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LEGISLATURE OF NEBRASKA
ONE HUNDRED EIGHTH LEGISLATURE
SECOND SESSION
LEGISLATIVE BILL 1086
Introduced by Walz, 15.
Read first time January 09, 2024
Committee: Health and Human Services
1 A BILL FOR AN ACT relating to the Department of Health and Human
2 Services; to amend sections 38-1,101, 43-2202, 44-7006, 68-1015,
3 68-1207.01, 71-504, 71-3601, 71-6042, 71-6732, and 71-9103, Reissue
4 Revised Statutes of Nebraska, sections 43-4203, 43-4216, 43-4401,
5 68-1207, 71-702, 71-8803, 81-101, 81-102, 81-132, 81-1113, 81-1316,
6 and 81-3133, Revised Statutes Cumulative Supplement, 2022, and
7 section 71-7305, Revised Statutes Supplement, 2023; to eliminate the
8 Department of Health and Human Services; to create the Department of
9 Children and Family Services, the Department of Public Health, and
10 the Department of Healthcare; to transfer programs, services, and
11 duties; to provide for the appointment of directors; to provide for
12 administration responsibilities; to provide for appointment of a
13 chief medical officer; to create the Health and Human Services Cash
14 Fund; to provide for the creation and use of petty cash funds by the
15 Department of Children and Family Services; to provide a duty for
16 the Health and Human Services Committee of the Legislature; to
17 eliminate obsolete provisions and provisions regarding divisions of
18 the Department of Health and Human Services; to harmonize
19 provisions; to provide an operative date; to repeal the original
20 sections; and to outright repeal sections 81-3110, 81-3111, 81-3112,
21 81-3114, 81-3115, 81-3117, 81-3118, 81-3120, 81-3121, 81-3122,
22 81-3123, and 81-3124, Reissue Revised Statutes of Nebraska, and
23 sections 81-3113, 81-3116, 81-3119, 81-3133.01, 81-3133.02, and
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1 81-3133.03, Revised Statutes Cumulative Supplement, 2022.
2 Be it enacted by the people of the State of Nebraska,
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1 Section 1. Sections 1 to 11 of this act shall be known and may be
2 cited as the Health and Human Services Act.
3 Sec. 2. The purpose of the Health and Human Services Act is to
4 create three departments under the executive branch of state government
5 to provide effective services and improved health outcomes for the people
6 of Nebraska.
7 Sec. 3. The Department of Children and Family Services is created.
8 The Governor shall appoint one director for the department who shall
9 serve at the pleasure of the Governor and be subject to confirmation by a
10 majority of the Legislature.
11 Sec. 4. The Department of Public Health is created. The Governor
12 shall appoint one director for the department who shall serve at the
13 pleasure of the Governor and be subject to confirmation by a majority of
14 the Legislature.
15 Sec. 5. The Department of Healthcare is created. The Governor shall
16 appoint one director for the department who shall serve at the pleasure
17 of the Governor and be subject to confirmation by a majority of the
18 Legislature.
19 Sec. 6. (1) Effective July 1, 2025, all programs, services, and
20 duties of the Division of Children and Family Services of the Department
21 of Health and Human Services shall be transferred to the Department of
22 Children and Family Services.
23 (2) Effective July 1, 2025, all programs, services, and duties of
24 the Division of Public Health of the Department of Health and Human
25 Services shall be transferred to the Department of Public Health.
26 (3) Effective July 1, 2025, all programs, services, and duties of
27 the Division of Behavioral Health, the Division of Developmental
28 Disabilities, and Division of Medicaid and Long-Term Care of the
29 Department of Health and Human Services shall be transferred to the
30 Department of Healthcare.
31 Sec. 7. (1) If the Director of Public Health is licensed to
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1 practice medicine and surgery in the State of Nebraska, the director
2 shall also be the chief medical officer. If the Director of Public Health
3 is not licensed to practice medicine and surgery in the State of
4 Nebraska, the Governor shall appoint a chief medical officer in addition
5 to the Director of Public Health. The chief medical officer shall be
6 licensed to practice medicine and surgery in the State of Nebraska, shall
7 serve at the pleasure of the Governor, and shall be subject to
8 confirmation by a majority of the members of the Legislature.
9 (2) The chief medical officer shall perform duties under the Uniform
10 Credentialing Act as provided in section 38-1,101, shall be the final
11 decisionmaker in contested cases of health care facilities defined in the
12 Health Care Facility Licensure Act arising under the act and sections
13 71-6042, 71-6732, and 81-604.03, and shall perform such other duties as
14 provided by law.
15 Sec. 8. The responsibilities of the departments created in sections
16 3 to 5 of this act include, but are not limited to:
17 (1) The Department of Children and Family Services shall administer
18 (a) protection and safety programs and services, including child welfare
19 programs and services and the Office of Juvenile Services, (b) economic
20 and family support programs and services, and (c) service areas as may be
21 designated by the Director of the Department of Children and Family
22 Services;
23 (2) The Department of Public Health shall administer (a) preventive
24 and community health programs and services, (b) the regulation and
25 licensure of health-related professions and occupations, and (c) the
26 regulation and licensure of health care facilities and health care
27 services; and
28 (3) The Department of Healthcare shall administer (a) the state
29 hospitals for the mentally ill designated in section 83-305, (b) publicly
30 funded community-based behavioral health services, (c) the Beatrice State
31 Developmental Center, (d) publicly funded community-based developmental
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1 disabilities services, (e) the medical assistance program also known as
2 medicaid, (f) aging services, and (g) other related programs and
3 services.
4 Sec. 9. The Health and Human Services Cash Fund is created and
5 shall consist of funds from contracts, grants, gifts, or fees. Transfers
6 may be made from the fund to the General Fund at the direction of the
7 Legislature. Any money in the Health and Human Services Cash Fund
8 available for investment shall be invested by the state investment
9 officer pursuant to the Nebraska Capital Expansion Act and the Nebraska
10 State Funds Investment Act.
11 Sec. 10. The Director of the Department of Children and Family
12 Services may request that petty cash funds be created at specific
13 locations which may be used for fees and costs related to the prosecution
14 of support establishment, modification, and enforcement cases, including,
15 but not limited to, court costs, filing fees, service of process fees,
16 sheriff's costs, garnishment and execution fees, court reporter and
17 transcription costs, costs related to appeals, witness and expert witness
18 fees, and fees or costs for obtaining necessary documents. The petty cash
19 funds shall be created and administered as provided in section 81-104.01,
20 except that the amount in each petty cash fund shall not be less than
21 twenty-five dollars nor more than two thousand dollars.
22 Sec. 11. The legal counsel of the Health and Human Services
23 Committee of the Legislature shall prepare a committee amendment to this
24 legislative bill to amend the necessary statutes to comply with the
25 provisions of the Health and Human Services Act.
26 Sec. 12. Section 38-1,101, Reissue Revised Statutes of Nebraska, is
27 amended to read:
28 38-1,101 If a chief medical officer is appointed pursuant to section
29 7 of this act 81-3115, the chief medical officer he or she shall perform
30 the duties of the director for decisions in contested cases under the
31 Uniform Credentialing Act other than contested cases under sections
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1 38-1,119 to 38-1,123.
2 Sec. 13. Section 43-2202, Reissue Revised Statutes of Nebraska, is
3 amended to read:
4 43-2202 For purposes of sections 43-2201 to 43-2209:
5 (1) Department means the Department of Children Health and Family
6 Human Services;
7 (2) Family finding means the process described in section 43-2203;
8 (3) Family member means:
9 (a) A person related to a child by blood, adoption, or affinity
10 within the fifth degree of kinship;
11 (b) A stepparent;
12 (c) A stepsibling;
13 (d) The spouse, widow, widower, or former spouse of any of the
14 persons described in subdivisions (a) through (c) of this subdivision;
15 and
16 (e) Any individual who is a primary caretaker or trusted adult in a
17 kinship home and who, as a primary caretaker, has lived with the child
18 or, as a trusted adult, has a preexisting, significant relationship with
19 the child;
20 (4) Kinship home means a home in which a child receives foster care
21 and at least one of the primary caretakers has previously lived with or
22 is a trusted adult that has a preexisting, significant relationship with
23 the child;
24 (5) Provider means an organization providing services as a child-
25 placing agency; and
26 (6) Service area means a geographic area administered by the
27 department and designated pursuant to section 8 of this act 81-3116.
28 Sec. 14. Section 43-4203, Revised Statutes Cumulative Supplement,
29 2022, is amended to read:
30 43-4203 (1) The Nebraska Children's Commission shall create a
31 committee to examine the Office of Juvenile Services and the Juvenile
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1 Services Division of the Office of Probation Administration. Such
2 committee shall review the role and effectiveness of out-of-home
3 placements utilized in the juvenile justice system, including the youth
4 rehabilitation and treatment centers, and make recommendations to the
5 commission on the juvenile justice continuum of care, including what
6 populations should be served in out-of-home placements and what treatment
7 services should be provided at the centers in order to appropriately
8 serve those populations. Such committee shall also review how mental and
9 behavioral health services are provided to juveniles in residential
10 placements and the need for such services throughout Nebraska and make
11 recommendations to the commission relating to those systems of care in
12 the juvenile justice system. The committee shall collaborate with the
13 Juvenile Justice Institute at the University of Nebraska at Omaha, the
14 Center for Health Policy at the University of Nebraska Medical Center,
15 the behavioral health regions as established in section 71-807, and state
16 and national juvenile justice experts to develop recommendations. The
17 recommendations shall include a plan to implement a continuum of care in
18 the juvenile justice system to meet the needs of Nebraska families,
19 including specific recommendations for the rehabilitation and treatment
20 model. The recommendations shall be delivered to the commission and
21 electronically to the Judiciary Committee of the Legislature annually by
22 September 1.
23 (2) The commission shall collaborate with juvenile justice
24 specialists of the Office of Probation Administration and county
25 officials with respect to any county-operated practice model
26 participating in the Crossover Youth Program of the Center for Juvenile
27 Justice Reform at Georgetown University.
28 (3) The commission shall analyze case management workforce issues
29 and make recommendations to the Health and Human Services Committee of
30 the Legislature regarding:
31 (a) Salary comparisons with other states and the current pay
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1 structure based on job descriptions;
2 (b) Utilization of incentives for persons who work in the area of
3 child welfare;
4 (c) Evidence-based training requirements for persons who work in the
5 area of child welfare and their supervisors; and
6 (d) Collaboration with the University of Nebraska to increase and
7 sustain such workforce.
8 (4) The Foster Care Reimbursement Rate Committee created pursuant to
9 section 43-4216, the Nebraska Strengthening Families Act Committee
10 created pursuant to section 43-4716, and the Bridge to Independence
11 Advisory Committee created pursuant to section 43-4513 shall be under the
12 jurisdiction of the commission.
13 (5) The commission shall work with the office of the State Court
14 Administrator, as appropriate, and entities which coordinate facilitated
15 conferencing as described in section 43-247.03.
16 (6) The commission shall work with administrators from each of the
17 service areas designated pursuant to section 8 of this act 81-3116, the
18 teams created pursuant to section 28-728, local foster care review
19 boards, child advocacy centers, the teams created pursuant to the Supreme
20 Court's Through the Eyes of the Child Initiative, community stakeholders,
21 and advocates for child welfare programs and services to establish
22 networks in each of such service areas. Such networks shall permit
23 collaboration to strengthen the continuum of services available to child
24 welfare agencies and to provide resources for children and juveniles
25 outside the child protection system.
26 (7) The commission may organize subcommittees as it deems necessary.
27 Members of the subcommittees may be members of the commission or may be
28 individuals who have knowledge of the subcommittee's subject matter,
29 professional expertise to assist the subcommittee in completing its
30 assigned responsibilities, or the ability to collaborate within the
31 subcommittee and with the commission to carry out the powers and duties
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1 of the commission. A subcommittee shall meet as necessary to complete the
2 work delegated by the commission and shall report its findings to the
3 relevant committee within the commission.
4 (8) No member of any committee or subcommittee created pursuant to
5 this section shall have any private financial interest, profit, or
6 benefit from any work of such committee or subcommittee.
7 Sec. 15. Section 43-4216, Revised Statutes Cumulative Supplement,
8 2022, is amended to read:
9 43-4216 (1) The Foster Care Reimbursement Rate Committee is created.
10 The committe