introduced by Sen. Suzanne Geist (R-Dist. 25, Lincoln): Creates Josh the Otter-Be Safe Around Water state fund through license plate sales.
  • LB337, introduced by Sen. Mark Kolterman (R-Dist. 24, Seward): Adopts the Step-Therapy Reform Act, making a formal process when payors require providers and patients to use less expensive drugs before allowing the most costly drug which was originally prescribed. The bill states that when a carrier requires a step-therapy protocol, the provider and/or patient can ask for an override exception.
  • LB485, introduced by Sen. Wendy DeBoer (D-Dist. 10, Bennington): Adds $44 million to expand eligibility for the Child Care Subsidy program to families whose income is less than 185% of the federal poverty level. The bill would also seek to address the childcare cliff effect (Translation: When a family receives an increase in their income that makes them unqualified to receive a certain public benefit, but their new income isn’t enough to cover the benefit they lost) by allowing families to qualify for transitional child care assistance if their income is less than 200% of the federal poverty level.

Delayed effective dates

  • LB108, introduced by Sen. John McCollister (R-Dist. 20, Omaha): Increases the gross income eligibilit for SNAP benefits in Nebraska from 130% FPL to 185% FPL. This will be effective October 1, 2021.
  • LB583, introduced by Sen. Dave Murman (R-Dist. 38, Glenvil): Requires all controlled substance prescriptions be issued electronically. Exclusions include veterinarians, areas where e-prescribe is not available due to technical failure, issued to out-of-state pharmacies and mail-order prescriptions. This will begin on January 1, 2022.

(Sources: CHA, Congress.gov, Nebraska Legislature)


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